A biosignal embedded system for physiological computing

Thesis submitted in the fulfilment of the requirements for the Degree of Master in Electronic and Telecomunications Engineering

A supervised versus home-based program effects on liver transplanted familial amyloidotic polyneuropathy patients: walking, fatigue and quality of life

Purpose: To evaluate the effects of a six months exercise training program on walking capacity, fatigue and health related quality of life (HRQL). Relevance: Familial amyloidotic polyneuropathy disease (FAP) is an autossomic neurodegenerative disease, related with systemic deposition of amyloidal fibre mainly on peripheral nervous system and mainly produced in the liver. FAP often results in severe functional limitations. Liver transplantation is used as the only therapy so far, that stop the progression of some aspects of this disease. Transplantation requires aggressive medication which impairs muscle metabolism and associated to surgery process and previous possible functional impairments, could lead to serious deconditioning. Reports of fatigue are common feature in transplanted patients. The effect of supervised or home-based exercise training programs in FAP patients after a liver transplant (FAPTX) is currently unknown.

Comparison of body fat content and distribution of familial amyloidotic polyneuropathy patients versus healthy subjects

The deposition of amyloid fibers at the peripheral nervous system can induce motor neuropathy in Familial Amiloidotic Polyneuropethy (FAP) patients. This produces progressive reductions in functional capacity. The only treatment for FAP is a liver transplant, followed by aggressive medication that can affect patients' metabolism. To our knowledge, there are no data on body fat distribution or comparison between healthy and FAP subjects, which may be important for clinical assessment and management of this disease. PURPOSE: To analyze body fat content and distribution between FAP patients and healthy subjects. METHODS: Body fat content and distribution were measured through Double Energy X-ray Densitometry (DXA) in two groups. Group 1 consisted of 43 Familial Amyloidotic Polyneuropathy patients (19 males, 32 + 8 Yrs, and 24 females, 37 + 5 yrs), who had liver transplant less than 2 months before. Group 2 consisted of 18 healthy subjects of similar age (8 males, 36 + 7 yrs, and 10 females, 39 + 5 yrs). RESULTS: Healthy subjects showed higher values than FAP patients for: BMI (24,2+2,3kg/m2 vs 22,3+3,8 kg/m2 respectively, p<0,05), % trunk BF (26,21+8,34kg vs 20,78+9,05kg respectively, p<0,05), % visceral BF (24,43+7,97% vs 19,21+9,30% respectively, p<0,05), % abdominal BF (26,63+8,51% vs 20,63+10,35% respectively, p<0,05) abdominal subcutaneous BF (0,533+0,421kg vs 0,353+0,257kg respectively, p=0,05), abdominal BF/BF ratio (0,09+0,02 vs 0,08+0,02 respectively, p<0,05) and abdominal BF/trunk BF ratio (0,19+0,03 vs 0,17+0,03 respectively, p<0,05). CONCLUSIONS: These results showed that FAP patients soon after liver transplantation exhibited a healthier body fat profile compared to controls. However, fat content and distribution varied widely in FAP subjects, suggesting an individualized approach for assessment and intervention rather than general guidelines. Future research is needed to investigate the long term consequences on body fat following liver transplant in this population.

Comparison of body fat content and distribution of familial amyloidotic polyneuropathy patients versus healthy subjects

The deposition of amyloid fibers at the peripheral nervous system can induce motor neuropathy in Familial Amiloidotic Polyneuropethy (FAP) patients. This produces progressive reductions in functional capacity. The only treatment for FAP is a liver transplant, followed by aggressive medication that can affect patients' metabolism. To our knowledge, there are no data on body fat distribution or comparison between healthy and FAP subjects, which may be important for clinical assessment and management of this disease.

Strength, muscle quality and functional capacity in liver transplanted familial amyloidotic polineuropathy patients

Liver transplantation is the unique treatment for several end-stage diseases. Familial Amiloidotic Polineuropathy (FAP) is a neurodegenerative disease related with systemic deposition of amyloidal fiber mainly on peripheral nervous system, clinically translated by an autonomous sensitive-motor neuropathy with severe functional limitations in some cases. The unique treatment for FAP disease is a liver transplant with a very aggressive medication to muscle metabolism and force production. To our knowledge there are no quantitative characterizations of body composition, strength or functional capacity in this population.

Peak force in familial amyloidotic polyneuropathy

Familial Amyloidotic Polyneuropathy FAP)- A neurodegenerative disease related with systemic deposition of amyloid fibers mainly at the level of the peripheral nervous system. Clinically, the disease is characterized by an autonomous sensitive-motor neuropathy, beginning nearly always in foot, and subsequently involving the hands. Purpose: Compare the levels of hand grip strength (peak force) in FAP patients with (FAPT) or without (FAPNT) liver transplant and in a healthy group (HG).

A supervised versus home-based program effects on liver transplanted familial amyloidotic polyneuropathy patients: walking, fatigue and quality of life

Familial amyloidotic polyneuropathy is a systemic deposition of amyloidal fibre mainly on peripheral nervous system (but also in other systems like heart, gastrointestinal tract, kidneys, etc) and mainly produced in the liver. Purpose of this study: to evaluate the effects of a six months exercise training program(supervised or home-based) on walking capacity, fatigue and health related quality of life (HRQL) on Familial Amyloidotic Polyneuropathy patients submitted to a liver transplant.

Occupational exposure to volatile organic compounds in the Portuguese printing industry

In the printing industry, volatile organic compounds main sources are the uses of organic solvents, fountain solutions and cleaning agents. Nowadays, one circumstance which might confuse the exposure reality is that the majority of solvents which are often used have a faint odour. Therefore, the conditions at offset printing in regard to solvent exposure may seem acceptable to workers. Fortunately, general ventilation and local exhaust systems have also become more common, and new printing machines, often with automatic cleaning, have entered the market. The health effects of volatile organic solvents are dependent on the chemicals involved but, normally, are associated with affecting the nervous system, the liver and also the kidneys. The purpose of this study was to document the conditions regarding exposure to volatile organic compounds in an offset printing unit and to permit identify task with higher exposure and with priority for preventive measures application. Exposure assessment was done before and after installation of general ventilation and local exhaust equipments and during printing and cleaning procedure.

Strength, muscle quality and functional capacity in liver transplanted familial amyloidotic polineuropathy patients

Liver transplantation is the unique treatment for several end stage diseases. Familial Amiloidotic Polineuropathy (FAP) is a neurodegenerative disease related with systemic deposition of amyloidal fibre mainly on peripheral nervous system, clinically translated by an autonomous sensitive-motor neuropathy with severe functional limitations in some cases. The unique treatment for FAP disease is a liver transplant with a very aggressive medication to muscle metabolism and force production. To our knowledge there are no quantitative characterizations of body composition, strength or functional capacity in this population. The purpose of this study was to compare levels of specific strength (isometric strength adjusted by lean mass or muscle quality) and functional capacity (meters in 6 minutes walk test) between FAP patients after a liver transplant (4.1±2 months after transplant surgery) (FAPT) and a healthy group (HG).

Modalidades síncronas e assíncronas no ensino da radiologia do sistema nervoso: estilos e resultados de aprendizagem

Lidar com as problemáticas da saúde, implica um domínio dos processos cognitivos (raciocínio, resolução de problemas e tomada de decisão) e de desempenhos práticos, o que obriga a afectação de um conjunto de atitudes e comportamentos específicos. Este estudo, implementou e avaliou o impacto de experiências pedagógicas desenvolvidas com os estudantes da unidade curricular Radiologia do Sistema Nervoso (RSN) da Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL). Aplicaram-se metodologias de ensino mistas (presenciais e virtuais) utilizadas na leccionação teórica e prática no ano curricular 2008/2009. Para a avaliação do perfil de aprendizagem dos estudantes foi aplicado o método de Honey & Munford e para a avaliação e monitorização dos conhecimentos aplicaram-se check list baseadas nos conteúdos programáticos. A monitorização das ferramentas da plataforma moodle complementaram a restante informação. Verificou-se uma progressão de aprendizagem positiva para um grupo de estudantes maioritariamente do estilo reflexivo (média=10,6 estudantes). As conclusões apontaram para um impacto positivo quanto à aplicação das metodologias híbridas com maior índice de sucesso para a metodologia assíncrona. Verificou-se também mais flexibilidade no acesso aos conteúdos porém com algumas limitações tais como residência inicial por parte dos estudantes, maior carga de trabalho para os docentes, falta de terminais para acesso à plataforma e pouca experiência de todos os envolvidos no domínio e manipulação da plataforma. ABSTRACT - This study focused on the role of cognitive processes (reasoning, problem solving and decision making) and performance practice in the formation of attitudes and behaviours relating to health issues. It was conducted to evaluate the effects of pedagogical experiences on students who participated in the course in radiography in the Nervous System Imaging Unit (RSN) of the Lisbon Health School of Technology. Mixed (face-to-face and virtual) teaching methodologies were used in theory and practice sessions. Honey and Munford’s method was used to evaluate the learning profile of students. To monitor and evaluate students’ knowledge acquisition, check lists based on program topics were applied. Other information was supplied through the learning platform of Moodle. The student group with mostly a reflective learning style increased their knowledge. The asynchronous method was shown to produce a higher success rate and more flexibility in accessing content but also registered some limitations such as resistance by students, increased workload for teachers, lack of access to the platform and inexperience of all involved in handling the platform.

Cyanobacteria toxicity: potential public health impact in South Portugal populations

Cyanobacteria are prokaryotic, plantlike organisms present in lakes, recreational waters, and reservoirs, and often dominate phytoplankton communities in warm, nutrient-enriched hard waters. A stable water column rich in certain nutrients, especially nitrogen and phosphorus, is associated with favorable environmental conditions that support development of cyanobacterial population maxima or "blooms." Under specific conditions, cyanobacteria produce toxins that are responsible for acute poisoning and death of animals and humans. The main aim of this study was to correlate the presence of cyanobacteria blooms with potential toxicity to humans as a public health issue. In Portugal, seven reservoirs located in the southern region were selected and studied between 2000 and 2008. Reservoirs were characterized by physical and chemical aspects, and identification of phytoplankton communities. In the case of cyanobacterial blooms, toxins that affected the liver, nervous system, and skin were detected, namely, Microcystis aeruginosa, Aphanizomenon spp., and Oscillatoria. These findings suggest the presence of a potential risk for public health, and indicate the need to implement mitigation measures in all studied reservoirs. These measures may involve (1) water eutrophication control to avoid blooms, (2) appropriate treatment of water for human consumption, and (3) public warnings or information to those individuals that use these reservoirs for several recreational activities.

A importância de um programa de atividade física em doentes com esclerose múltipla na satisfação com a vida e bem-estar psicológico

A Esclerose Múltipla (EM) é uma doença crónica do sistema nervoso central, que afeta com mais frequentemente mulheres jovens. A EM é uma doença progressiva e imprevisível, resultando em alguns casos de incapacidades e limitações a nível físico, psicológico e social. Este estudo tem como objetivo verificar o efeito de um programa de intervenção para a promoção da atividade física (PIPAF) em indivíduos com EM no bem-estar psicológico (BEP) e na satisfação com a vida (SV). Métodos – É um estudo quasi-experimental. Utilizamos a escala de satisfação com a vida (7 itens) e a componente BEP do inventário de saúde mental (14 itens). O estudo inclui 24 doentes EM com idade média de 44 anos, 58,3% são mulheres, 37,5% são casados, 67% estão reformados, a média de escolaridade é de 12,5 anos, sendo a EM diagnosticada há pelo menos um ano. O programa consiste numa intervenção para a promoção da atividade física em grupos de oito pessoas, semanalmente, durante 90 minutos, em sete semanas. Para analisar os resultados utilizamos o programa SPSS, versão 20. Resultados – Utilizamos o teste Wilcoxon para as variáveis BEP e a SV, obtido a partir da avaliação antes do programa de intervenção e no final do programa. Verificamos que houve alterações significativas entre os dois tempos p <0,01, em ambas as variáveis, com resultados mais elevados no final do programa de intervenção. Discussão/Conclusão – Através da leitura dos resultados podemos verificar que a implementação do PIPAF, em doentes com EM, utilizando um modelo holístico e integrado numa perspetiva biopsicossocial, melhora a SV e a BEP destes doentes.

Relatório de estágio em reabilitação neurológica

Mestrado em Fisioterapia.

Caracterização da exposição e eventuais efeitos para a saúde da exposição profissional ao estireno nos ortoprotésicos

Mestrado em Segurança e Higiene do Trabalho.

Programa de intervenção segundo o modelo de auto-regulação na esclerose múltipla

A esclerose múltipla é um doença crónica do sistema nervoso central, que afecta mais frequentemente adultos jovens, no auge da sua carreira profissional e desenvolvimento pessoal, sem cura e de causas desconhecidas. Os sintomas e sinais mais comuns são a fadiga, fraqueza muscular, alterações da sensibilidade, ataxia, alterações do equilíbrio, dificuldades na marcha, dificuldades de memória, alterações cognitivas e dificuldades na resolução de problemas. A esclerose múltipla é uma doença progressiva e imprevisível, resultando, nalguns casos, em incapacidades e limitações de actividade de vida diária, causando danos irreparáveis para os indivíduos. Esta doença pode surgir através de surtos ou de uma forma progressiva.