Diabetes : percepção da doença e auto-cuidado

RESUMO - O aumento da prevalência da diabetes e a baixa adesão ao seu tratamento estão associados a um mau controlo metabólico, desenvolvimento de complicações, aumento dos custos económicos e ineficiência do sistema de saúde. De acordo com o modelo de auto-regulação, o estudo das representações da doença permite predizer os comportamentos dos doentes face a esta patologia. O objectivo do estudo é verificar a existência de relação entre a forma como os diabéticos tipo 2 percepcionam a sua doença, de acordo com o modelo de auto-regulação de Leventhal e colaboradores, e a adesão às actividades de auto-cuidado da diabetes. Consiste num estudo observacional, descritivo, analítico, do tipo transversal, a desenvolver em Cuidados de Saúde Primários. A amostra é constituída por 339 indivíduos diabéticos, de ambos os sexos, com idade igual ou superior a 20 anos e com diagnóstico de diabetes tipo 2 há mais de 6 meses. Trata-se de uma amostra probabilística, aleatória simples, seleccionada numa Unidade de Saúde Familiar (USF). A recolha de dados é realizada através do preenchimento de uma ficha de caracterização socio-demográfica e clínica, a partir do processo clínico electrónico, e através da aplicação de dois questionários de auto-preenchimento. Os resultados são analisados através do Statistical Program for Social Sciences (SPSS) – versão 17.0.

Clinical and Genetic Characterization of Portuguese Patients with Pseudohypoparathyroidism Type Ib

Patients with pseudohypoparathyroidism type Ib (PHP-Ib) present hypocalcemia and hyperphosphatemia, as a consequence of a resistance to PTH action, through its G-protein-coupled receptor, in the renal tubules. This resistance results from tissue-specific silencing of the G-protein alpha-subunit (G(s)α), due to imprinting disruption of its encoding locus--GNAS. In familial PHP-Ib, maternally inherited deletions at the STX16 gene are associated to a regional GNAS methylation defect. In sporadic PHP-Ib, broad methylation changes at GNAS arise from unknown genetic causes. In this study, we describe the clinical presentation of PHP-Ib in four Portuguese patients (two of whom were siblings), and provide further insight for the management of patients with this disease. The diagnosis of PHP-Ib was made after detection of GNAS imprinting defects in each of the cases. In the siblings, a regional GNAS methylation change resulted from a known 3.0 kb STX16 deletion. In the other two patients, the broad methylation defects at GNAS, which were absent in their relatives, resulted from genetic alterations that remain to be identified. We report the first clinical and genetic study of Portuguese patients with PHP-Ib. The genetic identification of a hereditary form of this rare disease allowed an early diagnosis, and may prevent hypocalcemia-related complications.

Mutational Analysis of Portuguese Families with Multiple Endocrine Neoplasia Type 1 Reveals Large Germline Deletions

OBJECTIVE: To determine the spectrum of MEN1 mutations in Portuguese kindreds, and identify mutation-carriers. PATIENTS, DESIGN AND RESULTS: Six unrelated MEN1 families were studied for MEN1 gene mutations by single-strand conformational polymorphism (SSCP) and DNA sequence analysis of the coding region and exon-intron boundaries of the MEN1 gene. These methods identified 4 different heterozygous mutations in four families: two mutations are novel (mt 1539 delG and mt 655 ims 11 bp) and two have been previously observed (mt 735 del 46p and mt 1656 del C) all resulting in a premature stop codon. In the remaining two families, in whom no mutations or abnormal MEN1 transcripts were detected, segregation studies of the 5' intragenic marker D11S4946 and codon 418 polymorphism in exon 9 revealed two large germline deletions of the MEN1 gene. Southern blot and tumour loss of heterozygosity analysis confirmed and refined the limits of these deletions, which spanned the MEN1 gene at least from: exon 7 to the 3' untranslated region, in one family, and the 5' polymorphic site D11S4946 to exon 9 (obliterating the initiation codon), in the other family. Twenty-six mutant-gene carriers were identified, 6 of which were asymptomatic. CONCLUSIONS: These results emphasize the importance of the detection of MEN1 germline deletions in patients who do not have mutations of the coding region. Important clues indicating the presence of such deletions may be obtained by segregation studies using the intragenic polymorphisms D11S4946 and at codon 418. The detection of these mutations will help in the genetic counselling of clinical management of the MEN1 families in Portugal.

Pyoderma Gangrenosum Associated with Sclerosing Cholangitis, Type 1 Diabetes Mellitus and Ulcerative Colitis

We describe the case of a 22-year-old black female with type 1 diabetes mellitus diagnosed when she was 12 years old. She first presented (March 1994) with pustules and ulcerations on the upper and lower limbs, trunk and scalp at the age 17. The diagnosis of pyoderma gangrenosum was made. Since presentation, changes in liver function were detected and subsequent study led to the diagnosis of sclerosing cholangitis. The diagnosis of ulcerative colitis was made after colonoscopy. Partial response was obtained with minocycline and clofazimine, but treatment with 5-aminosalicylic acid achieved no improvement of the ulcerations. Liver transplantation, followed by immunosuppressive therapy led to complete regression of the cutaneous lesions.

The impact of type of language and number of reasons on purchase intent

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

Influence of lime type and curing conditions on lime and lime-metakaolin mortars

Durability of Building Materials and Components (Vasco Peixoto de de Freitas, J.M.P.Q. Delgado, eds.), Building Pathology and Rehabilitation, vol. 3, VIII, 105-126. ISBN: 978-3-642-37474-6 (Print) 978-3-642-37475-3 (Online). Springer-Verlag Berlin Heidelberg. DOI: 10.1007/978-3-642-37475-3_5

Studying urban space and literary representations using GIS: Lisbon, Portugal, 1852-2009

This article proposes a methodology to address the urban evolutionary process, demonstrating how it is reflected in literature. It focuses on “literary space,” presented as a territory defined by the period setting or as evoked by the characters, which can be georeferenced and drawn on a map. It identifies the different locations of literary space in relation to urban development and the economic, political, and social context of the city. We suggest a new approach for mapping a relatively comprehensive body of literature by combining literary criticism, urban history, and geographic information systems (GIS). The home-range concept, used in animal ecology, has been adapted to reveal the size and location of literary space. This interdisciplinary methodology is applied in a case study to nineteenth- and twentieth-century novels involving the city of Lisbon. The developing concepts of cumulative literary space and common literary space introduce size calculations in addition to location and structure, previously developed by other researchers. Sequential and overlapping analyses of literary space throughout time have the advantage of presenting comparable and repeatable results for other researchers using a different body of literary works or studying another city. Results show how city changes shaped perceptions of the urban space as it was lived and experienced. A small core area, correspondent to a part of the city center, persists as literary space in all the novels analyzed. Furthermore, the literary space does not match the urban evolution. There is a time lag for embedding new urbanized areas in the imagined literary scenario.

Clonal structure of Trypanosoma cruzi Colombian strain (biodeme Type III): biological, isoenzymic and histopathological analysis of seven isolated clones

The clonal structure of the Colombian strain of Trypanosoma cruzi, biodeme Type III and zymodeme 1, was analyzed in order to characterize its populations and to establish its homogeneity or heterogeneity. Seven isolated clones presented the basic characteristics of Biodeme Type III, with the same patterns of parasitemic curves, tissue tropism to skeletal muscle and myocardium, high pathogenicity with extensive necrotic-inflammatory lesions from the 20th to 30th day of infection. The parental strain and its clones C1, C3, C4 and C6, determined the higher levels of parasitemia, 20 to 30 days of infection, with high mortality rate up to 30 days (79 to 100%); clones C2, C5 and C7 presented lower levels of parasitemia, with low mortality rates (7.6 to 23%). Isoenzymic patterns, characteristic of zymodeme 1, (Z1) were similar for the parental strain and its seven clones. Results point to a phenotypic homogeneity of the clones isolated from the Colombian strain and suggest the predominance of a principal clone, responsible for the biological behavior of the parental strain and clones.

Native american women in sherman Alexie's short stories: stereotypical representations

Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Línguas, Literaturas e Culturas

Design of a balanced scorecard-type management system for a back-office department in a bank

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

Language and culture: representations of English-speaking cultures in 1st year secondary english language coursebooks in the Kingdom of Saudi Arabia

Dissertação apresentada para o cumprimento dos requisitos necessários á obtenção do grau de Mestre em Didáctica de Inglês

The strength of the waterbed effect depends on tariff type

We show that the waterbed effect, i.e. the pass-through of a change in one price of a firm to its other prices, is much stronger if the latter include subscription rather than only usage fees. In particular, in mobile network competition with a fixed number of customers, the waterbed effect is full under two-part tariffs, while it is only partial under linear tariffs.