28 resultados para CANCER - ASPECTOS PSICOLOGICOS

em Repositório Científico do Instituto Politécnico de Lisboa - Portugal


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O presente relatório insere-se no âmbito do trabalho final de Mestrado do curso de Engenharia Civil, área de especialização de Estruturas, do Instituto Superior de Engenharia de Lisboa. O estágio realizou-se na área de projecto do núcleo de engenharia de estruturas na empresa Mota-Engil, Engenharia e Construção, S.A. (MEEC) e teve como objectivo o desenvolvimento de competências no âmbito das contenções tipo “Berlim” provisórias utilizada nas escavações, nomeadamente, os seus aspectos de projecto e sua execução. Foi feita uma descrição geral deste tipo de estruturas de contenção onde se discutem as suas características, vantagens e inconvenientes. Descreveu-se e analisou-se um caso de estudo, onde se desenvolveram os aspectos de cálculo com recurso aos métodos clássicos da mecânica dos solos e a um programa de cálculo automático. O programa de cálculo automático utilizado foi o programa PLAXIS, no qual foram criados modelos simples de estruturas de contenção em madeira, e dos quais se obtiveram resultados relativos ao comportamento das estruturas. Procedeu-se ainda a uma breve introdução ao Eurocódigo 7 (EN 1997), referindo-se os estados limites últimos aplicados ao mesmo caso de estudo e destacando-se as principais diferenças que este veio introduzir no cálculo, procedendo-se de seguida a uma breve análise dos resultados obtidos.

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Esta tese teve como finalidade fazer um estudo sobre os edifícios Pré-pombalinos dando especial relevo às patologias que os afectam bem como as técnicas mais adequadas à sua resolução. Fez-se um breve enquadramento deste tipo de edifícios na evolução dos edifícios construídos no país e na cidade de Lisboa, localizando alguns exemplares nos bairros históricos desta cidade. Fez-se também a caracterização da sua arquitectura tentando explicar a sua evolução ao longo de todo o período Pré-pombalino. Ainda dentro da caracterização arquitectónica fez a descrição dos edifícios no que respeita à geometria da sua fachada, do número de pisos, da ocupação dos lotes onde estão implantados e da distribuição e ocupação do seu espaço interior. No que respeita à construção propriamente dita dos referidos edifícios fez-se um levantamento dos materiais e técnicas usados na sua construção bem como a descrição dos diferentes tipos de paredes usadas. Enumeraram-se as principais patologias neste tipo de edifícios, fazendo a sua descrição e referindo a forma como afectam os seus elementos constituintes. Por fim reuniu-se um conjunto de técnicas e procedimentos para a reparação das anomalias mais comuns, fazendo também a indicação dos materiais mais adequados a usar em cada intervenção.

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Objectivo: Identificar os factores psicossociais que influenciam a percepção da dor pós-operatória em doentes submetidos a cirurgia de revascularização do miocárdio (CRM). Material e Métodos: Estudo exploratório correlacional de 91 doentes (71 homens e 20 mulheres) submetidos a CRM (pontagem aortocoronária) por esternotomia). A idade média era de 63,8 ± 9,6 anos (entre 39 e 84). Foram utilizados os seguintes instrumentos: Escala Analógica Visual às 24, 48 e 96 horas do pós-operatório; Questionário de Caracterização Demográfica; Mental Health Inventory de 5 itens; Percepção de Saúde Geral (SF-36); Escala de Expectativas de Dor; Escala de Percepção de Apoio; Escala de Expectativas de Auto-eficácia; Satisfação com o tratamento, médicos e enfermeiros (American Pain Society Questionnaire) aplicados às 96 horas após a cirurgia. Resultados: Os doentes que apresentaram expectativas elevadas de dor, percepcionaram maior apoio, apresentaram níveis elevados de auto-eficácia para lidar com a dor ou, se pertenciam ao sexo masculino, sentiram menos dor. De igual modo, os doentes que apresentaram melhor saúde mental, percepcionaram a sua saúde como boa e os doentes que expressaram maior satisfação com o tratamento sentiram menos dor. A dor não foi influenciada pela idade, grau de escolaridade ou pela satisfação com a conduta de médicos e enfermeiros. Conclusão: Após as primeiras 48 horas do pós-operatório, a experiência de dor é influenciada por factores psicossociais, em oarticular pela expectativa de dor, expectativa de auto-eficácia, apoio percebido, percepção da saúde geral, percepção de saúde mental e satisfação com o tratamento para a dor. Perante os resultados, evidencia-se a necessidade de conjugar conhecimentos no sentido de dar respostas mais alargadas e de carácter multidisciplinar no tratamento da dor pós-operatória em CRM devendo, a par de outros aspectos, focar-se na gestão das expectativas dos doentes. ABSTRACT - Objective: To identify the psychological factors that influence post-surgery pain perception in patients undergoing coronary artery bypass graft surgery (CABG). Methods: This was an exploratory correlational study of 91 patients (71 men and 20 women) who underwent CABG (aortocoronary anastomosis) by sternotomy. Mean age was 63.8 ± 9.6 years (between 39 and 84). The following instruments were used: visual analogical scales at 24, 48 and 96 hours of post-surgery; demographic characteristics survey; pain expectations scale; perceived support scale; self-efficacy scale, Mental Inventory (5 items); health perception scale; and satisfaction with treatment, doctors and nurses (American Pain Society questionnaire) at 96 hours after surgery. Results: Patients who had presented high expectations of pain, perceived more support, presented high levels of self-efficacy to deal with pain or were male, felt less pain. Furthermore, patients who presented better mental health, perceived their general health as being good, or expressed greater satisfaction with treatment, felt less pain. Pain was not influenced by age, level of education or satisfaction with doctors and nurses. Conclusion: After the first 48 hours following surgery, the pain experience is influenced by psychosocial factors, in particular by expectation of pain and of self-efficacy, perceived support, perception of general and mental health, and satisfaction with pain treatment. The results confirm the need to bring together different kinds of knowledge for a broad, multidisciplinary approach to postoperative CABG pain treatment, focusing, along with other aspects, on management of patients’ expectations.

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A dor é uma das experiência humanas mais importantes, sendo basicamente uma experiência emocional. Os conhecimentos actuais sobre a importância e riqueza dos fenómenos psicológicos perante o acto cirúrgico evidenciam a necessidade de uma preparação psicológica cuidada. A intervenção psicológica, do psicólogo a par com os restantes profissionais deve focar a gestão das expectativas do doente dado que a dor é um dos aspectos deletérios da intervenção cirúrgica mais salientes. Objectivo do estudo - Identificar quais os factores psicossociais associados à percepção de dor, num grupo de doentes cardíacos, recentemente submetidos a intervenção cirúrgica.

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Esta ponencia presenta un estudio de las principales líneas teóricas existentes sobre la gestión, la teoría de los costes de transacción, la de los recursos y capacidades y la teoría de la KM. Se desarrollan las aportaciones más importantes sobre el aprendizaje en las organizaciones realizadas por la literatura especializada. Seguidamente y a partir de la bibliografía analizada se establecen las relaciones existentes entre la cooperación interempresarial y la creación de conocimiento organizacional en el seno de las empresas, para determinar que se debe medir en el aprendizaje organizativo en acuerdos de cooperación interempresarial.

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Since last decade, the debate on the parameter which reflects prostate cancer sensitivity to fractionation in a radiotherapy treatment, the α/β, has become extensive. Unlike most tumors, the low labeling indices (LI) and large potential doubling time that characterize the prostate tumor led some authors to consider that it may behave as a late responding tissue. So far, the existing studies with regard to this subject point to a low value of α/β, around 2.7 Gy, which may be considered as a therapeutic gain in relation to surrounding normal tissues by using fewer and larger fractions. The aim of this paper is to review several estimates that have been made in the last few years regarding the prostate cancer α/β both from clinical and experimental data, as well as the set of factors that have potentially influenced these evaluations.

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Will the existing means in Radiotherapy respond to the needs of the potential user population in 2014 for Lisbon and Santarém districts? Number of treatment units? Number of Radiotherapy Technologists? Temporal variations of the dimension and age structure of the populations: Coastal areas/Interior areas, Urban areas/Rural areas. Temporal variations in the incidence of several types of cancer. Overall objectives: evaluate of the necessities of Radiotherapy for Lisbon and Santarém districts in 2014 and elaboration of proposals that aim the access/use for the potential user population.

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Objective: To evaluate the influence of Everolimus (RAD001) on chemically induced urothelial lesions in mice and its influence on in vitro human bladder cancer cell lines. Methods: ICR male mice were given N-butyl-N-(4-hydroxybutyl) nitrosamine in drinking water for a period of 12 weeks. Subsequently, RAD001 was administered via oral gavage, for 6 weeks. At the end of the experiment, all the animals were sacrificed and tumor development was determined by means of histopathologic evaluation; mammalian target of rapamycin (mTOR) expressivity was evaluated by immunohistochemistry. Three human bladder cancer cell lines (T24, HT1376, and 5637) were treated using a range of RAD001 concentrations. MTT assay, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and flow cytometry were used to assess cell proliferation, apoptosis index, and cell cycle analysis, respectively. Immunoblotting analysis of 3 cell line extracts using mTOR and Akt antibodies was performed in order to study the expression of Akt and mTOR proteins and their phosphorylated forms. Results: The incidence of urothelial lesions in animals treated with RAD001 was similar to those animals not treated. RAD001 did not block T24 and HT1376 cell proliferation or induce apoptosis. A reduction in cell proliferation rate and therefore G0/G1 phase arrest, as well as a statistically significant induction of apoptosis (P 0.001), was only observed in the 5637 cell line. Conclusion: RAD001 seems not to have a significant effect on chemically induced murine bladder tumors. The effect of RAD001 on tumor proliferation and apoptosis was achieved only in superficial derived bladder cancer cell line, no effect was observed in invasive cell lines.

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Purpose/Objective: The purpose of this work was to determine biologically equivalent alternative regimens for the treatment of prostate cancer using External Beam Radiotherapy (EBRT) and Low Dose-Rate Brachytherapy (LDRBT) with 125I implants and to evaluate the sensitivity of these regimens to different sets of radiobiological parameters of the Linear-Quadratic (LQ) model.

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Background: There are now several lines of evidence to suggest that protein synthesis and translation factors are involved in the regulation of cell proliferation and cancer development. Aims: To investigate gene expression patterns of eukaryotic releasing factor 3 (eRF3) in gastric cancer. Methods: RNA was prepared from 25 gastric tumour biopsies and adjacent non-neoplastic mucosa. Real time TaqMan reverse transcription polymerase chain reaction (RT-PCR) was performed to measure the relative gene expression levels. DNA was isolated from tumour and normal tissues and gene dosage was determined by a quantitative real time PCR using SYBR Green dye. Results: Different histological types of gastric tumours were analysed and nine of the 25 tumours revealed eRF3/GSPT1 overexpression; moreover, eight of the 12 intestinal type carcinomas analysed overexpressed the gene, whereas eRF3/GSPT1 was overexpressed in only one of the 10 diffuse type carcinomas (Kruskal-Wallis Test; p , 0.05). No correlation was found between ploidy and transcript expression levels of eRF3/GSPT1. Overexpression of eRF3/GSPT1 was not associated with increased translation rates because the upregulation of eRF3/GSPT1 did not correlate with increased eRF1 levels. Conclusions: Overexpression of eRF3/GSPT1 in intestinal type gastric tumours may lead to an increase in the translation efficiency of specific oncogenic transcripts. Alternatively, eRF3/GSPT1 may be involved in tumorigenesis as a result of its non-translational roles, namely (dis)regulating the cell cycle, apoptosis, or transcription.

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Quando alguém é afectado por uma doença crónica tem que alterar o seu estilo de vida de modo a poder viver o melhor possível com a doença que o vai acompanhar, se não durante toda a vida, pelo menos durante grande parte da vida. Em função das características pessoais e da interacção como o meio envolvente, social e físico, alguns ajustar-se-ão melhor e mais facilmente do que outros. Estas alterações denominam-se Ajustamento ou Adaptação. Embora estes termos sejam sinónimos, por vezes a denominação expressa orientação teórica diferente: a primeira, mais interactiva, para designar o comportamento resultante dessa interacção, momento a momento, com o meio envolvente, a segunda mais estrutural. “Ajustamento” é um termo do senso comum, utilizado na linguagem de todos os dias. O dicionário diz que ajustamento e adaptação são sinónimos e, em contexto de psicologia, saúde e doenças, os dois termos também são utilizados como sinónimos. No entanto, na psicologia, por vezes, estes termos podem expressar conceitos diferentes, consoante a orientação teórica que os utiliza. O interesse pela mudança subjacente ao ajustamento ou à adaptação considera dois aspectos: a estrutura e o processo. A estrutura refere-se a factores estáveis tais como a traços de personalidade ou estrutura cognitiva e, também, a características estáveis do meio ambiente, enquanto o processo refere-se às mudanças que vão ocorrendo em consequência das interacções, momento a momento, com as situações que surgem, explicam Lazarus e Folkman (1985).

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Background: The eukaryotic release factor 3 (eRF3) has been shown to affect both tubulin and actin cytoskeleton, suggesting a role in cytoskeleton assembly, mitotic spindle formation and chromosome segregation. Also, direct interactions between eRF3 and subunits of the cytosolic chaperonin CCT have been described. Moreover, both eRF3a and CCT subunits have been described to be up-regulated in cancer tissues. Our aim was to evaluate the hypothesis that eRF3 expression levels are correlated with the expression of genes encoding proteins involved in the tubulin folding pathways. Methods: Relative expression levels of eRF1, eRF3a/GSPT1, PFDN4, CCT2, CCT4, and TBCA genes in tumour samples relative to their adjacent normal tissues were investigated using real time-polymerase chain reaction in 20 gastric cancer patients. Results: The expression levels of eRF3a/GSPT1 were not correlated with the expression levels of the other genes studied. However, significant correlations were detected between the other genes, both within intestinal and diffuse type tumours. Conclusions: eRF3a/GSPT1 expression at the mRNA level is independent from both cell translation rates and from the expression of the genes involved in tubulin-folding pathways. The differences in the patterns of expression of the genes studied support the hypothesis of genetically independent pathways in the origin of intestinal and diffuse type gastric tumours.

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Background: Polymorphisms located in genes involved in the metabolism of folate and some methyl-related nutrients are implicated in colorectal cancer (CRC). Objective: We evaluated the association of 3 genetic polymorphisms [C677T MTHFR (methylene tetrahydrofolate reductase), A2756G MTR (methionine synthase), and C1420T SHMT (serine hydroxymethyltransferase)] with the intake of methyl-donor nutrients in CRC risk. Design: Patients withCRC(n 196) and healthy controls (n 200) matched for age and sex were evaluated for intake of methyl-donor nutrients and the 3 polymorphisms. Results: Except for folate intake, which was significantly lower in patients (P 0.02), no differences were observed in the dietary intake of other methyl-donor nutrients between groups. High intake of folate ( 406.7 g/d) was associated with a significantly lower risk of CRC (odds ratio: 0.67; 95% CI: 0.45, 0.99). The A2756G MTR polymorphism was not associated with the risk of developing CRC. In contrast, homozygosity for the C677TMTHFRvariant (TT) presented a 3.0-fold increased risk of CRC (95% CI: 1.3, 6.7). Similarly, homozygosity for the C1420T SHMT polymorphism also had a 2.6-fold increased risk (95% CI: 1.1, 5.9) of developing CRC. When interactions between variables were studied, low intake of all methyl-donor nutrients was associated with an increased risk ofCRC in homozygous participants for the C677T MTHFR polymorphism, but a statistically significant interaction was only observed for folate (odds ratio: 14.0; 95% CI: 1.8, 108.5). No significant associations were seen for MTR or SHMT polymorphisms. Conclusion: These results show an association between the C677T MTHFR variant and different folate intakes on risk of CRC.

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Background: CDC25 phosphatases control cell cycle progression by activating cyclin dependent kinases. The three CDC25 isoforms encoding genes are submitted to alternative splicing events which generate at least two variants for CDC25A and five for both CDC25B and CDC25C. An over-expression of CDC25 was reported in several types of cancer, including breast cancer, and is often associated with a poor prognosis. Nevertheless, most of the previous studies did not address the expression of CDC25 splice variants. Here, we evaluated CDC25 spliced transcripts expression in anti-cancerous drug-sensitive and resistant breast cancer cell lines in order to identify potential breast cancer biomarkers. Methods: CDC25 splice variants mRNA levels were evaluated by semi-quantitative RT-PCR and by an original real-time RT-PCR assay. Results: CDC25 spliced transcripts are differentially expres-sed in the breast cancer cell lines studied. An up-regulation of CDC25A2 variant and an increase of the CDC25C5/C1 ratio are associated to the multidrug-resistance in VCREMS and DOXOR breast cancer cells, compared to their sensitive counterpart cell line MCF-7. Additionally, CDC25B2 tran-script is exclusively over-expressed in VCREMS resistant cells and could therefore be involved in the development of certain type of drug resistance. Conclusions: CDC25 splice variants could represent interesting potential breast cancer prognostic biomarkers.

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The human eukaryotic release factor 3a (eRF3a), encoded by the G1 to S phase transition 1 gene (GSPT1; alias eRF3a), is upregulated in various human cancers. GSPT1 contains a GGCn polymorphism in exon 1, encoding a polyglycine expansion in the N-terminal of the protein. The longer allele, GGC12, was previously shown to be associated to cancer. The GGC12 allele was present in 2.2% of colorectal cancer patients but was absent in Crohn disease patients and in the control group. Real-time quantitative RT-PCR analysis showed that the GGC12 allele was present at up to 10-fold higher transcription levels than the GGC10 allele (P < 0.001). No GSPT1 amplifications were detected, and there was no correlation between the length of the alleles and methylation levels of the CpG sites inside the GGC expansion. Using flow cytometry, we compared the levels of apoptosis and proliferation rates between cell lines with different genotypes, but detected no significant differences. Finally, we used a cytokinesis-block micronucleus assay to evaluate the frequency of micronuclei in the same cell lines. Cell lines with the longer alleles had higher frequencies of micronuclei in binucleated cells, which is probably a result of defects in mitotic spindle formation. Altogether, these findings indicate that GSPT1 should be considered a potential proto-oncogene.