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Publication
Featured researches published by Maria Inês Santos.
Journal of Pediatric Endocrinology and Metabolism | 2015
Maria Inês Santos; Catarina Limbert; Filipa Carlota Marques; Frederico Rosário; Lurdes Lopes
Abstract Background: Serum thyroid stimulating hormone (TSH) levels are frequently elevated in obese children and are most likely to be associated with insulin resistance. However, clinical relevance of this association remains unclear. Objectives: To assess the prevalence of hyperthyrotropinemia; to analyze the relationship between TSH and homeostasis model assessment – insulin resistance (HOMA-IR); and to verify whether TSH levels and HOMA-IR vary with weight loss in obese children. Subjects and Methods: Retrospective longitudinal study with data from baseline and 1 year after lifestyle intervention in a pediatric obese group (344 children were recruited and 100 among them completed follow-up). For postintervention analysis, three groups were considered according to body mass index-standard deviation score (BMI-SDS) variations: ≤–0.5 (significant weight loss); 0.5–0 (weight loss); and >0 (weight gain). Statistical analysis was performed using SPSS 19.0®. Results: The prevalence of increased TSH levels was 9.3%. At baseline TSH (p=0.007), fT4 (p=0.006), and HOMA-IR (p<0.001) were positively correlated to BMI-SDS (n=344). Weight reduction was verified in 67 out of 100 cases but significant loss was present in only 21 cases. Decreases in both TSH and BMI-SDS were independently associated with decreases in HOMA-IR (p=0.005 and p=0.016, respectively). There was no correlation between TSH and BMI-SDS variation. Significant decreases in the HOMA-IR (p=0.006) were only achieved in the significant weight loss group. Conclusions: The prevalence of hyperthyrotropinemia was lower than previously reported. However, cutoff values were adjusted to pubertal stage, suggesting an over report in other studies. Insulin resistance and TSH were positively correlated, independent of body status. Although weight loss was not associated with TSH variation, a decrease in TSH levels was independently associated with decreases in HOMA-IR.
International journal of adolescent medicine and health | 2017
Pedro Marques; Catarina Limbert; Laura Oliveira; Maria Inês Santos; Lurdes Lopes
Abstract Introduction: Childhood obesity prevalence is rising and new therapeutical approaches are needed. Metformin is likely beneficial in obese and/or insulin-resistant children/adolescents, but its role in this setting is still unclear. We aimed to evaluate the effectiveness, in terms of weight loss and insulin resistance, and safety of metformin in nondiabetic overweight/obese children and adolescents. Methods: We retrospectively reviewed clinical records of 78 nondiabetic obese/overweight [body mass index (BMI)≥85th/95th percentile for age and sex] children and adolescents. Anthropometric and metabolic outcomes of 39 patients treated with metformin (mean daily dose: 1.3±0.5 g) were analyzed and compared to lifestyle intervention alone at different follow-up times (12 and 24 months). Results: The mean age of the 78 patients was 13.3 years, 41 were females and mean BMI and BMI-SDS were 32.8 kg/m2 and 3.1, respectively. There was a decrease in mean BMI-SDS within each treatment group in all periods, except at 24 months for lifestyle intervention. However, the change in BMI-SDS was not significantly superior in the metformin group when compared to lifestyle intervention. Metformin had greater effectiveness over lifestyle intervention alone in reducing fasting insulin levels and homeostasis model assessment for insulin-resistance index (HOMA-IR) at both 12 and 24 months. Five patients had gastrointestinal adverse effects (12.8%), four requiring dose reduction, but metformin could be resumed in all. Conclusion: Metformin for nondiabetic obese/overweight children and adolescents resulted in a noteworthy insulin resistance improvement, without significant BMI advantage when compared to lifestyle intervention. Metformin metabolic and anthropometric effects appear to be beneficial up to 24 months, without relevant adverse effects, highlighting its potential long-term benefits.
Social Science & Medicine | 2018
Joana Andrade; Ana Manuela Rocha; Maria Inês Santos; Joana Campos; Elisabete Santos; Alzira Ferrão
AIMS: To characterize the way in which general and family physicians and pediatricians consider approaching adolescents, identify their qualifications in Adolescent Medicine, ascertain which topics of this specialty these physicians would like to see addressed in future training, and to compare the perceptions of physicians of both specialties with respect to their experience in adolescent health practice. METHODS: Cross-sectional study based on a survey sent by e-mail to 241 physicians in the area of influence of a level II hospital, including specific training interns or experts in Pediatrics and General and Family Medicine from health centers of the municipality of Viseu, Portugal. Chi-square tests or Fishers exact test were used to test associations between variables, assuming statistical significance when p <0.05. RESULTS: A total of 113 physicians completed the survey, of them 74% female, with a median of 12 years of practice (interquartile range 5-30, minimum 2 years, maximum 38 years). The pediatrics group had more training in Adolescent Medicine (57%) than the general and family medicine group (25%) (p=0.007). More physicians with specific training in Adolescent Medicine considered themselves prepared for the adolescent interview (51%, vs. 28% of those who did not have specific training, p=0.03). Family and general practitioners guided adolescents more about substance use, contraception, and sexually transmitted diseases, while pediatrics doctors identified more adolescents with depression. Most physicians rated themselves as having insufficient knowledge in Adolescent Medicine, with insufficient training being the most frequently referred barrier. Fifty-seven percent of pediatrics doctors, 78% of general practitioners and 84% of those with no specific training in Adolescent Medicine, considering the two specialties, would like to deepen their knowledge in this area. CONCLUSIONS: This study allowed identifying which areas of knowledge on Adolescent Medicine are deficient in the training of pediatricians and general practitioners. Most physicians, especially those with no training in Adolescent Medicine, showed interest in filling this gap.AIMS: To characterize the way in which general and family physicians and pediatricians consider approaching adolescents, identify their qualifications in Adolescent Medicine, ascertain which topics of this specialty these physicians would like to see addressed in future training, and to compare the perceptions of physicians of both specialties with respect to their experience in adolescent health practice.METHODS: Cross-sectional study based on a survey sent by e-mail to 241 physicians in the area of influence of a level II hospital, including specific training interns or experts in Pediatrics and General and Family Medicine from health centers of the municipality of Viseu, Portugal. Chi-square tests or Fishers exact test were used to test associations between variables, assuming statistical significance when p <0.05.RESULTS: A total of 113 physicians completed the survey, of them 74% female, with a median of 12 years of practice (interquartile range 5-30, minimum 2 years, maximum 38 years). The pediatrics group had more training in Adolescent Medicine (57%) than the general and family medicine group (25%) (p=0.007). More physicians with specific training in Adolescent Medicine considered themselves prepared for the adolescent interview (51%, vs. 28% of those who did not have specific training, p=0.03). Family and general practitioners guided adolescents more about substance use, contraception, and sexually transmitted diseases, while pediatrics doctors identified more adolescents with depression. Most physicians rated themselves as having insufficient knowledge in Adolescent Medicine, with insufficient training being the most frequently referred barrier. Fifty-seven percent of pediatrics doctors, 78% of general practitioners and 84% of those with no specific training in Adolescent Medicine, considering the two specialties, would like to deepen their knowledge in this area.CONCLUSIONS: This study allowed identifying which areas of knowledge on Adolescent Medicine are deficient in the training of pediatricians and general practitioners. Most physicians, especially those with no training in Adolescent Medicine, showed interest in filling this gap.
International journal of adolescent medicine and health | 2018
Maria Inês Santos; Frederico Rosário; Elisabete Santos; Alzira Ferrão
Abstract Background Investing in adolescent health is among the most cost-effective health measures. Primary care practitioners are ideally positioned to deliver such interventions. However, several barriers hinder them from engaging with adolescents. Objective To pilot test the impact of a 1-day training session on adolescent health on the attitudes of primary care practitioners toward adolescent care. Subjects Participants were family physicians and nurses enrolled in a 1-day training session on adolescent health. Methods A non-randomized, pre-post intervention study with no control group. Data on barriers for providing care to adolescents, preferred pediatric age group and attitudes toward adolescent care were collected immediately prior. Participants’ attitudes were measured again immediately after training. Results Most participants reported they preferred to attend pediatric groups other than adolescents. The most frequently reported barriers were: excessive amount of time needed and lack of training. Participants reported positive pre-training attitudes, with mean scores above the midpoint of the scale in all dimensions. Significant positive improvements were observed after training in Adequacy, Self-esteem and Satisfaction. Subgroup analysis showed that at baseline, professionals who preferred to work with adolescents had significantly more positive attitudes in Adequacy, Self-esteem and Satisfaction. After training there was a general improvement in attitudes in both groups, with attenuation of the differences between them. Conclusion Participation in a 1-day tailored educational intervention on adolescent health had a positive impact on the attitudes of primary care practitioners, regardless of their preferred age group. This improvement may lead to more active engagement with adolescents and substantial health gains.
15th European Congress of Endocrinology | 2013
Catarina Limbert; Maria Inês Santos; Frederico Rosário; Daniela Amaral; Rosa Pina; Laura Oliveira; Lurdes Lopes
To estimate the prevalence of hyperthyrotropinemia in obese children; To analyze the influence of BMI-SDS and TSH in other metabolic variables. Obesity in children has been increasing dramatically, with a significant increase in cardiovascular and metabolic diseases risk. The role of thyroid dysfunction has been extensively analyzed in obese adults, but to a limited extent in children. Serum TSH values are often elevated in obese children and may be associated with modifications in lipid and glucose metabolism. However, the clinical relevance of these associations remains unclear.
Family Practice | 2011
Maria Inês Santos; Frederico Rosário
Acta Médica Portuguesa | 2012
Maria Inês Santos; Hipólito Nzwalo; José Paulo Monteiro; Maria José Fonseca
Acta Médica Portuguesa | 2013
Carlos Escobar; Duarte Malveiro; António Salgado; Maria Inês Santos; João Lameirão Campagnolo; Manuel Cassiano Neves
Acta Médica Portuguesa | 2018
Frederico Rosário; Maria Inês Santos; Kathryn Angus; Leo Pas; Niamh Fitzgerald
Acta Médica Portuguesa | 2011
Maria Inês Santos; Catarina Resende; Frederico Rosário; Joana Campos; Graça Carvalho; Cecília Figueiredo