Effects of an exercise training program in physical condition after liver transplantation in familial amyloidotic polyneuropathy: a case report

Introduction: Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease that leads to sensory and motor polyneuropathies as well as functional limitations. So far, liver transplantation is the only treatment for FAP because the mutated protein causing the disease is mainly produced in the liver. With the increasing survival of transplant recipients, functional and cardiovascular problems as consequences of immunosuppressant side effects are increasing associated with sedentary lifestyles and/or retransplantation status. We sought to analyze the impact of exercise training programs on 1 FAP patient’s course long-term after liver transplantation. Methodology. A FAP patient (female; 49 years of age; body mass index 18.8 kg/m2) underwent a liver transplantation 133 months before assessment. She was assessed for body composition, isometric quadriceps muscle strength, functional capacity, fatigue, and levels of physical activity before and after a 6-month period of combined exercise training. Results: After the exercise training program, almost all variables were improved, namely, total body skeletal muscle mass, proximal femoral bone mineral density, quadriceps strength, maximal oxygen consumption on 6 minutes walk test (6mwt) or VO2peak, total ventilation on 6mwt, and fatigue. The improvement in distance on 6mwt (69.2 m) was clinically significant. Preintervention the levels of physical activity were below international recommendations for health; after the program they achieved the recommendations. Conclusion: The results showed an improvement in functional capacity with a decrease in future disability risk associated with a better lifestyle with respect to physical activity levels in 1 patient.

Intermittent claudication and physical exercise: effectiveness of a home-based program

Peripheral arterial disease (PAD) as a high incidence in general population and 12% to 20% of population with more than 60 years has already clinical symptoms, such as intermittent claudication (IC), pain, loss of strength and functional incapacity. There are already some studies who refer the possible positive effects of physical exercise in functional consequences of PAD.

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.

Fraccionamento do efluente da indústria da cortiça por ultra-nanofiltração: caracterização e estudo da sua biodegradabilidade

O efluente da Indústria da Cortiça apresenta elevados teores de carga orgânica e de compostos fenólicos, nomeadamente teninos, com baixa biodegradabilidade e significativa toxicidade, o que dificulta o seu tratamento. O objectivo deste trabalho é o estudo da biodegradabilidade de diferentes fracções do efluente da cortiça, na perspectiva de contribuir para viabilizar o seu tratamento. Biológico, em simultâneo com a sua valorização, pela recuperação do seu conteúdo em taninos. O fraccionamento foi realizado através de processos de separação por membranas, nomeadamente por ultrafiltração e nanofiltração, de Limite de Exclusão Molecular (MWCO) compreendido entre 0,125-91kDa. O efluente e as fracções permeadas obtidas foram analisadas em termos de conteúdo orgânico (COT, CBO, CQO), fenóis, taninos, cor, pH e condutividade. A caracterização do efluente revelou um elevado conteúdo orgânico (2285-2604 mg de CQO/L, 670,5-1056,8 mg C/L, 1000-1225 mg CBO/L), biodegradabilidade relativamente baixa (0,44-0,47 para CBO/CQO; k de 0,25-0,24 d-1) e elevado conteúdo de fenóis (0,36-0,41 g de ácido tânico/L) e de taninos (0,25-0,27 g ácido tânico/L). O fraccionamento do efluente permitiu concluir uma diminuição do seu conteúdo poluente nos permeados com a diminuição do MWCO das membranas utilizadas. A diminuição simultânea de matéria orgânica e fenóis foi particularmente significativa no permeado da membrana de MWCO de 3,8 kDa que, por outro lado, apresenta uma melhoria significativa para o índice de biodegradabilidade e k (0,83;0,38-0,44 d-1), o que significa que este permeado apresenta já viabilidade para sofrer um processo biológico para remoção de matéria orgânica e o concentrado apresenta um elevado potencial para recuperação de taninos. Nas fracções de MWCO inferior a 3,8 kDa, a diminuição de matéria orgânica é muito significativa, com um aumento da sua fracção biodegradável. Embora os resultados não sejam totalmente conclusivos em termos de biodegradabilidade, esta fracção apresenta já características adequadas para reutilização como água de processo.

Optimização do processo de extracção por ultra-sons

Neste trabalho foi estudado o método de preparação de amostras baseado numa extracção ácida assistida por ultra-sons para a quantificação de metais pesados (Pb, Ni, Cd e Cr), em amostras de solo. Usou-se a espectrometria de absorção atómica com câmara de grafite (GFAAS) para quantificar os metais nestas amostras recolhidas em diferentes locais da cidade de Lisboa. A optimização dos parâmetros que influenciam a extracção dos metais por ultra-sons foi realizada a cinco variáveis: quantidade de amostra, volume de extractor (água-régia), tempo de sonificação, potência de sonificação e ciclo de sonificação. A eficiência do método foi testada por comparação dos resultados com os obtidos pela digestão ácida “tradicional” em banho de areia. A optimização do processo foi realizada para o metal chumbo. Os resultados analíticos obtidos por ambos os métodos apresentaram diferenças significativas. A extracção de chumbo das amostras, por ultra-sons, apresentou uma eficiência entre 65 a 78% quando comparada com o método “tradicional”. A recuperação de cádmio apresentou percentagens entre 36 e 90%. No caso do níquel e crómio, concluiu-se haver necessidade de optimizar o processo para cada um dos metais, pois apresentaram uma baixa taxa de recuperação.

Intermittent claudication and physical exercise: effectiveness of a home-based program

Peripheral arterial disease (PAD) as a high incidence in general population and 12% to 20% of population with more than 60 years has already clinical symptoms, such as intermittent claudication (IC), pain, loss of strength and functional incapacity. There are already some studies that refer the possible positive effects of physical exercise in functional consequences of PAD. The purpose of this study was to verify the results of a home-based (HB) weekly supervised physical exercise program in patients with IC in consequence of PAD in lower limbs, and observe the medium number of diary steps walked by the subjects of our study.

Esclerose múltipla e atividade física

A prescrição de atividade física (AF) em doentes com esclerose múltipla (EM) é um tema controverso mas de grande atualidade. Diferentes estudos demonstram o interesse da prática de AF nesta população, particularmente no grupo com incapacidade baixa ou moderada. O aumento da mobilidade, a maior tolerância ao esforço e a redução da componente depressiva são os benefícios mais apresentados. ABSTRACT - The prescription of physical activity in patients with multiple sclerosis is controversial but very timely. Different studies have shown the benefits of physical activity in this population, particularly in the group with low or moderate disability. Increased mobility and exercise tolerance and the reduction of depression are the most mentioned benefits.

Comunicações digitais através de ultra-sons em ambientes subaquáticos

Actualmente, as comunicações digitais em ambientes subaquáticos representam uma necessidade humana e um desafio à engenharia de sistemas. A maioria das aplicações dirigidas a meios subaquáticos recorre a sinais acústicos, já que relativamente a sinais de natureza electromagnética ou óptica, os sinais acústicos desfrutam de uma atenuação reduzida. Contudo, os meios subaquáticos possuem um comportamento complexo relativamente à propagação de sinais acústico, sendo caracterizados como canais dispersivos, no domínio do tempo e no domínio da frequência. Como os sistemas acústicos possuem uma largura de banda limitada, requer-se que um sistema de comunicação acústico subaquático seja, simultaneamente, eficiente na gestão dos recursos que possui e eficaz nos mecanismos que implementa para ultrapassar as limitações providenciadas pelo meio. Enquadrada neste âmbito, a presente dissertação propõe uma solução completa de um sistema de comunicação digital. Apresenta-se o dimensionamento de uma plataforma genérica, de baixo custo, que suporta a transmissão e recepção de sinais acústicos num ambiente subaquático. Através desta, verifica-se num meio subaquático real se as características deste ambiente coincidem com a informação presente na respectiva literatura científica. Adicionalmente, são analisadas quais as técnicas de processamento de sinal mais adequadas às comunicações digitais neste meio. Converge-se para uma solução baseada na modulação OFDM (Orthogonal Frequency Division Multiplexing), que alcança uma eficiência espectral de 2,95 bit/s/Hz, a um ritmo binário máximo de 103,288 kbit/s, numa largura de banda de 35 kHz. Através desta técnica, obtém-se elevada robustez aos efeitos de dispersão temporal do canal de comunicação, minimizando de forma eficaz a distorção de sinal devido à interferência inter-simbólica. Esta modulação multi-portadora recorre a sub-portadoras ortogonais, maximizando desta forma a eficiência espectral do sistema. Contudo, a ortogonalidade destas componentes pode ser comprometida pelo espalhamento de Doppler introduzido pelo canal subaquático. Para minimizar este efeito, é implementado um algoritmo adaptativo baseado na técnica LMS (Least Mean Squares).

The impact of exercise training on liver transplanted familial amyloidotic polyneuropathy (FAP) patients

Liver transplantation is nowadays the only effective answer to adjourn the outcome of functional limitations associated with familial amyloidotic polyneuropathy (FAP), a neurodegenerative disease characterized by sensory and motor polyneuropathies. Nevertheless, there is a detrimental impact associated with the after-surgery period on the fragile physical condition of these patients. Exercise training has been proven to be effective on reconditioning patients after transplantation. However, the effects of exercise training in liver transplanted FAP patients have not been scrutinized yet.

Cork industry wastewater partition by ultra/nanofiltration: A biodegradation and valorisation study

Wastewater from cork processing industry present high levels of organic and phenolic compounds, such as tannins, with a low biodegradability and a significant toxicity. These compounds are not readily removed by conventional municipal wastewater treatment, which is largely based on primary sedimentation followed by biological treatment. The purpose of this work is to study the biodegradability of different cork wastewater fractions, obtained through membrane separation, in order to assess its potential for biological treatment and having in view its valorisation through tannins recovery, which could be applied in other industries. Various ultrafiltration and nanofiltration membranes where used, with molecular weight cut-offs (MWCO) ranging from 0.125 to 91 kDa. The wastewater and the different permeated fractions were analyzed in terms of Total Organic Carbon (TOC), Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Phenols (TP), Tannins, Color, pH and Conductivity. Results for the wastewater shown that it is characterized by a high organic content (670.5-1056.8 mg TOC/L, 2285-2604 mg COD/L, 1000-1225 mg BOD/L), a relatively low biodegradability (0.35-0.38 for BODs/COD and 0.44-0.47 for BOD20/COD) and a high content of phenols (360-410 mg tannic acid/L) and tannins (250-270 mg tannic acid/L). The results for the wastewater fractions shown a general decrease on the pollutant content of permeates, and an increase of its biodegradability, with the decrease of the membrane MWCO applied. Particularly, the permeated fraction from the membrane MWCO of 3.8 kDa, presented a favourable index of biodegradability (0.8) and a minimized phenols toxicity that enables it to undergo a biological treatment and so, to be treated in a municipal wastewater treatment plant. Also, within the perspective of valorisation, the rejected fraction obtained through this membrane MWCO may have a significant potential for tannins recovery. Permeated fractions from membranes with MWCO lower than 3.8 kDa, presented a particularly significant decline of organic matter and phenols, enabling this permeates to be reused in the cork processing and so, representing an interesting perspective of zero discharge for the cork industry, with evident environmental and economic advantages. (C) 2010 Elsevier Ltd. All rights reserved.

Design of a Multiband Full-Rate Ultra-Wideband Receiver in FPGA

MultiBand OFDM (MB-OFDM) UWB [1] is a short-range promising wireless technology for high data rate communications up to 480 Mbps. In this paper, we have designed and implemented in an Virtex-6 FPGA an MB-OFDM UWB receiver for the highest data rate of 480 Mbps. To test the system, we have also implemented an MB-OFDM transmitter and an AWGN generator in VHDL and determined the bit error rates at the receiver running in an FPGA.

Familial amyloid polyneuropathy (FAP): clinical features, pathophysiology and treatment

In the literature, concepts of “polyneuropathy”, “peripheral neuropathy” and “neuropathy” are often mistakenly used as synonyms. Polyneuropathy is a specific term that refers to a relatively homogenous process that affects multiple peripheral nerves. Most of these tend to present as symmetric polyneuropathies that first manifest in the distal portions of the affected nerves. Many of these distal symmetric polyneuropathies are due to toxic-metabolic causes such as alcohol abuse and diabetes mellitus. Other distal symmetric polyneuropathies may result from an overproduction of substances that result in nerve pathology such as is observed in anti-MAG neuropathy and monoclonal gammopathy of undetermined significance. Other “overproduction” disorders are hereditary such as noted in the Portuguese type of familial amyloid polyneuropathy (FAP). FAP is a manifestation of a group of hereditary amyloidoses; an autosomal dominant, multisystemic disorder wherein the mutant amyloid precursor, transthyretin, is produced in excess primarily by the liver. The liver accounts for approximately 98% of all transthyretin production. FAP is confirmed by detecting a transthyretin variant with a methionine for valine substitution at position 30 [TTR (Met30)]. Familial Amyloidotic Polyneuropathy (FAP) – Portuguese type was first described by a Portuguese neurologist, Corino de Andrade in 1939 and published in 1951. Most persons with this disorder are descended from Portuguese sailors who sired offspring in various locations, primarily in Sweden, Japan and Mallorca. Their descendants emigrated worldwide such that this disorder has been reported in other countries as well. More than 2000 symptomatic cases have been reported in Portugal. FAP progresses rapidly with an average time course from symptom onset to multi-organ involvement and death between ten and twenty years. Treatments directed at removing this aberrant protein such as plasmapheresis and immunoadsorption proved to be unsuccessful. Liver transplantation has been the only effective solution as evidenced by almost 2000 liver transplants performed worldwide. A therapy for FAP with a novel agent, “Tafamidis” has shown some promise in ongoing phase III clinical trials. It is well recognized that regular physical activity of moderate intensity has a positive effect on physical fitness as gauged by body composition, aerobic capacity, muscular strength and endurance and flexibility. Physical fitness has been reported to result in the reduction of symptoms and lesser impairment when performing activities of daily living. Exercise has been advocated as part of a comprehensive approach to the treatment of chronic diseases. Therefore, this chapter concludes with a discussion of the role of exercise training on FAP.

Análise por ultra-sons no controlo de condição

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Non invasive ventilation during exercise in COPD patients: a systematic review with meta-analysis

COPD is a major cause of morbidity and mortality worldwide, representing a major public health problem due to the high health and economic resource consumption. Pulmonary rehabilitation is a standard care recommendation for these patients, in order to control the symptoms and optimize the functional capacity, reducing health care costs associated with exacerbations and activity limitations and participation. However, in patients with severe COPD exercise performance can be difficult, due to extreme dyspnea, decreased muscle strength and fatigue. In addition, hypoxemia and dyspnea during efforts and daily activities may occur, limiting their quality of life. Thus, NIV have been used as adjunct to exercise, in order to improve exercise capacity in these patients. However, there is no consensus for this technique recommendation. Our objective was to verify whether the use of NIV during exercise is effective than exercise without NIV in dyspnea, walked distance, blood gases and health status in COPD patients, through a systematic review and meta-analysis.

Evidence based for exercise program in physical therapy in patients with multiple sclerosis

Background: Multiple sclerosis is a disease of the central nervous system that affects more frequently young women. It is a progressive and unpredictable disease, resulting in some cases of disabilities and limitations to physical, psychological and social level. Purpose: To review the literature for evidence based of the effectiveness of physiotherapy intervention in multiple sclerosis.