Strength, muscle quality and functional capacity in liver transplanted familial amyloidotic polineuropathy patients

Liver transplantation is the unique treatment for several end stage diseases. Familial Amiloidotic Polineuropathy (FAP) is a neurodegenerative disease related with systemic deposition of amyloidal fibre mainly on peripheral nervous system, clinically translated by an autonomous sensitive-motor neuropathy with severe functional limitations in some cases. The unique treatment for FAP disease is a liver transplant with a very aggressive medication to muscle metabolism and force production. To our knowledge there are no quantitative characterizations of body composition, strength or functional capacity in this population. The purpose of this study was to compare levels of specific strength (isometric strength adjusted by lean mass or muscle quality) and functional capacity (meters in 6 minutes walk test) between FAP patients after a liver transplant (4.1±2 months after transplant surgery) (FAPT) and a healthy group (HG).

Intermittent claudication and physical exercise: effectiveness of a home-based program

Peripheral arterial disease (PAD) as a high incidence in general population and 12% to 20% of population with more than 60 years has already clinical symptoms, such as intermittent claudication (IC), pain, loss of strength and functional incapacity. There are already some studies that refer the possible positive effects of physical exercise in functional consequences of PAD. The purpose of this study was to verify the results of a home-based (HB) weekly supervised physical exercise program in patients with IC in consequence of PAD in lower limbs, and observe the medium number of diary steps walked by the subjects of our study.

Use of psychoactive drugs and related falls among older people living in a community in Brazil

INTRODUCTION: Population aging in Brazil has increased the prevalence of neurodegenerative diseases (Parkinson's and Alzheimer's disease) and affective disorders (anxiety, depression), all common in old age. A retrospective study was carried out with the purpose of ascertaining if there is an association between falls and psychoactive medication use among older residents of a community in Brazil. METHODS: All residents aged 65+ (n=161) of one neighborhood of Campo Belo, Brazil (population of 48,000) were evaluated regarding the use of psychoactive drugs and the occurrence of falls in the 12 months preceding the study. Vision and hearing screenings were also performed. RESULTS: From the study population, 9.3% were taking prolonged half-life benzodiazepines, 4.4% anticonvulsants (mostly barbiturates), 2.5% antidepressants (all cyclics) and 8.1% alpha-methyldopa. No subject reported use of hypnotics, neuroleptics or drugs to treat Alzheimer's or Parkinson's diseases (except biperiden). As a whole, drugs that increase the risk of falls were used by 1/5 of this population. In the 12-month period preceding the study, 27 residents (16.8%) experienced falls and, of those, 4 (14.8%) had fracture(s). There was an independent association between psychoactive drug use and falls when variables such as age, gender, vision and hearing were controlled (p=0.02). CONCLUSIONS: Although the population of this neighborhood must be considered young (only 4% are 65 years old or more), there are already problems related to the use of psychoactive drugs among people. Prescribed anxiolytics, anticonvulsants, antidepressants and antihypertensives are not appropriate for this age group and their use is associated with falls.

Estudo da transferência das cloraminas da água para o ar duma piscina coberta

Mestrado em Engenharia Química

Avaliação de fatores determinantes e da taxa de incidência da condição DFD (Dark, Firm, Dry) na carne de bovinos abatidos no matadouro da ilha Terceira

Dissertação de Mestrado, Engenharia Zootécnica, 13 de Junho de 2014, Universidade dos Açores.

Efeitos do treinamento aeróbio intervalado periodizado sobre os parâmetros antropométricos, bioquímicos e clínicos em portadores de síndrome metabólica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Evaluation of 99mTc-Sestamibi as a potential tool to investigate PgP activity in inflammation

Introduction: In the XXI Century ’s Society the scientific investigation process has been growing steadily , and the field of the pharmaceutical research is one of the most enthusiastic and relevant . Here, it is very important to correlate observed functional alterations with possibly modified drug bio distribution patterns . Cancer, inflammation and inf ection are processes that induce many molecular intermediates like cytokines, chemokines and other chemical complexes that can alter the pharmacokinetics of many drugs. One cause of such changes is thought to be the modulator action of these complexes in t he P - Glyco p rotein activity, because they can act like inducers/inhibitors of MDR - 1 expression. This protein results from the expression of MDR - 1 gene, and acts as an ATP energy - dependent efflux pump, with their substrates including many drugs , like antiretrovirals, anticancers, anti - infectives, immunosuppressants, steroids or opioids . Objectives: Because of the lack of methods to provide helpful information in the investigation of in vivo molecular changes in Pgp activity during infection/infl ammation processes, and its value in the explanation of the altered drug pharmacokinetic, this paper want to evaluate the potential utility of 99m Tc - Sestamibi scintigraphy during this kind of health sciences investigation. Although the a im is indeed to create a technique to the in vivo study of Pgp activity, this preliminary Project only reaches the in vitro study phase, assumed as the first step in a n evaluation period for a new tool development. Materials and Methods: For that reason , we are performing in vitro studies of influx and efflux of 99m Tc - Sestamibi ( that is a substrate of Pgp) in hepatocytes cell line (HepG2). We are interested in clarify the cellular behavior of this radiopharmaceutical in Lipopolysaccharide(LPS) stimulated cells ( well known in vitro model of inflammation) to possibly approve this methodology. To validate the results, the Pgp expression will be finally evaluated using Western Blot technique. Results: Up to this moment , we still don’t have the final results, but we have already enough data to let us believe that LPS stimulation induce a downregulation of MDR - 1, and consequently Pgp, which could conduce to a prolonged retention of 99m Tc - Sestamibi in the inflamed cells . Conclusions: If and when this methodology demonstrate the promising results we expect, one will be able to con clude that Nuclear Medicine is an important tool to help evidence based research also on this specific field .

Magnesium, insulin resistance and body composition in healthy postmenopausal women

Objective: This study was conducted to determine the association between magnesium (Mg), body composition and insulin resistance in 136 sedentary postmenopausal women, 50 to 77 years of age. Methods: Diabetics, hypertensives and women on hormonal replacement therapy were excluded and the remaining 74 were divided according to BMI≥25 (obese: OG) and BMI<25 kg/m2 (non-obese: NOG). Nutritional data disclosed that intakes were high for protein and saturated fat, low for carbohydrates, polyunsaturated fat and Mg and normal for the other nutrients, according to recommended dietary allowances (RDA). Mg values in red blood cells (RBC-Mg) and plasma (P-Mg), were determined, as were fasting glucose, and insulin levels, Homeostasis Model Assessment (HOMA), body mass index (BMI), body fat percent (BF %), abdominal fat (AF) and free fat mass (FFM). Results: RBC-Mg values were low in both groups when compared with normal values. There were significant differences in body composition parameters, HOMA and insulin levels, with higher basal insulin levels in OG. RBC-Mg was directly correlated with insulin, HOMA and FFM in both groups, according to Pearson correlations. HOMA in OG was also directly correlated with BMI, FFM and AF. In NOG, HOMA was only correlated with FFM. The low RBC-Mg levels observed were probably due to low Mg intake and to deregulation of factors that control Mg homeostasis during menopause. Conclusions: Both Mg deficit and obesity may independently lead to a higher risk for insulin resistance and cardiovascular disease.

Efeitos de um programa prolongado de exercício na tolerância ao esforço de indivíduos com antecedentes de síndrome coronário agudo

Objectivos: Este estudo teve por objectivo verificar a influência de um programa prolongado de exercício físico em parâmetros de aptidão física e cardiovasculares avaliados em prova de esforço máximo, em sujeitos com diagnóstico recente de síndrome coronário agudo. Métodos: A amostra, constituída por 50 sujeitos, foi distribuída por um grupo experimental (n=25) e por um grupo controlo (n=25), tendo o grupo experimental ficado sujeito a um programa de exercício físico regular durante 52 semanas. Todos os indivíduos realizaram duas provas de esforço máximas (PEM) em tapete rolante, uma no início e a outra no final do protocolo experimental, tendo a primeira prova sido realizada 2-3 meses após o evento cardíaco. Nas PEM foram registados parâmetros de aptidão física (velocidade máxima, inclinação máxima do tapete e tempo de prova), dos indicadores metabólicos (METs máximo) e parâmetros cardiovasculares (frequência cardíaca repouso e máxima durante a prova, tensão arterial de repouso e máxima durante a prova e o duplo produto máximo e em repouso). Resultados: Comparativamente à primeira prova, na segunda PEM verificou-se no grupo experimental um aumento significativo (p<0,05) dos valores absolutos dos indicadores de aptidão física, com uma percentagem de variação destes parâmetros significativamente superior à do grupo controlo. No entanto, apesar do melhor desempenho físico evidenciado pelo grupo experimental, não se verificaram diferenças significativas entre os dois grupos no que respeita aos parâmetros cardiovasculares. Conclusão: Os resultados permitem concluir que o programa de exercícios se revelou vantajoso para os indivíduos do grupo experimental, tendo-lhes aumentado a tolerância ao esforço físico máximo sem uma aparente sobrecarga cardiovascular adicional.

Infância Institucionalizada: Narrativas das crianças sobre o antes, o durante e o pós alta hospitalar

Dissertação apresentada à Escola Superior de Educação de Lisboa para a obtenção do grau de Mestre em Ciências da Educação, especialização em Educação Social e Intervenção Comunitária

Trajetórias de vida de sucesso em indivíduos com passado de vivência prolongada em contexto institucional

Dissertação de Mestrado em Psicologia da Educação, especialidade em Contextos Comunitários.

A literacia em saúde: investimento na promoção da saúde e na racionalização de custos

A Organização Mundial da Saúde define a literacia em saúde como o conjunto de competências cognitivas e sociais e a capacidade dos indivíduos para compreenderem e usarem informação para a promoção e manutenção da saúde. A transmissão de informação sobre saúde é mais eficaz quando os seus conteúdos são especificamente desenhados para uma pessoa ou para um grupo populacional e quando a mensagem é bem delimitada, realçando os benefícios (ganhos) e os custos (perdas) associados aos comportamentos e às tomadas de decisão. Analisa-se, neste estudo, o conceito de literacia em saúde e a associação da baixa literacia em saúde aos comportamentos em saúde e aos gastos em saúde. Apresenta-se uma análise da literatura científica publicada sobre a baixa literacia em saúde e a sua implicação nos custos na saúde usando, para este objectivo, uma base de dados das ciências da saúde (MEDLINE/PubMed) e quatro plataformas científicas (DOAJ, SCOPUS, SciELO e Web of Science). A literatura científica analisada evidencia que pessoas com baixa literacia em saúde apresentam uma menor capacidade de compreensão dos conteúdos de material informativo sobre alimentos, doenças crónicas ou sobre o uso de medicamentos, por exemplo, bem como maior dificuldade em pesquisar, seleccionar, ler e assimilar a informação em saúde disponível na Internet. A baixa literacia em saúde relaciona-se, então. com a dificuldade na prevenção e na gestão de problemas de saúde, bem como com comportamentos ineficazes de saúde, i.e., com o uso inadequado de medicamentos, com o recurso excessivo aos serviços de saúde (em especial, os de urgências) ou com a ineficácia em lidar com situações de emergência. A baixa literacia está também associada a taxas de hospitalização mais altas, mas também mais longas no tempo (o que implica mais custos associados a internamento prolongado, mais exames de diagnóstico e fraca adesão à terapêutica medicamentosa), a uma diminuição da utilização de medidas preventivas e a uma fraca adesão à prescrição terapêutica. A baixa literacia acaba por afectar igualmente a comunicação (e a relação) médico-doente. Apresentam-se, como complemento, sugestões de melhoria da literacia em saúde e da comunicação médico-doente para efeitos da promoção da saúde.

Influence of long-term wearing of unstable shoes on compensatory control of posture: An electromyography-based analysis

Purpose: This study investigated the influence of long-term wearing of unstable shoes (WUS) on compensatory postural adjustments (CPA) to an external perturbation. Methods: Participants were divided into two groups: one wore unstable shoes while the other wore conventional shoes for 8 weeks. The ground reaction force signal was used to calculate the anterior– posterior (AP) displacement of the centre of pressure (CoP) and the electromyographic signal of gastrocnemius medialis (GM), tibialis anterior (TA), rectus femoris (RF) and biceps femoris (BF) muscles was used to assess individual muscle activity, antagonist co-activation and reciprocal activation at the joint (TA/GM and RF/(BF + GM) pairs) and muscle group levels (ventral (TA + RF)/dorsal (GM + BF) pair) within time intervals typical for CPA. The electromyographic signal was also used to assess muscle latency. The variables described were evaluated before and after the 8-week period while wearing the unstable shoes and barefoot. Results: Long-term WUS led to: an increase of BF activity in both conditions (barefoot and wearing the unstable shoes); a decrease of GM activity; an increase of antagonist co-activation and a decrease of reciprocal activation level at the TA/GM and ventral/dorsal pairs in the unstable shoe condition. Additionally, WUS led to a decrease in CoP displacement. However, no differences were observed in muscle onset and offset. Conclusion: Results suggest that the prolonged use of unstable shoes leads to increased ankle and muscle groups’ antagonist co-activation levels and higher performance by the postural control system.

Cardiorespiratory fitness is negatively associated with metabolic risk factors independently of the adherence to a healthy dietary pattern

Background and aim: Cardiorespiratory fitness (CRF) and diet have been involved as significant factors towards the prevention of cardio-metabolic diseases. This study aimed to assess the impact of the combined associations of CRF and adherence to the Southern European Atlantic Diet (SEADiet) on the clustering of metabolic risk factors in adolescents. Methods and Results: A cross-sectional school-based study was conducted on 468 adolescents aged 15-18, from the Azorean Islands, Portugal. We measured fasting glucose, insulin, total cholesterol (TC), HDL-cholesterol, triglycerides, systolic blood pressure, waits circumference and height. HOMA, TC/HDL-C ratio and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score (MRS) was constructed by summing the Z scores of all individual risk factors. High risk was considered when the individual had 1SD of this score. CRF was measured with the 20 m-Shuttle-Run- Test. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire. Logistic regression showed that, after adjusting for potential confounders, unfit adolescents with low adherence to SEADiet had the highest odds of having MRS (OR Z 9.4; 95%CI:2.6e33.3) followed by the unfit ones with high adherence to the SEADiet (OR Z 6.6; 95% CI: 1.9e22.5) when compared to those who were fit and had higher adherence to SEADiet.

Avaliação da influência dos estímulos alimentares na actividade extracardíaca

Mestrado em Medicina Nuclear - Ramo de especialização: Radiofarmácia