Biomedical subjects

Isabel Soares

Publications and source records attributed to Isabel Soares.

11 recordsLinked to original sources

PubMed2005

Attachment and motivational strategies in adolescence: exploring links.

Within the framework of attachment theory and of motivation goal theory, this study explored the relation between quality of attachment strategies and quality of motivational strategies in a sample of young adolescents. Specifically, this study examined patterns of thoughts, behaviors, and emotions as they related to representations of attachment and motivational functioning in situations that challenge or threaten three psychological needs (emotional security, competence, and autonomy). Forty-four students, aged 11 to 14 years, responded to imagined stressful situations in order to: (a) assess attachment strategies; (b) identify and assess students' motivational strategies in stressful classroom circumstances; (c) assess motivational strategies of students with high and low control and agency beliefs; and (d) examine the relations between attachment and motivational strategies. Four distinct action patterns were identified: flexible action, rigid action, passive behavior, and disorganized behavior. Significant relations were found between control beliefs and motivational strategies, as well as a trend toward relations between attachment and motivational strategies, suggesting that secure adolescents show more constructive motivational strategies and less disorganized strategies when compared to insecure adolescents.

Adolescent↗

PubMed2005

Primary amyloidosis as a cause of microvascular angina and intermittent claudication.

Primary systemic amyloidosis or AL amyloidosis is a rare condition characterized by extracellular deposits of fibrils composed of fragments of immunoglobulin light chains. Widespread deposition of this amyloid in tissues interferes with their normal function and leads to multiple organ failure. Clinical manifestations are highly variable due to the wide range of organs involved. The heart is affected in 90% of cases; in 30% of these, cardiac dysfunction is the form of presentation and in 50% it is the cause of death. The commonest form of cardiovascular manifestation is congestive heart failure due to restrictive cardiomyopathy caused by extensive interstitial infiltration of amyloid into the myocardium. Occasionally, it can present as angina, due to infiltration of amyloid into the walls of small vessels. The authors describe the case of a patient in whom the disease presented simultaneously with heart failure and effort angina, as well as intermittent claudication.

Aged↗

PubMed2003

Evaluation of the clinical sensitivities of three viral load assays with plasma samples from a pediatric population predominantly infected with human immunodeficiency virus type 1 subtype G and BG recombinant forms.

The viral load assays AMPLICOR HIV-1 Monitor Test 1.5, Nuclisens HIV-1 QT, and Quantiplex HIV RNA 3.0 (bDNA) were evaluated for their abilities to quantify human immunodeficiency virus type 1 (HIV-1) RNA in 64 plasma samples from 21 children infected in Portugal. The children were infected with HIV-1 subtypes A1, B, F1, G, and BG recombinant virus. AMPLICOR v1.5 and Quantiplex v3.0 detected all samples, and there was a good correlation of results between the two kits. Thirty-eight specimens containing HIV-1 subtype B, G, or recombinant BG, could not be detected by Nuclisens HIV-1 QT. We also evaluated the new Retina HIV-1 assay on 21 samples that were HIV-1 positive; Retina HIV-1 failed to detect 5 of 11 subtype G specimens. AMPLICOR v1.5 and Quantiplex v3.0 assays may be used for HIV-1 RNA quantification in Portugal, whereas an improvement in sensitivity for subtype G and recombinant BG is required for Nuclisens HIV-1 QT and Retina HIV-1.

Branched DNA Signal Amplification Assay↗

PubMed2003

Prevention and screening. Part II: Critical appraisal of articles on screening.

Currently, a substantial part of clinical practice is involved with health maintenance and disease prevention. However, there continue to be deficiencies in the delivery of preventive care, and it is sometimes difficult to identify which interventions are effective--for lack of randomized clinical trials--and the theoretical basis of this approach is not always clear. In the previous paper published in the Journal, we presented the general conceptual principles of preventive medicine, starting with levels of prevention and followed by the criteria for selecting a preventive intervention. Regarding the latter, the characteristics of the disease to be screened and the respective screening test were discussed, as well as therapy for positive cases. Finally, we discussed the possible consequences of screening for disease. In this paper we present guidelines for the critical appraisal of articles on screening.

Cardiovascular Diseases↗

PubMed2002

[Smoking cessation: evidence-based recommendations].

Smoking is an important cause of morbidity and mortality, and is considered the most important preventable cause of disease and death in the developed world. It is a cause of cancer, heart disease, stroke, chronic obstructive pulmonary disease and pregnancy complications. Even though smoking is known as an important health hazard, tobacco use remains surprisingly high. In Portugal, 18% of the adult population smokes, and the prevalence of adolescent smoking has risen dramatically during the 90s. A significant percentage of actual smokers are willing to quit, creating a major responsibility for health care providers. Cardiologists bear a special responsibility, because there is good observational evidence that patients with coronary disease that quit smoking significantly lower their risk of recurrent ischemic events or death, and patients with peripheral vascular disease or stroke also get benefits, with better exercise tolerance, diminished rates of limb amputation, increased survival and less stroke recurrence. We wrote this paper to summarize the main recommendations on techniques of smoking cessation, based on evidence-based recommendations.

Evidence-Based Medicine↗

PubMed2002

Basics of methodologic analysis of therapeutic trials. Part I: Validity of the results.

One of the most compelling questions a cardiologist (and, for that matter, any clinician) has to face involves choosing the optimal management strategy for their patients. One of the best sources of information about therapy is the randomized controlled trial, which, despite several significant shortcomings, is considered to be the gold standard in studies about therapeutics and prevention. The methodological quality of therapeutic trials is highly variable and--as already discussed in previous articles--in order to be useful they have to be critically appraised in terms of the validity of their results, their importance, and their applicability to the individual patient. In this article, we will introduce guidelines for the critical appraisal of evidence in therapy, discussing the issue of validity. In future articles we will present a critical appraisal of the importance and applicability of randomized clinical trial results.

Clinical Trials as Topic↗

PubMed2002

Basics of methodologic analysis of therapeutic trials. Part II: Importance of the results.

One of the most compelling questions a cardiologist (and, for that matter, any clinician) has to face involves choosing the optimal management strategy for their patients. One of the best sources of information about therapy is the randomized controlled trial, which, despite several significant shortcomings, is considered to be the gold standard in studies about therapeutics and prevention. The methodologic quality of therapeutic trials is highly variable and--as already discussed in previous articles--in order to be useful they have to be critically appraised in terms of the validity of their results, their importance, and their applicability to the individual patient. In a previous article published in the Journal, critical appraisal of evidence in therapy was presented, concerning the issue of validity. In this article, we will introduce a critical appraisal of the importance of the results obtained through randomized clinical trials, and in the final article we will discuss their applicability.

Cardiology↗

PubMed2002

Basics of methodologic analysis of therapeutic trials. Part III: applicability of the results to the individual patient.

One of the most compelling questions a cardiologist (and, for that matter, any clinician) has to face involves choosing the optimal management strategy for their patients. One of the best sources of information about therapy is the randomized controlled trial, which, despite several significant shortcomings, is considered to be the gold standard in studies about therapeutics and prevention. The methodologic quality of therapeutic trials is highly variable and--as already discussed in previous articles--in order to be useful they have to be critically appraised in terms of the validity of their results, their importance, and their applicability to the individual patient. In two previous articles published in the Journal, critical appraisal of evidence in therapeutic trials was presented, concerning the validity and the importance of the results. In this article, we will present a critical appraisal of the applicability of the results to the individual patient.

Cardiology↗

PubMed2002

Drug class effects: definitions and practical applications.

The concept of drug class effect is profoundly rooted in clinical practice. The use of drugs seen as similar in their clinical effects--and therefore interchangeable--is very frequent: two examples of this are the use of beta-blockers in arterial hypertension and angiotensin-converting enzyme (ACE) inhibitors in congestive heart failure. The definition of drug class effect is based on three concepts: a similar chemical structure (for example, the dihydropyridine ring of some calcium channel blockers), a similar mechanism of action (beta-blockers block adrenoreceptors), or similar pharmacological effects (antihypertensives, antianginals, etc.). In this article, we will describe the type of evidence that a cardiologist can use in order to select a specific drug (from within a class). It constitutes a clinical approach, different from the one that might be used by a third party payer (more interested in cost-effectiveness issues) or the pharmaceutical industry (more interested in promoting sales). As usual, the recommendations are based on the strength of scientific evidence.

Adrenergic beta-Antagonists↗

PubMed2002

Intention-to-treat analysis in clinical trials: principles and practical importance.

Intention-to-treat analysis is a technique used in randomized controlled trials (RCTs), where patients are compared--in terms of their final results--within the groups to which they were initially randomized, independently of receiving the allocated treatment, having dropped out of the study or having violated the initial protocol (for whatever reason). In other words, it constitutes an analysis of the results based on the treatment arm to which the patients belong due to the initial random allocation, and not on the treatment actually received (active or placebo). Intention-to-treat analysis permits the pragmatic evaluation of the benefit of a treatment change, and not the potential benefit in patients getting the pre-planned allocated treatment only. Full application of the intention-to-treat principle is only possible in those circumstances where all results from all patients are available. A significant number of RCTs state that they use intention-to-treat analysis, but the ways that violations of randomized allocation is handled varies considerably. Many trials present flaws in gathering primary data, and their methods of handling this problem are normally poor. Lastly, the intention-to-treat principle is frequently poorly described and applied. In this article we will present the importance, utilization, limitations and errors of intention-to-treat analysis.

Attitude of Health Personnel↗

PubMed2002

Prevention and screening. Part I: General principles.

Currently, a substantial part of clinical practice is involved with health maintenance and disease prevention. However, there continue to be deficiencies in the delivery of preventive care, and it is sometimes difficult to identify which interventions are effective--for lack of randomized clinical trials--and the theoretical basis of this approach is not always clear. In this paper, the first in a series of two, we will present the general conceptual principles of preventive medicine, starting with levels of prevention and followed by the criteria for selecting a preventive intervention. Regarding the latter, the characteristics of the disease to be screened and the respective screening test will be discussed, as well as therapy for positive cases. Finally, we will discuss the possible consequences of screening for disease. In our second paper, to be published in the next issue, we will present guidelines for the critical appraisal of an article about screening.

Humans↗