Prostatic Artery Embolization in the Treatment of Benign Prostatic Hyperplasia: Short and Medium Follow-Up

To evaluate the short and mid-term results of prostatic artery embolization in patients with benign prostatic embolization. Retrospective study between March 2009 and June 2011 with 103 patients (mean age 66.8 years, 50-85) that met our inclusion criteria with symptomatic benign prostatic hyperplasia. The clinical outcome was evaluated by the International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function, prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow (Q(max)), and post-void residual volume (PVR) measurements at 3 and 6 months, 1 year, 18 months, and 2 years after PAE and comparison with baseline values was made. Technical and clinical successes, as well as poor clinical outcome definitions, were previously defined. In this review, we evaluate the short and mid-term clinical outcomes and morbidity of patients treated only with non-spherical polyvinyl alcohol. Six months after the procedure, the PV decreased about 23%, IPSS changed to a mean value of 11.95 (almost 50% reduction), the QoL improved slightly more than 2 points, the Q(max) changed to a mean value of 12.63mL/s, the PVR underwent a change of almost half of the baseline value, and the PSA decreased about 2.3ng/mL. In the mid-term follow-up and comparing to the baseline values, we still assisted to a reduction in PV, IPSS, QoL, PVR, and PSA, and an increase in Q(max). Prostatic Artery Embolization is a safe procedure with low morbidity that shows good short- and mid-term clinical outcome in our institution.

Summer Vacations not Only a Memory for Life, but Also a Rare Infection

Introduction: Rhinoscleroma is a rare, chronic, granulomatous disease that most frequently affects the upper respiratory tract, especially the nasal cavity and sometimes extends through the lower respiratory tract. Is associated with Klebsiella rhinoscleromatis, which is endemic in certain geographic regions namely Central America. The pathogenesis and risk factors remain unclear. Clinical case: We report a five years Old Portuguese boy, previously healthy, brought to the Emergency Department with epistaxis, without other accompanying signs or symptoms. The Otorhinolaryngologist (ORL) performed rhinoscopy and identified an intranasal bleeding mass. The MRI revealed an intranasal mass with extension to the ethmoid bone sinus, and performed biopsy. The histopathology was vital, making the diagnosis of Rhinoscleroma. The child had traveled abroad for the first time on vacations a year before to Dominican Republic. The bacteriologic exam identified a Klebsiella spp. sensible to the association of amoxicillin and clavulanic acid. Blood test performed excluded association of immunodeficiency. Since it’s a rare disease genetic study are under course. Monthly evaluation by ORL and pediatrician was performed which documented progressive reduction until total disappearing of the macro and microscopic lesion, and negative bacteriologic exam. Six months of antibiotic therapy were completed without any known secondary effects. The child remained asymptomatic up to the last visit, 3 months following treatment and has shown no evidence of recurrence. Conclusion: Globalization and free transit of people to areas far from origin countries here some rare diseases are endemic brings a new challenge to modern medicine. Sometimes vacations bring more than memories.

Embolisation of Prostatic Arteries as Treatment of Moderate to Severe Lower Urinary Symptoms (LUTS) Secondary to Benign Hyperplasia: Results of Short- and Mid-Term Follow-Up

OBJECTIVES: To evaluate the short- and medium-term results of prostatic arterial embolisation (PAE) for benign prostatic hyperplasia (BPH). METHODS: This was a prospective non-randomised study including 255 patients diagnosed with BPH and moderate to severe lower urinary tract symptoms after failure of medical treatment for at least 6 months. The patients underwent PAE between March 2009 and April 2012. Technical success is when selective prostatic arterial embolisation is completed in at least one pelvic side. Clinical success was defined as improving symptoms and quality of life. Evaluation was performed before PAE and at 1, 3, 6 and every 6 months thereafter with the International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF), uroflowmetry, prostatic specific antigen (PSA) and volume. Non-spherical polyvinyl alcohol particles were used. RESULTS: PAE was technically successful in 250 patients (97.9 %). Mean follow-up, in 238 patients, was 10 months (range 1-36). Cumulative rates of clinical success were 81.9 %, 80.7 %, 77.9 %, 75.2 %, 72.0 %, 72.0 %, 72.0 % and 72.0 % at 1, 3, 6, 12, 18, 24, 30 and 36 months, respectively. There was one major complication. CONCLUSIONS: PAE is a procedure with good results for BPH patients with moderate to severe LUTS after failure of medical therapy. KEY POINTS: • Prostatic artery embolisation offers minimally invasive therapy for benign prostatic hyperplasia. • Prostatic artery embolisation is a challenging procedure because of vascular anatomical variations. • PAE is a promising new technique that has shown good results.

O Papel da Memória de Trabalho na Perturbação do Desenvolvimento da Coordenação, em Crianças Com Diagnóstico de Perturbação de Hiperatividade e Défice de Atenção

Este estudo pretende (1) encontrar a prevalência da Perturbação do Desenvolvimento da Coordenação (PDC) em crianças com Perturbação de Hiperatividades e Défice de Atenção (PHDA); (2) analisar qual a prevalência de défices de memória de trabalho verbal e não-verbal, em crianças com PHDA e comparar o desempenho entre as crianças que só apresentam PHDA e aquelas que apresentam também PDC; (3) verificar se a ocorrência de PDC é agravada, de acordo com a presença ou ausência de alterações de memória de trabalho e se estas podem ser consideradas fatores de risco ou de proteção para a manifestação de PDC, enquanto comorbilidade de PHDA. Foram selecionadas 37 crianças com diagnóstico de PHDA, com idades compreendidas entre os 7 e os 14 anos. A componente motora foi avaliado com a versão curta do Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) e o Questionário de Perturbação do Desenvolvimento da Coordenação 2007 (DCDQ’07); a memória de trabalho foi avaliada através da Figura Complexa de Rey, Trail Making Test - parte B e Memória de Dígitos – sentido inverso. Para determinar o impacto da memória de trabalho na componente motora, recorreu-se a uma regressão logística. Encontrou-se uma prevalência de PDC de 51% e de défices ao nível da memória de trabalho verbal e não-verbal de 60% e 80%, respetivamente, para a amostra total de crianças com PHDA. A terapêutica farmacológica para a PHDA revelou-se fator protetor para a manifestação de PDC, principalmente quando a primeira se encontra associada com o nascimento de termo. Um mau desempenho no teste Memória de Dígitos – sentido inverso é fator de risco para a manifestação de PDC, em crianças com PHDA. Este estudo permitiu verificar que crianças com PHDA+PDC apresentam défices motores genuínos, característicos de manifestação de PDC. Parecem também existir relações bastante complexas entre a memória de trabalho e os mecanismos de controlo motor na PHDA, sendo que estes podem ser distintos quando está presente uma comorbilidade de PDC.

Correlation between the mechanical cycling behavior and microstructure in laser welded joints using NiTi memory shape alloys

Dissertação para obtenção do Grau de Mestre em Engenharia de Materiais

Utilização de sensores de baixo custo na medição de monóxido de carbono no ar ambiente

Nos últimos anos tem-se assistido à introdução de novos dispositivos de medição da poluição do ar baseados na utilização de sensores de baixo custo. A utilização menos complexa destes sistemas, possibilita a obtenção de dados com elevada resolução temporal e espacial, abrindo novas oportunidades para diferentes metodologias de estudos de monitorização da poluição do ar. Apesar de apresentarem capacidades analíticas distantes dos métodos de referência, a utilização destes sensores tem sido sugerida e incentivada pela União Europeia no âmbito das medições indicativas previstas na Diretiva 2008/50/CE, com uma incerteza expandida máxima de 25%. O trabalho desenvolvido no âmbito da disciplina de Projeto consistiu na escolha, caracterização e utilização em medições reais de um sensor de qualidade do ar, integrado num equipamento protótipo desenvolvido com esse fim, visando obtenção uma estimativa da incerteza de medição associada à utilização deste dispositivo através da aplicação da metodologia de demonstração de equivalência de métodos de medição de qualidade do ar definida pela União Europeia. A pesquisa bibliográfica realizada permitiu constatar que o monóxido de carbono é neste momento o parâmetro de qualidade do ar que permite ser medido de forma mais exata através da utilização de sensores, nomeadamente o sensor eletroquímico da marca Alphasense, modelo COB4, amplamente utilizado em projetos de desenvolvimento neste cotexto de monitorização ambiental. O sensor foi integrado num sistema de medição com o objetivo de poder ser utlizado em condições de autonomia de fornecimento de energia elétrica, aquisição interna dos dados, tendo em consideração ser o mais pequeno possível e de baixo custo. Foi utlizado um sistema baseado na placa Arduino Uno com gravação de dados em cartão de memória SD, baterias e painel solar, permitindo para além do registo das tensões elétricas do sensor, a obtenção dos valores de temperatura, humidade relativa e pressão atmosférica, com um custo global a rondar os 300 euros. Numa primeira fase foram executados um conjunto de testes laboratoriais que permitiram a determinação de várias características de desempenho em dois sensores iguais: tempo de resposta, a equação modelo do sensor, avaliação da repetibilidade, desvio de curto e longo termo, interferência da temperatura e histerese. Os resultados demonstraram um comportamento dos sensores muito linear, com um tempo de resposta inferior a um minuto e com uma equação modelo do sensor dependente da variação da temperatura. A estimativa da incerteza expandida laboratorial ficou, para ambos os sensores, abaixo dos 10%. Após a realização de duas campanhas reais de medição de CO em que os valores foram muito baixos, foi realizada uma campanha de quinze dias num parque de estacionamento subterrâneo que permitiu a obtenção de concentrações suficientemente elevadas e a comparação dos resultados dos sensores com o método de referência em toda a gama de medição (0 a 12 mol.mol-1). Os valores de concentração obtidos pelos dois sensores demonstraram uma excelente correlação com o método de referência (r2≥0,998), obtendo-se resultados para a estimativa da incerteza expandida de campo inferiores aos obtidos para a incerteza laboratorial, cumprindo o objetivo de qualidade de dados definido para as medições indicativas de incerteza expandida máxima de 25%. Os resultados observados durante o trabalho realizado permitiram confirmar o bom desempenho que este tipo de sensor pode ter no âmbito de medições de poluição do ar com um caracter mais indicativo.

A modular distributed transactional memory framework

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

Short QT Syndrome Presenting As Syncope: How Short Is Too Short?

We report the case of a 52-year-old man who presented to our emergency department (ED) after three episodes of syncope in the seven hours before admission. During his stay in the ED he had recurrent ventricular tachycardia (VT) requiring external electrical cardioversion. A 12-lead electrocardiogram (ECG) showed a short QT (SQT) interval (270 ms, QTc 327 ms), with frequent R-on-T extrasystoles triggering sustained polymorphic VT. After exclusion of other precipitating causes, the patient was diagnosed as having SQT syndrome (SQTS) according to the Gollob criteria. To our knowledge, this is the first known documentation of an SQT-caused arrhythmic episode on a 12-lead ECG, as well as the first reported case of SQTS in Portugal. The patient received an implantable cardioverter-defibrillator and was discharged. At a follow-up assessment 14 months later he was symptom-free, interrogation of the device showed no arrhythmic events, and the ECG showed a QT interval of 320 ms (QTc 347 ms).

Short-Lasting Headaches in Children

Short-lasting headaches have been studied infrequently in children and it is not known if the main categories of primary headaches of this type in adults are applicable to children. We report our experience with a group of 20 children with a brief headache. Two patients had a secondary headache. One patient had a headache with some clinical characteristics of paroxysmal hemicrania. The remaining 17 had a very brief headache. They were in many aspects comparable to others from previous studies on idiopathic stabbing headache in children: no associated symptoms, no other associated headache, frequent family history of migraine. They differed, however, in the younger age of the patients and themore frequent extratrigeminal location of the pain. Extratrigeminal ice-pick pain may be a variant of idiopathic stabbing headache, more prevalent in young children.

Medium-short-term and repetition effects of advergames on children consumer behaviour

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Partial replication in distributed software transactional memory

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

Polycystic hydatid disease in Brazil: report of five new human cases and a short review of other published observations

This paper describes five additional Brazilian human cases of polycystic hydatid disease due to Echinococcus vogeli, reviews the previous cases reported in Brazil, including one report of E. oligarthus (20 in total), and some epidemiological aspects of this disease which is no longer a curiosity but rather a problem that is not medically easy to handle. Its presence should be expected in any rural area of the New World where humans have not eliminated wild felids/canids, bush dogs, pacas, agoutis and other wild rodents.

Effect of surfactant on PDLC films with and without permanent memory effect

Dissertação para obtenção do Grau de Mestre em Engenharia Química e Bioquímica

A short review of the previous and current epidemiological situation of schistosomiasis in China

Schistosomiasis japonica has long been endemic in the People's Republic of China. In the 1950s, the number of the infected persons was estimated at 10 million; infected snail habitats were estimated at more than 14 billion square metres and infected cattle at 1.2 million. After schistosomiasis control measures were carried out, it was a great success. According to the survey of 1989, infected persons were estimated at 0.95 million; infected snails at 3.47 billion and infected cattle at about 0.1 million.These results compared with those of the 1950s show big reductions in prevalence rates 90.5%, 75.2% and 91.6%, respectively. At present, the disease is a threat in the marshland and lake regions and the high mountainous regions. To maintain the success achieved in effective control and to bring the yet endemic marshland and lake regions and mountainous areas under control are hard and long-term tasks confronting the People's Republic of China.

Maintaining the correctness of transactional memory programs

Dissertação para obtenção do Grau de Doutor em Engenharia Informática