Ana Luisa Papoila

• Universidade NOVA de Lisboa

This study's purpose was to assess symptom cluster (SC) stability during disease progression and determine their strength of association with survival in patients with advanced cancer . Consecutively eligible patients with advanced cancer not receiving cancer-specific treatment and referred to a Tertiary Palliative Care Clinic were enrolled in a pr...

The aim of GERIA project is to carry out a risk assessment, often difficult for older people, involving the identification of multiple factors potentially affecting health and quality of life, the quantification of human exposure to pollutants, and the evaluation of the individual’s response to these stimuli. The results of this project contribute...

Tinnitus is a phantom sound perceived in the absence of external acoustic stimulation. It is described in a variety of ways (e.g., buzzing, ringing, and roaring) and can be a single sound or a combination of different sounds. Our study evaluated associations between audiological parameters and the presence or severity of tinnitus, to improve tinnit...

Many countries have applied mandatory confinement measures in response to the COVID-19 pandemic, such as school and kindergarten closures, which confined families to their homes. The study concerns the impacts of the first COVID-19 lockdown on the relationships between Portuguese parents and their children, in a non-clinical population composed of...

No estudo geriátrico dos efeitos na saúde da qualidade do ar interior em lares da 3.ª idade de Portugal (GERIA) foi estabelecido como objetivo principal de estudar os efeitos da qualidade do ar interior (IAQ) de equipamentos residenciais para pessoas idosos (ERPI) na saúde respiratória de idosos institucionalizados. Um total de 269 idosos responder...

BACKGROUND AND AIMS Nutritional status management and rehabilitation are significant concern treating maintenance haemodialysis (HD) patients. Oral nutritional supplements are essential to complement insufficient dietary intake, namely of energy and protein, and to rehabilitate a patient's nutritional status. Therefore, the objective of this prelim...

BACKGROUND Studies on acute kidney injury (AKI) in hematopoietic stem cell transplant (HSCT) consider several haematologic diagnoses in their cohorts and heterogeneous definitions for AKI not taking into consideration urinary output (UO). We aimed to evaluate the incidence and risk factors of the first AKI episode in patients with leukaemia submitt...

Background Coronary microvascular dysfunction constitutes an important pathophysiological feature in hypertrophic cardiomyopathy (HCM). We aimed to assess the association between impaired coronary flow velocity reserve (CFVR) and ventricular systolic function and functional capacity. Methods Eighty-three patients with HCM were enrolled in this pro...

Background Inflammation is a crucial component in carcinogenesis. The neutrophil-to-eosinophil ratio (NER) has been studied as a biomarker of prognosis and predictive of response in metastatic renal cell carcinoma (mRCC). In the present study, we evaluated the relevance of baseline NER on the progression-free survival (PFS) and overall survival (OS...

Background and objectives Randomized trials for mechanical thrombectomy (MT) excluded patients with ischemic strokes due to isolated posterior cerebral artery occlusion (IPCAO), and there is no evidence for best acute treatment strategy in these patients. We aimed to assess the effectiveness and safety of MT in acute IPCAO. Methods We retrospectiv...

Objectives Patients’ previous disability (PD) is a key factor when considering acute stroke therapy. PD's exact impact on functional prognosis of patients with acute ischemic stroke remains not entirely clarified. We aimed to analyze PD's influence on functional outcome three months after ischemic stroke. Materials and methods Retrospective analys...

Aims: The aim of the study is to investigate the association between the degree of ischemia due to coronary microvascular dysfunction (CMD) and the left ventricular (LV) tissue characteristics, systolic performance, and clinical manifestations in hypertrophic cardiomyopathy (HCM). Methods and Results: This prospective study enrolled 75 patients wit...

Objective: Since its development, cumulative evidence has accumulated regarding the prognostic value of the Malnutrition-Inflammation Score (MIS/Kalantar score) prognostic value; however, there is a shortage of recent and large studies with comprehensive statistical methodologies that contribute to support a higher level of evidence and a consensu...

The recently published CABANA trial demonstrated that catheter ablation was significantly more effective than anti-arrhythmic drugs for the reduction of hospitalizations and mortality (intention-to-treat, ITT analysis hazard ratio = 0.83, 95% confidence interval 0.74–0.93, P = 0.001),¹ corresponding to a number needed to treat (i.e. ablate) of 12.8...

Background Coronary microvascular dysfunction (CMD) is an important pathophysiological feature in hypertrophic cardiomyopathy (HCM). Purpose This study investigated the role of CMD in tissue characteristics, left ventricular (LV) systolic performance and clinical manifestations in HCM. Methods This prospective study enrolled patients with HCM wit...

Background Despite all efforts, the demand for organs increases. New and better strategies are still needed, critical in a crisis like pandemics. Methodology A mathematical approach that integrates need, Opportunity, and Accessibility to kidney transplantation, was created. NOA method, corresponds to the lateral surface area of a trigonal pyramid...

BACKGROUND AND PURPOSE: The developing nervous system is particularly vulnerable to late adverse effects of cranial radiation therapy, such as leukoencephalopathy, microbleeds, and cavernomas. Cystlike lesions have been rarely described and characterized in the literature. We aimed to characterize cystlike lesions, their risk factors, and associati...

Purpose: To compare outcomes of primary trabeculectomy using either mitomycin C (MMC) alone versus MMC augmented with intracamerular bevacizumab in patients with open-angle glaucoma. Methods: Retrospective, cohort, two-centre, comparative study. Patients' data were screened between October 2015 and March 2019, with inclusion requiring a minimum...

Objective The study aimed to assess the association between intrauterine growth of preterm infants and energy and macronutrient contents in their mothers' milk. Study Design A historical cohort of mothers of preterm infants was assessed according to offspring's intrauterine growth. Fetal growth restriction (FGR) was defined as small-for-gestational...

Purpose The aim of this study was to compare all retinal layers’ thickness in full-term and preterm children without retinopathy of prematurity (ROP). Methods Cross-sectional study including two groups of patients: group 1 children with history of preterm gestation without ROP (gestational age < 37 weeks) and group 2 healthy children with history...

Subjective tinnitus is a phantom sound heard only by the affected person and may be a symptom of various diseases. Tinnitus diagnosis and monitoring is based on subjective audiometric and psychometric methods. This review aimed to synthesize evidence for tinnitus presence or its severity. We searched several electronic databases, citation searches...

Purpose/Aim: Our study aims to evaluate corneal subbasal nerve plexus morphology by in vivo corneal confocal microscopy (CCM) in Multiple Sclerosis (MS) patients, and to explore their potential ability to distinguish between MS patients and healthy subjects. Materials and Methods: Cross-sectional study, including sixty MS patients and twenty-two he...

Introduction Combined intravenous therapy (IVT) and mechanical thrombectomy (MT) is the standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO). However, the use of IVT before MT is recently being questioned. Objectives To compare patients treated with IVT before MT with those treated with MT alone, in a real-world sce...

Background: Systemic lupus erythematosus (SLE) is a chronic, autoimmune and multisystemic disease. Recent studies with functional and structural magnetic resonance imaging and cognitive tests report an unexpectedly high frequency of central nervous system involvement, even in patients with asymptomatic SLE. The purpose of this study was to identif...

Introduction: Increased life expectancy leads to older and frailer surgical patients. Co-management between medical and surgical specialities has proven favourable in complex situations. Selection of patients for co-management is full of difficulties. The aim of this study was to develop a clinical decision support tool to select surgical patients...

Introduction. The Test for Respiratory and Asthma Control in Kids (TRACK) is a tool to assess asthma control in preschool children. This study aims to validate the Portuguese from Portugal version of the TRACK questionnaire. Methods. A prospective cohort study was carried out to assess their psychometric characteristics. Caregivers of 141 children...

To prospectively evaluate changes in peripapillary retinal nerve fibre layer (pRNFL), in all macular layers and in choroidal thickness (CT) in a cohort of systemic lupus erythematosus (SLE) patients without ophthalmologic manifestations. To associate those changes with ophthalmic characteristics, disease activity state, medication and systemic como...

Objective To compare the activity the Urology Department of a Portuguese Academic Hospital during the state of emergency and the equivalent period at the previous year. We compared the number of elective consultations and diagnostic urologic examinations, number and type of elective surgeries, as well as patients’ demographic characteristics and ma...

This cohort study describes the evolution of resting energy expenditure (REE), respiratory quotient (RQ), and adiposity in infants recovering from corrective surgery of major congenital gastrointestinal tract anomalies. Energy and macronutrient intakes were assessed. The REE and RQ were assessed by indirect calorimetry, and fat mass index (FMI) was...

Introduction: Following the 2014 International Society of Urological Pathology meeting, a rapidly growing body of evidence by several researchers has been demonstrating a poor prognosis in association with cribriform morphology. The aim of our study was to describe the presence of cribriform foci in specimens of radical prostatectomies and to eval...

Objectives: Sense of coherence (SOC) is increasingly recognized as an important health determinant, particularly for mental health. Part of the evidence comes from informal caregivers in diverse clinical conditions. The extent to which SOC influences caregiving outcomes, however, is relatively under-researched in dementia, particularly regarding p...

Background Mechanical thrombectomy is the standard treatment in acute ischemic stroke due to large vessel occlusion, but there is limited evidence about its efficacy in very old patients. We sought to analyse safety and effectiveness of mechanical thrombectomy in nonagenarian versus octagenarian patients. Methods We included consecutive patients w...

Background and objective: There are controversial data about risk factors for uncontrolled asthma in preschool children. Objective: This study aims to explore the association between clinical and functional parameters and the lack of asthma control in preschool children. Methods: Children 3-5 years-old with asthma and healthy controls were recru...

Objective: To compare the activity the Urology Department of a Portuguese Academic Hospital during the state of emergency and the equivalent period at the previous year. We compared the number of elective consultations and diagnostic urologic examinations, number and type of elective surgeries, as well as patients' demographic characteristics and...

Background and Aims Malnutrition Inflammation score (MIS) is a risk score published in 2001 (Kalantar-Zadeh, 2001) and validated in 2008 (Rambod, 2009). It is associated with a high mortality and morbidity risk in hemodialysis (HD) patients (pts). Currently, HD pts population is composed of much older individuals, submitted to a high efficient trea...

Background: Although there are articles and studies that associate postural changes with changes in vocal quality, to the best of our knowledge, this was the first study investigating the association between balance disorders and voice. Objective: This study aimed to determine whether patients with balance disorders present any clinical, acousti...

In biomedical research, generalized artificial neural networks (GANNs) have been proposed as an alternative to a multi-layer perceptron owing to their greater ability to generate more interpretable results. GANNs were inspired by statistical generalized additive models (GAMs), and because of the parallelism that can be established between ANNs and...

Psoriasis is a chronic inflammatory immune disorder associated with an increased risk of atherosclerosis. This increased risk is not fully understood. High-density lipoproteins (HDL) play an important role in the prevention of atherosclerosis and any factors that may hamper HDL function such as anti-HDL antibodies (aHDL) might be associated with an...

Purpose: To evaluate the association between quantitative optical coherence tomography angiography (OCT-A) parameters and clinical outcomes in treatment-naïve neovascular age-related macular degeneration (nAMD) patients treated with a treat-and-extend dosing regimen on a 12-month follow-up interval. Methods: Observational, prospective study of c...

Having 2 or more relatives involved in the informal care of people with dementia is frequent worldwide. There are, however, few comparisons of primary and secondary caregivers and even fewer of those who are caring for the same person. Our study aimed to contrast these 2 experiences of caregiving. We compared 2 related samples of 61 primary and 61...

Objective To evaluate ocular involvement in a cohort of systemic lupus erythematosus (SLE) patients of a tertiary referral center and to compare the results with the existing literature. Methods Patients underwent a complete ophthalmological evaluation, including visual acuity, slit-lamp examination, fluorescein staining, Schirmer-I test, Goldmann...

Background: Spirometry is the single most important test for the evaluation of respiratory function. The results are interpreted by comparing measured data with predicted values previously obtained from a reference population. Reference equations for spirometry have been discussed previously. The aim of this study was to compare reference values ba...

Purpose To find early signs of retinal neurodegeneration by comparing the thickness of peripapillary retinal nerve fiber layer (pRNFL) and of all macular layers between systemic lupus erythematosus (SLE) patients without ophthalmologic manifestations and healthy controls. The effect of disease duration and systemic comorbidities was also studied....

Purpose To compare choroidal thickness (CT) between patients with systemic lupus erythematosus (SLE) without ophthalmologic manifestations and a control group. To study the effects in CT of disease duration, disease activity index, medication and systemic comorbidities. Methods Cross‐sectional study where spectral‐domain optical coherence tomograp...

Purpose: Multiple Sclerosis (MS) is the most frequent cause of neurologic disability in young adults, characterized by demyelination and axonal degeneration. Monitoring this last component remains an important challenge. Our study aims to assess corneal subbasal nerve plexus morphology by in vivo confocal microscopy (CCM) and explore the possibilit...

Purpose To compare choroidal thickness (CT) between patients with systemic lupus erythematosus (SLE) without ophthalmologic manifestations and a control group. To study the effects in CT of disease duration, activity index, medication and systemic comorbidities. Methods Cross-sectional study where spectral-domain optical coherence tomography with...

In the Portuguese Geriatric Study of the Health Effects of Indoor Air Quality in Senior Nursing Homes, we aimed to evaluate the impact of indoor air contaminants on the respiratory symptoms and biomarkers in a sample of elderly living in nursing homes. A total of 269 elderly answered a health questionnaire, performed a spirometry and 150 out of the...

Background: The association between voice and body posture is consensual across the scientific literature and seems to be established both ways. Any changes in normal posture can influence the mechanisms of vocal production; on the other hand, vocal rehabilitation can influence posture. Objectives: This study aimed to evaluate the postural patte...

Background Changes in cerebral perfusion occur in subarachnoid hemorrhage that possibly relate to clinical presentation and complications. Purpose To evaluate changes in computed tomography perfusion (CTP) parameters between the acute and subacute stage of subarachnoid hemorrhage. To analyze correlation of these parameters to SAH severity and dela...

Objective To investigate whether glycated albumin, fructosamine, and hemoglobin A1c (HbA1c) are associated with neonatal complications in newborns of pregnant women with gestational diabetes mellitus (GDM). Methods Between November 2016 and September 2017, women with a singleton pregnancy and GDM were enrolled in a prospective study in an obstetri...

Background Follicular T-cells, characterized by the expression of CXCR5, secrete interleukin 21 (IL-21) and help B-cell differentiation in lymphoid follicles. They are also found in circulation and may play a key role in Sjögren’s syndrome’s (pSS) chronic autoimmune epithelitis. Objectives To characterize circulating follicular helper (Tfh) and cy...

Background Some B-cell subsets contribute to the regulation of immune responses, mainly through the secretion of interleukin-10, which suppresses T-helper 1 (Th1) and Th17 cells and induces regulatory T-cells (Tregs). The role of Bregs and Tregs in Sjögren’s syndrome (pSS) pathogenesis is an active field of research. Objectives To evaluate the dis...

This birth cohort study compared the infant growth curve estimates in São Tomé Island to the WHO growth standards. Despite this island belonging to a lower-middle-income country, there were several factors favorable for growth that were present. Four-hundred and seventy-five full-term singleton appropriate for-gestational-age infants were enrolled...

Purpose: To study the association between the assessment of central macular vascular layers by optical coherence tomography angiography (OCT-A) and peripheral nonperfusion evaluated by fluorescein angiography (FA) in patients with retinal venous occlusion (RVO). Methods: Retrospective review of RVO patients without macular edema. Patients underw...

This study aims to investigate associations between glycated haemoglobin (HbA1c), glycated albumin (GA) and fructosamine with neonatal birthweight in gestational diabetes mellitus (GDM). The prospective cohort consisted of 82 women with GDM and their newborns, enrolled between November 2016 and September 2017. Considering neonatal birthweight and b...

Artificial neural networks have been proposed in medical research as an alternative to some regression models such as the generalized linear models, being the multilayer perceptron (MLP) the most used architecture. However, inspired in the generalized additive models (GAM), recent studies proposed the more transparent generalized additive neural ne...

Background: Computed tomography (CT) perfusion has been studied as a tool to predict delayed cerebral ischemia (DCI) and clinical outcome in spontaneous subarachnoid hemorrhage (SAH). The purpose of the study was to determine whether quantitative CT perfusion performed within 72 hours after admission can predict the occurrence of DCI and clinical...

Background: Spirometry is the single most important test for the evaluation of respiratory function. The results are interpreted by comparing measured data with predicted values previously obtained from a reference population. Reference equations for spirometry have been discussed previously. The aim of this study was to compare reference values b...

Purpose: To evaluate the structural changes in the neurosensory retina (NSR) in patients with type 2 diabetes mellitus (T2DM) without diabetic retinopathy (WDR), as measured by spectral-domain optical coherence tomography (SD-OCT). Methods: Cross-sectional, non-interventional, comparative study of patients with diagnosis of T2DM WDR against matched...

Purpose To characterize quantitative optical coherence tomography angiography (OCT-A) parameters in active neovascular age-related macular degeneration (nAMD) patients under treatment and remission nAMD patients. Design Retrospective, cross-sectional study. Participants One hundred and four patients of whom 72 were in Group 1 (active nAMD) and 32...

Background: Educational outreach visits are meant to improve the practice of health professionals by promoting face-to-face visits to deliver educational contents. They have been shown to change prescription behavior, but long-term effects are still uncertain. This trial aimed to determine if they improve family physician prescribing compared with...

B-cells play a pivotal role in primary Sjögren’s syndrome (pSS) pathogenesis. We aim to (1) evaluate the distribution of B-lymphocyte subpopulations in pSS and Sicca patients, (2) establish cut-off points that discriminate pSS from controls, (3) evaluate the association between memory B-cells and phenotypic features in pSS. We included 57 pSS patie...

Background B-cell disturbances are a hallmark of pSS and play a pivotal role in the disease pathogenesis and clinical evolution, and may as well have a potential role in diagnosis. In pSS, an increase of the naïve subset and a decrease of memory B-cells have been reported. A decreased frequency of memory cells has also been identified in patients w...

Quantitative and qualitative defects of high-density lipoprotein (HDL) are important in atherogenesis. In this study, we investigated whether antibodies against HDL components had additional value to conventional cardiovascular risk factors for the diagnosis of ischaemic stroke (IS) and coronary artery disease (CAD). Cross-sectional study was condu...

OBJECTIVE Clinical outcome in nontraumatic subarachnoid hemorrhage (SAH) is multifactorial and difficult to predict. Diffusion tensor imaging (DTI) findings are a prognostic marker in some diseases such as traumatic brain injury. The authors hypothesized that DTI parameters measured in the subacute phase of SAH can be associated with a poor clinica...

The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric as...

Introduction and aims: Selecting patients for heart transplantation is challenging. We aimed to identify the most important risk predictors in heart failure and an approach to optimize the selection of candidates for heart transplantation. Methods: Ambulatory patients followed in our center with symptomatic heart failure and left ventricular eje...

Background Invasive cardiac monitoring using thermodilution methods such as PiCCO¨r) is widely used in critically ill patients and provides a wide range of hemodynamic variables, including cardiac output (CO). However, in post-cardiac arrest patients subjected to therapeutic hypothermia, the low body temperature possibly could interfere with the te...

Introduction and Aims Selecting patients for heart transplantation is challenging. We aimed to identify the most important risk predictors in heart failure and an approach to optimize the selection of candidates for heart transplantation. Methods Ambulatory patients followed in our center with symptomatic heart failure and left ventricular ejectio...

Objective: the aim of this study was to analyze the etiology and clinical consequences of viral respiratory infections in 18 elderly care centers (ECC) in Lisbon, which housed a total of 1022 residents. Methods: nasopharyngeal swabs were collected whenever an elderly had symptoms of acute respiratory infections (ARI). PCR and RT-PCR were perform...

Background Obstructive sleep apnea (OSA) is associated with increased cardiovascular risk. This study aim to assess differences in changes in arterial stiffness of two groups of patients, defined as having daytime sleepiness or not, after continuous positive airway pressure (CPAP) treatment. Methods A selected cohort of consecutive male patients,...

Purpose: This study aimed to assess the efficacy of a staff-training intervention to improve service users' engagement in activities and quality of care, by means of a cluster randomised controlled trial. Method: All residential units with at least 12-h a day staff support (n = 23) were invited to participate. Quality of care was assessed with t...

Introduction: The resting energy expenditure (REE) evolution after liver transplantation is not fully understood. Objective: To assess longitudinally the REE evolution in adults undergoing liver transplantation, in association with other nutritional measurements that characterize the metabolic profile. Methods: A single-center cohort of consec...

Background: Peripapillary retinal nerve fiber layer (pRNFL) and internal macular layer thinning have been demonstrated in Alzheimer's disease (AD) with optical coherence tomography (OCT) studies. The purpose of this study is to compare the pRNFL thickness and overall retinal thickness (RT) in AD patients with non-AD patients, using spectral domain...

Objetivo: Desenvolver um Core Set Geriátrico Abreviado para avaliação/intervenção da funcionalidade, em cuidados de reabilitação de contexto pós-agudo. Materiais e Métodos: Desenvolveu-se um estudo observacional do tipo analítico e longitudinal, que permitisse conhecer os domínios e as variáveis com maior valor preditivo e discriminativo relativame...

Background Cholestasis is a common complication in infants receiving prolonged parenteral nutrition (PN). We studied the effects of two intravenous lipid emulsions composed with either 30% soybean oil, 30% medium-chain triglycerides (MCT), 25% olive oil, and 15% fish oil (SMOF) or with 50% MCT and 50% soybean oil n-6 (MCT/SOY) on the incidence of c...

Background and objectives In dialysis patients, there is an increasing evidence that altered bone metabolism is associated with cardiovascular calcifications. The main objective of this study was to analyse, in hemodialysis patients, the relationships between bone turnover, mineralization and volume, evaluated in bone biopsies, with a plain X-ray v...

This study aimed to examine the differences between mothers of children with and without respiratory problems in variables related to psychological, parental, and marital functioning and to determine which contributed more to parenting stress, because there is a lack of information in this field. Participants were 459 mothers of children attending...

Background and purpose: Diffusion tensor imaging (DTI) parameters are markers of cerebral lesion in some diseases. In patients with acute subarachnoid hemorrhage (SAH), we investigated whether DTI parameters measured at <72 hours might be associated with delayed cerebral ischemia (DCI) and with poor functional outcome at 3 months (modified Rankin...