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- Injury risk assessment of microtome manipulation using kinematic analysisPublication . Barbosa, Inês; Maduro, Ana; Mendonça, PaulaTo study human tissue for the diagnosis of diseases or to evaluate the effectiveness of a treatment, a very thin sample of tissue must be obtained using a microtome. The movement associated with the manipulation of most microtomes is cyclical and leads to a continuous repetition of the movement during the workday. This repeated motion, associated with inadequate postures, increases the risk of musculoskeletal injuries. The use of kinematics is proposed to assess this risk by obtaining the acceleration and velocity profiles of the movement. This characterization of the movement is very important to define the different phases and positions, gaining information on critical points of the movement that might be related to the potential of injury. In this work, the movement performed by a laboratory technician using a microtome was captured during a regular workday session. The kinematics of the movement was obtained, and its characterization was attained. High accelerations in the elbow and wrist, associated with the high frequency of the motion, suggest a potential for injury at these locations. Moreover, the inclination of the neck is within the range of risk of injury.
- Identifying concerns and needs in AYA survivors of pediatric cancer: a scoping reviewPublication . Moura, Maria Jesus; Santos, Margarida Custódio dos; Barros, LuísaBackground: Adolescent and young adult survivors of pediatric cancer (AYA-CCS) require specialized, age-appropriate care throughout their lives. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) to identify and map self-reported difficulties, concerns, and needs among AYA-CCS. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and EBSCOhost (PsycINFO and CINAHL) for articles published between 2014 and 2024. Eligible studies included first-person data from AYA-CCS (aged 15-39 years), addressing their cancer-related difficulties, concerns, or needs. Studies using qualitative, quantitative, or mixed methods were considered. Two reviewers independently screened studies and resolved discrepancies through discussion. Results: We screened 1,247 records, of which 24 studies met the inclusion criteria. The findings were classified into two main dimensions: (1) Concerns, including psychological burden, long-term effects, infertility, and its impact on relationships, transition of care, fear of recurrence, and social, professional, and financial challenges; and (2) Needs, including tailored information, psychological support, and communication challenges. Conclusion: This scoping review highlights the multiple challenges faced by AYA-CCS, with emphasis on psychological burden. Survivors report needs related to information, psychological support, and communication. Flexible, age-adapted psychoeducational approaches may be beneficial. Involving survivors in program design could enhance relevance. Stratified research by age or developmental stage is essential to align care with evolving needs. A lack of standardized AYA-CCS definitions was identified, underscoring the need for uniform criteria to strengthen future research and care.
- Personalizing total quality management strategies for transfusion services: integrating artificial intelligence, Big Data, and the SoHO frameworkPublication . Pereira, PauloOver the past three decades, Total Quality Management (TQM) has evolved from a management philosophy rooted in industrial engineering to a foundational paradigm in healthcare and transfusion medicine. Initially designed to optimize production consistency, reduce waste, and enhance customer satisfaction, TQM has been progressively adapted to the complex, high-stakes environment of blood establishments and transfusion services, where patient and donor safety are inseparable from process quality and regulatory compliance. The implementation of TQM in transfusion medicine has traditionally relied on statistical process control (SPC), process capability assessment, and continuous improvement cycles, ensuring that blood components meet specifications defined by the European Directorate for the Quality of Medicines & HealthCare (EDQM) and national competent authorities. These methods, rooted in classical quality engineering, have proven effective for standardization but are now being challenged by the growing complexity of data generated across the blood chain - from donor screening and laboratory testing to storage and clinical use.
- Quantification methods for 99mTc-labelled disphosphonates uptake in cardiac amyloidosisPublication . Ferreira, José Manuel Belo; Neves, Matilde Sousa; Figueiredo, SérgioIntroduction: Bone scintigraphy (BS) has emerged as a non-invasive technique of increasing importance in the diagnosis of transthyretin cardiac amyloidosis (CA). The most commonly used approaches include visual grading and semi-quantitative analysis. However, these techniques are limited by operator dependence and subjectivity in interpretation. To address these challenges, absolute quantification techniques are being explored to enhance diagnostic accuracy and consistency and to minimize interobserver variability. The objective is to identify the quantification methods currently employed in the assessment of CA. Material and methods: A systematic review was conducted, including 12 articles retrieved from Scopus, PubMed, and Web of Science databases. Studies published in the last 5 years were selected, focusing on quantification methods applied to planar imaging and single-photon emission computed tomography combined with computed tomography (SPECT/CT) in the context of CA. Results: All 12 selected studies (100%) utilized visual grading; semi-quantitative methods were reported in 91.7% of studies, while absolute quantification techniques were applied in 33.3%. Among the semi-quantitative methods, the heart-to-contralateral lung (H/CL) ratio was the most commonly reported, with similar cut-off values (± 1.5) in the different articles. Additional ratios [heart-to-rib (H/R), heart-to-whole-body (H/WB), heart-to-pelvis (H/P), ratio of heart-to-thigh (RHT)] appeared less frequently, though they were investigated as alternative diagnostic markers. Absolute quantification methods reported heterogeneous cut- -off thresholds, ranging from 1.25 to 6.1, based on standardized uptake values (SUVs), to discriminate between individuals with and without CA. Conclusions: Visual grading remains the clinical standard approach. The H/CL ratio is the most reported semi-quantitative method, although it presents some limitations. Absolute quantification with SPECT/CT (SUVmax, SUVpeak) is promising for diagnosis, prognosis, and monitoring of transthyretin amyloidosis (ATTR) CA, yet consensus reference values are lacking.
- Adverse events identified by a trigger tool as indicators of patient safety and safety management in a medical departmentPublication . Pierdevara, Ludmila; Porcel-Gálvez, Ana Maria; Eiras , MargaridaBackground: Adverse events (AEs) in hospital settings pose a significant threat to patient safety, particularly in patients with multiple comorbidities. Systematic detection tools, such as the Global Trigger Tool, have proven to be more sensitive than traditional voluntary reporting systems in identifying AEs. Objective: This study analyzes the prevalence, characteristics, and factors associated with the occurrence of AEs in an internal medicine department, focusing on patients with multiple morbidities, using a combined approach that integrates the European Portuguese version of the Global Trigger Tool (GTT-PT) and a voluntary reporting system. Methods: This observational, retrospective, exploratory study was conducted in four internal medicine departments at a Portuguese hospital center. A total of 360 randomly selected clinical records were included in this study. AEs were identified using the GTT-PT and by analyzing voluntary incident reports. Sociodemographic and clinical variables were analyzed using binary logistic regression. Results: A total of 718 AEs were identified, of which 564 (78.6%) occurred during hospitalization. Most events were of moderate severity (categories E and F in the Institute for Healthcare Improvement classification). Length of hospital stay was the main predictor of AEs occurrence (odds ratio [OR] range 1.011-1.173). The use of a nasogastric tube was also significantly associated with increased AE risk (OR = 6.693). The GTT-PT detected significantly more events than the voluntary reporting system. Conclusion: The combined use of the GTT-PT and voluntary reporting systems is highly effective in detecting AEs in internal medicine settings. Length of hospital stay and use of invasive devices are key factors associated with AE occurrence. These findings underscore the importance of institutional policies that support a non-punitive safety culture and encourage the systematic integration of proactive monitoring methodologies into clinical practice.
- Closing remarksPublication . Antunes, Maria LuzThe project you presented so clearly and, in such detail, made me reflect on what has been done in Portugal regarding health literacy aimed at disadvantaged populations. Actually, the Directorate-General of Health, which is a governmental institution, developed a national Health Literacy Action Plan since 2019 and carried out a representative national survey using the short-form of the HLS₁₉‑Q12 under the larger M-POHL consortium (the European Network for Measuring Population and Organizational Health Literacy). We identified that specific community-level interventions have targeted vulnerable and marginalized groups — like migrants and socially excluded individuals — to improve their access to health information, reduce obstacles, and increase empowerment. Furthermore, there are initiatives aimed at specific high-risk demographics. Among these are academic and public health programs focused on migrants, individuals experiencing homelessness, and individuals utilizing social welfare services. These initiatives include community-based interventions, capacity-building activities in local settings, and adapted materials (such as plain language or culturally appropriate resources). Examples and case studies have been published in institutional repositories. And, of course, all these interventions produced practical guides and tools designed for use by health services and community partners.
- Colaboração de bibliotecários em equipas de investigação em saúdePublication . Antunes, Maria Luz; Lopes, Carlos; Borges, Maria ManuelIntrodução: O bibliotecário tem adotado estratégias que refletem a sua relevância profissional, podendo incorporar os seus conhecimentos na investigação. A colaboração em projetos de investigação em saúde, académicos ou clínicos, é um objetivo em desenvolvimento. Objetivos: Identificar a perceção das competências dos bibliotecários sobre a sua colaboração em equipas de investigação em saúde (EIS); identificar as perceções dos investigadores sobre as competências dos bibliotecários enquanto colaboradores em EIS; identificar as competências que os bibliotecários devem possuir para colaborar com as EIS; redigir um conjunto de recomendações e/ou orientações para a formação de bibliotecários tendo em vista a colaboração com EIS. Métodos: Metodologia mista. A abordagem quantitativa assenta num questionário sobre perceções de competências para uma amostra de investigadores e bibliotecários sobre a colaboração com equipas de investigação em saúde. A abordagem qualitativa assenta numa entrevista semiestruturada sobre perceções de competências e perspetivas do contributo do bibliotecário, realizada junto de bibliotecários da saúde e de uma amostra seletiva de investigadores em saúde. Resultados: A perceção dos participantes no estudo aponta para um conjunto de competências superiormente valorizado pelos investigadores e que o bibliotecário domina: 1) competências que se inserem no chamado core da profissão (seleção de recursos de informação, pesquisa de informação, citar e referenciar, identificação de revistas e editoras predadoras, etc.); 2) competências que o bibliotecário domina, mas que adquiriu em contexto profissional (filtro dos resultados de pesquisa, migração de dados, etc.). Os resultados do estudo permitiram a redação das recomendações para a renovação de competências a integrar na formação do bibliotecário da saúde. Conclusões: Ficou demonstrada a existência de uma interação permanente de competências entre o bibliotecário e os investigadores, que o resultado da colaboração integra um diálogo assente no equilíbrio entre áreas do conhecimento e saberes.
- O papel da Inteligência Artificial no rastreio automatizado da retinopatia diabéticaPublication . Brito, Gabriel Bertosin Silva; Ventura, Luiza Ferreira; Burjack, Izabella do Vale; Oliveira, Cláudia Santos de; Oliveira, Salomão Antonio; Menezes Júnior, Eumar Evangelista de; Silva, Sandro Dutra eA retinopatia diabética (RD) é uma complicação microvascular grave da diabetes mellitus e uma das principais causas de cegueira evitável em adultos. Este estudo analisa o impacto da Inteligência Artificial (IA) no rastreio automatizado da RD, destacando sua capacidade de melhorar a precisão e a eficiência das triagens. A IA permite a detecção precoce da doença, com a redução da dependência de especialistas e o aumento do acesso a cuidados em regiões com poucos recursos. As tecnologias discutidas incluem algoritmos avançados de aprendizagem profunda e técnicas de explicabilidade, que ajudam a interpretar os resultados clínicos. Apesar dos avanços, barreiras como a falta de padronização de dados, questões éticas e limitações na generalização das estruturas de IA precisam ser superadas. O estudo conclui que a IA representa uma ferramenta promissora no manejo da RD, com potencial para transformar a identificação da doença e prevenir complicações visuais graves em diferentes contextos socioeconômicos.
- Validação de método de análise quantitativa de carvacrol por HPLC-DAD em creme veterinário de Origanum vulgare L. 2% (m/m)Publication . Pádua, Mário; Machado, Alexandra; Zegre, Miguel; Martinho, Pedro; Costa-Veiga, AnaIntrodução – A utilização de cremes contendo óleos essenciais de plantas aromáticas é uma área em crescente desenvolvimento em medicina veterinária. Os óleos essenciais apresentam propriedades biológicas, incluindo atividades antimicrobianas, antioxidantes e anti-inflamatórias que podem coadjuvar o tratamento de problemas de pele em gatos e cães. O controlo de qualidade de um creme com óleo essencial de Origanum vulgare L. inclui, entre outros ensaios, a quantificação de carvacrol (um monoterpeno fenólico maioritário). Objetivos – Pretende-se extrair, separar e quantificar o carvacrol presente num creme farmacêutico, validando este método de controlo de qualidade. Métodos – Foram realizadas três extrações sólido-líquido consecutivas de 100mg de creme, tendo-se obtido uma distribuição da quantidade de carvacrol extraída de 74,7%, 19,4% e 5,9%, respetivamente, correspondendo a 95% de recuperação do total de óleo essencial contido no creme. Os extratos foram analisados por HPLC-DAD numa coluna RP-C18 com uma fase móvel de metanol:água:acetonitrilo. Resultados – O método foi validado, tendo resultado em precisão intraensaio e interensaio inferiores a 2%RSD. Obteve-se limite de deteção de 0,65µg/mL e limite de quantificação de 1,95µg/mL. O carvacrol constituía cerca de 36% da massa do óleo essencial do quimiotipo principal. Conclusões – O método desenvolvido pode ser utilizado para controlo de qualidade de cremes contendo carvacrol, podendo ser aplicado a outros monoterpenos.
- O impacto dos sistemas de lembrete na redução da não comparência dos utentes às consultas externas: revisão de âmbitoPublication . Barão, Sónia; Coelho, AndréIntrodução – A não comparência dos utentes às consultas externas é um problema prevalente e sistemático que impacta negativamente tanto na efetividade dos sistemas de saúde como na saúde dos utentes. Os sistemas de lembrete emergiram como uma solução promissora para mitigar esse problema. Objetivo – Sintetizar a evidência disponível sobre o impacto dos sistemas de lembrete na taxa de não comparência (Tx.NC) dos utentes às consultas externas. Métodos – Sustentada na metodologia do Joanna Briggs Institute, a pesquisa realizou-se nas bases de dados PubMed, Scopus e Web of Science, utilizando palavras-chave como no-show patients, non-attendance e reminder systems, combinadas com operadores booleanos. O desenho do estudo seguiu os itens do PRISMA-ScR para Scoping Reviews, tendo sido incluídos apenas artigos de investigação original com foco nos sistemas de lembrete aplicados no âmbito de consultas externas. Resultados – Foram identificados 429 artigos, dos quais 15 foram incluídos na análise após aplicação dos critérios de elegibilidade. A implementação de sistemas de lembrete reduziu a Tx.NC dos utentes às consultas externas até 40-50%. Embora o SMS tenha sido a estratégia mais observada, foi a chamada telefónica, com confirmação de consulta, que revelou maior efetividade na redução da Tx.NC. Conclusão – Esta revisão evidencia a importância dos sistemas de lembrete na redução da Tx.NC às consultas externas, contribuindo ativamente para a efetividade dos sistemas de saúde.