25 resultados para Neurological manifestations

em Repositório Científico do Instituto Politécnico de Lisboa - Portugal


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In the last decades, the value of research on neurological patients’ quality of life (QOL) has become unquestionable. In this context, most studies focus on the relationship between patients’ QOL and their sociodemographic and/or clinical and/or modifiable psychosocial characteristics. They give us information regarding the sociodemographic and clinical profile most prone to low QOL reports and also on ways to improve patients’ QOL (e.g., targeting their selfesteem). Nevertheless, little is known about the role nonmodifiable psychosocial variables can have on patients’ QOL perception. Consequently, the aim of the present study is to explore the relationship between QOL and personality in neurological patients.

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Since the first in vivo studies of cerebral function with radionuclides by Ingvar and Lassen, nuclear medicine (NM) brain applications have evolved dramatically, with marked improvements in both methods and tracers. Consequently it is now possible to assess not only cerebral blood flow and energy metabolism but also neurotransmission. Planar functional imaging was soon substituted by single-photon emission computed tomography (SPECT) and positron emission tomography (PET); it now has limited application in brain imaging, being reserved for the assessment of brain death.

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A esclerose múltipla (EM) é a doença crónica neurológica que mais afeta adultos jovens; em 80% dos casos, a doença progride para situações de níveis variados de incapacidade, o que torna necessário avaliar a qualidade de vida (QV) desses indivíduos. O objetivo desta revisão foi localizar estudos que avaliam a QV em indivíduos com EM, identificando os instrumentos utilizados e suas características psicométricas. Foram consultadas as bases Psycinfo, Psycarticles, Psycbooks, Psychology & Behavioral Science Collection, EJS E-Journal, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Medline, e Academic Search Complete, utilizando os descritores 'multiple sclerosis' e 'quality of life', para localizar artigos publicados no período 1997-2007. Foram selecionados 1.376 artigos e, após a leitura dos resumos, excluídos os referentes a instrumentos que não tinham boas características psicométricas e/ou eram pouco referenciados. Foram encontrados 461 artigos, dos quais 267 usaram instrumentos genéricos e 194 específicos para a EM. Dos 7 instrumentos (2 genéricos, 5 específicos) com boas características psicométricas utilizados pelos estudos consultados, o mais usado é o SF-36 (em 237 estudos). Todos os instrumentos têm validade verificada e apresentam grau elevado de confiabilidade, podendo ser utilizados para avaliação da qualidade de vida de pacientes com EM tanto em pesquisa quanto na clínica. ABSTRACT - Multiple sclerosis (MS) is the chronic neurological disease that most affects young adults; 80% of patients experience a transition towards persistent disability, hence the need to assess their quality of life (QoL). The aim of the study was to review studies that assess QoL in patients with multiple sclerosis, inquiring on the instruments used and their psychometric features. Articles published from 1997 through 2007 were searched for by means of key words 'multiple sclerosis' and 'quality of life' in databases Psycinfo, Psycarticles, Psycbooks, Psychology & Behavioral Science Collection, EJS E-Journal, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Medline, and Academic Search Complete. From the 1,376 studies found, after abstract reading those that reported on instruments with poor psychometric properties and/or were little referred were excluded. A total of 461 articles were selected, of which 267 reported using generic instruments and 194, MS-specific ones. Among the 7 instruments reported by the studies as having good psychometric characteristics (2 generic, five MS-specific), the most used is the SF-36 (by 237 studies). All instruments have shown adequate psychometric properties and a high degree of reliability, hence may be used to assess QoL in subjects with multiple sclerosis both in clinic and research.

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Mestrado de Radiações aplicadas às Tecnologias da Saúde. Área de especialização: Imagem Digital com Radiação X.

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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.

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Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Especialização: Ressonância Magnética.

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Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção do grau de Mestre em Didática da Língua Portuguesa no 1.º e no 2.º Ciclos.

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Introdução – A adaptação ao ensino superior reveste-se de experiências académicas que podem constituir fonte de stress para os estudantes. A implementação de novos modelos pedagógicos, no âmbito do processo de Bolonha, introduz novas variáveis cujo impacto, designadamente em termos de saúde, importa conhecer. Este estudo tem como objetivo analisar as associações entre modelo pedagógico (Problem Based Learning – PBL vs. modelos próximos do tradicional) e variáveis psicológicas (coping, desregulação emocional, sintomas psicossomáticos, perceção de stress e afeto). Metodologia – O estudo tem um design transversal. Foram usados os seguintes questionários online: Brief-COPE, Escala de Dificuldades de Regulação Emocional, Questionário de Manifestações Físicas de Mal-Estar, Escala de Stress Percebido e Escala de Afeto Positivo e Negativo. A amostra é constituída por 183 estudantes do primeiro ano (84% do género feminino) de cursos da Escola Superior de Tecnologia da Saúde do Porto – Instituto Politécnico do Porto (ESTSP-IPP). Resultados – Foram encontradas correlações significativas entre as variáveis demográficas e psicológicas. Considerando diferentes modelos pedagógicos, foram encontradas diferenças significativas nas variáveis psicológicas. Os principais preditores de stress na amostra foram: ser mulher, frequentar uma licenciatura no modelo PBL, ter maiores índices de desregulação emocional, apresentar mais sintomas psicossomáticos, menos afeto positivo e mais afeto negativo. Conclusão – As diferenças encontradas entre modelos pedagógicos são discutidas, possibilitando a reflexão sobre as implicações práticas e sugestões para futuras investigações.

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Mestrado em Fisioterapia.

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ABSTRACT - Tinea pedis and onychomycosis are two rather diverse clinical manifestations of superficial fungal infections, and their etiologic agents may be dermatophytes, non-dermatophyte moulds or yeasts. This study was designed to statistically describe the data obtained as results of analysis conducted during a four year period on the frequency of Tinea pedis and onychomycosis and their etiologic agents. A questionnaire was distributed from 2006 to 2010 and answered by 186 patients, who were subjected to skin and/or nail sampling. Frequencies of the isolated fungal species were cross-linked with the data obtained with the questionnaire, seeking associations and predisposing factors. One hundred and sixty three fungal isolates were obtained, 24.2% of which composed by more than one fungal species. Most studies report the two pathologies as caused primarily by dermatophytes, followed by yeasts and lastly by non-dermatophytic moulds. Our study does not challenge this trend. We found a frequency of 15.6% of infections caused by dermatophytes (with a total of 42 isolates) of which T. rubrum was the most frequent species (41.4%). There was no significant association (p >0.05) among visible injury and the independent variables tested, namely age, gender, owning pet, education, swimming pools attendance, sports activity and clinical information. Unlike other studies, the variables considered did not show the expected influence on dermatomycosis of the lower limbs. It is hence necessary to conduct further studies to specifically identify which variables do in fact influence such infections.

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A great number of low-temperature geothermal fields occur in Northern-Portugal related to fractured rocks. The most important superficial manifestations of these hydrothermal systems appear in pull-apart tectonic basins and are strongly conditioned by the orientation of the main fault systems in the region. This work presents the interpretation of gravity gradient maps and 3D inversion model produced from a regional gravity survey. The horizontal gradients reveal a complex fault system. The obtained 3D model of density contrast puts into evidence the main fault zone in the region and the depth distribution of the granitic bodies. Their relationship with the hydrothermal systems supports the conceptual models elaborated from hydrochemical and isotopic water analyses. This work emphasizes the importance of the role of the gravity method and analysis to better understand the connection between hydrothermal systems and the fractured rock pattern and surrounding geology. (c) 2013 Elsevier B.V. All rights reserved.

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Mestrado em Fisioterapia

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Objective - We aimed to identify the clinical and genetic [IL23 receptor (IL23R) single nucleotide polymorphisms (SNPs)] predictors of response to therapy in patients with ulcerative colitis. Patients and methods - A total of 174 patients with ulcerative colitis, 99 women and 75 men, were included. The mean age of the patients was 47±15 years and the mean disease duration was 11±9 years. The number of patients classified as responders (R) or nonresponders (NR) to several therapies was as follows: 110 R and 53 NR to mesalazine (5-ASA), 28 R and 20 NR to azathioprine (AZT), 18 R and 7 NR to infliximab. Clinical and demographic variables were recorded. A total of four SNPs were studied: IL23R G1142A, C2370A, G43045A, and G9T. Genotyping was performed by real-time PCR using Taqman probes. Results - Older patients were more prone to respond to 5-ASA (P=0.004), whereas those with pancolitis were less likely to respond to such therapies (P=0.002). Patients with extraintestinal manifestations (EIMs) were less likely to respond to 5-ASA (P=0.001), AZT (P=0.03), and corticosteroids (P=0.06). Carriers of the mutant allele for IL23R SNPs had a significantly higher probability of developing EIMs (P<0.05), a higher probability of being refractory to 5-ASA (P<0.03), but a higher likelihood of responding to AZT (P=0.05). A significant synergism was observed between IL23R C2370A and EIMs with respect to nonresponse to 5-ASA (P=0.03). Conclusion - Besides extent of disease and age at disease onset, the presence of EIMs may be a marker of refractoriness to 5-ASA, corticosteroids, and AZT. IL23R SNPs are associated both with EIMs and with nonresponse to 5-ASA and corticosteroids.

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As sociedades estão sendo moldados por estereótipos invasivos, baseados num factor puramente economico ou consumista, deixando de lado aspectos tradicionais, tais como a família, educação, cultura e até mesmo a política. Mediante a publicidade é possível difundir costumes e tradições que se manifestam dentro da sociedade, mas não é possível determinar até que ponto essas manifestações são características próprias da sociedade ou são conductas alheias, próprias de uma sociedade globalizada. Nesta situação surge a questão de saber se a publicidade emitida em contexto nacional reflecte os valores culturais da sociedade portuguesa. Como objectivo geral, procurou-se encontrar características similares nos anúncios publicitários televisivos, emitidos no horário nobre nos canais de maior audiência em Portugal, como são a TVI e a SIC. Estes anúncios foram analizados á luz das dimensões culturais de Hofstede (1997), com base das descrições dadas por de Mooij (2005). Para a análise do corpus (224 anúncios) utilizou-se um método do tipo qualitativo tendo sido considerados três aspectos fundamentais tais como: a mensagem central, o áudio e a imagem. Os resultados revelaram que as dimensões culturais mais usadas são a Masculinidade, o Individualismo e a Orientação a Curto Prazo. Estas descobertas permitiram concluir que a mensagem dos anúncios está mais direccionada à uma individualização do sujeito, em deterimento do grupo social.

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The Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymatic defect in the world. The most common clinical manifestations are acute hemolytic anemia associated with drugs, infections, neonatal jaundice and hemolytic non-spherocytic chronic anemia. The main aim of this study was to determine the frequency of major genetic variants of G6PD leading to enzyme deficiency in children from 0 to 14 years at a Pediatric Hospital in Luanda, Angola. A cross-sectional and descriptive analytical study covered a total of 194 children aged from 0 to 14 years, of both genders and hospitalized at the Pediatric Hospital David Bernardino, Luanda between November and December, 2011. The G202A, A376G and C563T mutations of the G6PD gene were determined by real-time PCR with Taqman probes. The disabled A-/A- genotype was detected in 10 girls (10.9%). Among the boys, 21 (20.6%) presented the genotype A-. Considering all the samples, the A- variant was observed in 22.4% of cases. The Mediterranean mutation was not detected in the Angolan sample. Furthermore, no association was found between genotype and anemia, nutritional state and mucosa color. A significant association, however, was observed with jaundice. Based on the results obtained, there is a clear need to identify those with the disabled genotype in the Angolan population in order to avoid cases of drug-induced anemia, particularly in the treatment of malaria, so prevalent in Angola.