Salutis Scientia

5

Authors: Helder Soares da Cruz

Cellular therapy has been used recently in patients suffering from acute myocardial infarction but the results show only a modest improvement in left ventricular structure and function, due to limitations of the cellular product and of the variable dose, often sub-therapeutic. Mesenchymal stem cells from the umbilical cord tissue, when administered into the mice myocardium after induction of myocardial infarction, have decreased the negative impact in the cardiac function, decreasing remodeling, increasing capillary density, limiting cardiomyocyte apoptosis and favoring the proliferation of cardiac progenitor cells.

7

Authors: Ana Filipa Dias, Liliana Andrade e Raposo

Spirometry has been used over the past decades as a way to assess respiratory function in adults and children, applied mostly to individuals older than six. Currently, a significant number of papers are reporting success in training children in preschool age (from two to six years) to perform a spirometry. The aim of the present review is to analyze the most recent and relevant papers, regarding the use of spirometry in preschool children, identifying the criteria to be used to assess the performance of the spirometry and the quality control standards that are better to apply to this age group. After searching the Pubmed database, a total of 30 papers were analyzed after exclusion of studies that did not address the subject of interest. The assessment parameters in this age group are different from those used in adults, being suggested the use of FEV0.5 and FEV0.75 instead of FEV1 due to the inability of these children to maintain an expiration time greater than 1 second. It seems that the most important parameter with a higher influence in reference equations is the child height. It is important to use incentive programs that proved to be effective in improving the children’s adherence collaboration to the tests. The methods for the interpretation of spirometry are different in children and adults, using preferably the Z-scores in the first group. It is expected, in the near future, that the validation of this technique in this age group, as well as its application in daily clinical practice, will happen.

11

Authors: Cátia Concórdia, Rodrigo Martins, Sandra Alves

The temporomandibular joint is part of a complex system involving the teeth, jaw, skull, cervical spine and shoulder girdle. Its dysfunction affects largely the adult population between 20 and 40 years old and comprises a complex and multifactorial condition involving a number of different signs and symptoms. There is no consensus on its etiology or diagnostic criteria. Also, there is some disagreement regarding the type of treatment, namely concerning the type of health professionals and techniques involved. This study aimed to understand the contribution of physiotherapy in this type of conditions and the relevance of its integration in the evaluation and treatment process leveraging a maximum functionality and quality of life of the patient.

5

Authors: Luis Janeiro; Luisa Nazaré

In contrast to the attention paid to many different critical issues of the exam, the conditions for image visualization in digital mammography do not receive the same level of attention from those who play some role in the process. Therefore, there is, in Portugal, the need to design protocols to warrant the optimal visualization conditions, without which it is not possible to maximize the potential of the whole image acquisition and processing chain. In the present paper we aim to underline the importance of such protocols, referring some international guidelines which importance made them unavoidable. In addition, we grasp from these guidelines some points that must be addressed when designing the protocols.

8

Authors: Mariana Girão, Sandra Alves

Physiotherapy is an autonomous profession, which has a wide field of intervention, ranging from health promotion to disease prevention. Its contribution should be considered as a separate action, integrated at all levels of care. Palliative care focus on promoting the comfort, dignity and quality of life to people of any age group with diseases incurable, progressive and in advanced stage that exclude the possibility of recovery. Although there is little scientific evidence mentioning the role of the physiotherapist in palliative care, it is possible to conclude that the participation of the physiotherapist in this area contributes positively on quality of life, relieving pain and promoting the welfare of users. In Portugal, we are still not acting according to the principles, assumptions and key concepts of this area, with a lower percentage of health professionals than it should be, according to the recommendations of the Portuguese Association of Physiotherapists (APF). It is intended, in this literature review, to analyze the state of the art of the importance of physiotherapy in palliative care.

12

Authors: Raquel Barros, Carina Neves, Diana Fernandes, Paula Pinto, Cristina Bárbara

Background: After the detection of airway obstruction it is common to administrate a bronchodilator and then evaluate the response to the therapeutic. Most societies consider that a positive response to the bronchodilator exists when FEV1 and/or FVC increased 12% and 200mL. Objeticve: To characterize the response to the bronchodilator according to criteria found in the literature. Method: Cross-sectional study. The sample included 52 subjects who performed lung function tests, and in whom an airway obstruction was detected with subsequent administration of bronchodilator. The sample was divided according to criteria of bronchodilator response and pulmonary hyperinflation proposed by ATS/ERS (Miller et al., 2005a; Miller et al., 2005b). Results: For the totality of the sample, the criterion which was able to detect the largest number of subjects with positive response to the bronchodilator was the increase of FEF25-75% ≥10% (63,5%). For the group with the presence of ATS/ERS criteria it was the increase of IC≥10% (76,9%) and for the group without this criteria it was the increase of FEF25-75% ≥10% (61,5%). For the group with pulmonary hyperinflation the best criteria were the increase of FEF25-75% ≥10% (66,7%) and the reduction of RV≥10% (66,7%), and for those without pulmonary hyperinflation it was the increase of FEF25-75% ≥10% (62,2%). Conclusion: The criterion which was able to detect the largest number of positive responses to bronchodilator was the increase of FEF25-75% ≥10%. However due to the existence of other criteria with good discriminative capacities we suggest a combination of several criteria for the correct characterization of airway reversibility.

7

Authors: Maria Goreti de Gouveia Martins da Silva

The Infection Control in Portugal has its own history, within Europe, with more projection from 1988-1998, with the “Infection Control Project”. The first legal framework for Infection Control Committees (ICC) emerged in 1996, also the guidelines, courses for the ICC professionals, postgraduate training, and surveillance of nosocomial infections (1998-2002). In 2007, the National Infection Control Program was reshaped, and Regional Structures were created to decentralize activities. With the emergence of the Patient Safety area, we perceived a greater involvement of management boards and health professionals, and increased information of the population through the media. In 2013, Infection Control and Antimicrobial Resistance Control were merged into a single Program – a Priority Program. And the future?

8

Authors: Joana Ferreira, Ana Paula Madeira, Manuel Valentim

Cardiovascular diseases (CVD) are the leading cause of death in developed countries. About 25% of patients with coronary heart disease have sudden death or risk factor for the occurrence of acute myocardial infarction (AMI), without previous symptoms, and therefore an early diagnosis may improve the prognosis of patients. In recent years, computerized tomography (CT) has been considered an excellent imaging technique evidencing its utility in CVD due to its high diagnostic accuracy in assessing coronary artery disease, being an alternative to invasive coronary angiography. However, the technique has disadvantages, such as radiation dose and artifacts that may lead to diagnostic errors and therefore a new technique applying dual source has been introduced - Dual Source CT. Its configuration may allow an increased diagnostic accuracy through the simultaneous acquisition of two energy spectra in a single image acquisition. According to the literature review, the Dual Source can be advantageous improving the description and communication of findings in the coronary arteries. Detection and characterization of different kinds of coronary plaques in patients with a clinical diagnosis of atherosclerosis, as well as the potential to differentiate between different types of atherosclerotic plaques provides a more detailed analysis of atherosclerotic plaques rupture and erosion considered responsible for AMI. Moreover, a description of the evolutionary injuries caused in the main arteries subjected to atherosclerosis may contribute to a more accurate diagnosis.

15

Authors: Ana Rita Rodrigues, Ricardo Pedro

Introduction: Musculoskeletal work related injuries (MWRI) are considered one of the greatest health problems among physiotherapists. Although being professionals with expertise in musculoskeletal disorders and respective prevention and intervention strategies, they show a high risk for developing MWRI. Objectives: To estimate the prevalence of MWRI among physiotherapists in Portugal (1 year) and find possible risk factors related to this phenomenon. Methodology: The present study is a descriptive-correlational study by using the Musculoskeletal Nordic Questionnaire applied to Portuguese physiotherapists. Results: 39.6% of the physiotherapists reported MWRI during the past 12 months, with the highest prevalence (8.5%) in the lumbar region. The workload (hours/week), the number of users/day, physical activity beyond the professional activity and a high body mass index (BMI) were found risk factors for an increased number of MWRI, with significant correlations. Conclusion: According to the results obtained in this study, further studies are needed with more homogeneous samples to develop more analytical information for a better understanding of the problems identified and to improve the quality of life of the physiotherapist.