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- Direct production of 99mTc-Technetium using low energy cyclotrons and radionuclidic purity: our results so far using natMo-MolybdenumPublication . Metelo, Luís Francisco; Costa, Pedro; Cunha, L.; Jonhson, R.; Matei, L.; Gelbart, W.; Obermair, J.; Artner, C.; Lass, P.; Currie, G.; Craciun, L.; Niculae, D.; Carmo, S.; Alves, F.; Botello, M.Despite the global crisis concerning 99mTc delivering to Nuclear Medicine Departments there isn’t yet a reliable solution. The cyclotron direct production of 99mTc, using the 100Mo(p,2n)99mTc nuclear reaction is our attempt to approach the problem, aiming to become efficient, reliable and sustainable from points of view as reducing drastically the radioactive waste being produced and becoming beneficial for all the involved parts. Between several critical factors, radionuclidic purity of cyclotron-produced 99mTc is being pointed as an issue of concern.
- PET aplicada à Medicina Moderna: prova de conceito baseada na produção de Titânio-45 ( 45Ti)Publication . Costa, Pedro; Alves, F.; Naia, M. DuarteOs paradigmas modernos da Medicina baseada em Evidência e/ou Ciência, bem como os conceitos relacionados com a Medicina Personalizada, têm levado ao crescente uso de meios complementares de diagnóstico, cada vez mais sensíveis específicos. Nesse contexto, as metodologias de imagem médica têm especial relevo .Dentro destas, vários exemplos podem ser destacados, mas a Medicina Nuclear, baseada no uso de radiofármacos, é especialmente importante ao nível do estudo funcional e molecular dos mais diversos processos patológicos.
- Preclinical Imaging: an Essential Ally in Modern BiosciencesPublication . Cunha, Lídia; Horvath, Ildiko; Ferreira, Sara; Lemos, Joana; Costa, Pedro; Vieira, Domingos; Veres, Dániel S.; Szigeti, Krisztián; Summavielle, Teresa; Máthé, Domokos; Metello, Luís F.Translational research is changing the practice of modern medicine and the way in which health problems are approached and solved. The use of small-animal models in basic and preclinical sciences is a major keystone for these kinds of research and development strategies, representing a bridge between discoveries at the molecular level and clinical implementation in diagnostics and/or therapeutics. The development of high-resolution in vivo imaging technologies provides a unique opportunity for studying disease in real time, in a quantitative way, at the molecular level, along with the ability to repeatedly and non-invasively monitor disease progression or response to treatment. The greatest advantages of preclinical imaging techniques include the reduction of biological variability and the opportunity to acquire, in continuity, an impressive amount of unique information (without interfering with the biological process under study) in distinct forms, repeated or modulated as needed, along with the substantial reduction in the number of animals required for a particular study, fully complying with 3R (Replacement, Reduction and Refinement) policies. The most suitable modalities for small-animal in vivo imaging applications are based on nuclear medicine techniques (essentially, positron emission tomography [PET] and single photon emission computed tomography [SPECT]), optical imaging (OI), computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy imaging (MRSI), and ultrasound. Each modality has intrinsic advantages and limitations. More recently, aiming to overcome the inherent limitations of each imaging modality, multimodality devices designed to provide complementary information upon the pathophysiological process under study have gained popularity. The combination of high-resolution modalities, like micro-CT or micro-MRI, with highly sensitive techniques providing functional information, such as micro-PET or micro-SPECT, will continue to broaden the horizons of research in such key areas as infection, oncology, cardiology, and neurology, contributing not only to the understanding of the underlying mechanisms of disease, but also providing efficient and unique tools for evaluating new chemical entities and candidate drugs. The added value of small-animal imaging techniques has driven their increasing use by pharmaceutical companies, contract research organizations, and research institutions.
- Desenvolvimento de casos clínicos para práticas de simulação em contexto pedagógicoPublication . Faias, Joaquim Manuel Ventura; Alexandrino, Ana Manuela Ferreira da Silva; Gonçalves, Maria João Moreira; Costa, Pedro Silva; Rua, SandraNos últimos anos, tem se verificado um grande investimento no apoio a práticas pedagógicas de simulação na educação. Em Portugal, este recurso permanece ainda pouco implementado. A simulação pode ser definida como “”uma técnica que cria uma situação ou ambiente que permite às pessoas experimentarem uma representação de um evento real para a finalidade da prática, aprendizagem, avaliação, teste ou para desenvolver uma compreensão de sistemas ou ações humanas””. A criação do ESSim pretende, entre outros objetivos, desenvolver recursos e competências entre os docentes de diferentes áreas de formação, para a utilização de simulações na educação clínica dos futuros profissionais de saúde. Constituiu-se um grupo de trabalho para a construção de situações clínicas considerando: competências a desenvolver no estudante; casuística que permita interdisciplinaridade; necessidade de um conjunto de perfis para diferentes níveis de formação; e conjunto de características que possa abranger diferentes áreas de formação.
- O ensino da Medicina Nuclear durante a pandemia de COVID-19: reflexão após um ano de experiênciaPublication . Costa, Pedro Silva; Vieira, Domingos Manuel da Silva; Lemos, Joana Cristina da Costa; Costa, Pedro; Lemos, JoanaA Medicina Nuclear é uma especialidade médica na qual a formação de base dos Técnicos Superiores de Diagnóstico e Terapêutica está, actualmente, integrada na Licenciatura em Imagem Médica e Radioterapia. Devido à sua vertente tecnológica, mas também ao dinamismo do conhecimento neste domínio científico e à actualização constante das ferramentas disponíveis para uso em ambiente clínico e biomédico, o investimento num processo de ensino-aprendizagem moderno e baseado em evidência reveste-se de especial interesse neste contexto. Apesar da importância que tais práticas já mereciam, a Pandemia de COVID-19 e as implicações da mesma ao nível da limitação da leccionação de aulas em contexto presencial obrigou a alterações relativamente profundas no processo de ensino-aprendizagem. Esta comunicação pretende promover reflexão acerca das estratégias de adaptação do ensino para metodologias à distância e/ou mistas implementadas pela Área Técnico-Científica de Medicina Nuclear da ESS|P.Porto, desde Março de 2020, apresentar os desafios inerentes a esse processo e partilhar resultados verificados em mais de um ano de experiência acumulada, na perspectiva dos docentes e dos estudantes envolvidos. Para além de testemunhos individuais recolhidos junto de docentes e estudantes, através de feedback empírico informal, está em curso a recolha estruturada de perspectivas, percepções e opiniões através de inquérito dirigido aos estudantes da Licenciatura em Imagem Médica e Radioterapia da ESS|P.Porto inscritos nos anos lectivos 2019/2020 e 2020/2021. Os resultados obtidos permitem sustentar a reflexão acerca da validade e interesse do recurso a metodologias de ensino à distância e/ou misto, com foco na identificação das variáveis influenciadoras deste processo.
- Survey on the knowledge of Portuguese society about Nuclear Medicine: A snapshot of the reality in the beginning of the decadePublication . Monteiro, Rafaela ; Costa, PedroNuclear Medicine has grown exponentially over the years, since it is useful in the early diagnosis and treatment of several pathologies. However, this field appears to be not widely recognized at the public level. An exploratory/descriptive cross-sectional study using a national survey assessed the Portuguese population's knowledge of Nuclear Medicine. A total of 211 questionnaires were collected and analyzed. The study population is made up of Portuguese adult citizens. The study revealed a lack of knowledge about Nuclear Medicine. Some respondents were aware of this field, however a significant number have low or no knowledge at all. Most individuals are not aware about the Nuclear Medicine Departments in their home districts. This project found limited knowledge within the Portuguese population about ionizing radiation in medical procedures, and mainly in Nuclear Medicine. Data highlighted the need to implement awareness campaigns to disseminate knowledge on this field. Health professionals should be aware about the lack of knowledge on this field by patients and public.
- Low dose ionizing radiation (LDIR) and the immune system: a reviewPublication . Martins, Ricardo; Ferraz, Ricardo; Costa, PedroIonizing radiation (IR) is unavoidable in medicine, whether it is in cancer treatment, through radiotherapy with high doses, or in imaging with low doses. While the effects of high dose ionizing radiation (HDIR) are well known, low dose effects are still shrouded in controversy. IR will act on cells either directly, altering DNA and protein structure, or through the creation offree radicals, affecting a cell’s functionality and ultimately, viability. This will affect the immune system, as IR not only induces an immune response, but also targets immune cells, which according to the law of Bergonie and Tribondeau are radiosensitive. While not consensual, it is theorized that IR might have an hormesis effect. LDIR has been defined in 2012 as any dose lower than 100 mGy. Despite this, multiple articles have different definitions of LDIR, and as a result, knowledge about the effects might be somewhat skewed. Through article and data analysis, our aim was to assess the knowledge of LDIR effects on the immune system and present a possible mechanism for their interaction. A literature review using a combination of keywords with Boolean search terms on the search engine of Web of Science™ was implemented. 100 articles were obtained and, after selection and filtering through inclusion and exclusion criteria, 45 articles had their data collected and compiled for complete analysis. LDIR showed activation ofpathways that induce immune activity. Acute LDIR was shown to increase pro-inflammatoryand decrease anti-inflammatory cytokine production, macrophage and natural killer cells’ proliferation and activity, while having a negative effect in splenocyte and T cell counts. Chronic LDIR showed reverse effects on cytokines, joined with a reduction of enzymes responsible forantioxidantdefenses. Results seem to show that acute LDIR induces a pro-inflammatory response and has anti-tumoral activity, where as chronic LDIR has anti-inflammatory properties
- Development of a framework for radiographer online clinical education (FORCE): the specifc strand of nuclear medicine within this european projectPublication . Costa, P.; Atutornu, J.; Bezzina, P.; Dalen, N.; Huhtanen, J.; Jaronen, M.; Saila, T.; Kraus, B.; Rainford, L.; Matthews, K.The overall aim of the FORCE project is to develop virtual web-based learning resources where Radiography undergraduates can engage in interactive, problem-based development of radiographic knowledge, ability and professional awareness. This European-funded project is internally divided in three diferent strands (Radiology Diagnostic Imaging, Radiotherapy and Nuclear Medicine). The aim of this presentation is to present the global project, mainly focusing developments, achievements and challenges within the Nuclear Medicine specifc strand.
- A scoping review of person-centred care strategies used in diagnostic Nuclear MedicinePublication . Champendal, M.; Grima, K. Borg; Costa, Pedro; Andersson, C.; Baun, C.; Gorga, R.G.; Murphy, S.; Kedves, A.; Santos, A.; Geao, A.Person-centred care (PCC) emphasises the need for the health care professional to prioritise individual patient needs, thereby fostering a collaborative and emphatic environment that empowers patients to actively participate in their own care. This article will explore the purpose of PCC in Nuclear Medicine (NM), while discussing strategies that may be used to implement PCC during diagnostic NM examinations performed on adult patients. The scoping review was conducted in accordance with the Joanna Briggs Institute methodology. The search was performed on PubMed, Embase and Cinhal in June 2023 and included studies in English, Spanish, Portuguese and Italian. The research equation combined keywords and Medical Subject Heading terms (MeSH) related to person-centred care (PCC), for all types of nuclear medicine diagnostic examinations performed. Three independent review authors screened all abstracts and titles, and all eligible full-text publications were included in this scoping review. Fifty-three articles, published between 1993 and 2022, met the inclusion criteria for this scoping review. Seven articles were published in 2015 while 56.6 % of all included studies were performed in Europe. Most studies (n = 39/53) focused on the patients only, with the identified patient benefits being: improve patient experience (67.9 %), increase patient comfort (13.2 %), increase patient knowledge (5.7 %), reduction of patient anxiety (9.4 %) and reduction of waiting/scan time (3.8 %). The scoping review identified a lack of research investigating the use of person-centred care strategies in NM. Future research will focus on using an international survey to explore this topic in nuclear medicine departments overseas.
- Desenvolvimento e aplicação de modelos biológicos para estudo de efeitos da radiação ionizantePublication . Lemos, Joana; Vieira, Domingos; Costa, PedroCom o crescente uso médico das radiações ionizantes, tanto ao nível dos meios complementares de diagnóstico (ex: Medicina Nuclear e Radiologia), como ao nível terapêutico (ex: Radioterapia), as preocupações inerentes ao aumento da exposição da população a este tipo de radiações têm aumentado. Apesar dessas preocupações, a literatura carece ainda de evidência científica suficiente para esclarecer a relação entre a irradiação com baixas doses de radiação ionizante e os efeitos despoletados.
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