Health related quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization: type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the health-related quality of life (HRQL) are largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions that constitute HRQL are still a matter of discussion. Objective: To evaluate the impact of CRT on the HRQL of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT. Methods: 43 patients, submitted to successful implantation of CRT, were evaluated in hospital just before intervention and in the outpatient clinic within 6 months after CRT. HRQL was analyzed based on the Kansas City Cardiomyopathy Questionnaire (KCCQ). Patients were classified as super-responders (ejection fraction of left ventricle - LVEF - ≥45% post-CRT), n=15, responders (sustained improvement in functional class and LVEF increased by 15%), n=19, and non-responders (no clinical or LVEF improvement), n=9. Results: In the group of super-responders, CRT was associated with an improvement in HRQL for the various fields and sums assessed (ρ<0.05); in responders, CRT has been associated with an improvement of HRQL in the various fields and sums, except in the self-efficacy dimension (ρ<0.05); in non-responders, CRT was not associated with improvement of HRQL. Conclusion: In a population with severe CHF undergoing CRT, the patients with clinical and echocardiographic positive response, obtained a favorable impact in all dimensions of HRQL, while the group without response to CRT showed no improvement. These data reinforces the importance of HRQL as a multidimensional tool for assessment of benefits in clinical practice.

Evaluating the quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization regarding the type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the quality of life have been largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions of quality of life is still a matter of discussion. Objective: to evaluate the impact of CRT on the quality of life of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT.

Relation of happiness, hope and affection with quality of life in patients with heart failure

Introduction: Meeting the actual role of positive psychology, begins to be recognized the relation of positive variables with health. Objective: To know the relation of happiness, hope and affection with quality of life in individuals with heart failure. Population and Methodology: 128 individuals with heart failure, 98 men and 30 women, 61.9±12,1 years of age, 6,6±3,9 years in school and 74,2% retired because of this disease. 56,3% were in Class III of New York Heart Association, with poor left ventricular ejection fraction (25,3±6,2%). The clinical history was of 9,4±8,5 years for this heart disease and had at least one hospitalization due to heart failure with 51,6% having ischemic heart disease.

Happiness, hope and affection as predictors of quality of life and functionality of individuals with heart failure at 3 month follow up

Introduction: Meeting the actual role of positive psychology, begins to be recognized the contribution of positive variables in health outcomes. Objective: To know the contribution of happiness, hope and affection individually and as a whole in the quality of life and functionality of individuals with heart failure. Population and Methodology: 128 individuals with heart failure, 98 men and 30 women, 61.9±12,1 years of age, 6,6±3,9 years of school and 74,2% retired because of this disease. 56,3% were in Class III of New York Heart Association, with poor left ventricular ejection fraction (25,3±6,2%). The clinical history was of 9,4±8,5 years for this heart disease and had at least one hospitalization due to heart failure with 51,6% having ischemic heart disease.

Quality of life in dilated cardiomyopathy with refractory chronic heart failure undergoing devices implantation

Heart failure is the final stage of most of cardiac diseases. It is a complex syndrome in which the patients should have the following features: symptoms of heart failure, typically shortness of breath at rest or during exertion, and/or fatigue; signs of fluid retention such as pulmonary congestion or ankle swelling; and objective evidence of an abnormality of the structure or function of the heart at rest. This progressive syndrome as a high incidence and prevalence and poor prognosis: four-year mortality is around 50% with 40% of the patients admitted to hospital dying or readmitted within a year. With ageing, many patients will develop chronic heart failure, which, because of its symptoms, patient’s awareness of their risk of dying, and the effects of therapy, together with frequent hospitalizations, has considerable impact on patient’s health-related quality of life.

Protection of wind energy systems against the indirect effects of lightning

This paper is concerned with the protection of wind energy systems against the indirect effects of lightning. As wind energy is gaining increasing importance throughout the world, lightning damages involving wind energy systems have come to be regarded with more attention. Nevertheless, there are still very few studies in Portugal regarding lightning protection of wind energy systems using models of the Electro-Magnetic Transients Program (EMTP). Hence, a new case study is presented in this paper, based on a wind turbine with an interconnecting transformer, considering that lightning strikes the soil near the tower at a distance such that galvanic coupling occurs through the grounding electrode. Computer simulations obtained by using EMTP-RV are presented and conclusions are duly drawn. (C) 2011 Elsevier Ltd. All rights reserved.

Radiographers and radiation protection: education, training and CPD

The increasing use of ionizing radiation for medical purposes emphasizes the concern about safety and justification of using ionizing radiation. This is linked with the use of new and high-dose X-ray technology (particularly CT). According to the UNSCEAR 2010 Report the total number of diagnostic medical examinations (both medical and dental) is estimated to have risen from 2.4 billion (period 1991–1996) to 3.6 billion (period 1997– 2008) - a marked increase in collective doses. An appropriate use of technology aiming diagnostic or therapy and respecting the ALARA principle is a mandatory requisite to safely perform any radiological procedure. Radiation protection is thus, a concern of all specialists in the radiology field ( radiologists, radiographers, medical physicists, among other professional groups). The importance of education and training of these professionals in reducing patients’ doses while maintaining the desired level of quality in medical exposures, as well as precise therapeutic treatments is well recognized. Education, training and continuing professional development (CPD) constitute a triad pointing towards the radiographers’ development of competences in the radiation protection field. This presentation excludes the radiographer role and competences in the fields of ultrasonography and MRI.

A Sensorless PMDC Motor Speed Controller with a Logical Overcurrent Protection

A method to control the speed or the torque of a permanent-magnet direct current motor is presented. The rotor speed and the external torque estimation are simultaneously provided by appropriate observers. The sensorless control scheme is based on current measurement and switching states of power devices. The observer’s performances are dependent on the accurate machine parameters knowledge. Sliding mode control approach was adopted for drive control, providing the suitable switching states to the chopper power devices. Despite the predictable chattering, a convenient first order switching function was considered enough to define the sliding surface and to correspond with the desired control specifications and drive performance. The experimental implementation was supported on a single dsPIC and the controller includes a logic overcurrent protection.

Inter-professional partnership: a case study

O estudo caso apresentado neste artigo aborda a colaboração entre profissionais de múltiplas áreas disciplinares. Este estudo descreve como foi realizada a parceria entre a equipa de enfermagem e a equipa de psicologia clinica nas visitas domiciliárias com familias em risco. Igualmente, discute as dificuldades enfrentadas quando os profissionais não partilhavam os mesmos modelos de praticas colaborativas.

Results of radiation protection programmes on mammography

In this paper, we present the results of mammography quality control tests related to the work with Portuguese mammography equipment, either in conventional or in digital mammography computed radiography, showing the main differences in the tested equipments. Quality control in mammography is a very special area of quality control in radiology, which demands relatively high knowledge on physics. Digital imaging is changing the standards of the radiographic imaging. Regarding mammography, this is yet a controversial issue owing to some limitations of the digital detectors, like the resolution for instance. A complete set of results regarding radiation protection of the patients submitted to mammography diagnosis is presented. A discussion of the quality image parameters and its interpretation in conventional and digital mammography is presented. In conclusion, we present a sample of results that can be considered as characteristics of mammography equipment in Portugal.

Protection against oxidative stress through SUA7/TFIIB regulation in Saccharomyces cerevisiae

The general transcription factor TFIIB, encoded by SUA7 in Saccharomyces cerevisiae, is required for transcription activation but apparently of a specific subset of genes, for example, linked with mitochondrial activity and hence with oxidative environments. Therefore, studying SUA7/TFIIB as a potential target of oxidative stress is fundamental. We found that controlled SUA7 expression under oxidative conditions occurs at transcriptional and mRNA stability levels. Both regulatory events are associated with the transcription activator Yap1 in distinct ways: Yap1 affects SUA7 transcription up regulation in exponentially growing cells facing oxidative signals; the absence of this activator per se contributes to increase SUA7 mRNA stability. However, unlike SUA7 mRNA, TFIIB abundance is not altered on oxidative signals. The biological impact of this preferential regulation of SUA7 mRNA pool is revealed by the partial suppression of cellular oxidative sensitivity by SUA7 overexpression, and supported by the insights on the existence of a novel RNA-binding factor, acting as an oxidative sensor, which regulates mRNA stability. Taken together the results point out a primarily cellular commitment to guarantee SUA7 mRNA levels under oxidative environments.

Impactos do projecto solvência II nos sistemas de governance das seguradoras portuguesas

Mestrado em Contabilidade e Gestão das Instituições Financeiras

Happiness, hope, and affection as predictors of quality of life and functionality of individuals with heart failure at three-month follow-up

The scientific evidence supporting the management of the chronically ill in a positive psychological perspective in opposition to traditional pathological approach is scarce. This study examines issues associated with recovery of health status in heart failure, in particular hope, affection, and happiness. We use a longitudinal study of 128 symptomatic patients who after medical intervention reported improved quality of life and function at 3-month follow-up. We evaluated the contribution of happiness, hope and affection, individually and as a whole, in the quality of life and functionality of individuals with heart failure. Happiness (Subjective Happiness Scale), Hope (HOPE Scale), and affection (PANAS (positive and negative affect schedule)) were determined before medical intervention. Individually, we found that happiness is correlated with the quality of life and functionality, hope to self-efficacy dimension of the quality of life scale, positive affect to functionality and negative affect with symptoms dimension, quality of life dimension, and overall sum of the quality of life scale. Overall, we found that happiness has a unique contribution to the quality of life, except in self-efficacy dimension where hope takes this contribution and positive affect has a unique contribution to the functionality in this short-term follow-up. The results highlight the importance of positive variables to health outcomes for people with heart failure and should be considered in intervention programs for this syndrome.

Perceptually driven video error protection using a distributed source coding approach

In video communication systems, the video signals are typically compressed and sent to the decoder through an error-prone transmission channel that may corrupt the compressed signal, causing the degradation of the final decoded video quality. In this context, it is possible to enhance the error resilience of typical predictive video coding schemes using as inspiration principles and tools from an alternative video coding approach, the so-called Distributed Video Coding (DVC), based on the Distributed Source Coding (DSC) theory. Further improvements in the decoded video quality after error-prone transmission may also be obtained by considering the perceptual relevance of the video content, as distortions occurring in different regions of a picture have a different impact on the user's final experience. In this context, this paper proposes a Perceptually Driven Error Protection (PDEP) video coding solution that enhances the error resilience of a state-of-the-art H.264/AVC predictive video codec using DSC principles and perceptual considerations. To increase the H.264/AVC error resilience performance, the main technical novelties brought by the proposed video coding solution are: (i) design of an improved compressed domain perceptual classification mechanism; (ii) design of an improved transcoding tool for the DSC-based protection mechanism; and (iii) integration of a perceptual classification mechanism in an H.264/AVC compliant codec with a DSC-based error protection mechanism. The performance results obtained show that the proposed PDEP video codec provides a better performing alternative to traditional error protection video coding schemes, notably Forward Error Correction (FEC)-based schemes. (C) 2013 Elsevier B.V. All rights reserved.

Anti-Corrosion performance of a new silane coating for corrosion protection of AZ31 Magnesium alloy in Hank’s solution

Mg alloys can be used as bioresorsable metallic implants. However, the high corrosion rate of magnesium alloys has limited their biomedical applications. Although Mg ions are essential to the human body, an excess may cause undesirable health effects. Therefore, surface treatments are required to enhance the corrosion resistance of magnesium parts, decreasing its rate to biocompatible levels and allowing its safe application as bioresorbable metallic implants. The application of biocompatible silane coatings is envisaged as a suitable strategy for retarding the corrosion process of magnesium alloys. In the current work, a new glycidoxypropyltrimethoxysilane (GPTMS) based coating was tested on AZ31 magnesium substrates subjected to different surface conditioning procedures before coating deposition. The surface conditioning included a short etching with hydrofluoric acid (HF) or a dc polarisation in alkaline electrolyte. The silane coated samples were immersed in Hank's solution and the protective performance of the coating was studied through electrochemical impedance spectroscopy (EIS). The EIS data was treated by new equivalent circuit models and the results revealed that the surface conditioning process plays a key role in the effectiveness of the silane coating. The HF treated samples led to the highest impedance values and delayed the coating degradation, compared to the mechanically polished samples or to those submitted to dc polarisation.