Health related quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization: type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the health-related quality of life (HRQL) are largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions that constitute HRQL are still a matter of discussion. Objective: To evaluate the impact of CRT on the HRQL of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT. Methods: 43 patients, submitted to successful implantation of CRT, were evaluated in hospital just before intervention and in the outpatient clinic within 6 months after CRT. HRQL was analyzed based on the Kansas City Cardiomyopathy Questionnaire (KCCQ). Patients were classified as super-responders (ejection fraction of left ventricle - LVEF - ≥45% post-CRT), n=15, responders (sustained improvement in functional class and LVEF increased by 15%), n=19, and non-responders (no clinical or LVEF improvement), n=9. Results: In the group of super-responders, CRT was associated with an improvement in HRQL for the various fields and sums assessed (ρ<0.05); in responders, CRT has been associated with an improvement of HRQL in the various fields and sums, except in the self-efficacy dimension (ρ<0.05); in non-responders, CRT was not associated with improvement of HRQL. Conclusion: In a population with severe CHF undergoing CRT, the patients with clinical and echocardiographic positive response, obtained a favorable impact in all dimensions of HRQL, while the group without response to CRT showed no improvement. These data reinforces the importance of HRQL as a multidimensional tool for assessment of benefits in clinical practice.

Evaluating the quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization regarding the type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the quality of life have been largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions of quality of life is still a matter of discussion. Objective: to evaluate the impact of CRT on the quality of life of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT.

O natural e o farmacológico: padrões de consumo terapêutico na população portuguesa

Neste artigo identificam-se os padrões de consumo terapêutico na população portuguesa, visando dar conta de um novo padrão emergente nas sociedades modernas, aqui designado de Pluralismo Terapêutico, noção com a qual se categoriza o uso conjugado ou alternado de recursos farmacológicos e naturais nas trajetórias terapêuticas dos indivíduos. O respetivo suporte empírico decorre de uma investigação, já concluída, que teve por base uma amostra nacional representativa. Os resultados mostram uma dualização dos consumos terapêuticos que é constituída por um padrão dominante de Farmacologismo – i.e., uso exclusivo de fármacos – coexistente com uma tendência crescente de pluralismo terapêutico. O efeito das fontes de informação terapêutica e dos seus usos leigos, bem como das perceções sociais de risco sobre o natural e o farmacológico, constitui neste estudo uma referência analítica central para a interpretação dos padrões encontrados. - ABSTRACT: In this article we identify patterns of therapeutic consumption, with the purpose of assessing an emerging pattern in modern societies, here designated as Therapeutic Pluralism, referring to the conjugated or alternated use of pharmacological and natural resources in the therapeutic trajectories of individuals. The empirical basis for this analysis stems from a concluded research on the topic, and is focused on a questionnaire administered to a representative sample of the Portuguese population. The results show a duality in therapeutic consumptions, expressed in the coexistence of a dominant pattern of Pharmacologism – that is, the exclusive therapeutic consumption of pharmaceuticals – and a growing trend towards therapeutic pluralism. The effects of information sources on health and its lay uses, as well as of the social perceptions of risk concerning the natural and the pharmacological, constitute key analytical references for this study’s interpretation of the identified patterns.

The expression of tubulin cofactor A (TBCA) is regulated by a noncoding antisense Tbca RNA during testis maturation

Abstract - Recently, long noncoding RNAs have emerged as pivotal molecules for the regulation of coding genes' expression. These molecules might result from antisense transcription of functional genes originating natural antisense transcripts (NATs) or from transcriptional active pseudogenes. TBCA interacts with β-tubulin and is involved in the folding and dimerization of new tubulin heterodimers, the building blocks of microtubules. Methodology/Principal findings: We found that the mouse genome contains two structurally distinct Tbca genes located in chromosomes 13 (Tbca13) and 16 (Tbca16). Interestingly, the two Tbca genes albeit ubiquitously expressed, present differential expression during mouse testis maturation. In fact, as testis maturation progresses Tbca13 mRNA levels increase progressively, while Tbca16 mRNA levels decrease. This suggests a regulatory mechanism between the two genes and prompted us to investigate the presence of the two proteins. However, using tandem mass spectrometry we were unable to identify the TBCA16 protein in testis extracts even in those corresponding to the maturation step with the highest levels of Tbca16 transcripts. These puzzling results led us to re-analyze the expression of Tbca16. We then detected that Tbca16 transcription produces sense and natural antisense transcripts. Strikingly, the specific depletion by RNAi of these transcripts leads to an increase of Tbca13 transcript levels in a mouse spermatocyte cell line. Conclusions/Significance: Our results demonstrate that Tbca13 mRNA levels are post-transcriptionally regulated by the sense and natural antisense Tbca16 mRNA levels. We propose that this regulatory mechanism operates during spermatogenesis, a process that involves microtubule rearrangements, the assembly of specific microtubule structures and requires critical TBCA levels.

Image quality of myocardial perfusion-gated studies: effect of ingestion of different fat content in the reduction of extra-myocardial abdominal signal

Myocardial perfusion-gated-SPECT (MP-gated-SPECT) imaging often shows radiotracer uptake in abdominal organs. This accumulation interferes frequently with qualitative and quantitative assessment of the infero-septal region of myocardium. The objective of this study is to evaluate the effect of ingestion of different fat content on the reduction of extra-myocardial uptake and to improve MP-gated-SPECT image quality. In this study, 150 patients (65 ^ 18 years) who were referred for MP-gated-SPECT underwent a 1-day-protocol including imaging after stress (physical or pharmacological) and resting conditions. All patients gave written informed consent. Patients were subdivided into five groups: GI, GII, GIII, GIV and GV. In the first four groups, patients ate two chocolate bars with different fat content. Patients in GV – control group (CG) – had just water. Uptake indices (UI) of myocardium (M)/liver(L) and M/stomach–proximal bowel(S) revealed lower UI of M/S at rest in all groups. Both stress and rest studies using different food intake indicate that patients who ate chocolate with different fat content showed better UI of M/L than the CG. The UI of M/L and M/S of groups obtained under physical stress are clearly superior to that of groups obtained under pharmacological stress. These differences are only significant in patients who ate high-fat chocolate or drank water. The analysis of all stress studies together (GI, GII, GIII and GIV) in comparison with CG shows higher mean ranks of UI of M/L for those who ate high-fat chocolate. After pharmacological stress, the mean ranks of UI of M/L were higher for patients who ate high- and low-fat chocolate. In conclusion, eating food with fat content after radiotracer injection increases, respectively, the UI of M/L after stress and rest in MP-gated-SPECT studies. It is, therefore, recommended that patients eat a chocolate bar after radiotracer injection and before image acquisition.

Marine cyanobacteria compounds with anticancer properties: a review on the implication of apoptosis

Marine cyanobacteria have been considered a rich source of secondary metabolites with potential biotechnological applications, namely in the pharmacological field. Chemically diverse compounds were found to induce cytoxicity, anti-inflammatory and antibacterial activities. The potential of marine cyanobacteria as anticancer agents has however been the most explored and, besides cytotoxicity in tumor cell lines, several compounds have emerged as templates for the development of new anticancer drugs. The mechanisms implicated in the cytotoxicity of marine cyanobacteria compounds in tumor cell lines are still largely overlooked but several studies point to an implication in apoptosis. This association has been related to several apoptotic indicators such as cell cycle arrest, mitochondrial dysfunctions and oxidative damage, alterations in caspase cascade, alterations in specific proteins levels and alterations in the membrane sodium dynamics. In the present paper a compilation of the described marine cyanobacterial compounds with potential anticancer properties is presented and a review on the implication of apoptosis as the mechanism of cell death is discussed.

TBCCD1, a new centrosomal protein, is required for centrosome and Golgi apparatus positioning

In animal cells the centrosome is positioned at the cell centre in close association with the nucleus. The mechanisms responsible for this are not completely understood. Here, we report the first characterization of human TBCC-domain containing 1 (TBCCD1), a protein related to tubulin cofactor C. TBCCD1 localizes at the centrosome and at the spindle midzone, midbody and basal bodies of primary and motile cilia. Knockdown of TBCCD1 in RPE-1 cells caused the dissociation of the centrosome from the nucleus and disorganization of the Golgi apparatus. TBCCD1-depleted cells are larger, less efficient in primary cilia assembly and their migration is slower in wound-healing assays. However, the major microtubule-nucleating activity of the centrosome is not affected by TBCCD1 silencing. We propose that TBCCD1 is a key regulator of centrosome positioning and consequently of internal cell organization.

Avaliação e controlo da dor em pediatria: uma década

Introdução – A negligência no controlo da dor é um problema amplamente reconhecido em Portugal. Desde 2001 têm sido realizadas inúmeras iniciativas para melhorar a prática de cuidados nesta área. Desenvolveram-se ações de sensibilização e formação dos profissionais de saúde, publicaram-se orientações técnicas e guias de boas práticas e realizaram-se os primeiros estudos para se fazer um diagnóstico da situação. Objetivos – O objetivo deste trabalho foi o de caracterizar os cuidados prestados na avaliação e no controlo da dor nas crianças até aos 18 anos internadas em serviços hospitalares em Portugal e analisar a evolução feita nos cuidados entre os anos de 2002 e 2012. Metodologia – Estudo descritivo, transversal, de consulta retrospetiva seriada de registos intermitentes efetuados no processo clínico em relação a um período de 24 horas. O recrutamento da amostra foi aleatório e incluiu todos os processos clínicos de crianças até aos 18 anos internados em serviços de quatro hospitais Portugueses entre agosto e dezembro de 2011. Resultados – A prevalência de dor reduziu de forma significativa entre 2002 e 2012. As crianças livres de dor subiram de 37% para 75%. O registo da avaliação da intensidade da dor e a colheita de informação sobre a história de dor passou a ser uma prática comum na maioria dos casos (53% e 64%, respetivamente), embora ainda direcionada para o modelo de cuidados biomédico. A prevalência das intervenções farmacológicas não se alterou (43% versus 42%), mas a implementação de estratégias não-farmacológicas baixou significativamente (72% versus 15%). Conclusões – As ações de sensibilização/formação realizadas no âmbito das políticas implementadas nestes últimos dez anos na área da avaliação e controlo da dor pediátrica geraram evidentes ganhos na qualidade de cuidados prestados, pelo que o investimento na formação deve continuar. No entanto, deve ser dada prioridade à formação para a aplicação de estratégias de intervenção não-farmacológicas e ao desenvolvimento de mais investigação que suporte as práticas.

Antimicrobial activity of pyrazine and quinoxaline N,N’-dioxide heterocyclic compounds

The nitrogen heterocyclic organic compounds 1,4 dioxide pyrazine and quinoxaline derivatives have been widely studied due to their potential use as synthetic drugs. The thermochemical study of three N,N´-dioxides: 2,3,5-trimethylpyrazine-1,4-dioxide, tetramethylpyrazine-1,4-dioxide and 6-chloro-2,3-dimethilquinoxaline 1,4-dioxide has been recently developed in order to establish relationships among the energetical, structural and reactivity properties [4,5]. Several studies have reported their pharmacological activity, particularly as antimicrobial agents [1,2,3]. It has also been established a relation between energetical and structural properties and biological activity, once these compounds present N – oxide bonds, increasing their oxidative capacity. The present work reports the study of antimicrobial activity for those compounds against the bacteria Geobacillus stearothermophylus, Staphylococcus aureus, Streptococcus agalactiae, Escherichia coli and also against the yeasts Saccharomyces cerevisiae PYCC 4072, Candida albicans PYCC3436T, Candida tropicalis PYCC, Issatchenka Orientalis PYCC. The determination of the minimal inhibitory concentration (MIC), points to an antimicrobial activity and the preliminary results indicate that these compounds may be potential candidates as antimicrobial drugs with clinical, agriculture or food industries applications.

Avaliação da aptidão física funcional em idosos hipertensos da Cidade da Praia - Cabo Verde

Mestrado em Fisioterapia.

Bioactive meroditerpenes from Cystoseira abies-marina, collected from the coast of S. Miguel island

3rd Portuguese Meeting on Medicinal Chemistry and 1st Portuguese-Spanish-Brazilian Meeting on Medicinal Chemistry, Aveiro, 28-30 Novembro 2012.

Purification and structural characterization of compounds isolated from Cystoseira abies-marina

6th Spanish-Portuguese-Japanese Organic Chemistry Symposium, Lisboa, de 18 a 20 de Julho de 2012 (Poster Communication).

Impacto de andrógenos sobre a proliferação e atividade de fibroblastos e células epiteliais em cultura celular

Pós-graduação em Odontologia - FOAR

A natureza sob o olhar da química: caracterizaçao de novas moléculas activas isoladas de productos naturais Açorianos

Jornadas "Ciência nos Açores – que futuro?", Ponta Delgada, 7-8 de Junho de 2013.

CCTα

In the cell, the correct folding of many proteins depends on the function of preexisting ones known as Molecular Chaperones (for a review see Hartl and Hayer-Hartl 2009). These, were defined as proteins that bind to and stabilize an otherwise unstable conformation of another protein, and by controlling binding and release, facilitate its correct fate in vivo, be it folding, oligomeric assembly, transport to a particular subcellular compartment, or disposal by degradation. Molecular chaperones do not convey steric information specifying correct folding: instead, they prevent incorrect interactions within and between nonnative peptides, thus typically increasing the yield but not the rate of folding reactions. Molecular chaperones are ubiquitous and comprise several protein families that are structurally unrelated (Hartl and Hayer-Hartl 2009). The Hsp70s and the Chaperonin families have been extensively studied.