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AnteayerInterdisciplinares

Cohort profile: the Mendelian randomisation in pregnancy (MR-PREG) collaboration - improving evidence for prevention and treatment of adverse pregnancy and perinatal outcomes

Por: McBride · N. · Clayton · G. L. · Goncalves Soares · A. · Yang · Q. · Bond · T. A. · Taylor · A. · Chatzigeorgiou · C. · Aiton · E. · West · J. · Magnus · M. C. · Lawlor · D. A. · Borges · M. C.
Purpose

Adverse pregnancy and perinatal outcomes (APPOs), including pre-term birth, pre-eclampsia and gestational diabetes, can result in maternal and neonatal morbidity and mortality, parental anxiety and increased healthcare costs. A better understanding of the causes of APPOs is essential to inform lifestyle and pharmaceutical interventions for their prevention and management. Given the difficulty of undertaking randomised controlled trials in pregnant women, triangulating evidence from across methods with different sources of bias may improve causal inference for APPOs. The purpose of the Mendelian randomisation in pregnancy (MR-PREG) collaboration is to support such triangulation using genetic (eg, Mendelian randomisation (MR)) and non-genetic (eg, partner negative controls) approaches to investigate the causal effects of maternal exposures on a comprehensive set of APPOs.

Participants

The MR-PREG collaboration includes individual participant data from three birth cohorts (two from the UK and one from Norway) and UK Biobank, as well as summary data from FinnGen and publicly available genome-wide association studies (GWAS). Data have been harmonised across studies and currently include information on up to 35 APPOs in up to 707 797 women.

Findings to date

The main aims of MR-PREG are to strengthen the evidence base for (1) prevention, by advancing understanding of maternal lifestyle factors on APPOs, (2) the role of pre-conceptional health, by improving understanding of the effect of maternal pre-existing conditions on APPOs, and (3) treatments, by evaluating the efficacy and safety of existing medications used for pre-existing conditions, and by identifying and testing novel or repurposed therapies for APPOs. To date, our published work has mainly addressed aims 1 and 3. Examples include triangulation of evidence from MR, conventional multivariable regression and paternal negative control, showing that higher maternal body mass index increases the risk of multiple APPOs, as well as the identification of maternal circulating metabolites and proteins that may influence birth weight.

Future plans

Future priorities include increasing diversity within the MR-PREG collaboration by expanding representation of participants from non-European ancestries. We are also integrating molecular data, including circulating protein levels and placental transcriptomics, to better characterise the molecular mechanisms underlying APPOs. Additionally, we are using whole-exome and whole-genome sequencing to identify novel causal genes and to inform the prioritisation of candidate therapeutic targets for APPOs.

Prognosis of drug-related hospital admissions in older adults in an acute-care geriatric unit: a prospective cohort study

Por: Lomba Goncalves · N. · Dauny · V. · Cochard · A. · Genet · B. · Bannelier · H. · Phagouape · J. · Simon-Tillaux · N. · Boutitie · L. · Boddaert · J. · Minaud · A. · Zerah · L.
Objectives

Drug-related hospital admissions (DRAs) are prevalent among older adults, with a substantial proportion deemed preventable. Despite their frequency, little is known about the prognosis of DRAs in this population, particularly concerning mortality and hospital readmissions. The objectives were to assess the prognosis of DRAs in older patients, focusing on 6-month mortality and unplanned readmissions.

Design

Prospective cohort study.

Setting

A 20-bed acute-care geriatric unit within an academic hospital.

Participants

All patients aged 75 years or older hospitalised in the unit during 2023.

Primary and secondary outcome measures

The primary outcome was 6-month all-cause mortality. The secondary outcome was the rate of unplanned hospital readmissions, including emergency department visits, within 6 months. DRAs were identified using a two-step standardised review process. Kaplan–Meier survival curves and Cox proportional hazards models were used to estimate hazard ratios (HRs) for mortality. Fine and Grey competing risk models were applied for the analysis of unplanned readmissions. Multivariable models adjusted for age, sex, Charlson Comorbidity Index, medication count, activities of daily living score, long-term care residency and prior hospitalisations.

Results

Among 483 patients included (median age 86 years [IQR 81–91]), 207 (43%) were admitted for a DRA. At 6 months, mortality was significantly lower in patients with DRAs compared with those without (19% [n=39] vs 37% [n=102]; p

Conclusions

DRAs have a distinct prognosis as compared with other causes of admission among older patients. Identifying and managing DRAs are crucial for minimising preventable complications in this vulnerable population.

Telenursing practice in the care of patients with surgical cancer: a scoping review

Por: Mozer · C. A. d. N. · Goncalves · J. d. C. · Rozetti · C. M. T. · Carvalho · R. d. · Fiorin · B. H. · Furieri · L. B. · Fioresi · M.
Objectives

Surgical oncology patients often experience doubts and uncertainties in the preoperative and postoperative periods, which can be addressed remotely through telenursing. Expanding telenursing services could contribute to more comprehensive perioperative care. We conducted a scoping review to characterise these telenursing services, identify their outcome indicators and examine the content of the care delivered.

Design

A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) recommendations.

Data sources

MEDLINE (PubMed), EMBASE, CINAHL, SCOPUS, Web of Science and Virtual Health Library (VHL), with searches performed up to 5 May 2025.

Eligibility criteria for selecting studies

We included studies that implemented telenursing interventions in the preoperative or postoperative period in adult oncology patients.

Data extraction and synthesis

Two independent reviewers used a standardised search to select and extract data from the included studies. Study characteristics were presented descriptively using absolute and relative frequencies, and the content of telenursing interventions was organised into a circular thematic matrix.

Results

A total of 37 studies were included, published between 1996 and 2024, conducted in 12 countries and primarily focused on postoperative telenursing via telephone or video calls. Preoperative care focused on psychosocial support and guidance related to surgical preparation. Postoperative topics included surgical wound care; handling of devices such as drains, ostomy bags and catheters; instructions for returning to work and support groups for financial and social assistance. Outcome indicators were primarily related to care, including levels of anxiety, stress, depression and quality of life.

Conclusions

Oncologic surgical telenursing remains primarily focused on postoperative care and the delivery of personalised support. Reporting on the protocols used, frequency and duration of sessions, nurse training and profiles, integration with in-person care workflows and operational cost data could strengthen the knowledge base for perioperative telenursing in oncology.

Asthma self-knowledge patient-reported outcome measures for the paediatric population with asthma: a systematic review protocol

Por: Goncalves · A. S. · Simoes · P. A. · Gama · J. M. R. · Jacome · C. · Maricoto · T.
Introduction

Asthma is a major personal and public health problem worldwide, with a significant impact on patients’ quality of life and health systems. The prevalence of asthma in children is 9.1% and in adolescents is 11%. Greater literacy among children is related to better asthma control. There are many validated Patient-Reported Outcome Measures (PROMs) related to asthma, but there are only a few, and no gold standard, to measure children and adolescents’ knowledge of asthma. Therefore, the purpose of this systematic review is to evaluate the most suitable asthma self-knowledge PROMs for the paediatric population with asthma.

Methods and analysis

The inclusion criteria will be children and adolescents diagnosed with asthma (population), validated PROMs about asthma self-knowledge (intervention), between each PROM (comparison) and measurement properties (outcome) (validity, reliability, interpretability and responsiveness). The search process will be conducted in PubMed, Web of Science, EMBASE and SCOPUS. The risk of bias evaluation will be done independently by two authors with the COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist, and the quality of evidence will be evaluated based on the Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination

Ethics approval is not applicable for this study since the data that will be collected are secondary data and are already in the public domain. The results will be disseminated through peer-reviewed publication and conference presentations.

PROSPERO registration number

CRD42024577500.

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