Loading...
5 results
Search Results
Now showing 1 - 5 of 5
- Metabolic syndrome and cardiovascular riskPublication . Rocha, EvangelistaThe effects of isolated and associated cardiovascular risk factors have been investigated since the mid-twentieth century, but the relationship between the elements of what is now termed the metabolic syndrome (MetS) and cardiovascular risk was paid little attention until 1988, when Reaven described the role of insulin resistance in human disease, which he called syndrome X.1 This did not include obesity, particularly abdominal obesity, which came to be considered an important component of insulin resistance syndrome, now known as MetS, the designation preferred by the American Association of Clinical Endocrinologists.
- Preoperative color Doppler ultrasound parameters for surgical decision-making in upper arm arteriovenous fistula maturationPublication . Gomes, António Pedro; Germano, Ana; Sousa, Marta; Martins, Rita; Coelho, Constança; Ferreira, Maria José; Rocha, Evangelista; Nunes, VítorObjective: Current scientific evidence is insufficient to determine the best vascular access for each patient. It is an unmet clinical need because vascular access dysfunction accounts for 20% to 30% of hospital admissions. Our aim was to evaluate preoperative color flow Doppler ultrasound (CDUS)-derived parameters (vein diameter and brachial artery flow and diameter) and their effect interaction with comorbidities as predictors of brachiocephalic (BC) and brachiobasilic (BB) arteriovenous fistula (AVF) maturation. Methods: A prospective analysis was performed of patients who underwent BC and BB AVF as primary definitive vascular access between January 2016 and May 2017. Variables included patients' demographics, comorbidities, medication, preoperative blood pressure, and CDUS-derived parameters. Outcomes were patency 48 hours after surgery and fistula maturation at 6 and 12 weeks. Nonparametric descriptive and univariate statistics were used. Logistic regression models and receiver operating characteristic curve analyses were performed. Results: There were 132 patients (91 with BC AVF and 41 with BB AVF) included. The 48-hour patency was 91.7%. AVF maturation at 6 weeks was observed in 71.3%, and AVF maturation at 12 weeks was observed in 66.3%. There were no associations in univariate and multivariate logistic regression analysis between AVF maturation and comorbidities. Systolic blood pressure was an independent predictor of 48-hour patency with an optimized cutoff of 154 mm Hg (area under the curve, 0.73; P = .013; Youden index, 0.40). Vein diameter with tourniquet was an independent predictor of AVF maturation at 6 and 12 weeks with an optimized cutoff of 3.9 mm (area under the curve, 0.74; P < .001; Youden index, 0.38). Conclusions: AVF maturation was independent of comorbidities. Systolic blood pressure ≥154 mm Hg and vein diameter with tourniquet ≥3.9 mm were the associated conditions that better predicted BC and BB AVF maturation. There were no effect interactions between CDUS-derived parameters and associated comorbidities.
- Tobacco use : more needs to be done to control active and passive smokingPublication . Rocha, EvangelistaThere was a time when tobacco was thought to have medicinal qualities and another time when tobacco consumption was common, fashionable, and ubiquitous, and considered socially acceptable. However, statistical evidence suggesting a relationship between smoking and lung cancer began to emerge in the late 1920s, although scientific evidence of a causal relationship was not available until the mid-twentieth century. Since then, epidemiologists have collected evidence in large prospective and case-control studies to support a causal relationship between smoking and various diseases, chiefly cancer and cardiovascular and chronic respiratory diseases. As evidence on the negative effects of tobacco use accumulated, numerous organizations produced technical reports with programs and strategies for tobacco control that changed the course of public health. However, despite some success in implementing evidence-based policies and programs that have decreased smoking rates in recent decades, more effective strategies are needed to end the tobacco epidemic.
- A prognostic model for the outcome of Nobel Biocare Dental Implants with peri-Implant disease after one yearPublication . Nobre, Miguel de Araújo; Salvado, Francisco; Nogueira, Paulo Jorge; Rocha, Evangelista; Ilg, Peter; Maló, PauloBackground: This investigation, based on a 1-year retrospective cohort study, aimed to estimate and validate a prognostic model for ailing and failing implants due to peri-implant disease. Methods: A total of 240 patients (male: 97; female: 143; average age of 57.3 years) with at least one ailing or failing implant were included: 120 patients for model derivation and 120 patients for model validation. The primary outcome measure was the implant status: success, defined as the arrest of the disease, or failure defined as implant extraction, prevalence or re-incidence of peri-implant disease). Potential prognostic risk indicators were collected at the baseline evaluation. The relative risk (RR) was estimated for the predictors through logistic regression and the c-statistic (95% confidence interval) was calculated for both derivation and validation sets. The significance level was set at 5%. Results: The risk model retrieved the prognostic factors age (RR = 1.04), history of Periodontitis (RR = 3.13), severe peri-implant disease status (RR = 3.26), implant length (RR = 3.52), early disease development (RR = 3.99), with good discrimination in both the derivation set (0.763 [0.679; 0.847]) and validation set (0.709 [0.616; 0.803]). Conclusions: A prognostic risk model for estimating the outcome of implants with peri-implant disease is available, with a good performance considering the c-statistic evaluation.
- Prevenção em Destaque : Portugal : relatório inserido na iniciativa Prevention in your Country promovido pela EACPR (European Association for Cardiovascular Prevention and Rehabilitation)Publication . Rocha, Evangelista; Ferreira, Rui Cruz; Abreu, Ana; Portugal, Rui; Nogueira, Paulo; Timóteo, Ana