Microcytic anemia factor no estudo das anemias microcíticas

A anemia ferropénica e a β-Talassemia menor são as anemias microcíticas mais frequentes na prática laboratorial, sendo o seu diagnóstico de extrema importância clínica. O objectivo deste estudo consistiu na análise do poder discriminatório do MAF na caracterização destas anamias. Foi desenvolvido um estudo caso-controlo, tendo sido analisados os hemogramas de um grupo de 47 indivíduos com anemia ferropénica e 37 com β-talassemia, e de um grupo controlo constituído por 58 indivíduos saudáveis. Na diferenciação dos grupos patológicos, apenas a Hemoglobina, o VGM e o RDW apresentaram diferenças significativas. O MAF não demonstrou poder discriminatório relativamente às anemias microcíticas.

A criação de valor no mercado da saúde enquanto factor diferenciador para a negociação de preços e competitividade em contexto de crise mundial

A criação de valor no mercado da saúde enquanto factor diferenciador para a negociação de preços e competitividade em contexto de crise mundial Numa altura em que o sector da saúde é apontado como uma área crítica de custos, torna-se cada vez mais difícil orientar a contratação em saúde baseada em valor para os pacientes, ou seja, pelos resultados obtidos e não pelo volume de cuidados prestados. Pretendeu-se estudar a criação de valor no mercado da saúde enquanto factor diferenciador para a negociação de preços e competitividade em contexto de crise económica. Procedeu-se à comparação dos resultados operacionais de uma empresa enquanto prestadora de serviços de Oxigenoterapia ao domicílio, tendo por base duas estratégias diferentes: redução directa de preços ou manutenção de preços com criação de valor para o cliente. As propostas foram posteriormente apresentadas para avaliação e votação on-line por um grupo 8 gestores hospitalares. A proposta baseada em valor (Nº2) apresenta melhores resultados operacionais (41%) embora apresente maiores custos. No que se refere à votação das propostas e tendo em conta o cenário apresentado, metade dos gestores optaram pela proposta Nº1 (N=4) e outra metade pela proposta Nº2 (N=4). Contudo, a maioria dos gestores (N=7) consideraram a proposta Nº1 a mais competitiva em contexto de competição com mais fornecedores. Conclui-se que numa negociação de contratos de cuidados de saúde, uma proposta baseada em valor, pode garantir a manutenção dos preços. Todavia, mantendo-se uma situação económica de recessão e num cenário competitivo de vários fornecedores este tipo de propostas pode não eleita, pelo facto de aparentemente não representar ganhos imediatos para a instituição contratante.

A realidade virtual como factor de atracção para a engenharia

O objectivo da Realidade Virtual é simples de entender mas muito difícil de implementar: criar ambientes completamente indiferenciáveis do mundo real com os quais se possa interagir de um modo natural. Desde a criação do Sensorama por Morton Heiling em 1962, passando pela difusão do conceito pelo público geral na década de 90 até os dias de hoje, a evolução da Realidade Virtual tem sido constante. Este conjunto de tecnologias tem estado envolvido por uma certa descrença por parte da sociedade, motivada pelas grandes expectativas que lhe foram atribuídas e pelo estado de desenvolvimento do hardware aquando do seu auge. No entanto, actualmente assiste-se a um ressurgimento do seu interesse no público geral com a introdução de imagem estereoscópica no cinema ou o sucesso dos controladores da consola Nintendo Wii. Hoje em dia as suas aplicações são muito variadas: desde o treino de pilotos de avião ao tratamento de fobias, passando pela industria do entretenimento e a visita virtual de locais com interesse histórico ou turístico. O objectivo desta tese de mestrado é explorar uma área que ainda não tem sido muito abrangida pela Realidade Virtual e que cobre também aspectos educacionais e lúdicos de modo a ser um factor de atracção para os estudantes do ensino secundário: a simulação de instrumentos musicais. Para tal foi implementado um sistema capaz de simular instrumentos musicais de percussão (uma bateria) utilizando imagem estereoscópica, som posicional e interfaces com o utilizador realistas. Os resultados obtidos nas sessões de avaliação efectuadas por alunos recentemente ingressados no ensino superior demonstram que o sistema desenvolvido, bem como a inovação em interfaces do utilizador com os dispositivos electrónicos de uma forma geral, constituem um meio efectivo na sua motivação para a escolha de um curso na área da engenharia.

The predominance of M2-polarized macrophages in the stroma of low-hypoxic bladder tumors is associated with BCG immunotherapy failure

OBJECTIVE: Bacillus Calmette-Guérin (BCG) immunotherapy is the gold standard treatment for superficial bladder tumors with intermediate/high risk of recurrence or progression. However, approximately 30% of patients fail to respond to the treatment. Effective BCG therapy needs precise activation of the type 1 helper cells immune pathway. Tumor-associated macrophages (TAMs) often assume an immunoregulatory M2 phenotype and may directly interfere with the BCG-induced antitumor immune response. Thus, we aim to clarify the influence of TAMs, in particular of the M2 phenotype in stroma and tumor areas, in BCG treatment outcome. PATIENTS AND METHODS: The study included 99 patients with bladder cancer treated with BCG. Tumors resected before treatment were evaluated using immunohistochemistry for CD68 and CD163 antigens, which identify a lineage macrophage marker and a M2-polarized specific cell surface receptor, respectively. CD68+ and CD163+ macrophages were evaluated within the stroma and tumor areas, and high density of infiltrating cells spots were selected for counting. Hypoxia, an event known to modulate macrophage phenotype, was also assessed through hypoxia induced factor (HIF)-1α expression. RESULTS: Patients in whom BCG failed had high stroma-predominant CD163+ macrophage counts (high stroma but low tumor CD163+ macrophages counts) when compared with the ones with a successful treatment (71% vs. 47%, P = 0.017). Furthermore, patients presenting this phenotype showed decreased recurrence-free survival (log rank, P = 0.008) and a clear 2-fold increased risk of BCG treatment failure was observed in univariate analysis (hazard ratio = 2.343; 95% CI: 1.197-4.587; P = 0.013). Even when adjusted for potential confounders, such as age and therapeutic scheme, multivariate analysis revealed 2.6-fold increased risk of recurrence (hazard ratio = 2.627; 95% CI: 1.340-5.150; P = 0.005). High stroma-predominant CD163+ macrophage counts were also associated with low expression of HIF-1α in tumor areas, whereas high counts of CD163+ in the tumor presented high expression of HIF-1α in tumor nests. CONCLUSIONS: TAMs evaluation using CD163 is a good indicator of BCG treatment failure. Moreover, elevated infiltration of CD163+ macrophages, predominantly in stroma areas but not in the tumor, may be a useful indicator of BCG treatment outcome, possibly owing to its immunosuppressive phenotype.

P53 and Cancer-Associated Sialylated Glycans Are Surrogate Markers of Cancerization of the Bladder Associated with Schistosoma haematobium Infection

BACKGROUND: Bladder cancer is a significant health problem in rural areas of Africa and the Middle East where Schistosoma haematobium is prevalent, supporting an association between malignant transformation and infection by this blood fluke. Nevertheless, the molecular mechanisms linking these events are poorly understood. Bladder cancers in infected populations are generally diagnosed at a late stage since there is a lack of non-invasive diagnostic tools, hence enforcing the need for early carcinogenesis markers. METHODOLOGY/PRINCIPAL FINDINGS: Forty-three formalin-fixed paraffin-embedded bladder biopsies of S. haematobium-infected patients, consisting of bladder tumours, tumour adjacent mucosa and pre-malignant/malignant urothelial lesions, were screened for bladder cancer biomarkers. These included the oncoprotein p53, the tumour proliferation rate (Ki-67>17%), cell-surface cancer-associated glycan sialyl-Tn (sTn) and sialyl-Lewisa/x (sLea/sLex), involved in immune escape and metastasis. Bladder tumours of non-S. haematobium etiology and normal urothelium were used as controls. S. haematobium-associated benign/pre-malignant lesions present alterations in p53 and sLex that were also found in bladder tumors. Similar results were observed in non-S. haematobium associated tumours, irrespectively of their histological nature, denoting some common molecular pathways. In addition, most benign/pre-malignant lesions also expressed sLea. However, proliferative phenotypes were more prevalent in lesions adjacent to bladder tumors while sLea was characteristic of sole benign/pre-malignant lesions, suggesting it may be a biomarker of early carcionogenesis associated with the parasite. A correlation was observed between the frequency of the biomarkers in the tumor and adjacent mucosa, with the exception of Ki-67. Most S. haematobium eggs embedded in the urothelium were also positive for sLea and sLex. Reinforcing the pathologic nature of the studied biomarkers, none was observed in the healthy urothelium. CONCLUSION/SIGNIFICANCE: This preliminary study suggests that p53 and sialylated glycans are surrogate biomarkers of bladder cancerization associated with S. haematobium, highlighting a missing link between infection and cancer development. Eggs of S. haematobium express sLea and sLex antigens in mimicry of human leukocytes glycosylation, which may play a role in the colonization and disease dissemination. These observations may help the early identification of infected patients at a higher risk of developing bladder cancer and guide the future development of non-invasive diagnostic tests.

Teaching and learning with social software in higher education: content management systems integrated with Web-based applications as a key factor for success

The change of paradigm imposed by the Bologna process, in which the student will be responsible for their own learning, and the presence of a new generation of students with higher technological skills, represent a huge challenge for higher education institutions. The use of new Web Social concepts in teaching process, supported by applications commonly called Web 2.0, with which these new students feel at ease, can bring benefits in terms of motivation and the frequency and quality of students' involvement in academic activities. An e-learning platform with web-based applications as a complement can significantly contribute to the development of different skills in higher education students, covering areas which are usually in deficit.

Stability of the Transthyretin Molecule as a Key Factor in

Transthyretin (TTR) protects against A-Beta toxicity by binding the peptide thus inhibiting its aggregation. Previous work showed different TTR mutations interact differently with A-Beta, with increasing affinities correlating with decreasing amyloidogenecity of the TTR mutant; this did not impact on the levels of inhibition of A-Beta aggregation, as assessed by transmission electron microscopy. Our work aimed at probing differences in binding to A-Beta by WT, T119M and L55P TTR using quantitative assays, and at identifying factors affecting this interaction. We addressed the impact of such factors in TTR ability to degrade A-Beta. Using a dot blot approach with the anti-oligomeric antibody A11, we showed that A-Beta formed oligomers transiently, indicating aggregation and fibril formation, whereas in the presence of WT and T119M TTR the oligomers persisted longer, indicative that these variants avoided further aggregation into fibrils. In contrast, L55PTTR was not able to inhibit oligomerization or to prevent evolution to aggregates and fibrils. Furthermore, apoptosis assessment showed WT and T119M TTR were able to protect against A-Beta toxicity. Because the amyloidogenic potential of TTR is inversely correlated with its stability, the use of drugs able to stabilize TTR tetrameric fold could result in increased TTR/ABeta binding. Here we showed that iododiflunisal, 3-dinitrophenol, resveratrol, [2-(3,5-dichlorophenyl)amino] (DCPA) and [4- (3,5-difluorophenyl)] (DFPB) were able to increase TTR binding to A-Beta; however only DCPA and DFPB improved TTR proteolytic activity. Thyroxine, a TTR ligand, did not influence TTR/A-Beta interaction and A-Beta degradation by TTR, whereas RBP, another TTR ligand, not only obstructed the interaction but also inhibited TTR proteolytic activity. Our results showed differences between WT and T119M TTR, and L55PTTR mutant regarding their interaction with A-Beta and prompt the stability of TTR as a key factor in this interaction, which may be relevant in AD pathogenesis and for the design of therapeutic TTR-based therapies.

Aerobic Exercise Does Not Predict Brain Derived Neurotrophic Factor And Cortisol Alterations in Depressed Patients

The pathophysiology of depression is related to neurobiological changes that occur in the monoamine system, hypothalamic-pituitary-adrenal axis, neurogenesis system and the neuroimmune system. In recent years, there has been a growing interest in the research of the effects of exercise on brain function, with a special focus on its effects on brainderived neurotrophic factor (BDNF), cortisol and other biomarkers. Thus, the aim of this study is to present a review investigating the acute and chronic effects of aerobic exercise on BDNF and cortisol levels in individuals with depression. It was not possible to establish an interaction between aerobic exercise and concentration of BDNF and cortisol, which may actually be the result of the divergence of methods, such as type of exercises, duration of the sessions, and prescribed intensity and frequency of sessions.