Variáveis psicológicas e percepção do estado de saúde em indivíduos submetidos a ressincronização cardíaca

A insuficiência cardíaca afecta cerca de 261 mil pessoas em Portugal constituindo um problema de saúde pública. Pretendemos avaliar aspectos associados à recuperação do estado de saúde nesta síndrome, em particular a esperança, o afecto e a felicidade. Recorremos a um estudo longitudinal com 128 indivíduos sintomáticos com má fracção de ejecção do ventrículo esquerdo. Utilizámos um questionário para caracterizar os aspectos sóciodemográficos, clínicos e funcionais, o Kansas City Cardiomiopathy Questionnaire (KCCQ) para avaliar a qualidade de vida, a Subjective Hapiness Scale (SHS) para a felicidade, a HOPE Scale (HOPE) para a esperança e a Positive And Negative Afect Schedule (PANAS) para o afecto. Os questionários de caracterização sócio-demográfica, clínica e funcional, KCCQ e o SHS foram aplicados em três momentos: no internamento, prévio à instituição de terapêutica médica na sua totalidade e ao terceiro e sexto mês após a intervenção médica, na consulta externa. A maioria dos participantes eram homens em classe III da classificação da New York Heart Association com etiologia isquémica. No internamento e antes da terapêutica médica, observámos que a esperança, a felicidade e o afecto se relacionaram com a qualidade de vida, a felicidade e o afecto positivo com a esperança. No período avaliado foram submetidos a: terapia de ressincronização cardíaca (n=52), cardioversor-desfibrilhador implantável (n=44), cirurgia valvular com revascularização do miocárdio (n=14), optimização terapêutica farmacológica (n=10), transplante cardíaco (n=8). Foram significativos os resultados da qualidade de vida, da classificação da New York Heart Association, do exercício físico, da fracção de ejecção do ventrículo esquerdo e das arritmias cardíacas (estrasístoles e taquicardias ventriculares). A felicidade foi preditora da qualidade de vida e da funcionalidade. O afecto negativo foi preditor da satisfação com a insuficiência cardíaca. Concluímos da importância das variáveis positivas a par dos procedimentos médicos no tratamento das pessoas com insuficiência cardíaca. ABSTRACT - Heart failure affects about 261 000 people in Portugal constituting a public health problem. We intend to evaluate aspects of the health recovery in this syndrome, in particular hope, affection and happiness. We used a longitudinal study with 128 symptomatic patients with poor ejection fraction of left ventricle. We used a questionnaire to characterize the socio-demographic, clinical and functional aspects, the Kansas City Cardiomiopathy Questionnaire (KCCQ) to assess the quality of life, the Subjective Happiness Scale (SHS) for happiness, the HOPE Scale (HOPE) for hope and the Positive And Negative Affect Schedule (PANAS) for affection. The questionnaires of sociodemographic, clinical and functional KCCQ and SHS were applied on three occasions: on admission, prior to the execution of medical therapy in its totality and in the third and sixth months after medical intervention in the outpatient. Most of the participants were men in Class III New York Heart Association classification with ischemic etiology. At admission and before medical therapy, we observed that the hope, happiness and affection were related to the quality of life, happiness and positive affect with hope. Over the studied period were submitted to: cardiac resynchronization therapy (n=52), implantable cardioverter-defibrillator (n=44), valvular surgery with coronary artery bypass graft surgery (n=14), optimizing drug therapy (n=10), heart transplant (n=8). The significant results were the quality of life, the New York Heart Association classification, the exercise, the ejection fraction and left ventricular cardiac arrhythmias (ventricular tachycardia and estrasistoles). Happiness was a predictor of quality of life and functionality. The negative affect was a predictor of satisfaction with heart failure. We concluded that the positive variables and the medical procedures were important in treating people with heart failure.

Oncology research and clinical decisions based on immunohistochemistry: the importance of the technical aspects that support a complex method

Immunohistochemistry (IHC) is the group of techniques that use antibodies as specific reagents to identify and demonstrate several cell and tissue components that are antigens. This linking allows locating and identifying the in situ presence of various substances by means of color that is associated with the formed antigen-antibody complexes. The practical value of this biotechnology area, widely used in Pathology and Oncology, in diagnostic, prognostic, theranostic and research context, results from the possibility of combining a colour marker with an antibody without causing any damage to specific binding established between antibody and antigen. This provides the microscopic observation of the target locations where the antibody and hence the antigen are present. IHC is presented as a powerful means for identification of several cellular and tissue structures that can be associated with pathologies, and of the consequences, at functional and morphological level, of these same elements action.

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.

Body composition, muscle strength, functional capacity, and physical disability risk in liver transplanted familial amyloidotic polyneuropathy patients

Abstract: Background: Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease leading to sensory and motor polyneuropathies, and functional limitations. Liver transplantation is the only treatment for FAP, requiring medication that negatively affects bone and muscle metabolism. The aim of this study was to compare body composition, levels of specific strength, level of physical disability risk, and functional capacity of transplanted FAP patients (FAPTx) with a group of healthy individuals (CON). Methods: A group of patients with 48 FAPTx (28 men, 20 women) was compared with 24 CON individuals (14 men, 10 women). Body composition was assessed by dual-energy X-ray absorptiometry, and total skeletal muscle mass (TBSMM) and skeletal muscle index (SMI) were calculated. Handgrip strength was measured for both hands as was isometric strength of quadriceps. Muscle quality (MQ) was ascertained by the ratio of strength to muscle mass. Functional capacity was assessed by the six-minute walk test. Results: Patients with FAPTx had significantly lower functional capacity, weight, body mass index, total fat mass, TBSMM, SMI, lean mass, muscle strength, MQ, and bone mineral density. Conclusion: Patients with FAPTx appear to be at particularly high risk of functional disability, suggesting an important role for an early and appropriately designed rehabilitation program.

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.

Effects of a randomized trial of exercise on body composition of liver transplanted patients

Liver transplantation is used as a only therapy so far, that stop the progression of some aspects of familial amyloidotic polyneuropathy disease (FAP) an autossomic neurodegenerative disease. FAP often results in severe functional limitations. Transplantation requires aggressive medication which impairs bone and muscle metabolism. Malnutrition plus weight loss is already one feature of FAP patients. All this may produce negative consequences on body composition. The effect of exercise training in FAP patients after a liver transplant (FAPTX) is currently unknown. The purpose of this study is to evaluate the effects of a six months exercise training program on body composition in FAPTX patients.

Knee muscle strength, balance and functional independence in persons with stroke

Purpose: to investigate the relationship between knee muscle strength, balance and functional independence within the first month after stroke. Relevance: cerebral vascular disease is one of the main causes of morbidity, disability and mortality in developed countries. Problems with movement control are frequent after stroke. Lower limb weakness and impaired balance are common problems that are related with the risk of falls and are likely to interfere with the ability to perform daily life activities. Physiotherapy intervention usually starts early after stroke and addresses impairments related to movement and posture in order to improve motor recovery and restore function.

Muscle strength, balance and functional independence in persons with stroke

Cerebral vascular disease is one of the main causes of morbidity, disability and mortality in developed countries. Problems with movement control are frequent after stroke. Lower limb weakness and impaired balance are common problems that are related with the risk of falls and are likely to interfere with the ability to perform daily life activities. Physiotherapy intervention usually starts early after stroke and addresses impairments related to movement and posture in order to improve motor recovery and restore function. Purpose: to investigate the relationship between knee muscle strength, balance and functional independence within the first month after stroke.

Análise funcional comparativa de algoritmos de aprendizagem por reforço

De entre todos os paradigmas de aprendizagem actualmente identificados, a Aprendizagem por Reforço revela-se de especial interesse e aplicabilidade nos inúmeros processos que nos rodeiam: desde a solitária sonda que explora o planeta mais remoto, passando pelo programa especialista que aprende a apoiar a decisão médica pela experiencia adquirida, até ao cão de brincar que faz as delícias da criança interagindo com ela e adaptando-se aos seus gostos, e todo um novo mundo que nos rodeia e apela crescentemente a que façamos mais e melhor nesta área. Desde o aparecimento do conceito de aprendizagem por reforço, diferentes métodos tem sido propostos para a sua concretização, cada um deles abordando aspectos específicos. Duas vertentes distintas, mas complementares entre si, apresentam-se como características chave do processo de aprendizagem por reforço: a obtenção de experiência através da exploração do espaço de estados e o aproveitamento do conhecimento obtido através dessa mesma experiência. Esta dissertação propõe-se seleccionar alguns dos métodos propostos mais promissores de ambas as vertentes de exploração e aproveitamento, efectuar uma implementação de cada um destes sobre uma plataforma modular que permita a simulação do uso de agentes inteligentes e, através da sua aplicação na resolução de diferentes configurações de ambientes padrão, gerar estatísticas funcionais que permitam inferir conclusões que retractem entre outros aspectos a sua eficiência e eficácia comparativas em condições específicas.

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).

Effects of lower limb strengthening on balance and function in persons who suffered a stroke

Introduction - Cerebrovascular diseases, and among them, cerebral vascular accidents, are one of the main causes of morbidity and disability at European Union countries. Clinical framework resulting from these diseases include important limitations in functional ability of the these patients Postural control dysfunctions are one of the most common and devastating consequences of a stroke interfering with function and autonomy and affecting different aspects of people’s life and contributing to decrease quality of life. Neurological physiotherapy plays a central role in the recovery of movement and posture, however it is necessary to study the efficacy of techniques that physiotherapists use to treat these problems. Objectives - The aim of this study was to investigate the effects of a physiotherapy intervention program, based on oriented tasks and strengthening of the affected lower limb, on balance and functionality of individuals who have suffered a stroke. In addition our study aimed to investigate the effect of strength training of the affected lower limb on muscle tone.

Avaliação de dados funcionais em repouso do cérebro normal: causalidade de Granger

Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Área de especialização: Ressonância Magnética

Study of the influence of count’s number in myocardium in the determination of reproducible functional parameters in Gated-SPECT studies simulated with GATE

Myocardial Perfusion Gated Single Photon Emission Tomography (Gated-SPET) imaging is used for the combined evaluation of myocardial perfusion and left ventricular (LV) function. But standard protocols of the Gated-SPECT studies require long acquisition times for each study. It is therefore important to reduce as much as possible the total duration of image acquisition. However, it is known that this reduction leads to decrease on counts statistics per projection and raises doubts about the validity of the functional parameters determined by Gated-SPECT. Considering that, it’s difficult to carry out this analysis in real patients. For ethical, logistical and economical matters, simulated studies could be required for this analysis. Objective: Evaluate the influence of the total number of counts acquired from myocardium, in the calculation of myocardial functional parameters (LVEF – left ventricular ejection fraction, EDV – end-diastolic volume, ESV – end-sistolic volume) using routine software procedures.

Functional validation of LexADBDGim chimeras in saccharomyces cerevisiae

GimC/Prefoldin is a hetero-oligomeric complex involved in cytoskeleton biogenesis. In order to identify by two-hybrid system targets that directly interact with Gims and support the stress phenotypes, this work aimed the functional validation of all Gims in saccharomyces cerevisiae.

Association between grip strength, anthropometric data and functional capacity

The hand is one of the most important instruments of the human body, mainly due to the possibility of grip movements. Grip strength has been described as an important predictor of functional capacity. There are several factors that may influence it, such as gender, age and anthropometric characteristics. Functional capacity refers to the ability to perform daily activities which allow the individual to self-care and to live with autonomy. Composite Physical Function (CPF) scale is an evaluation tool for functional capacity that includes daily activities, self-care, sports activities, upper limb function and gait capacity. In 2011, Portugal had 15% of young population (0-14years) and 19% of elderly population (over 65 years). Considering the double-ageing phenomen, it is important to understand the effect of the grip strength in elderly individuals, considering their characteristics, as the need to maintainin dependency as long as possible.