Browsing by Author "Costa-Veiga, Ana"
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- Ambulatory oncology therapy: impact on public health and environmentPublication . Costa-Veiga, Ana; Medeiros, Bruno; Luís, Rafael; Viegas, SusanaThe increasing use of chemotherapy has impelled hospitals to reorganize their services, shifting from inpatient to outpatient care. Antineoplastic drugs are a heterogeneous group of widely used treatments for neoplastic and non-neoplastic diseases, proved to be mutagens, carcinogens, and teratogens. Chemical contamination that for a long time was concentrated in care institutions can be shifting towards homes and environment. Patients excrete these drugs and their metabolic by-products in body wastes, which can expose home caregivers and family members by skin absorption and unintentional ingestion from hand to mouth contact. An example of environmental impact is their presence in freshwater systems and the consequent contamination of the potable water supply, with a risk of human exposure. This study intends to create and validate a checklist for identification of the daily routine of the patients to define surfaces which are often touched and/or used or where potential spillage of drug-loaded urine or vomit is most likely. This information is crucial to do proposals of the most appropriate corrective measures to eliminate/reduce contamination and exposure of family members in homes of ambulatory chemotherapy patients.
- DeSaFIo-ME: desnutrição, sarcopénia, fragilidade e medicação na pessoa idosaPublication . Cebola, Marisa; Tomás, Maria Teresa; Costa-Veiga, Ana; Rico, Miguel Toscano; Coelho, André; Mendes, Diana; Duque, Sofia; Galán-Mercant, Alejandro; Mendes, Lino; Marinho, Aníbal; Guerreiro, AntónioO envelhecimento ativo é definido pela Organização Mundial da Saúde (OMS) como o "processo de desenvolver e manter a capacidade funcional que promove o bem-estar da população idosa". No processo de envelhecimento são frequentes algumas alterações a nível físico, como alterações na composição corporal, diminuição na força muscular, flexibilidade, maior sensação de fadiga, que estão muitas vezes associadas a situações de doença. Ao associar ao processo de envelhecimento uma situação de doença, como obesidade, diabetes mellitus, dislipidemia, doença cardiovascular e alterações músculo-esqueléticas como a osteoartrite, osteoporose, entre outras, é previsível encontrar frequentemente diminuição da força muscular, flexibilidade e maior sensação de fadiga. Estas situações surgem mais cedo (por vezes a partir dos 30 anos e com maior intensidade a partir dos 50 anos), mas só mais tarde é que surgem os sinais e sintomas. Mas não tem que ser assim! As situações não são todas iguais! Há pessoas idosas que mantiveram estilos de vida saudáveis ao longo da sua vida e neste momento têm uma vida ativa e há outras em que as alterações fisiológicas são mais marcadas. A abordagem deve ser multidisciplinar para que todas as dimensões do envelhecimento sejam avaliadas e sejam preconizadas medidas que previnam/retardem o aparecimento/agravamento de situações mais específicas, nomeadamente desnutrição, sarcopénia e fragilidade. Com esta leitura pretende-se dar indicações para que se possa ter um estado nutricional adequado e manter hábitos de prática de atividade física.
- Exposição profissional a medicamentos antineoplásicos em medicina veterinária: a importância do seu estudoPublication . Oliveira, Ana Cebola de; Costa-Veiga, Ana; Pádua, Mário; Viegas, SusanaComo resultado da melhoria na nutrição e cuidados médicos profiláticos e terapêuticos, os animais de estimação vivem mais tempo. Isto, em combinação com a melhoria das capacidades de diagnóstico, propiciou o aumento da ocorrência de doenças neoplásicas nos animais de companhia, o que resulta numa procura de opções de tratamento com medicamentos antineoplásicos. Segundo a classificação da International Agency for Research on Cancer um grande número destes medicamentos é carcinogénico para os humanos. No entanto, atualmente, existem ainda poucos dados relativos à sua comercialização e condições de utilização em medicina veterinária. Sendo a absorção cutânea uma das principais vias de exposição dos profissionais de saúde a estes medicamentos, importa monitorizar a contaminação das superfícies de trabalho. Este artigo pretende rever o conhecimento atual acerca da exposição dos profissionais de hospitais e clínicas veterinárias a medicamentos antineoplásicos.
- Forgotten public health impacts of cancer: an overviewPublication . Viegas, Susana; Ladeira, Carina; Costa-Veiga, Ana; Perelman, Julian; Gajski, GoranCancer is one of the diseases of greatest concern in developed countries and much effort has been invested in discovering and developing therapeutics for curing cancer. Despite the improvements in antineoplastic therapeutics in the last decades, cancer is still one of the most harmful diseases worldwide. The global burden of cancer also implies financial costs: these can be direct costs, such as those related to treatment, care, and rehabilitation and indirect, which include the loss of economic output due to missed work (morbidity costs) and premature death (mortality costs). There are also hidden costs such as health insurance premiums and nonmedical expenses that are worth noting. This paper intends to present an overview of the generally forgotten impacts that the increasing number of cancer cases can have on the environment, workers who handle antineoplastic drugs, and health services. The knowledge available of each of the impacts will be addressed and discussed regarding the expected development. Overall, lessons learned reflect on the impact of cancer through aspects not commonly evidenced in the literature or even considered in the socio-economic analysis, in part due to the fact that these are difficult to contemplate in direct and indirect cancer costs already defined. Attention may be drawn to the need for continuous investment in prevention to reduce the negative impact on the environment and in the health of workers who handle antineoplastic drugs for patients’ treatment.
- Gestão da medicação em creches e pré-escolar: a construção de manualPublication . Costa-Veiga, Ana; Gonçalves, Margarida; Duarte, Marta; Luz, RitaEnquadramento: A gestão da medicação é o processo desde a seleção do medicamento à sua administração e monitorização, incluindo etapas como o armazenamento. Este processo, aplicado ao contexto de creches e pré-escolar, tem como objetivo principal garantir a administração do medicamento correto à criança correta, na dose, hora e pela via de administração corretas, bem como assegurar boas condições de armazenamento dos medicamentos. A gestão da medicação em creches e no pré-escolar é uma realidade pouco explorada em Portugal, no entanto, é uma área de grande importância, uma vez que as intoxicações agudas medicamentosas são frequentes na faixa etária pediátrica. Objetivo: Construir um manual de práticas seguras para utilização das instituições, com a finalidade de contribuir e auxiliar as mesmas numa correta gestão da medicação em creches e no pré-escolar. Métodos: Para a construção do manual de práticas seguras realizou-se uma revisão sistemática da literatura, extraindo-se e sistematizando informação disponível em sites de instituições e organizações nacionais (como Direção-Geral da Saúde e Segurança Social) e internacionais. Além disso, foi realizada uma visita a uma instituição com valência de creche e pré-escolar, de forma a aprofundar o conhecimento e a melhor poder adequar o manual a esta realidade. Resultados: O manual construído incide em áreas prioritárias como: armazenamento, administração, documentação relativa à administração de medicamentos e níveis de responsabilidade na instituição, aplicadas à gestão da medicação. Conclusões: O contributo do Técnico de Farmácia nesta área tem especial relevância uma vez que pretende promover o bom uso do medicamento, contribuindo para o aumento da literacia da medicação em educadores, auxiliares e pais, prevenindo potenciais erros de medicação.
- Malnutrition and body composition in elderly populationPublication . Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Tomás, Maria Teresa; Coelho, André; Mendes, Lino; Rico, Miguel Toscano; Guerreiro, António SousaIntroduction: Ageing leads to an increase in chronic disease’s prevalence, change in body composition: increased fat mass and decreased lean mass that can lead to malnutrition. Objectives: The aim was relating malnutrition with depletion of lean mass and alteration of fat mass. Materials and methods: Cross-sectional study, developed in the district of Lisbon, in the period from January 1, 2019, to June 30, 2019. Elderly people (≥ 65 years) admitted to the Internal Medicine Unit of a central hospital (up to 72 hours) were eligible for the study. The elderly participants had to present the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. The nutritional assessment was performed through the MNA-LF® and the analysis of the body composition through the measurement of the calf circumference and triceps skinfold. Results: n=38 patients, with a mean age of 78.8 + 5.8 years (70-91), 50% (n=19) males and 73.6%. At hospital admission 7.9% (n=3) were malnourished, 39.5% (n=15) presented nutritional risk, 34.2% (n=13) presented depletion of lean mass and 31.6% (n=12) depletion of fat mass. When we reported the presence of malnutrition with the calf circumference and tricipital skin fold, there was a statistically significant correlation (4=0,04; r=0,05). Malnourished patients presented the depletion of lean mass and fat mass. Discussion/Conclusion: The nutritional assessment using the body composition analysis presents extreme importance in the hospital admission, which allows better performance of the nutritional support adapted to each elderly and better nutritional goals. Signaling the patients who need intervention alert all the clinical team to the importance of nutritional intervention also in the community.
- Malnutrition in elderly population: hospital versus communityPublication . Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Tomás, Maria Teresa; Coelho, André; Mendes, Lino; Rico, Miguel; Guerreiro, AntónioIntroduction: There are many factors that lead to malnutrition in the elderly. Prevention of malnutrition is important, and screening and assessment are necessary. Objectives: The aim was relating malnutrition in the elderly population at hospital admission and in the community. Materials and methods: Multicentric quasi-experimental, correlational, longitudinal, developed in the district of Lisbon. Elderly people (≥ 65 years) admitted to the Internal Medicine Unit of a central hospital (up to 72 hours) and in the community were eligible. The elderly participants had to present the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. The nutritional assessment was performed through the MNA-LF® and the analysis of the body composition through the measurement of the calf circumference and triceps skinfold. Results: n= 56 patients, with a mean age of 79.8 + 6.3 years (70-94), 60.3% (n=35) males, 5.2% (n=3) were malnourished, 38,2% (n=19) presented nutritional risk, 24.1% (n=14) presented depletion of lean mass and 30,4% (n=17) depletion of fat mass. When we reported the presence of malnutrition with the calf circumference and tricipital skin fold, there was a statistically significant correlation (4=0,000; r=0,009). Malnourished patients presented the depletion of lean mass and fat mass. At hospital admission 7.9% were malnourished, 39.5% presented a nutritional risk, 34.2% presented depletion of lean mass and 31.6% depletion of fat mass. In community 22.2% presented a nutritional risk, 5.6% presented depletion of lean mass and 27.8% depletion of fat mass. No statistically significant differences were found between nutritional status and depletion of lean and fat mass. Discussion/Conclusion: Screening and nutritional assessment are important in the elderly population. It was verified that nutritional status and depletion of lean mass and fat mass is a reality in situations of acute illness.
- Malnutrition, sarcopenia and current medical use in elderly populationPublication . Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Tomás, Maria Teresa; Coelho, André; Mendes, Lino; Rico, Miguel; Guerreiro, AntónioIntroduction: Ageing leads to an increase in chronic disease’s prevalence, progressive loss of muscle mass, muscle weakness, and polypharmacy, contributing to the establishment of malnutrition and sarcopenia. Objectives: The aim was: 1. Characterize the prevalence of malnutrition, sarcopenia, and current medication use; 2. Relate malnutrition to sarcopenia and current medication use. Materials and methods: Cross-sectional study, developed in the district of Lisbon, in the period from January 1, 2019, to June 30, 2019. Elderly people (≥ 65 years) admitted to the Internal Medicine Unit of a hospital institution (up to 72 hours) were admitted to the study. Participants in this study were the elderly with the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. Nutritional assessment was assessed through MNA® and sarcopenia through the SARC-F® Questionnaire. The medication was counted through the number of drugs. Results: n=38 patients, with a mean age of 78.8 + 5.8 years (70-91), born in Lisbon, living in their own home, 50% (n=19) males and 73.6% (n=28) with the first cycle of basic education. At hospital admission 7.9% (n=3) were malnourished, 39.5 (n=15) presented a nutritional risk, 47.4% (n=18) presented a risk of sarcopenia and 60.5% had a prescription of more than three drugs. There was a statistically significant correlation between polypharmacy and malnutrition, (r=0,046). Discussion/Conclusion: The nutritional assessment, presence of sarcopenia and current medication use are extremely relevant at hospital admission. This assessment allows patients to be signaled that they need early nutritional intervention to prevent deteriorating during hospitalization.
- Movement and mobility: a series of case studies in very old womenPublication . Tomás, Maria Teresa; Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Coelho, André; Mendes, LinoIntroduction: Normal aging implies different physiological and functional changes. One of the most affected components is mobility whose decrease implies an increased risk of morbidity and mortality. Objectives: To verify in a series of cases the effects of a movement program on the mobility of very elderly individuals using daycare centers. Materials and methods: A quasi-experimental study was developed in a day-care center for elderly people in the district of Lisbon. A small sample of older adults had participated in an 8 weeks exercise training program aiming to develop general mobility. Before and after the exercise program delivered twice a week, participants were assessed relating to mobility with the Timed-up-go test (TUG), a simple and rapid test to assess mobility, agility and fall risk. Participants in this study gave their informed consent, without intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. Results: Four older (81,5 ± 6,8 yr) and overweight women (28,6 ± 6,0 kg/m2) performed both assessment moments and participated in more than 75% of all the sessions. TUG time has decreased in all the participants (26,0 ±15,9%). Discussion/Conclusion: Although very older adults had difficulty and lack of motivation to participate in exercise sessions this small sample shows that even a small amount of movement delivered twice a week is beneficial for her mobility. This study should be done in a higher sample in order to verify the significance of results and allow translate interventions and results to very older populations.
- Occupational exposure to antineoplastic drugs in veterinary practicePublication . Costa-Veiga, Ana; Lourenço, Daniela; Parreira, Daniel; Silva, Hugo; Viegas, SusanaHandling cytotoxic drugs can imply the contamination of workplace surfaces and consequently workers exposure by dermal absorption. Mutagenicity, carcinogenicity, teratogenicity and acute side effects are linked to occupational exposure to these drugs. The growing demand for advanced treatments in companion animals increased the use of cytotoxic and immunosuppressive drugs in veterinary practice. Contrarily to human oncology, there are a small number of studies in veterinary oncology, therefore the aim of this study was to investigate the compliance rates of safety procedures in veterinary hospitals and clinics located in Lisbon that prepare and administrate cytotoxic therapies.