Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies

Recent advances in psychosocial treatments for schizophrenia have targeted social cognitive deficits. A critical literature review and effect-size (ES) analysis was conducted to investigate the efficacy of comprehensive programs of social cognitive training in schizophrenia. Results revealed 16 controlled studies consisting of seven models of comprehensive treatment with only three of these treatment models investigated in more than one study. The effects of social cognitive training were reported in 11/15 studies that included facial affect recognition skills (ES=.84) and 10/13 studies that included theory-of-mind (ES=.70) as outcomes. Less than half (4/9) of studies that measured attributional style as an outcome reported effects of treatment, but effect sizes across studies were significant (ESs=.30-.52). The effect sizes for symptoms were modest, but, with the exception of positive symptoms, significant (ESs=.32-.40). The majority of trials were randomized (13/16), selected active control conditions (11/16) and included at least 30 participants (12/16). Concerns for this area of research include the absence of blinded outcome raters in more than 50% of trials and low rates of utilization of procedures for maintaining treatment fidelity. These findings provide preliminary support for the broader use of comprehensive social cognitive training procedures as a psychosocial intervention for schizophrenia.

Learning in higher education: strategies to overcome challenges faced by adult students - lessons drawn from two studies in portugal

Int’l J. of Information and Communication Technology Education, 3(2), 1-14, April-June 2007

Eastwards / westwards: which direction for gender studies in the 21st century?

Eastwards / Westwards: Which Direction for Gender Studies in the XXIst Century? is a collection of essays which focus on themes and methods that characterize current research into gender in Asian countries in general. In this collection, ideas derived from Gender Studies elsewhere in the world have been subjected to scrutiny for their utility in helping to describe and understand regional phenomena. But the concepts of Local and Global – with their discoursive productions – have not functioned as a binary opposition: localism and globalism are mutually constitutive and researchers have interrogated those spaces of interaction between the ‘self’ and the ‘other’, bearing in mind their own embeddedness in social and cultural structures and their own historical memory. Contributors to this collection provided a critical transnational perspective on some of the complex effects of the dynamics of cultural globalization, by exploring the relation between gender and development, language, historiography, education and culture. We have also given attention to the ideological and rhetorical processes through which gender identity is constructed, by comparing textual grids and patterns of expectation. Likewise, we have discussed the role of ethnography, anthropology, historiography, sociology, fiction, popular culture and colonial and post-colonial sources in (re)inventing old/new male/female identities, their conversion into concepts and circulation through time and space. This multicultural and trans-disciplinary selection of essays is totally written in English, fully edited and revised, therefore, it has a good potential for an immediate international circulation. This project may trace new paths and issues for discussion on what concerns the life, practices and narratives by and about women in Asia, as well as elsewhere in the present day global experience. Academic readership: Researchers, scholars, educators, graduate and post-graduate students, doctoral students and general non-fiction readers, with a special interest in Gender Studies, Asia, Colonial and Post-Colonial Literature, Anthropology, Cultural Studies, History, Historiography, Politics, Race, Feminism, Language, Linguistics, Power, Political and Feminist Agendas, Popular Culture, Education, Women’s Writing, Religion, Multiculturalism, Globalisation, Migration. Chapter summary: 1. “Social Gender Stereotypes and their Implication in Hindi”, Anjali Pande, Jawaharlal Nehru University, New Delhi, India. This essay looks at the subtle ways in which gender identities are constructed and reinforced in India through social norms of language use. Language itself becomes a medium for perpetuating gender stereotypes, forcing its speakers to confirm to socially defined gender roles. Using examples from a classroom discussion about a film, this essay will highlight the underlying rigid male-female stereotypes in Indian society with their more obvious expressions in language. For the urban woman in India globalisation meant increased economic equality and exposure to changed lifestyles. On an individual level it also meant redefining gender relations and changing the hierarchy in man-­woman relationships. With the economic independence there is a heightened sense of liberation in all spheres of social life, a confidence to fuzz the rigid boundaries of gender roles. With the new films and media celebrating this liberated woman, who is ready to assert her sexual needs, who is ready to explode those long held notions of morality, one would expect that the changes are not just superficial. But as it soon became obvious in the course of a classroom discussion about relationships and stereotypes related to age, the surface changes can not become part of the common vocabulary, for the obvious reason that there is still a vast gap between the screen image of this new woman and the ground reality. Social considerations define the limits of this assertiveness of women, whereas men are happy to be liberal within the larger frame of social sanctions. The educated urban woman in India speaks in favour of change and the educated urban male supports her, but one just needs to scratch the surface to see the time tested formulae of gender roles firmly in place. The way the urban woman happily balances this emerging promise of independence with her gendered social identity, makes it necessary to rethink some aspects of looking at gender in a gradually changing, traditional society like India. 2. “The Linguistic Dimension of Gender Equality”, Alissa Tolstokorova, Kiev Centre for Gender Information and Education, Ukraine. The subject-matter of this essay is gender justice in language which, as I argue, may be achieved through the development of a gender-related approach to linguistic human rights. The last decades of the 20th century, globally marked by a “gender shift” in attitudes to language policy, gave impetus to the social movement for promoting linguistic gender equality. It was initiated in Western Europe and nowadays is moving eastwards, as ideas of gender democracy progress into developing countries. But, while in western societies gender discrimination through language, or linguistic sexism, was an issue of concern for over three decades, in developing countries efforts to promote gender justice in language are only in their infancy. My argument is that to promote gender justice in language internationally it is necessary to acknowledge the rights of women and men to equal representation of their gender in language and speech and, therefore, raise a question of linguistic rights of the sexes. My understanding is that the adoption of the Universal Declaration of Linguistic Rights in 1996 provided this opportunity to address the problem of gender justice in language as a human rights issue, specifically as a gender dimension of linguistic human rights. 3. “The Rebirth of an Old Language: Issues of Gender Equality in Kazakhstan”, Maria Helena Guimarães, Polytechnic Institute of Porto, Portugal. The existing language situation in Kazakhstan, while peaceful, is not without some tension. We propose to analyze here some questions we consider relevant in the frame of cultural globalization and gender equality, such as: free from Russian imperialism, could Kazakhstan become an easy prey of Turkey’s “imperialist dream”? Could these traditionally Muslim people be soon facing the end of religious tolerance and gender equality, becoming this new old language an easy instrument for the infiltration in the country of fundamentalism (it has already crossed the boarders of Uzbekistan), leading to a gradual deterioration of its rich multicultural relations? The present structure of the language is still very fragile: there are three main dialects and many academics defend the re-introduction of the Latin alphabet, thus enlarging the possibility of cultural “contamination” by making the transmission of fundamentalist ideas still easier through neighbour countries like Azerbaijan, Uzbekistan and Turkmenistan (their languages belong to the same sub-group of Common Turkic), where the Latin alphabet is already in use, and where the ground for such ideas shown itself very fruitful. 4. “Construction of Womanhood in the Bengali Language of Bangladesh”, Raasheed Mahmood; University of New South Wales, Sydney. The present essay attempts to explore the role of gender-based language differences and of certain markers that reveal the status accorded to women in Bangladesh. Discrimination against women, in its various forms, is endemic in communities and countries around the world, cutting across class, race, age, and religious and national boundaries. One cannot understand the problems of gender discrimination solely by referring to the relationship of power or authority between men and women. Rather one needs to consider the problem by relating it to the specific social formation in which the image of masculinity and femininity is constructed and reconstructed. Following such line of reasoning this essay will examine the nature of gender bias in the Bengali language of Bangladesh, holding the conviction that as a product of social reality language reflects the socio-cultural behaviour of the community who speaks it. This essay will also attempt to shed some light on the processes through which gender based language differences produce actual consequences for women, who become exposed to low self-esteem, depression and systematic exclusion from public discourse. 5. “Marriage in China as an expression of a changing society”, Elisabetta Rosado David, University of Porto, Portugal, and Università Ca’Foscari, Venezia, Italy. In 29 April 2001, the new Marriage Law was promulgated in China. The first law on marriage was proclaimed in 1950 with the objective of freeing women from the feudal matrimonial system. With the second law, in 1981, values and conditions that had been distorted by the Cultural Revolution were recovered. Twenty years later, a new reform was started, intending to update marriage in the view of the social and cultural changes that occurred with Deng Xiaoping’s “open policy”. But the legal reform is only the starting point for this case-study. The rituals that are followed in the wedding ceremony are often hard to understand and very difficult to standardize, especially because China is a vast country, densely populated and characterized by several ethnic minorities. Two key words emerge from this issue: syncretism and continuity. On this basis, we can understand tradition in a better way, and analyse whether or not marriage, as every social manifestation, has evolved in harmony with Chinese culture. 6. “The Other Woman in the Portuguese Colonial Empire: The Case of Portuguese India”, Maria de Deus Manso, University of Évora, Portugal. This essay researches the social, cultural and symbolic history of local women in the Portuguese Indian colonial enclaves. The normative Portuguese overseas history has not paid any attention to the “indigenous” female populations in colonial Portuguese territories, albeit the large social importance of these social segments largely used in matrimonial and even catholic missionary strategies. The first attempt to open fresh windows in the history of this new field was the publication of Charles Boxer’s referential study about Women in lberian Overseas Expansion, edited in Portugal only after the Revolution of 1975. After this research we can only quote some other fragmentary efforts. In fact, research about the social, cultural, religious, political and symbolic situation of women in the Portuguese colonial territories, from the XVI to the XX century, is still a minor historiographic field. In this essay we discuss this problem and we study colonial representations of women in the Portuguese Indian enclaves, mainly in the territory of Goa, using case studies methodologies. 7. “Heading East this Time: Critical Readings on Gender in Southeast Asia”, Clara Sarmento, Polytechnic Institute of Porto, Portugal. This essay intends to discuss some critical readings of fictional and theoretical texts on gender condition in Southeast Asian countries. Nowadays, many texts about women in Southeast Asia apply concepts of power in unusual areas. Traditional forms of gender hegemony have been replaced by other powerful, if somewhat more covert, forms. We will discuss some universal values concerning conventional female roles as well as the strategies used to recognize women in political fields traditionally characterized by male dominance. Female empowerment will mean different things at different times in history, as a result of culture, local geography and individual circumstances. Empowerment needs to be perceived as an individual attitude, but it also has to be facilitated at the macro­level by society and the State. Gender is very much at the heart of all these dynamics, strongly related to specificities of historical, cultural, ethnic and class situatedness, requiring an interdisciplinary transnational approach.

Sinergia extensora do membro superior no movimento de alcance. Capacidade de placing do polegar

Objetivo: avaliar as modificações ocorridas no âmbito da sequência de ativação o da sinergia extensora do MS e na sua influência sobre a capacidade de placing do polegar face à aplicação de um programa de intervenção em fisioterapia. Pretendeu-se também verificar as repercussões ao nível da participação dos indivíduos nas AVD`s. Metodologia: esta série de estudos de casos foi constituída por dois indivíduos com modificações nas componentes neuromotoras de movimento após AVE predominantes no MS. A avaliação dois indivíduos foi realizada em dois momentos PRE e POST separados por um período de intervenção de cerca de quinze semanas. Em cada momento de avaliação foi aplicada a F-MAMR, foi recolhido sinal electromiográfico dos músculos GD, DP, TLONG, TLAT e ABDPOL durante o movimento de alcance e usaram-se seis itens da CIF selecionadas de acordo com as necessidades sentidas. No momento PRE aplicou-se a MMSE para detetar défices cognitivos que interferissem com o processo de avaliação e de intervenção. O programa de intervenção foi individualizado e devidamente ajustado aos indivíduos, procurando que estes mantivessem um papel ativo durante a reabilitação. Esta foi realizada com a frequência de três vezes por semana e cada sessão teve cerca de quarenta e cinco minutos de trabalho ativo. Resultados: encontraram-se modificações na sequência de ativação muscular nos dois indivíduos e entre os indivíduos nos dois momentos de avaliação, nomeadamente no tempo de ativação muscular. O ABDPOL modificou o tempo em que iniciou atividade muscular e passou a recrutar atividade quase simultaneamente ao início do movimento da mão, verificando-se uma influência positiva da sinergia extensora do MS na capacidade de placing do polegar. Verificaram-se resultados positivos no estado sensório-motor do MS e na capacidade do indivíduo em participar em diversas AVD`s selecionadas de acordo com as necessidades. Conclusão: este estudo parece apontar para uma influência positiva nas modificações do nível de atividade da sinergia extensora do MS e na influência desta sobre a capacidade de placing do polegar durante o movimento de alcance, face a um programa de intervenção. Este estudo parece apontar também para uma influência positiva sobre a capacidade do indivíduo em participar em AVD`s selecionadas para a avaliação de acordo com necessidades sentidas.

Qualidade de vida relacionada com o exercício em indivíduos com asma: revisão sistemática

Background: A asma condiciona o dia-a-dia do indivíduo asmático do ponto de vista clínico e emocional demonstrando-se muitas vezes como um subtractivo da qualidade de vida (QV). Alguns estudos, com particular incidência nos últimos dez anos, para além de demonstrarem os benefícios da actividade física na componente clínica da doença, têm analisado o seu efeito na QV dos asmáticos. Objectivo: Analisar os efeitos da actividade física na QV de indivíduos com asma tendo por base uma revisão da literatura actual. Métodos: Foi conduzida uma pesquisa dos randomized controlled trials (RCT) compreendidos entre Janeiro de 2000 e Agosto de 2010, bem como as citações e as referências bibliográficas de cada estudo nas principais bases de dados de ciências da saúde (Academic Search Complete, DOAJ, Elsevier – Science Direct, Highwire Press, PubMed, Scielo Global, Scirus, Scopus, SpringerLink, Taylor & Francis e Wiley Interscience) com as palavras-chave: asthma, quality of life, QoL, physical activity, exercise, breathing, training e programme em todas as combinações possíveis. Os estudos foram analisados independentemente por dois revisores quanto aos critérios de inclusão e qualidade dos estudos. Resultados: Dos 1075 estudos identificados apenas onze foram incluídos. Destes, seis apresentaram um score 5/10, três 6/10 e dois 7/10 segundo a escala PEDro. Cinco destes estudos foram realizados em crianças entre os 7 e os 15 anos e os restantes em adultos. Os programas de intervenção dividiram-se em programas de treino aeróbio e programas de exercícios respiratórios. Todos programas de treino aeróbio apresentaram melhorias na QV demonstrando uma influência positiva do treino aeróbio na asma. Principais conclusões: Há uma tendência notória do benefício dos programas de treino aeróbio na QV dos indivíduos asmáticos. Os programas de exercícios respiratórios foram poucos e heterogéneos impossibilitando uma conclusão positiva quanto à sua recomendação para a melhoria da QV nesta patologia. Há uma grande necessidade de mais RCT com rigor metodológico.

A eficácia e segurança da fisioterapia respiratória no tratamento da bronquiolite aguda em crianças até 2 anos de idade: revisão sistemática

Contexto: a bronquiolite aguda é a principal patologia a afectar a criança nos primeiros 2 anos de vida, a fisioterapia respiratória é uma intervenção terapêutica utilizada com a intenção de melhorar o curso desta doença mantendo-se a incerteza sobre a sua eficácia. Objectivo: determinar a eficácia e segurança da fisioterapia respiratória em crianças com menos de 2 anos com bronquiolite aguda. Fontes de Informação: Medline (1966 a Agosto 2010), EMBASE(1990 a Agosto 2010), Pedro e Lilacs (1982 a Agosto 2010). Outra fonte de informação incluiu a bibliografia dos estudos obtidos. Selecção de estudos: estudos experimentais comparando a fisioterapia respiratória com cuidados habituais, em crianças com menos de 2 anos e bronquiolite aguda, em ventilação espontânea, em qualquer contexto. Estudos pré-experimentais ou observacionais com os mesmos participantes e intervenções foram admitidos complementarmente aos experimentais. Extracção de dados e análise: um investigador extraiu os dados dos artigos obtidos e avaliou o risco de viés. A eficácia e segurança da fisioterapia respiratória foram determinadas pelos seguintes outcomes: duração do internamento hospitalar ou do evento, variação de scores de severidade clínica, saturação periférica e suplementação de oxigénio, recidivas, recurso a antibióticos e efeitos deletérios ou deterioração clínica reportada. Síntese de dados: 6 estudos experimentais foram admitidos. As suas amostras provinham de criança internadas em hospital. As técnicas de fisioterapia respiratória foram comparadas com cuidados habituais. Nenhum estudo evidenciou melhoria dos outcomes de interesse na comparação entre grupos, excepto avaliações de curta duração da saturação periférica de oxigénio e scores de severidade clínica. 1 estudo reportou uma percentagem significativamente maior no grupo submetido a fisioterapia respiratória de crianças que vomitaram, tiveram uma desestabilização respiratória transitória, e na percepção de stress da criança pelos cuidadores. São relatadas ainda fracturas costais a causa de fisioterapia respiratória. Limitações: o risco de viés era alto em 2 estudos, baixo num estudo e indeterminado nos restantes. Conclusões: aparentemente a fisioterapia respiratória não é eficaz e pode produzir efeitos deletérios importantes, mas a evidência é pobre, carecendo de novos estudos.

Estudo descritivo da unidade de cuidados intensivos e intermédios respiratórios do Hospital Clínico - Barcelona

Este estudo tem como objectivo descrever a Unidade de cuidados intensivos e intermédios respiratórios do Hospital Clínico em Barcelona de forma a caracterizá-la tanto ao nível de recursos materiais e humanos como em termos de protocolos usados. Esta unidade é considerada uma das melhores da Europa, dispondo da mais alta tecnologia, desenvolvendo protocolos baseados na evidência de forma a reduzir ao máximo a taxa de mortalidade neste local. O staff médico sempre em constante actualização, trabalhando muito no campo da investigação. Por outro lado, a fisioterapia integrante no Instituto Clínico do Tórax realiza menos investigação investindo mais no tratamento de doentes não intubados, tendo como técnicas de eleição posicionamento, mobilização, expiração forçada e hidratação oral. Em relação à VNI, muitos dos estudos referentes a este tema foram realizados pelo staff médico deste Hospital. O staff de fisioterapia é responsável pela adaptação da VNI nos pacientes hipercápnicos. Em conclusão, o número e tempo limitado de fisioterapeutas na unidade não contribuem para a aplicação de novas técnicas que requerem a intervenção de dois fisioterapeutas. Palavras-chave: unidade de cuidados intensivos respiratórios, unidade de cuidados intermédios respiratórios, VNI, papel dos fisioterapeutas respiratórios.

Supporting leadership development by exposure to role models: two case studies

The idiomatic expression “In Rome be a Roman” can be applied to leadership training and development as well. Leaders who can act as role models inspire other future leaders in their behaviour, attitudes and ways of thinking. Based on two examples of current leaders in the fields of Politics and Public Administration, I support the idea that exposure to role models during their training was decisive for their career paths and current activities as prominent characters in their profession. Issues such as how students should be prepared for community or national leadership as well as cross-cultural engagement are raised here. The hypothesis of transculturalism and cross-cultural commitment as a factor of leadership is presented. Based on current literature on Leadership as well as the presented case studies, I expect to raise a debate focusing on strategies for improving leaders’ training in their cross-cultural awareness.

The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles

DESIGN: A randomized controlled trial.OB JECTIVE: To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. BACKGROUND : Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. METHODS: One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. RESULTS: The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P =.003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. CONCLUSIONS: The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. LEVEL OF EVIDENCE : Therapy, level 1b. J Orthop Sports Phys Ther 2010;40(5):310-317. doi:10.2519/jospt.2010.3257. KEYWORDSDS: cervical manipulation, muscle trigger points, neck, TMJ, upper cervical.

Peer Instruction method in introductory math courses

Learning is not a spectator’s sport. Students do not learn much by just sitting in class listening their teachers, memorizing pre-packaged assignments and spitting out answers. The teaching-learning process has been a constant target of studies, particularly in Higher Education, in consequence of the annual increase of new students. The concern with maintaining a desired quality level in the training of these students, conjugated with the will to widen the access to all of those who finish Secondary School Education, has triggered a greater intervention from the education specialists, in partnership with the teachers of all Higher Education areas, in the analysis of this problem. Considering the particular case of Engineering, it has been witnessed a rising concern with the active learning strategies and forms of assessment. Research has demonstrated that students learn more if they are actively engaged with the material they are studying. In this presentation we describe, present and discuss the techniques and the results of Peer Instruction method in an introductory Calculus courses of an Engineering Bach

Data mining applications in power systems - case-studies and future trends

Presently power system operation produces huge volumes of data that is still treated in a very limited way. Knowledge discovery and machine learning can make use of these data resulting in relevant knowledge with very positive impact. In the context of competitive electricity markets these data is of even higher value making clear the trend to make data mining techniques application in power systems more relevant. This paper presents two cases based on real data, showing the importance of the use of data mining for supporting demand response and for supporting player strategic behavior.

A new wind farm in Santiago Island, cape verde - simulation and economic studies

Ensuring sustainable development conditions is presently world widely recognized as a critically important goal. This makes the use of electricity generation technologies based on renewable energy sources very relevant. Developing countries depend on an adequate availability of electrical energy to assure economic progress and are usually characterized by a high increase in electricity consumption. This makes sustainable development a huge challenge but it can also be taken as an opportunity, especially for countries which do not have fossil resources. This paper presents a study concerning the expansion of an already existent wind farm, located in Praia, the capital of Cape Verde Republic. The paper includes results from simulation studies that have been undertaken using PSCAD software and some economic considerations.

Qualidade de vida do doente com insuficiência cardíaca do Centro Hospitalar Tâmega e Sousa

A Insuficiência Cardíaca (IC), como uma doença crónica, tem vindo a ser alvo de análise devido ao seu impacto, não só a nível económico, mas também a nível da qualidade de vida (QV). Vários estudos demonstram que os doentes com IC apresentam um comprometimento da QV, em várias dimensões. OBJETIVO: Descrever a QV dos doentes com IC do Centro Hospitalar Tâmega e Sousa (CHTS). METODOLOGIA: O estudo é quantitativo, transversal, prospetivo e descritivo. Foi aplicado, entre janeiro a junho de 2012, o Euro Quality of Life Instrument-5D (EQ-5D) para avaliar o estado de saúde (ES) e o Kansas City Cardiomyopathy Questionnaire (KCCQ) para avaliar a QV de 326 doentes com IC, dos quais 226 seguidos na Consulta Externa (77,9% masculinos, idade média 67,5 ±11,6 anos, desvio padrão) e 100 na Clínica de IC (CIC) (73,0% masculinos, idade média 59,0 anos, desvio padrão ±12,7). Foi usada a estatística descritiva, teste t, qui quadrado e a análise da variância. RESULTADOS: Os doentes do género feminino, do grupo etário 75-100 anos, solteiros, divorciados, separados ou viúvos, que não sabem ler nem escrever, sem apoio dos amigos e sem condições económicas mínimas para o tratamento da IC apresentaram pior ES e QV. Os doentes submetidos à terapia de ressincronização cardíaca e às cirurgias valvular e de revascularização tiveram melhor QV. Os doentes com IC de etiologia isquémica e em classe III-IV da New York Heart Association apresentaram pior ES. Nestas classes e com fração de ejeção ≤35% os doentes tiveram pior QV. Os doentes da CIC evidenciaram melhor ES e QV. CONCLUSÕES: A QV dos doentes com IC do CHTS é influenciada pelos fatores pessoais, clínicos e pelo local de intervenção. É fundamental mensurar a QV, na prática clínica, para evidenciar a perceção do ES dos doentes e o impacto da IC na QV.

Effect of oxidative stress upon absorption of glucose by the human placenta: in vitro studies with BeWo cells

Pregnancy is a dynamic state and the placenta is a temporary organ that, among other important functions, plays a crucial role in the transport of nutrients and metabolites between the mother and the fetus, which is essential for a successful pregnancy. Among these nutrients, glucose is considered a primary source of energy and, therefore, fundamental to insure proper fetus development. Several studies have shown that glucose uptake is dependent on several morphological and biochemical placental conditions. Oxidative stress results from the unbalance between reactive oxygen species (ROS) and antioxidants, in favor of the first. During pregnancy, ROS, and therefore oxidative stress, increase, due to increased tissue oxygenation. Moreover, the relation between ROS and some pathological conditions during pregnancy has been well established. For these reasons, it becomes essential to understand if oxidative stress can compromise the uptake of glucose by the placenta. To make this study possible, a trophoblastic cell line, the BeWo cell line, was used. Experiments regarding glucose uptake, either under normal or oxidative stress conditions, were conducted using tert-butylhydroperoxide (tBOOH) as an oxidative stress inducer, and 3H-2-deoxy-D-glucose (3H-DG) as a glucose analogue. Afterwards, studies regarding the involvement of glucose facilitative transporters (GLUT) and the phosphatidylinositol 3-kinases (PI3K) and protein kinase C (PKC) pathways were conducted, also under normal and oxidative stress conditions. A few antioxidants, endogenous and from diet, were also tested in order to study their possible reversible effect of the oxidative effect of tBOOH upon apical 3H-DG uptake. Finally, transepithelial studies gave interesting insights regarding the apical-to-basolateral transport of 3H-DG. Results showed that 3H-DG uptake, in BeWo cells, is roughly 50% GLUT-mediated and that tBOOH (100 μM; 24h) decreases apical 3H-DG uptake in BeWo cells by about 33%, by reducing both GLUT- (by 28%) and non-GLUT-mediated (by 40%) 3H-DG uptake. Uptake of 3H-DG and the effect of tBOOH upon 3H-DG uptake are not dependent on PKC and PI3K. Moreover, the effect of tBOOH is not associated with a reduction in GLUT1 mRNA levels. Resveratrol, quercetin and epigallocatechin-3-gallate, at 50 μM, reversed, by at least 45%, the effect of tBOOH upon 3H-DG uptake. Transwell studies show that the apical-to-basolateral transepithelial transport of 3H-DG is increased by tBOOH.In conclusion, our results show that tBOOH caused a marked decrease in both GLUT and non-GLUT-mediated apical uptake of 3H-DG by BeWo cells. Given the association of increased oxidative stress levels with several important pregnancy pathologies, and the important role of glucose for fetal development, the results of this study appear very interesting.