978 resultados para Diffuse Suffering


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The current study describes the in vitro phosphorylation of a human hair keratin, using protein kinase for the first time. Phosphorylation of keratin was demonstrated by 31P NMR (Nuclear Magnetic Resonance) and Diffuse Reflectance Infrared Fourier Transform (DRIFT) techniques. Phosphorylation induced a 2.5 fold increase of adsorption capacity in the first 10 minutes for cationic moiety like Methylene Blue (MB). Thorough description of MB adsorption process was performed by several isothermal models. Reconstructed fluorescent microscopy images depict distinct amounts of dye bound to the differently treated hair. The results of this work suggest that the enzymatic phosphorylation of keratins might have significant implications in hair shampooing and conditioning, where short application times of cationic components are of prime importance.

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OBJECTIVE:To use a semi-structured interview to detect depression in postpartum women according to the criteria proposed by the DSM in child health care clinics in the city of Recife, together with the proper association of this disorder to bio-socio-demographic data. METHODS: The study used a cross-section method and contained a convenience sample of 400 women that were between 2 and 26 weeks of postpartum in child health care clinics. A bio-socio-demographic questionnaire and the Portuguese version of the Structured Clinical Interview for DSM-IV Axis I Disorders were used. RESULTS: Twenty nine of the mothers (7.2%) were diagnosed as suffering from postpartum depression. Women with a past history of psychiatric disorders, a family history of psychiatric disorder and some sort of clinical complication presented a higher prevalence of depression. The same happened to those with a past history of spontaneous abortion, those who had a transpelvic birth and those over 8 weeks of puerperium. CONCLUSION: The rate of postpartum depression in this sample, 7.2%, was lower than that reported by other Brazilian studies. It probably occurred because the other researchers used screening scales to assess this estimate instead of a clinical interview.

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INTRODUCTION: Thyroid dysfunction has often been associated with several psychiatric manifestations. Previous case reports/series suggest the possible role played by acute alteration of thyroid status in the onset of psychotic symptoms. METHODS: Case report and literature review. RESULTS: A 45-year-old woman with no psychiatric antecedents was brought to the ER with a full-blown psychotic episode, marked by paranoid delusions, which developed gradually over two months. She had been treated elsewhere for hyperthyroidism for five years with methimazole 40 mg/d, with poor compliance. One month before the beginning of the psychotic symptoms, methimazole was raised to 60 mg/d and she started taking it correctly. Five months earlier she had TSH: 0.074 uUI/ml and free T4: 1.3 ng/dl. At admission we found a diffuse thyroid goiter, TSH: 70.9 uUI/ml and free T4: 0.03 ng/dl. Brain CT was normal. We hospitalized her with the diagnosis of a psychosis secondary to hypothyroidism, suspended methimazole, and gave her levothyroxine (up to 75 µg/d) and risperidone (2 mg/d). The patient had a quick remission and was discharged after 15 days. Within one month she had TSH: 0.7 uUI/ml and was completely recovered psychiatrically. She has been well since then, with risperidone in the first 8 months, and without it for 10 months now. CONCLUSION: This case report is a reminder of the necessity of checking thyroid status as part of clinical assessment of psychoses. It also supports the hypothesis that antithyroid drugs may have severe psychiatric consequences, especially when they lead to an acute change of thyroid status.

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Tese de Doutoramento em Engenharia Civil.

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Tese de Doutoramento (Programa Doutoral em Engenharia de Materiais)

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OBJECTIVE: To analyze the initial clinical experience of transmyocardial laser revascularization (TMLR) in patients with severe diffuse coronary artery disease. METHODS: Between February, 1998 and February, 1999, 20 patients were submitted to TMLR at the Heart Institute (InCor), University of São Paulo Medical School, Brazil, isolated or in association with conventional coronary artery bypass graft (CABG). All patients had severe diffuse coronary artery disease, with angina functional class III/IV (Canadian Cardiovascular Society score) unresponsive to medical therapy. Fourteen patients were submitted to TMLR as the sole therapy, whereas 6 underwent concomitant CABG. Fifty per cent of the patients had either been previously submitted to a CABG or to a percutaneous transluminal coronary angioplasty (PTCA). Mean age was 60 years, ranging from 45 to 74 years. RESULTS: All patients had three-vessel disease, with normal or mildly impaired left ventricular global function. Follow-up ranged from 1 to 13 months (mean 6.6 months), with no postoperative short or long term mortality. There was significant symptom improvement after the procedure, with 85% of the patients free of angina, and the remaining 15 % of the patients showing improvement in functional class, as well as in exercise tolerance. CONCLUSION: This novel technique can be considered a low risk alternative for a highly selected group of patients not suitable for conventional revascularization procedures.

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We report here a case of coronary artery fistula in a neonate with clinical signs of heart failure. The electrocardiogram showed signs of left ventricular hypertrophy and diffuse alterations in ventricular repolarization. Chest X-ray showed an enlargement of the cardiac silhouette with an increase in pulmonary flow. After echocardiographic diagnosis and angiographic confirmation, closure of the fistulous trajectory was performed with a detachable balloon with an early and late successful outcome.

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Relatório de estágio de mestrado em Ensino de Música

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OBJECTIVE: To investigate the effects of receptive music therapy in clinical practice. METHODS: Receptive music therapy was individually applied via musical auditions, including five stages: musical stimulation, sensation, situation, reflection, and behavioral alteration. Following anamnesis and obtainment of consent, patients answered a first questionnaire on health risk evaluation (Q1), and after participating in 16 weekly music therapy sessions, answered a second one (Q2). RESULTS: Two men and 8 women, aged above 18 years, referred to us due to symptoms of stress, emotional suffering, and the need to change lifestyles (health risk behavior) were studied between August 1998 and December 1999. Comparison between answers to Q1 and Q2, showed a trend (P=0.059) for reduction of ingestion of cholesterol-rich foods and for increased prospects in life with a tendency towards improvement, and also of increased intake of fiber-rich food (55.6%), increased levels of personal satisfaction (44.5%), and decreased levels of stress (66.7%). CONCLUSION: The study demonstrated decreased stress levels and increased personal satisfaction, higher consumption of fiber-rich food, lower cholesterol intake, and a better perspective on life, suggesting that receptive music therapy may be applied in clinical practice as an auxiliary therapeutic intervention for the treatment of behavioral health risks.

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OBJECTIVE: To analyze the efficacy of percutaneous transluminal septal alcoholization in the treatment of refractory obstructive hypertrophic cardiomyopathy (HOC). METHODS: The patients were referred for alcoholization after Doppler echocardiography. Before and after alcoholization, the intraventricular pressure gradient was recorded. Alcoholization was performed with a 3mL injection of absolute alcohol through a coronary angioplasty balloon catheter. The procedure was concluded after a significant reduction or abolition of the pressure gradient. RESULTS: Of 22 patients, 18 (81.8%) successfully concluded the procedure with a reduction in intraventricular pressure gradient at baseline (from 67.6±24.2 mmHg to 3.8± 1.9 mmHg, p<0.005) and after extrasystole (from 110.4± 24.2 mmHg to 9.6±2.6 mm Hg, p<0.005). A significant reduction in mean interventricular septal thickness (from 2± 0.3 mm to 1.7±0.2 mm, p<0.005) and in peak pressure gradient (from 90.7±23.5 mmHg to 6.1±1.4 mmHg, p<0.005) was observed on Doppler echocardiography after 6 months, when all patients were in functional class I. The most frequent acute complication, present in 11% of the patients, was the need for definitive pacing implantation. Relapse of the symptoms and reappearance of the pressure gradient occurred in 16.6% of the patients. One patient (5.5%) died probably due to a diffuse coronary spasm prior to the procedure, and another died suddenly on late follow-up. CONCLUSION: Percutaneous transluminal septal alcoholization is effective and safe in the treatment of HOC.

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A realização deste estudo junta duas áreas distintas: a arbitragem de futsal e o Balanced Scorecard (BSC). Nos últimos anos, devido ao crescimento acentuado da modalidade de Futsal, a mesma tem sido alvo de várias mudanças, nomeadamente no número de competições realizadas ao longo de uma época desportiva. Inerente ao elevado nível de competitividade alcançado, surge a necessidade de melhorar a gestão de uma área fundamental do jogo de futsal, a arbitragem. A arbitragem de futsal a nível nacional é gerida pelo Conselho de Arbitragem da Federação Portuguesa de Futebol (FPF). O Balanced Scorecard é uma metodologia de gestão estratégica, desenvolvida por Robert Kaplan e David Norton em 1992, que pode ser aplicada quer em organizações com fins lucrativos quer em organizações sem fins lucrativos, como é o caso do Conselho de Arbitragem da FPF. Desta forma, para colmatar a necessidade de melhorar a gestão da arbitragem de futsal, o presente estudo propõem-se aplicar a metodologia Balanced Scorecar ao Conselho de Arbitragem da Federação Portuguesa de Futebol na vertente futsal. Assim, irá ser apresentada uma análise do ambiente externo e interno, a definição de posicionamento e planeamento estratégico, o mapa estratégico e os objetivos definidos para cada perspetiva. Por fim, será feita uma reflexão quanto ao problema e aos objetivos do estudo, bem como, uma apresentação de algumas recomendações para futuros estudos.

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The aim of the project was to determine the extent and quality of the groundwater in Tipperary South Riding with a view to developing a groundwater protection plan which would allow the Local Authority to manage, protect and develop the groundwater as efficiently as possible. The geology of the area varies with topography. The low-lying areas of the county comprise mainly Carboniferous limestones while the elevated regions consist of sandstones and shales of Upper Carboniferous, Devonian and Silurian ages. Deformation of these rocks decreases in magnitude moving northwards over the area; the Southern Synclines having suffered the effects of the Hercynian orogeny and the northern region exhibiting Caledonian orogenic trends. Quaternary (subsoil) deposits are found throughout the area and are of variable thickness and permeability. Till is the most widespread deposit with discontinuous pockets of sand and gravel in various proportions, and some marl, alluvium and peat in places. The principal aquifers of the area are the Kiltorcan sandstone formation and various limestone units within the Carboniferous succession. 50 % of south Tipperary constitutes either regionally or locally important aquifers. Secondary permeabilities created by structural deformation, dolomitisation, karstification and weathering processes create high transmissivities and often have large well yields. Specific baseflow analysis highlighted the complexity of the aquifers and proved that the lower part of the Suir river system is a major groundwater resource region. The hydrochemistry and water quality of the local authority groundwater sources was examined briefly. The majority of south Tipperary is underlain by limestone or Quaternary deposits derived from limestone and, consequently, calcium/magnesium bicarbonate waters predominate. The quality of the groundwater in south Tipperary demonstrates that the main concern originates from the presence of E.coli, and Total coliforms. The primary sources of contamination are from farmyard wastes and septic tanks. The vulnerability of groundwater to diffuse and point sources of pollution has been found to be dependent on the overlying soil, subsoil and the thickness of the unsaturated zone. A conceptual rather than quantitative approach is used and it is found that approximately 60% of south Tipperary is designated as being extremely or highly vulnerable. The groundwater protection plan was devised subsequent to an understanding of the aquifer systems, an assessment of the vulnerability, and a review of the Irish planning system and environmental law. It is recommended that the plan be integrated into the county development plan for legislative purposes. A series of acceptability matrices were devised to restrict potentially polluting activities in vulnerable areas while maintaining a balance between protection of the groundwater resource and the need to site essential developments.

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Background: Coronary artery bypass graft (CABG) is a standard surgical option for patients with diffuse and significant arterial plaque. This procedure, however, is not free of postoperative complications, especially pulmonary and cognitive disorders. Objective: This study aimed at comparing the impact of two different physiotherapy treatment approaches on pulmonary and cognitive function of patients undergoing CABG. Methods: Neuropsychological and pulmonary function tests were applied, prior to and following CABG, to 39 patients randomized into two groups as follows: Group 1 (control) - 20 patients underwent one physiotherapy session daily; and Group 2 (intensive physiotherapy) - 19 patients underwent three physiotherapy sessions daily during the recovery phase at the hospital. Non-paired and paired Student t tests were used to compare continuous variables. Variables without normal distribution were compared between groups by using Mann-Whitney test, and, within the same group at different times, by using Wilcoxon test. The chi-square test assessed differences of categorical variables. Statistical tests with a p value ≤ 0.05 were considered significant. Results: Changes in pulmonary function were not significantly different between the groups. However, while Group 2 patients showed no decline in their neurocognitive function, Group 1 patients showed a decline in their cognitive functions (P ≤ 0.01). Conclusion: Those results highlight the importance of physiotherapy after CABG and support the implementation of multiple sessions per day, providing patients with better psychosocial conditions and less morbidity.