José Ponte | University of Algarve. Faro. Portugal (original) (raw)
Papers by José Ponte
![Research paper thumbnail of [The New Medical Licensing Examination in Portugal: A Gigantic Millimeter Leap]](https://attachments.academia-assets.com/86302982/thumbnails/1.jpg)
](Acta medica portuguesa, 2018
Anesthesiology, 2001
Background Thromboelastography is used for assessment of hemostasis. Adherence to thromboelastogr... more Background Thromboelastography is used for assessment of hemostasis. Adherence to thromboelastography-guided algorithms and aprotinin administration each decrease bleeding and blood product usage after cardiac surgery. Aprotinin, through inhibition of kallikrein, causes prolongation of the celite-activated clotting time and the activated partial thromboplastin ratio. The aim of this study was to assess the effects of aprotinin on the thromboelastography trace. Methods Three activators were used in the thromboelastography: celite (which is widely established), kaolin, and tissue factor. Assessment was performed on blood from volunteers and from patients before and after cardiac surgery. Results The tissue factor-activated thromboelastography trace was unaffected by the addition of aprotinin. When celite and kaolin were used as activators in the presence of aprotinin, the reaction time (time to clot formation) of the thromboelastography trace was prolonged (P < 0.0001) and the maxi...
Part 1 Anaesthesia and perioperative 1. Survey of anaesthetic techniques historical notes. 2. Pri... more Part 1 Anaesthesia and perioperative 1. Survey of anaesthetic techniques historical notes. 2. Principles of pharmacology and autonomic physiology relevant to anaesthesia in intensive care. 3. Pre-operative management: assessment and premedication. 4. The process of anaesthesia: the doctor's and the patient's perception. 5. Peri-operative fluid management: blood and colloid administration coagulation disorders. 6. Perioperative drugs. 7. Postoperative nausea and vomiting and the stress response to surgery. 8. The "nuts and bolts" of anaesthetic machines, tubes, ventilators, infusion pumps and defibrillators. 9. Practical aspects: airway, drips and chest drains. 10. Monitoring: Blood pressures and electrocardiogram, pulse oximetry, capnograph and temperature. 11. Accidents and complications of anaesthesia and surgery. 12. Special problems in anaesthesia. Part 2 Pain management and local analgesic techniques 13. Approaches to management of acute and chronic pain. 14. ...
Medical teacher, 2016
Many internal and external obstacles, must be overcome when establishing a new medical school, or... more Many internal and external obstacles, must be overcome when establishing a new medical school, or when radically revising an existing medical curriculum. Twenty-five years after the Flinders University curriculum was introduced as the first graduate-entry medical programme (GEMP) in Australia, we aim at describing how it has been adopted and adapted by several other schools, in Australia and in Europe (UK, Ireland, and Portugal). This paper reports on the experience of four schools establishing a new medical school or new curriculum at different times and in different settings. We believe that these experiences might be of interest to others contemplating a similar development.
Perspectives on Medical Education, 2014
Studies conducted in medical education show that personality influences undergraduate medical stu... more Studies conducted in medical education show that personality influences undergraduate medical students academic and clinical performances and also their career interests. Our aims with this exploratory study were: to assess the contribution of graduate entry students to the diversity of personality in medical student populations; to assess whether eventual differences may be explained by programme structure or student age and sex. We performed a cross-sectional study underpinned by the five-factor model of personality, with students attending three medical schools in Portugal. The five personality dimensions were assessed with the Portuguese version of the NEO-Five Factor Inventory. MANOVA and MANCOVA analyses were performed to clarify the contributions of school, programme structure, age and sex. Student personality dimensions were significantly different between the three medical schools [F (10,1026) = 3.159, p \ .001, g 2 p = 0.03, p = 0.987]. However, taking sex and age into account the differences became non-significant. There were Pedro Marvão, Isabel Neto, Patrício Costa, Manuel João Costa have contributed equally to this work. institutional differences in personality dimensions. However, those were primarily accounted for by sex and age effects and not by the medical school attended. Diversifying age and sex of the admitted students will diversify the personality of the medical student population.
Journal of Cardiothoracic and Vascular Anesthesia, 1998
Current Opinion in Anaesthesiology, 1995
British Journal of Anaesthesia, 2004
Background. Using algorithms based on point of care coagulation tests can decrease blood loss and... more Background. Using algorithms based on point of care coagulation tests can decrease blood loss and blood component transfusion after cardiac surgery. We wished to test the hypothesis that a management algorithm based on near-patient tests would reduce blood loss and blood component use after routine coronary artery surgery with cardiopulmonary bypass when compared with an algorithm based on routine laboratory assays or with clinical judgement.
The Annals of Thoracic Surgery, 2005
1. Trotter TH, Knott-Craig CJ, Ward KE. Blunt injury rupture of tricuspid valve and right coronar... more 1. Trotter TH, Knott-Craig CJ, Ward KE. Blunt injury rupture of tricuspid valve and right coronary artery. Ann Thorac Surg 1998;66:1814 -6. 2. Pringle SD, Davidson KG. Myocardial infarction caused by coronary artery damage from blunt chest injury. Br Heart J 1987;57:375-6. 3. Patel R, Samaha FF. Right coronary artery occlusion caused by blunt trauma.
Anesthesia & Analgesia, 2000
Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, po... more Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, possibly because of differences in end-tidal CO(2) concentrations. We studied the effect of isoflurane on the hypoxic chemosensitivity of carotid body chemoreceptors at three different PaCO(2) levels before and during the administration of 1.0% isoflurane (0.5 minimum alveolar anesthetic concentration) in six normothermic New Zealand white rabbits anesthetized with thiopental. The response of the chemoreceptors was fitted to the equation: Frequency (Hz) = a + b x PaCO(2) + c x (1/PaO(2)) + Dx (1/PaO(2))(2). Mean values for the coefficients a, b, c and d for the control state were -4.5, 0.13, 771, and 6332, respectively. This relationship was not changed by addition of isoflurane at 1.0% end-tidal concentration (P = 0.40, analysis of variance). We conclude that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic response of rabbit carotid body chemoreceptors during either hypo-, normo-, or hypercapnia. By measuring single-fiber chemoreceptor activity in anesthetized rabbits, we showed that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic chemosensitivity of peripheral chemoreceptors during either hypo-, normo-, or hypercapnia in this species.
British Journal of Anaesthesia, 2004
Background. Using algorithms based on point of care coagulation tests can decrease blood loss and... more Background. Using algorithms based on point of care coagulation tests can decrease blood loss and blood component transfusion after cardiac surgery. We wished to test the hypothesis that a management algorithm based on near-patient tests would reduce blood loss and blood component use after routine coronary artery surgery with cardiopulmonary bypass when compared with an algorithm based on routine laboratory assays or with clinical judgement.
The respiratory responses to intravenous morphine sulphate (0.12 mg/kg), morphine-6-glucuronide (... more The respiratory responses to intravenous morphine sulphate (0.12 mg/kg), morphine-6-glucuronide (M6G: 0.03 mg/kg) and placebo were assessed in 6 healthy volunteers, using a single blind randomised crossover design. Five of these subjects underwent an additional study of M6G at 0.06 mg/kg. Respiratory rate, minute volume and end-tidal CO2 were continuously measured using a low resistance non-rebreathing circuit, a mass spectrometer and a dry gas meter. The ventilatory responses to CO2 exposures (5.5% for 4 min) were assessed 40 and 20 min before, and 20, 40 and 80 min after drug administration. Following placebo and M6G (at both doses) no change in end-tidal CO2 occurred whilst the subjects were breathing air, whereas following morphine a significant rise was seen (P less than 0.05). Morphine reduced the ventilatory response to 5.5% CO2 at all times tested (P less than 0.05) and M6G (at both doses) reduced the response to CO2 at 20 and 40 min after administration, but to a lesser degree than did morphine (P less than 0.05).
Anesthesia & Analgesia, 2000
Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, po... more Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, possibly because of differences in end-tidal CO(2) concentrations. We studied the effect of isoflurane on the hypoxic chemosensitivity of carotid body chemoreceptors at three different PaCO(2) levels before and during the administration of 1.0% isoflurane (0.5 minimum alveolar anesthetic concentration) in six normothermic New Zealand white rabbits anesthetized with thiopental. The response of the chemoreceptors was fitted to the equation: Frequency (Hz) = a + b x PaCO(2) + c x (1/PaO(2)) + Dx (1/PaO(2))(2). Mean values for the coefficients a, b, c and d for the control state were -4.5, 0.13, 771, and 6332, respectively. This relationship was not changed by addition of isoflurane at 1.0% end-tidal concentration (P = 0.40, analysis of variance). We conclude that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic response of rabbit carotid body chemoreceptors during either hypo-, normo-, or hypercapnia. By measuring single-fiber chemoreceptor activity in anesthetized rabbits, we showed that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic chemosensitivity of peripheral chemoreceptors during either hypo-, normo-, or hypercapnia in this species.
American Journal of Respiratory and Critical Care Medicine, 2001
To be most effective, noninvasive ventilation (NIV) ventilators should synchronize well with pati... more To be most effective, noninvasive ventilation (NIV) ventilators should synchronize well with patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; breathing. However, the speed with which different ventilators can respond to the transitions between inspiration and expiration may vary, and abnormal respiratory mechanics and mask leaks may exacerbate this problem. This study explored synchronization using a new test lung model designed to simulate acute exacerbations of chronic obstructive pulmonary disease (COPD). Thirteen ventilators were tested against different combinations of tidal volume (VT), airways resistance (Raw), FRC, and mask leak. These combinations ranged from those of a severe exacerbation of COPD, to a mild condition reflecting the optimal triggering conditions a ventilator is likely to encounter. The triggering delays from the beginning and end of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;inspiration&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of the test lung, to the appropriate responses from the ventilators were measured. Three of the ventilators had trigger delays less than approximately 120 ms at both the beginning and end of expiration under all conditions. Trigger delays of other ventilators were mainly in the range of 120 to 300 ms, although exceptionally as long as 500 ms. Varying the conditions had a variable but generally small effect on triggering times, suggesting that there is a largely unavoidable element to the triggering delays intrinsic to the design of the ventilators.
Acta Anaesthesiologica Scandinavica, 1996
Acta medica portuguesa, 2018
Anesthesiology, 2001
Background Thromboelastography is used for assessment of hemostasis. Adherence to thromboelastogr... more Background Thromboelastography is used for assessment of hemostasis. Adherence to thromboelastography-guided algorithms and aprotinin administration each decrease bleeding and blood product usage after cardiac surgery. Aprotinin, through inhibition of kallikrein, causes prolongation of the celite-activated clotting time and the activated partial thromboplastin ratio. The aim of this study was to assess the effects of aprotinin on the thromboelastography trace. Methods Three activators were used in the thromboelastography: celite (which is widely established), kaolin, and tissue factor. Assessment was performed on blood from volunteers and from patients before and after cardiac surgery. Results The tissue factor-activated thromboelastography trace was unaffected by the addition of aprotinin. When celite and kaolin were used as activators in the presence of aprotinin, the reaction time (time to clot formation) of the thromboelastography trace was prolonged (P < 0.0001) and the maxi...
Part 1 Anaesthesia and perioperative 1. Survey of anaesthetic techniques historical notes. 2. Pri... more Part 1 Anaesthesia and perioperative 1. Survey of anaesthetic techniques historical notes. 2. Principles of pharmacology and autonomic physiology relevant to anaesthesia in intensive care. 3. Pre-operative management: assessment and premedication. 4. The process of anaesthesia: the doctor's and the patient's perception. 5. Peri-operative fluid management: blood and colloid administration coagulation disorders. 6. Perioperative drugs. 7. Postoperative nausea and vomiting and the stress response to surgery. 8. The "nuts and bolts" of anaesthetic machines, tubes, ventilators, infusion pumps and defibrillators. 9. Practical aspects: airway, drips and chest drains. 10. Monitoring: Blood pressures and electrocardiogram, pulse oximetry, capnograph and temperature. 11. Accidents and complications of anaesthesia and surgery. 12. Special problems in anaesthesia. Part 2 Pain management and local analgesic techniques 13. Approaches to management of acute and chronic pain. 14. ...
Medical teacher, 2016
Many internal and external obstacles, must be overcome when establishing a new medical school, or... more Many internal and external obstacles, must be overcome when establishing a new medical school, or when radically revising an existing medical curriculum. Twenty-five years after the Flinders University curriculum was introduced as the first graduate-entry medical programme (GEMP) in Australia, we aim at describing how it has been adopted and adapted by several other schools, in Australia and in Europe (UK, Ireland, and Portugal). This paper reports on the experience of four schools establishing a new medical school or new curriculum at different times and in different settings. We believe that these experiences might be of interest to others contemplating a similar development.
Perspectives on Medical Education, 2014
Studies conducted in medical education show that personality influences undergraduate medical stu... more Studies conducted in medical education show that personality influences undergraduate medical students academic and clinical performances and also their career interests. Our aims with this exploratory study were: to assess the contribution of graduate entry students to the diversity of personality in medical student populations; to assess whether eventual differences may be explained by programme structure or student age and sex. We performed a cross-sectional study underpinned by the five-factor model of personality, with students attending three medical schools in Portugal. The five personality dimensions were assessed with the Portuguese version of the NEO-Five Factor Inventory. MANOVA and MANCOVA analyses were performed to clarify the contributions of school, programme structure, age and sex. Student personality dimensions were significantly different between the three medical schools [F (10,1026) = 3.159, p \ .001, g 2 p = 0.03, p = 0.987]. However, taking sex and age into account the differences became non-significant. There were Pedro Marvão, Isabel Neto, Patrício Costa, Manuel João Costa have contributed equally to this work. institutional differences in personality dimensions. However, those were primarily accounted for by sex and age effects and not by the medical school attended. Diversifying age and sex of the admitted students will diversify the personality of the medical student population.
Journal of Cardiothoracic and Vascular Anesthesia, 1998
Current Opinion in Anaesthesiology, 1995
British Journal of Anaesthesia, 2004
Background. Using algorithms based on point of care coagulation tests can decrease blood loss and... more Background. Using algorithms based on point of care coagulation tests can decrease blood loss and blood component transfusion after cardiac surgery. We wished to test the hypothesis that a management algorithm based on near-patient tests would reduce blood loss and blood component use after routine coronary artery surgery with cardiopulmonary bypass when compared with an algorithm based on routine laboratory assays or with clinical judgement.
The Annals of Thoracic Surgery, 2005
1. Trotter TH, Knott-Craig CJ, Ward KE. Blunt injury rupture of tricuspid valve and right coronar... more 1. Trotter TH, Knott-Craig CJ, Ward KE. Blunt injury rupture of tricuspid valve and right coronary artery. Ann Thorac Surg 1998;66:1814 -6. 2. Pringle SD, Davidson KG. Myocardial infarction caused by coronary artery damage from blunt chest injury. Br Heart J 1987;57:375-6. 3. Patel R, Samaha FF. Right coronary artery occlusion caused by blunt trauma.
Anesthesia & Analgesia, 2000
Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, po... more Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, possibly because of differences in end-tidal CO(2) concentrations. We studied the effect of isoflurane on the hypoxic chemosensitivity of carotid body chemoreceptors at three different PaCO(2) levels before and during the administration of 1.0% isoflurane (0.5 minimum alveolar anesthetic concentration) in six normothermic New Zealand white rabbits anesthetized with thiopental. The response of the chemoreceptors was fitted to the equation: Frequency (Hz) = a + b x PaCO(2) + c x (1/PaO(2)) + Dx (1/PaO(2))(2). Mean values for the coefficients a, b, c and d for the control state were -4.5, 0.13, 771, and 6332, respectively. This relationship was not changed by addition of isoflurane at 1.0% end-tidal concentration (P = 0.40, analysis of variance). We conclude that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic response of rabbit carotid body chemoreceptors during either hypo-, normo-, or hypercapnia. By measuring single-fiber chemoreceptor activity in anesthetized rabbits, we showed that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic chemosensitivity of peripheral chemoreceptors during either hypo-, normo-, or hypercapnia in this species.
British Journal of Anaesthesia, 2004
Background. Using algorithms based on point of care coagulation tests can decrease blood loss and... more Background. Using algorithms based on point of care coagulation tests can decrease blood loss and blood component transfusion after cardiac surgery. We wished to test the hypothesis that a management algorithm based on near-patient tests would reduce blood loss and blood component use after routine coronary artery surgery with cardiopulmonary bypass when compared with an algorithm based on routine laboratory assays or with clinical judgement.
The respiratory responses to intravenous morphine sulphate (0.12 mg/kg), morphine-6-glucuronide (... more The respiratory responses to intravenous morphine sulphate (0.12 mg/kg), morphine-6-glucuronide (M6G: 0.03 mg/kg) and placebo were assessed in 6 healthy volunteers, using a single blind randomised crossover design. Five of these subjects underwent an additional study of M6G at 0.06 mg/kg. Respiratory rate, minute volume and end-tidal CO2 were continuously measured using a low resistance non-rebreathing circuit, a mass spectrometer and a dry gas meter. The ventilatory responses to CO2 exposures (5.5% for 4 min) were assessed 40 and 20 min before, and 20, 40 and 80 min after drug administration. Following placebo and M6G (at both doses) no change in end-tidal CO2 occurred whilst the subjects were breathing air, whereas following morphine a significant rise was seen (P less than 0.05). Morphine reduced the ventilatory response to 5.5% CO2 at all times tested (P less than 0.05) and M6G (at both doses) reduced the response to CO2 at 20 and 40 min after administration, but to a lesser degree than did morphine (P less than 0.05).
Anesthesia & Analgesia, 2000
Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, po... more Whether volatile anesthetics have an effect on the peripheral chemoreceptors is controversial, possibly because of differences in end-tidal CO(2) concentrations. We studied the effect of isoflurane on the hypoxic chemosensitivity of carotid body chemoreceptors at three different PaCO(2) levels before and during the administration of 1.0% isoflurane (0.5 minimum alveolar anesthetic concentration) in six normothermic New Zealand white rabbits anesthetized with thiopental. The response of the chemoreceptors was fitted to the equation: Frequency (Hz) = a + b x PaCO(2) + c x (1/PaO(2)) + Dx (1/PaO(2))(2). Mean values for the coefficients a, b, c and d for the control state were -4.5, 0.13, 771, and 6332, respectively. This relationship was not changed by addition of isoflurane at 1.0% end-tidal concentration (P = 0.40, analysis of variance). We conclude that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic response of rabbit carotid body chemoreceptors during either hypo-, normo-, or hypercapnia. By measuring single-fiber chemoreceptor activity in anesthetized rabbits, we showed that isoflurane at 1.0% end-tidal concentration does not depress the hypoxic chemosensitivity of peripheral chemoreceptors during either hypo-, normo-, or hypercapnia in this species.
American Journal of Respiratory and Critical Care Medicine, 2001
To be most effective, noninvasive ventilation (NIV) ventilators should synchronize well with pati... more To be most effective, noninvasive ventilation (NIV) ventilators should synchronize well with patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; breathing. However, the speed with which different ventilators can respond to the transitions between inspiration and expiration may vary, and abnormal respiratory mechanics and mask leaks may exacerbate this problem. This study explored synchronization using a new test lung model designed to simulate acute exacerbations of chronic obstructive pulmonary disease (COPD). Thirteen ventilators were tested against different combinations of tidal volume (VT), airways resistance (Raw), FRC, and mask leak. These combinations ranged from those of a severe exacerbation of COPD, to a mild condition reflecting the optimal triggering conditions a ventilator is likely to encounter. The triggering delays from the beginning and end of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;inspiration&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of the test lung, to the appropriate responses from the ventilators were measured. Three of the ventilators had trigger delays less than approximately 120 ms at both the beginning and end of expiration under all conditions. Trigger delays of other ventilators were mainly in the range of 120 to 300 ms, although exceptionally as long as 500 ms. Varying the conditions had a variable but generally small effect on triggering times, suggesting that there is a largely unavoidable element to the triggering delays intrinsic to the design of the ventilators.
Acta Anaesthesiologica Scandinavica, 1996