Afonso Rocha

Centro Hospitalar de São João | CHSJ · PMR

Introduction Hypertriglyceridemia has long been described as a marker of increased cardiovascular (CV) risk, but the intricate interplay of triglycerides (TG) and CV events is still a matter of ongoing debate, with previous studies showing controversial data. Purpose The aim of this study was to determine whether TG level in very-high risk patient...

Purpose To analyze the long-term consequences of critical COVID-19, regarding physical, mental, cognitive and functional impairments, and to describe its evolution through time. Methods Prospective cohort study, with consecutive inclusion of patients admitted due to SARS-CoV-2 to intensive care units(ICU) of a tertiary-care center, between May/202...

Objective: To identify factors associated with CR referral following an acute coronary syndrome (ACS) at a university hospital. Design: We analyzed 2,814 hospitalizations due to ACS between 2017 and 2019 in Centro Hospitalar São João. The hospital's morbidity database was used to retrieve patient information. CR referral and participation was id...

Objective: To characterize pressure injuries (PI), identify risk factors, and develop a predictive model for PI at intensive care unit (ICU) admission for critical COVID-19 patients. Design: Retrospective analysis of a consecutive sample of patients admitted to ICU between May/2020 and September/2021. Inclusion criteria encompassed the diagnosis...

Objective: To evaluate whether critical SARS-CoV-2 infection is more frequently associated with signs of corticospinal tract dysfunction and other neurological signs, symptoms, and syndromes, than other infectious pathogens. Methods: This was a prospective cohort study with consecutive inclusion of patients admitted to intensive care units due t...

Objective To evaluate whether critical SARS-CoV-2 infection is more frequently associated with signs of corticospinal tract dysfunction and other neurological signs, symptoms, and syndromes, than other infectious pathogens. Methods This was a prospective cohort study with consecutive inclusion of patients admitted to intensive care units due to pr...

Lipid control is one of the most important secondary cardiovascular prevention targets. Although cardiovascular disease is the most common cause of death in both sexes, women are less likely to receive guideline-recommended secondary prevention medications. To compare sex disparities in dyslipidemia control in a secondary prevention population, we...

Objectives We aimed to evaluate the effect of previous cerebrovascular disease (CVD) on mortality rates of critically ill COVID-19 patients. Materials & methods A prospective cohort study was performed between May/2020 and May/2021, at a tertiary-care-center. We consecutively included adult patients admitted to intensive care units (ICU) having as...

Objective. This study aims to characterize neurocognitive functioning after acute coronary syndrome (ACS), and to determine the relations between sociodemographic, cardiovascular risk factors and clinical variables with different aspects of neurocog-nitive functioning. Moderation effects regarding those relations will be determined. Methods. The Ad...

Introduction Clinical use of chronotropic response has been limited due to lack of consensus on the appropriate formula for chronotropic index (Ci) calculation and the definition of chronotropic incompetence. Objectives To assess the effects of cardiac rehabilitation programs (CRP) on Ci, irrespective of betablockers (BB) use and dosage. Assess th...

Introduction Clinical use of chronotropic response has been limited due to lack of consensus on the appropriate formula for chronotropic index (Ci) calculation and the definition of chronotropic incompetence. Objectives To assess the effects of cardiac rehabilitation programs (CRP) on Ci, irrespective of betablockers (BB) use and dosage. Assess th...

Aims Assess trends and factors associated with interhospital transfers (IHT) and 30-day acute coronary syndrome (ACS) rehospitalizations in a national administrative database of patients admitted with an ACS between 2000–2015. Methods and results Cohort study of patients hospitalized with ACS from 2000 to 2015, using a validated linkage algorithm...

Background Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the manage...

Lipid control is one of the most important secondary cardiovascular prevention targets. The 4S trial¹ in 1994 was the first study to demonstrate the benefit of statin therapy in coronary artery disease patients. Ten years later, the PROVE IT-TIMI 22² showed the benefit of intensive vs. moderate statin therapy in patients with a recent acute coronar...

Funding Acknowledgements Type of funding sources: None. Lipid control is one of the most important secondary cardiovascular prevention targets. The 4S trialin 1994 was the first study to demonstrate the benefit of statin therapy in coronary artery disease patients. More recently, the FOURIER trial (2017) and the ODYSSEY Outcomes (2018) demonstrated...

Objective To assess the clinical impact of a cardiac rehabilitation program in an older population. Methods This is a retrospective analysis of 731 coronary patients who attended phase 2 of a cardiac rehabilitation program between January 2009 and December 2016. We compared the response to the program of older (≥65 years) and younger (<65 years) p...

Objective To assess the clinical impact of a cardiac rehabilitation program in an older population. Methods This is a retrospective analysis of 731 coronary patients who attended phase 2 of a cardiac rehabilitation program between January 2009 and December 2016. We compared the response to the program of older (≥65 years) and younger (<65 years) p...

Introdução –A disfunção neurocognitiva no contexto da síndrome coronária aguda (SCA) apresenta uma incidência entre os 10.51% e os 85%. A SCA representa um risco cinco vezes acrescido para o desenvolvimento de demência. Os fatores que estão na base destas associações são extensos e não totalmente compreendidos. Objetivos – O presente estudo pretend...

Objectives To assess validity of record linkage using multiple indirect personal identifiers to identify same-patient hospitalisations and definition of episode of care (EC) due to acute coronary syndrome (ACS). Methods Using national hospital discharge data to identify all admissions due to ACS, we used six different linkage rules using indirect...

Purpose: To evaluate the response of patients with obesity to a cardiac rehabilitation program (CRP), compared with patients without obesity. Methods: We performed a retrospective analysis of 731 patients who completed phase II of a CRP after an acute coronary syndrome. The response to the CRP was assessed using the relative changes in exercise...

Purpose: To study the role of left ventricle systolic function in cardiac rehabilitation program (CRP) response in stage B heart failure patients. Methods: A retrospective analysis was completed of 691 patients with previous myocardial infarction that underwent a CRP, classified in 3 groups: preserved ejection fraction (pEF), mid-range ejection...

Bone marrow edema represents a typical pattern on magnetic resonance imaging consisting of an area of abnormal bone signal with low to intermediate intensity on T1-weighted images and a high intensity on fat-suppressed T2-weighted images. Bone marrow edema syndromes are a group of entities characterized by idiopathic bone marrow edema and osteoporo...

Introduction: Prospective studies have shown the relation between acute coronary syndrome (ACS) and neurocognitive dysfunction with prevalence ranging between 10.51% and 66.8%. The present study aims to determine the prevalence level of neurocognitive dysfunction; the relations between sociodemographic, clinical and emotional variables and neurocog...

Objectives To estimate cardiac rehabilitation (CR) referral and participation rates among patients with acute coronary syndrome (ACS) and to identify their determinants, in two Portuguese regions. Design Prospective cohort study. Setting Patients consecutively admitted to the cardiology department of two hospitals, one in the district of Porto an...

To assess the prevalence of musculoskeletal complaints and their association with risk factor profile and functional and psychosocial status in patients on a cardiac rehabilitation program. In this cross-sectional study of 449 patients admitted within three months of an acute coronary syndrome, patients were divided into those with (MSC+) and those...

Purpose: 3D echocardiography (3DE) enables fast 3D acquisition but subsequent manual navigation to find 2D diagnostic planes can be time consuming. We have developed and validated an automated machine learning-based technique to find apical 2-, 3- and 4-chamber (A2C, A3C, A4C) views that enables fast volume navigation and analysis. Methods: 3DE vol...

Introduction: There is evidence that cardiac rehabilitation programs (CRP) exert significant benefits in patients with coronary artery disease (CAD). However, safety and influence of residual significant coronary stenosis on CRP outcomes remain unclear. Methods: We retrospectively analyzed clinical, angiographic and functional data of a total of 28...

Background: Cardiac rehabilitation has a well known positive impact on physiological and psychosocial status. Left ventricular dysfunction is often regarded as a criterion for postponing referral, even though LV function might not impact on the degree of improvement achieved by the program. The purpose of this study was to evaluate if the benefits...

Objective: This study aims to describe psychosocial status in lower limb amputees referred to a Physical and Rehabilitation Medicine (PRM) department of a central Portuguese Hospital. Methods: Cross-sectional study of 45 consecutive patients with lower limb amputation, referred to PMR consultation after hospital discharge. Of the initial sample,...

Despite increasing prevalence of coronary heart disease among the elderly and their greater susceptibility to its clinical, functional and psychosocial sequelae, referral to and participation in cardiac rehabilitation programs (CRPs) remains low in this age group. We aimed to assess the effect of age on the hemodynamic, biochemical, anthropometric,...

Mechanical ventilation is probably the medical intervention which resulted in more lifes saved in the history of Medicine. However, it is associated with several potential deleterious consequences, especially when it's maintained for unnecessarily long periods or, on the other hand, when suspended before full recovery is attained. Shortening the du...

Complex regional pain syndrome is characterized by an over reaction to injury of one extremity, with severe pain (many times with allodynia), autonomic disturbance, trophic changes and delayed functional recovery. The authors present a case report of complex regional syndrome of the knee with atypical clinical onset and course, and review of the cu...

Amyotrophic lateral sclerosis is a devastating progressive neurodegenerative disorder, involving motor neurons in the cerebral cortex, brainstem and spinal cord. Mean duration of survival from the time of diagnosis is around 15 months, being pulmonary complications and respiratory failure responsible for more than 85% of deaths. Albeit the inevitab...