Queratocone : impacto psico-social da doença na vida do doente

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Conhecimento da doença renal crônica entre médicos conforme as diretrizes práticas

INTRODUCTION: Chronic kidney disease (CKD) is a global health problem, with increasing prevalence in its terminal stage and one of the factors that can contribute is the failure to recognize the disease and its risk factors. OBJECTIVE: To evaluate the knowledge of medical residents (MR) and medical preceptors (MP) in hospitals in the Federal University of Rio Grande do Norte in Natal-RN - Brazil, on the DRC, based on the policy of the Kidney Disease Improving Global Outcomes (KDIGO ). METHODS: Cross-sectional study where 64 MR (R1 = 32; R2 = 15; R3 = 17) and 63 MP answered a questionnaire divided into seven sessions that addressed aspects of the DRC since the setting up referral to a nephrologist. RESULTS: Only 20 participants (15.7%) reported using any guidelines for the management of CKD. The scores obtained by session were: Definition and classification (46.1 ± 47.8); Risk factors (70.5 ± 27.9); Laboratory evaluation (58.2 ± 8.8); Clinical action plan (57.6 ± 19.9); Reduction in proteinuria (68.3 ± 15.0); Complications (64.8 ± 19.9); Referral to a nephrologist (73.0 ± 44.6). There was a statistically significant difference between the knowledge of MR and MP in the sessions: Laboratory evaluation (MR 61.5 ± 8.4 vs 54.8 ± 7.9 MP; p <0.001); Reduction in proteinuria (73.1 ± 11.4 vs MR MP 63.5 ± 16.7; p <0.001) and Referral to a nephrologist (MR 81.2 ± 39.3 vs 64.5 ± 48.2 MP; p = 0.035). Among the MR, the R2 obtained the best score (63.9 ± 22.6 vs R1 R2 R3 71.9 ± 17.2 vs 63.5 ± 22.5, p = 0.445). It identified a low percentage of success of the doctors on the definition of CKD (MP = 46%; R1 = 40.6%; R2 = 60%; R3 = 52.9%; p = 0.623) and classification (MP = 34.9%; R1 = 53.1%, R2 = 60%; R3 = 52.9%; p = 0.158). CONCLUSION: The study showed that most doctors do not use any guidelines for clinical management of CKD and that there are gaps in knowledge on the subject, even among physicians who work in the university environment. In this sense, we propose the realization of mini-workshops for participants and students from boarding UFRN, using Case-Based Learning Strategy (CBL), with small group discussion, to strengthen the incorporation of CKD guidelines in undergraduate teaching and in clinical medical practice in general.

Conhecimento da doença renal crônica entre médicos conforme as diretrizes práticas

INTRODUCTION: Chronic kidney disease (CKD) is a global health problem, with increasing prevalence in its terminal stage and one of the factors that can contribute is the failure to recognize the disease and its risk factors. OBJECTIVE: To evaluate the knowledge of medical residents (MR) and medical preceptors (MP) in hospitals in the Federal University of Rio Grande do Norte in Natal-RN - Brazil, on the DRC, based on the policy of the Kidney Disease Improving Global Outcomes (KDIGO ). METHODS: Cross-sectional study where 64 MR (R1 = 32; R2 = 15; R3 = 17) and 63 MP answered a questionnaire divided into seven sessions that addressed aspects of the DRC since the setting up referral to a nephrologist. RESULTS: Only 20 participants (15.7%) reported using any guidelines for the management of CKD. The scores obtained by session were: Definition and classification (46.1 ± 47.8); Risk factors (70.5 ± 27.9); Laboratory evaluation (58.2 ± 8.8); Clinical action plan (57.6 ± 19.9); Reduction in proteinuria (68.3 ± 15.0); Complications (64.8 ± 19.9); Referral to a nephrologist (73.0 ± 44.6). There was a statistically significant difference between the knowledge of MR and MP in the sessions: Laboratory evaluation (MR 61.5 ± 8.4 vs 54.8 ± 7.9 MP; p <0.001); Reduction in proteinuria (73.1 ± 11.4 vs MR MP 63.5 ± 16.7; p <0.001) and Referral to a nephrologist (MR 81.2 ± 39.3 vs 64.5 ± 48.2 MP; p = 0.035). Among the MR, the R2 obtained the best score (63.9 ± 22.6 vs R1 R2 R3 71.9 ± 17.2 vs 63.5 ± 22.5, p = 0.445). It identified a low percentage of success of the doctors on the definition of CKD (MP = 46%; R1 = 40.6%; R2 = 60%; R3 = 52.9%; p = 0.623) and classification (MP = 34.9%; R1 = 53.1%, R2 = 60%; R3 = 52.9%; p = 0.158). CONCLUSION: The study showed that most doctors do not use any guidelines for clinical management of CKD and that there are gaps in knowledge on the subject, even among physicians who work in the university environment. In this sense, we propose the realization of mini-workshops for participants and students from boarding UFRN, using Case-Based Learning Strategy (CBL), with small group discussion, to strengthen the incorporation of CKD guidelines in undergraduate teaching and in clinical medical practice in general.

Fungicidas protetores no manejo da ferrugem da soja, processos fisiológicos e produtividade da cultura

Currently, the management recommendations for asian soybean rust (ASR) has been based on the application of protective fungicides mixed with triazoles and stronilurins. Thus, this study aimed at assessing whether the increased productivity provided by the application of protective fungicides is due solely to the fungicidal action of the product or some physiological changes in the plant and which the latter would be. The experiment was conducted from March to July 2015 at the experimental station of Udi Research and Development in Uberlândia-MG, with the cultivar 97Y07 RR. The experimental design chosen for this study was comprised of a randomized block with four replications and 16 treatments: check, fluxapyroxad + pyraclostrobin (116.55 + 58.45 g ha-1), azoxystrobin + benzovindiflupir (90 + 45 g ha-1), trifloxystrobin + prothioconazole (60 + 70 g ha-1), tebuconazole + picoxystrobin (100 + 60 g ha-1), picoxystrobin + cyproconazole (60 + 24 g ha-1), mancozeb (1125 g ha-1), azoxistrobina + tebuconazole + difenoconazole (60 + 75 + 120 g ha-1), azoxystrobin + tebuconazole + difenoconazole + chlorothalonil ( 60 + 120 + 75 + 1440 g ha-1), and mistures fluxapyroxad + pyraclostrobin + mancozeb, azoxystrobin + benzovindiflupir + mancozeb, trifloxystrobin + prothioconazole + mancozeb, tebuconazole + picoxystrobin + mancozeb, picoxystrobin + cyproconazole + mancozeb, azoxystrobin + tebuconazole + difenoconazole + mancozeb, and azoxystrobin + benzovindiflupir + chlorothalonil, from the aforesaid doses. The first application of the treatments occurred in R1, in the absence of symptoms. The number of applications, intervals and the use of adjuvants were performed according to the recommendations by manufacturers. The variables analyzed were: disease severity, concentration of chlorophylls and carotenoids, photosynthetic rate (A), transpiration rate (E), stomatal conductance (gs), internal carbon concentration (Ci), instantaneous efficiency in water use (A/E), intrinsic water use efficiency (A/gs), and carboxylation efficiency (A/C). With these data collected, this study set to date the progress curve of each variable (AUPC). At the end of the crop cycle, the average of pods per plant was quantified, grain per pod, productivity and weight of 1,000 grains. It was concluded that: the addition of mancozeb to fluxapyroxad + pyraclostrobin, azoxystrobin + benzovindiflupir, trifloxystrobin + prothioconazole and tebuconazole + picoxystrobin potentiated the ASR control; adding mancozebe to the mixture azoxystrobin + benzovindiflupir provided better control of the disease compared to the addition of chlorothalonil; mancozeb amounts to AUPC concentration of photosynthetic pigments and when added to axozystrobin + tebuconazole + difenoconazole, increases the AUPC for total chlorophyll concentration, as well as when chlorothalonil was added; mancozeb added to the mix fluxapyroxad + pyraclostrobin raised the AUPC for A/Ci and A/gs, increasing the W1,000G and crop productivity; the addition of protectors similarly reflected on the productivity of culture.

Desempenho de fosfitos de potássio no manejo de mofo branco em soja

Soybean plays an important role in the Brazilian agriculture being one of the products most exported by the country. Its yield may be affected by diseases such as white mold, caused by the fungus Sclerotinia sclerotiorum Lib. de Bary, which, under favorable field conditions prevents the crop of expressing all its productive potential. The fungus is cosmopolitan and infects more than 400 species of plants. This disease is difficult to control, and the use of chemicals has not been sufficient to avoid significant losses, thus, this products are expensive and may cause environmental damage. Alternative methods, such as foliar fertilizers based on potassium phosphite, can also be used in the management of this disease. In this context, this work aimed to study different sources of potassium phosphite and its effects in the control of white mold in soybeans, as well as the time of application in culture, its action in inducing plants defense responses and/or its influence over the seeds quality. The effect of phosphites, over the pathogen, was evaluated in vitro, on mycelial inhibition, the mass of dry mycelium and germination of sclerotia. In all tests, the following phosphites were utilized: Phosphite A (P2O5-40%; K2O-20% - 1 L/ha); Phosphite B (P2O5-40%; K2O-28% - 1 L/ha); Phosphite C (P2O5-40%; K2O-20% - 1 L/ha) e Phosphite D (P2O5-30%; K2O-20% - 2,4 L/ha). At the induction of resistance tests were evaluated the synthesis of phytoalexin in soybean cotyledons and the enzymes FAL and POX evaluated in seedlings in growing chamber, sprayed with phosphites and the fungicide fluazinam. Field experiment was carried out at Coronel Domingos Soares-PR, in the 2012/2013 season, in an area with natural infestation of the pathogen. Soybean cultivar BMX Active was no-till seeded with 0,5m between rows. The experimental was laid out as a factorial 5 x 4 scheme (treatment x application time). Phosphites sources were used, as described above, and water was sprayed in the control treatment. Treatments were applied at four different growth stages: V4, V4 + R1, R1 and R2 at the rates recommended by the manufacturer. Soybean yield components and seeds and health and physiological quality were evaluated after harvesting. None of the tested phosphites affected mycelial growth and sclerotia germination or influenced phytoalexin synthesis. Phosphites C and D stood out due to an increasing in the phenylalanine ammonia-lyase activity 48 hours after its inoculation. These same products also induced the synthesis and peroxidases and phosphite C kept the levels of this enzyme elevated up to 72 hours after inoculation. At the field trials, phosphites C and D stood out in the control of white mold. There was no significant interaction of potassium phosphite on physiological and sanitary quality of the seeds.

Intervenção psicossocial na doença mental grave: revisão da evidência.

Introdução: Existe uma extensa quantidade de investigação empírica relativa a efectividade de várias intervenções psicossociais em pacientes com doenca mental grave (DMG). No entanto, estes resultados mostram-se, por vezes, contraditórios, fruto de trabalhos com sérias limitações metodológicas, sendo difícil a sua integração e aplicação na prática clínica. Objetivo: Revisão da literatura atual relativa à efetividade das várias intervenções psicossociais no doente mental grave, no âmbito da Psiquiatria Comunitária. Foram utilizadas bases de dados online – Medline, Cochrane Library, Embase e PsycINFO. Resultados: Os programas de treino de atividades diárias não evidenciam diferenças clinicamente significativas face a intervenções usuais. Os programas residenciais na comunidade parecem melhorar o funcionamento social, a integração no meio e a satisfação dos utentes com doença mental grave, além de promover a adesão à terapia farmacológica. Os programas dirigidos ao lazer e ao tempo livre parecem melhorar o funcionamento social dos indivíduos com DMG, bem como a satisfação geral. Em termos de programas orientados para o emprego, existe boa evidência quanto a programas com tipologias de emprego protegido ou apoio no emprego - colocação rápida, com treino prévio curto, e apoio individual frequente. Relativamente às intervenções ao nível dos serviços, o tratamento assertivo na comunidade está associado a uma maior probabilidade de manter o doente em contacto com os serviços, com efetiva redução dos internamentos hospitalares. O doente com DMG integrado em programa de terapeuta de referência – ‘Case Management’ (CM) – tem maior possibilidade de se manter em contacto com os serviços e maior adesão à medicação psicotrópica. O Case Management de aplicação intensiva poderá ter um desempenho mais eficiente face ao CM convencional, prevendo-se um melhor desempenho no paciente com DMG que tende a utilizar frequentemente os cuidados hospitalares. Os Hospitais de Dia (não-agudos) não evidenciam eficácia superior às intervenções regulares em termos de taxas de internamento, psicopatologia ou funcionamento social.

Doença bipolar de início tardio: caso clínico

Introdução: A perturbação bipolar afecta aproximadamente 1% da população, com o diagnóstico geralmente estabelecido durante a adolescência/início da idade adulta e sendo apenas feito em 0.1% da população geriátrica. A perturbação bipolar de início tardio é heterogénea e a sua etiopatogenia é complexa. A idade de início tem um impacto significativo na natureza e curso desta doença. Objectivos: As autoras apresentam um caso de perturbação bipolar de início tardio, aos 76 anos, sem que esteja identificada uma causa orgânica subjacente. Conclusão: Este caso demonstra a importância de um amplo diagnóstico diferencial e manejo farmacológico, quando se abordam sintomas maniformes/depressivos de novo em doentes geriátricos.

Vasculites cerebrais na doença inflamatória intestinal

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Avaliação dos valores séricos de troponina cardíaca I (cTnI) e capacidade antioxidante total (TAC) em felídeos com doença renal crónica e seu valor de prognóstico : estudo preliminar

Dissertação de Mestrado Integrado em Medicina Veterinária

Efeitos secundários da quimioterapia antineoplásica e seu impacto na qualidade de vida em cães e gatos com doença oncológica

Mestrado Integrado em Medicina Veterinária

Moras sin espinas (Rubus glaucus Benth) para el fácil manejo del cultivo en la sierra sur del Ecuador

La presente investigación tiene por objeto seleccionar líneas de mora sin espinas (Rubus glaucus Benth), para el fácil manejo del cultivo en la sierra sur del Ecuador.- El experimento se desarrollo en la Estación Experimental del Austro del Instituto Nacional Autónomo de Investigaciones Agropecuarias INIAP, en el cual se evaluaron 85 plantas segregantes, más la planta Testigo. De las 85 segregaron 7 plantas estériles, 21 plantas sin espinas y 57 plantas con espinas. Al realizar el análisis de conglomerados se obtuvo dos grandes grupos, el primero integrado por 79 plantas productivas y el segundo integrado por 7 plantas estériles. Dentro de las 79 moras productivas se pueden diferenciar Otros conglomerados que son los de mayor interés en el análisis. Los conglomerados 5 y 1 que suman un total de 23 líneas son los más importantes, to por conglomerar a plantas que presentan los mayores rendimientos experimentales y en las cuales constan las mejores líneas de moras sin espinas.- Las plantas de mora sin espinas 38 y 26 con 9,04 y 9,03 kg/planta/ciclo respectivamente, son las mejores después de las plantas de mora con espinas 54 y 50 con 9,54 y 9,37 kg/planta/ciclo respectivamente. Comparando los rendimientos de las plantas 38 y 26 con la testigo que presenta un rendimiento de 0,5 kg/planta/ciclo, las 2 plantas sin espinas rinden 18 veces más que el testigo, por lo que estas se perfilan como futuras variedades de mora sin espinas para facilitar el manejo del cultivo a los productores de la sierra sur del Ecuador.au

Caracterização da variação do índice de resistência renal e o seu potencial papel como fator de diagnóstico precoce na doença renal em Felis catus

Dissertação de Mestrado Integrado em Medicina Veterinária

Manejo de solo e coberturas vegetais na cultura do mamoeiro em tabuleiros costeiros.

Apresenta os resultados da pesquisa acerca do manejo de coberturas vegetais no controle integrado do mato em mamão.

Manejo da uva "Niágara" em regiões tropicais.

2015

Utilização de agentes microbianos de controle biológico para o manejo de doenças de plantas no Brasil.

2008