Atividade tradutológica: a (r)evolução dos últimos 20 anos

Trabalho de natureza profissional para a atribuição do Título de Especialista do Instituto Politécnico do Porto, na área de Línguas e Cuturas - Línguas e Literaturas Estrangeiras, defendido a 11-11-2015.

Aneurismas das Artérias Viscerais: Alternativa Terapêutica

The authors report two cases in which stent grafts were used to treat visceral artery aneurysms. Case number 1 was a 42-year old woman with a history of renal colic who was found to have a right renal artery aneurysm. Two 6-mm x 20-mm Wallgraft endoprosthesis (Boston Scientific, Watertown, Mass) were placed across the aneurysm neck. Case number 2 was a 72 year-old woman with a past medical history significant for hepatic angioma and hypothyroidism. She was found to have a superior mesenteric artery aneurysm that was treated with a 6-mm x 17-mm Jostent stent graft (Jomed, GmbH, Ra). In both cases the aneurysm was completely excluded and distal end-organ flow preserved. Stent graft placement is a safe and effective treatment for visceral artery aneurysms. If this approach proves durable and reproducible, it can become the method of choice for the management of visceral artery aneurysms in selected patients.

Incidência de "Falsos-Positivos" em Idosos com Fibrilhação Auricular Paroxística Submetidos a Teste de Inclinação

The autonomic nervous system (ANS) plays a role as a modulator in the pathogenesis of paroxysmal atrial fibrillation (PAF). The clinical pattern of vagally mediated PAF has been observed mainly in young patients. Neurocardiogenic responses during orthostatic stress are related to autonomic reflexes in which the vagal influence predominates. AIM: To evaluate the susceptibility of elderly patients with PAF to activation of vasovagal syncope mechanisms. METHODS: We performed passive head-up tilt testing (HUT) in 34 patients (62% women, aged 72 +/- 7 years), with > or = 1 year of clinical history of PAF--19 without structural heart disease, 11 with hypertensive heart disease and 4 with coronary artery disease (who had no previous myocardial infarction, had undergone myocardial revascularization, and had no documented ischemia) (PAF group), and compared the results with those obtained in a group of 34 age-matched patients (53% women, aged 74 +/- 6 years), who underwent HUT due to recurrent syncope (Sc group). In this group, 21 had no documented heart disease and none had a clinical history of AF. There was no diabetes, congestive heart failure or syncope in the PAF group. After a supine resting period, the subjects were tilted at 70 degrees for 20 minutes while in sinus rhythm. No provocative agents were used to complement the HUT. ECG and blood pressure were continuously monitored (Task Force Monitor, CNSystems). The test was considered positive when syncope or presyncope occurred with bradycardia and/or arterial hypotension. Abnormal responses were classified as cardioinhibitory, vasodepressor or mixed. RESULTS: HUT was positive in seven patients of the PAF group--vasodepressor response in five and mixed in two (20.5% of the total; 26.3% of those without heart disease)--and in eight patients (vasodepressor in six and mixed in two) of the Sc group (p=NS). During HUT, three patients of the PAF group had short periods of self-limited PAF (in one, after vasodepressor syncope). There were no differences in gender distribution, age or heart disease. No cardioinhibitory responses or orthostatic hypotension were observed. CONCLUSION: In elderly patients with PAF, a significant number of false positive results during passive HUT may be expected, suggesting increased vasovagal reactions despite aging. This suggests that ANS imbalances may be observed in this population.

Abcesso Tubo-Ovárico. Análise de 20 Casos

Os autores procedem à análise retrospectiva dos casos de abcesso tubo-ovárico, internados no Serviço de Ginecologia da Maternidade Dr. Alfredo da Costa, num período de 3 anos (1991-1993). O número total de casos foi 20. A incidência em nulíparas foi 25%. Uma percentagem significativa das doentes (30%) tinha sido recentemente submetida a técnicas de instrumentação uterina. Em apenas 15% dos casos havia antecedentes de doença inflamatória pélvica. Nas doentes portadoras de DIU a incidência de abcessos unilaterias e bilaterais foi idêntica. Na maioria dos casos (85%) a apirexia surgiu até 48 horas após o início da antibioterapia. A maioria das doentes (90%) foi submetida a terapêutica cirúrgica. O tempo médio decorrido entre o início da antibioterapia e a intervenção cirúrgica foi 3 dias. Registou-se um caso de rotura de abcesso. Em 3 (15%) doentes verificou-se intraoperatoriamente a co-existência de um abcesso apendicular. Em 30% dos casos as doentes foram submetidas a histerectomia total com anexectomia unilateral ou bilateral. Uma das 2 (10%) doentes submetidas a terapêutica médica isolada apresentou recidiva 1 mês após a alta. A abordagem terapêutica do abcesso tubo-ovárico embora se tenha tornado mais conservadora, continua a incluir, na maioria dos casos, drenagem ou resecção cirúrgica após antibioterapia adequada.

O capital intelectual e a performance das empresas do PSI 20

Num contexto de crescente complexidade e disponibilidade de informação, a gestão do capital intelectual assume cada vez mais preponderância como vantagem competitiva para as empresas que procuram maximizar o valor gerado. Esta investigação usa como metodologia príncipal o VAIC (coeficiente intelectual do valor adicionado), para assim estudar a existência de relação entre capital intelectual e a performance bolsista e financeira das empresas do PSI20. O VAIC é decomposto nos seus três indicadores de eficiência, tais como: capital humano, capital estrutural e capital físico. Os dados contemplam quinze empresas e nove anos de análise (2003 - 2011). Elaborou-se uma abordagem que recorre à utilização de técnicas econométricas para reduzir potênciais falhas no tratamento de dados em painel. Os resultados da análise demonstram uma relação positiva entre a aposta em capital intelectual a performance bolsista e financeira, ou seja, a utilização e gestão eficientes do capital intelectual contribuem de forma significativa na avaliação bolsista e financeira das empresas do PSI20.

THE SERO-CONVERSION AND EVALUATION OF RENAL ALTERATIONS IN DOGS INFECTED BY Leishmania (Infantum) chagasi

This study investigated the sero-conversion period in which dogs from endemic areas test positive for visceral leishmaniasis (VL) as well as the early post-infection period in which renal alterations are observed. Dogs that were initially negative for Canine Visceral Leishmaniasis (CVL) were clinically evaluated every three months by serological, parasitological and biochemical tests until sero-conversion was confirmed, and six months later a subsequent evaluation was performed. Samples of kidney tissues were processed and stained with Hematoxylin and Eosin (H&E), Periodic Acid Schiff (PAS) and Masson’s trichrome stain and lesions were classified based on the WHO criteria. Of the 40 dogs that initially tested negative for VL, 25 (62.5%) exhibited positive serological tests during the study period. Of these 25 dogs, 15 (60%) tested positive within three months, five (20%) tested positive within six months and five (20%) tested positive within nine months. The dogs exhibited antibody titers between 1:40 and 1:80 and 72% of the dogs exhibited clinical symptoms. The Leishmania antigen was present in the kidneys of recently infected dogs. We found higher levels of total protein and globulin as well as lower levels of albumin in the infected dogs when compared to the control dogs. Additionally, infected dogs presented levels of urea and creatinine that were higher than those of the uninfected dogs. Glomerulonephritis was detected in some of the dogs examined in this study. These data suggest that in Teresina, the sero-conversion for VL occurs quickly and showed that the infected dogs presented abnormal serum proteins, as well as structural and functional alterations in the kidneys during the early post-infection period.

Mortalidade numa Unidade de Cuidados Intensivos Pediátricos

Artigos descrevendo o movimento assistencial de Unidades de Cuidados Intensivos Pediátricos e analisando as respectivas mortalidades não são muito comuns. Este estudo retrospectivo tem como objectivo avaliar e analisar o movimento assistencial e a mortalidade da Unidade de Cuidados Intensivos Pediátricos (UCIP) do Hospital Dona Estefania (HDE) num período de 6 anos (0.4.04.91 e 03.04.97). Neste período houve 2987 internamentos na UCIP e foram registados 200 (6.70%) óbitos, os quais corresponderam a 40.48% dos 494 6bitos verificados no HDE. A análise estatística mostrou diferenças significativas, entre sobreviventes e falecidos, relativamente aos seguintes parâmetros: índice de gravidade (4.65 vs 21.42); probabilidade de morte (3,69% vs 39.97%); grau de intervenção terapêutica (14.70 vs 34.80); idade média (4.11 vs 3.33 anos), demora média (2.70 vs 8.86 dias); incidência de doença crónica (44.73 vs 62.79%); reinternamentos(2.20 vs 16.28%) e proveniencia - Serviço de Urgência / Outros Hospitais - (51.95 vs 25.58 / 18.87 vs 39.53%). Existia doença crónica em 108 (62.79%) dos falecidos (ligeira em 27.78% e significativa em 72.22%), salientando-se a cardíaca (27.78%), a do SNC (13.89%), e a relacionada com patologia do período neonatal (10.19%). A causa final de morte relacionou-se predominantemente com patologia infecciosa (40.70%), respiratória (19.77%), cardíaca (12.21 %) e do SNC (11.63%). Existia falência mono-orgão (OSF) em 24 (13.95%) e falência múltipla de orgão (MOSF) em 148 (86.05%) dos falecidos. A mortalidade esperada era de 5.807%, tendo a mortalidade observada sido de 5.840% (Standardized Mortality Ratio = 1.006).

SEROPREVALENCE OF CHAGASIC INFECTION IN YOUNG INDIVIDUALS IN A BLOOD CENTER IN THE STATE OF SAO PAULO, BRAZIL

SUMMARY This study aimed at estimating the number of cases of non-negative serological reactions to Chagas disease in blood donors at the Blood Center of Botucatu, São Paulo, Brazil, from 2003 to 2010 and at relating them to their cities of origin. Five hundred and seventy-four non-negative results for Chagas disease were evaluated. Of these, 371 (64.8%) were reagent, and 203 (35.4%) were inconclusive. The prevalence of Chagas disease in blood donors was 0.05%. There were, on average, 72 cases/year, and a prevalence of males was observed (64.8%). Forty-three (7.49%) individuals were 18 to 30 years old; 92 (16.02%) were 31 to 40; 147 (25.61%) 41 to 50, and 292 (50.87%) were older than 50 years. It was observed that 29.3% of females with reagent serology were at their fertile age (18 and 45 years). The majority of donors were originally from cities in the southwestern and central regions of São Paulo, but individuals from other states contributed with 20%. The provenance of most donors was the city of Botucatu/SP, followed by the city of Taquarituba/SP. Therefore, the profile of donors at this blood center favors the occurrence of a larger number of non-negative serological reactions. Although there has been a significant reduction in the number of new cases/year for this disease, it is still a public-health problem, and results suggest the need for new epidemiological assessments in the studied region.

Can red cell distribution width be used as a marker of Crohn's disease activity?

Introduction: Recently, it has been suggested an association between red cell distribution width (RDW) and Crohn’s disease activity index (CDAI), but its use is not yet performed in daily clinical practice. Objectives: To determine whether RDW can be used as a marker of Crohn’s disease (CD) activity. Methods: This was a cross-sectional study including patients with CD, observed consecutively in an outpatient setting between January 1st and September 30th 2013. Blood cell indices, erythrocyte sedimentation rate (ESR), and C-reactive protein were measured. CD activity was determined by CDAI (active disease if CDAI ≥ 150). Associations were analyzed using logistic regression (SPSS version 20). Results: 119 patients (56% female) were included in the study with a mean age of 47 years (SD 15.2). Twenty patients (17%) had active disease. The median RDW was 14.0 (13---15). There was an association between RDW and disease activity (p = 0.044). After adjustment for age and gender, this association remained consistent (OR 1.20, 95% CI 1.03---1.39, p = 0.016). It was also found that the association between RDW and disease activity was independent of hemoglobin and ESR (OR 1.36, 95% CI 1.08---1.72, p = 0.01) and of biologic therapy (OR 1.19, 95% CI 1.03---1.37, p = 0.017). A RDW cutoff of 16% had a specificity and negative predictive value for CDAI ≥ 150 of 88% and 86%, respectively. Conclusion: In this study, RDW proved to be an independent and relatively specific marker of CD activity. These results may contribute to the implementation of this simple parameter, in clinical practice, aiming to help therapeutic decisions.

OCCUPATIONAL EXPOSURES TO BODY FLUIDS AND BEHAVIORS REGARDING THEIR PREVENTION AND POST-EXPOSURE AMONG MEDICAL AND NURSING STUDENTS AT A BRAZILIAN PUBLIC UNIVERSITY

A cross-sectional study was conducted to assess the frequencies and characteristics of occupational exposures among medical and nursing students at a Brazilian public university, in addition to their prevention and post-exposure behavior. During the second semester of 2010, a self-administered semi-structured questionnaire was completed by 253/320 (79.1%) medical students of the clinical course and 149/200 (74.5%) nursing students who were already performing practical activities. Among medical students, 53 (20.9%) suffered 73 injuries, which mainly occurred while performing extra-curricular activities (32.9%), with cutting and piercing objects (56.2%), in the emergency room (39.7%), and as a result of lack of technical preparation or distraction (54.8%). Among nursing students, 27 (18.1%) suffered 37 injuries, which mainly occurred with hollow needles (67.6%) in the operating room or wards (72.2%), and as a result of lack of technical preparation or distraction (62.1%). Among medical and nursing students, respectively, 96.4% and 48% were dissatisfied with the instructions on previously received exposure prevention; 48% and 18% did not always use personal protective equipment; 67.6% and 16.8% recapped used needles; 49.3% and 35.1% did not bother to find out the source patient's serological results post-exposure; and 1.4% and 18.9% officially reported injuries. In conclusion, this study found high frequencies of exposures among the assessed students, inadequate practices in prevention and post-exposure, and, consequently, the need for training in “standard precautions” to prevent such exposures.

PRESENCE OF RESPIRATORY VIRUSES IN EQUINES IN BRAZIL

Equines are susceptible to respiratory viruses such as influenza and parainfluenza. Respiratory diseases have adversely impacted economies all over the world. This study was intended to determine the presence of influenza and parainfluenza viruses in unvaccinated horses from some regions of the state of São Paulo, Brazil. Blood serum collected from 72 equines of different towns in this state was tested by hemagglutination inhibition test to detect antibodies for both viruses using the corresponding antigens. About 98.6% (71) and 97.2% (70) of the equines responded with antibody protective titers (≥ 80 HIU/25µL) H7N7 and H3N8 subtypes of influenza A viruses, respectively. All horses (72) also responded with protective titers (≥ 80) HIU/25µL against the parainfluenza virus. The difference between mean antibody titers to H7N7 and H3N8 subtypes of influenza A viruses was not statistically significant (p > 0.05). The mean titers for influenza and parainfluenza viruses, on the other hand, showed a statistically significant difference (p < 0.001). These results indicate a better antibody response from equines to parainfluenza 3 virus than to the equine influenza viruses. No statistically significant differences in the responses against H7N7 and H3N8 subtypes of influenza A and parainfluenza 3 viruses were observed according to the gender (female, male) or the age (≤ 2 to 20 years-old) groups. This study provides evidence of the concomitant presence of two subtypes of the equine influenza A (H7N7 and H3N8) viruses and the parainfluenza 3 virus in equines in Brazil. Thus, it is advisable to vaccinate equines against these respiratory viruses.

Aplicação do modelo de Elton-Gruber para a construção de carteira no índice PSI-20

Os mercados financeiros têm um papel fundamental na dinamização das economias modernas. Às empresas cotadas oferece o capital necessário para impulsionar o seu crescimento e aos investidores individuais proporciona a diversificação das suas carteiras, usufruindo desta forma do crescimento e da vitalidade da economia mundial. A gestão de carteiras de ativos financeiros constitui uma área que procura apresentar mecanismos para a obtenção de uma relação ótima entre retorno e risco. Neste sentido, inúmeros estudos têm contribuído de forma significativa para a eficiência e para a prática desta técnica. Esta dissertação pretende analisar a metodologia desenvolvida por Elton-Gruber para a construção de carteiras otimizadas e aplicar as técnicas subjacentes ao mercado acionista português. Para o efeito, serão realizadas pesquisas em fontes bibliográficas da especialidade e serão consultadas bases de dados de cotações históricas das ações e do índice de mercado nacional. A aplicação incidiu sobre ações cotadas no índice PSI-20 durante o período compreendido entre 2010 e 2014. No intuito de melhorar a compreensão das séries de retornos das amostras, o estudo de caráter quantitativo também recorreu à análise estatística. As evidências mostram que a carteira otimizada, no período em análise, contém apenas as ações da empresa Portucel. Este resultado estará condicionado pelos efeitos da crise financeira que iniciou em 2008.

EFFICACY OF NITAZOXANIDE AGAINST Toxocara canis: LARVAL RECOVERY AND HUMORAL IMMUNE RESPONSE IN EXPERIMENTALLY INFECTED MICE

SUMMARY The efficacy of nitazoxanide (NTZ) against toxocariasis was investigated in an experimental murine model and results were compared to those obtained using mebendazole. Sixty male BALB/c mice, aged six to eight weeks-old, were divided into groups of 10 each; fifty were orally infected with 300 larvaed eggs of T. canisand grouped as follows, G I: infected untreated mice; G II: infected mice treated with MBZ (15 mg/kg/day) 10 days postinfection (dpi); G III: infected mice treated with NTZ (20 mg/kg/day) 10 dpi; G IV: infected mice treated with MBZ 60 dpi; G V: infected mice treated with NTZ 60 dpi; GVI: control group comprising uninfected mice. Mice were bled via retro-orbital plexus on four occasions between 30 and 120 dpi. Sera were processed using the ELISA technique to detect IgG anti- Toxocaraantibodies. At 120 dpi, mice were sacrificed for larval recovery in the CNS, liver, lungs, kidneys, eyes and carcass. Results showed similar levels of anti- ToxocaraIgG antibodies among mice infected but not submitted to treatment and groups treated with MBZ or NTZ, 10 and 60 dpi. Larval recovery showed similar values in groups treated with NTZ and MBZ 10 dpi. MBZ showed better efficacy 60 dpi, with a 72.6% reduction in the parasite load compared with NTZ, which showed only 46.5% reduction. We conclude that administration of these anthelmintics did not modify the humoral response in experimental infection by T. canis. No parasitological cure was observed with either drug; however, a greater reduction in parasite load was achieved following treatment with MBZ.

Lúpus Eritematoso Disseminado. Revisão de 20 Casos

Os autores reviram 20 casos de L.E.D. estudados no Serviço de 1982 a 1985, sujeitaram-nos a um protocolo baseado nos critérios estabelecidos pela A.R.A. para o diagnóstico desta doença e comentaram, à luz da literatura actualmente disponível, os seus achados clínico-laboratoriais.