Psicopatologia obsessivo-compulsiva na distonia focal primária : aspectos neuropsiquiátricos de uma doença do movimento

RESUMO: pela contracção involuntária de grupos musculares de extensão variável, originando movimentos involuntários e posturas anómalas, por vezes dolorosas. O tratamento convencional consiste em injecções localizadas de toxina botulínica, podendo, em casos refractários, estar indicado o tratamento por estimulação cerebral profunda. A neurobiologia da distonia focal primária permanece incompletamente compreendida. Os estudos de neuro-imagem estrutural e funcional revelam alterações subtis da anatomia e funcionamento do estriado e das vias cortico-basais, com destaque para o aumento do volume, da actividade metabólica e da neuroplasticidade do putamen e de áreas corticais motoras, pré-motoras e sensitivas. O conjunto destas alterações aponta para uma disrupção da regulação inibitória de programas motores automáticos sustentados pelo estriado e pelas vias ortico-subcorticais. Nos últimos anos tem crescido o interesse pelas manifestações psiquiátricas e cognitivas da distonia (estas últimas muito pouco estudadas). Tem despertado particular interesse a possível associação entre distonia focal primária e perturbação obsessivo-compulsiva (POC), cuja neurobiologia parece notavelmente sobreponível à da distonia primária. Com efeito, os estudos de neuro-imagem estrutural e funcional na POC revelam consistentemente aumento do volume e actividade do estriado e do córtex órbito-frontal, apontando mais uma vez para uma disfunção do controlo inibitório, no estriado, de programas comportamentais e cognitivos automáticos. Objectivos: 1. Explorar a prevalência e intensidade de psicopatologia em geral, e de psicopatologia obsessivo-compulsiva em particular, numa amostra de indivíduos com distonia focal primária; 2. Explorar a ocorrência, natureza e intensidade de alterações do funcionamento cognitivo numa amostra de indivíduos com distonia focal primária; 3. Investigar a associação entre a gravidade da distonia focal, a intensidade da psicopatologia, e a intensidade das alterações cognitivas. Metodologia: Estudo de tipo transversal, caso-controlo, observacional e descritivo, com objectivos puramente exploratórios. Casos: 45 indivíduos com distonia focal primária (15 casos de blefaroespasmo, 15 de cãibra do escrivão, 15 de distonia cervical espasmódica), recrutados através da Associação Portuguesa de Distonia. Critérios de inclusão: idade = 18; distonia focal primária pura (excluindo casos de distonia psicogénica possível ou provável de acordo com os critérios de Fahn e Williams); Metabolismo do cobre e Ressonância Magnética Nuclear sem alterações. Controlos doentes: 46 casos consecutivos recrutados a partir da consulta externa do Hospital Egas Moniz: 15 doentes com espasmo hemifacial, 14 com espondilartropatia cervical, 17 com síndrome do canal cárpico. Controlos saudáveis: 30 voluntários. Critérios de exclusão para todos os grupos: Mini-Mental State Examination patológico, tratamento actual com anti-colinérgicos, antipsicóticos, inibidores selectivos da recaptação da serotonina, antidepressivos tri- ou tetracíclicos. Avaliação: Avaliação neurológica: história e exame médico e neurológico completos. Cotação da gravidade da distonia com a Unified Dystonia Rating Scale. Avaliação psicopatológica: Symptom Check-List-90-Revised; entrevista psiquiátrica de 60 minutos incluindo a Mini-International Neuropsychiatric Interview (MINI), versão 4.4 (validada em Português), complementada com os módulos da MINI Plus versão 5.0.0 para depressão ao longo da vida e dependência/ abuso do álcool e outras substâncias ao longo da vida; Yale-Brown Obsessive-Compulsive Symptom Checklist e a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Avaliação neuropsicológica: Wisconsin Card Sorting Test (WCST; flexibilidade cognitiva); Teste de Stroop (inibição de resposta); Block Assembly Test (capacidade visuo-construtiva); Teste de Retenção Visual de Benton (memória de trabalho visuo-espacial). Análise estatística:os dados foram analisados com a aplicação informática SPSS for Windows, versão 13. Para a comparação de proporções utilizaram-se o teste do Chi-quadrado e o teste de Fisher. Para a comparação de variáveis quantitativas entre dois grupos utilizou-se o teste t de Student ou o teste U de Mann-Whitney (teste de Wilcoxon no caso de amostras emparelhadas). Para comparações de médias entre três grupos recorreu-se à Análise de Variância a um factor (variáveis de intervalo e de rácio), ou ao teste de Kruskal-Wallis (variáveis ordinais). Para o estudo da associação entre variáveis foram utilizados os coeficientes de correlação de Pearson ou de Spearman, a análise de correlações canónicas, a análise de trajectórias e a regressão logística. Adoptou-se um Alpha de 0.05. Resultados: Os doentes com distonia focal primária apresentaram uma pontuação média na Y- -BOCS significativamente superior à dos dois grupos de controlo. Em 24.4% dos doentes com distonia a pontuação na Y-BOCS foi superior a 16. Estes doentes eram predominantemente mulheres, tinham uma maior duração média da doença e referiam predominantemente sintomas obsessivo-compulsivos (SOC) de contaminação e lavagem. Os dois grupos com doença crónica apresentaram pontuações médias superiores às dos indivíduos saudáveis nas escalas de ansiedade, somatização e psicopatologia geral. Os doentes com distonia tratados com toxina botulínica apresentaram pontuações inferiores às dos doentes não tratados nas escalas de ansiedade generalizada, fobia, somatização e depressão, mas não na Y-BOCS. Sessenta por cento dos doentes com distonia apresentavam pelo menos um diagnóstico psiquiátrico actual ou pregresso. O risco de apresentar um diagnóstico psiquiátrico actual era menor nos doentes tratados com toxina botulínica, aumentando com a gravidade da doença. A prevalência de POC foi 8,3% e a de depressão major 37,7%. No WCST e na Prova de Benton, os doentes com distonia focal primária demonstraram um desempenho inferior ao de ambos os grupos de controlo, cometendo sobretudo erros perseverativos. Os doentes com distonia e pontuação na Y-BOCS > 16 cometeram mais erros e respostas perseverativas no WCST do que os restantes doentes com distonia. As análises de correlações e de trajectórias revelaram que nos doentes com distonia a gravidade da distonia foi, juntamente com a idade e a escolaridade, o factor que mais interagiu com o desempenho cognitivo. Discussão: o nosso estudo é o primeiro a descrever, nos mesmos doentes com distonia focal primária, SOC significativos e alterações cognitivas. Os nossos resultados confirmam a hipótese de uma associação clínica específica entre distonia focal primária e psicopatologia obsessivo-compulsiva. Confirmam igualmente que a distonia focal primária está associada a um maior risco de desenvolver morbilidade psiquiátrica ansiosa e depressiva. O tratamento com toxina botulínica reduz este risco, mas não influencia os SOC. Entre os doentes com distonia, os que têm SOC significativos poderão diconstituir um grupo particular com maior duração da doença (mas não uma maior gravidade), predomínio do sexo feminino e predomínio de SOC de contaminação e limpeza. Em termos cognitivos, os indivíduos com distonia focal primária apresentam défices significativos de flexibilidade cognitiva (particularmente acentuados nos doentes com SOC significativos) e de memória de trabalho visuo-espacial. Estes últimos devem-se essencialmente a um défice executivo e não a uma incapacidade visuo-construtiva ou visuo-perceptiva. A disfunção cognitiva não é explicável pela psicopatologia depressiva nem pela incapacidade motora, já que os controlos com doença periférica crónica tiveram um desempenho superior ao dos doentes com distonia. No seu conjunto os nossos resultados sugerem que os SOC que ocorrem na distonia focal primária constituem uma das manifestações clínicas da neurobiologia desta doença do movimento. O predomínio de sintomas relacionados com higiene e o perfil disexecutivo de alterações cognitivas–perseveração e dificuldades executivas de memória de trabalho visuo-espacial – apontam para a via cortico-basal dorso-lateral e para as áreas corticais que lhe estão associadas como estando implicadas na tripla associação entre sintomas motores, obsessivo-compulsivos e cognitivos. Conclusões: A distonia focal primária é um síndrome neuropsiquiátrico complexo com importantes manifestações não motoras, nomeadamente compromisso cognitivo do tipo disexecutivo e sintomas obsessivo-compulsivos. Clinicamente estas manifestações representam necessidades de tratamento que vão muito para além da simples incapacidade motora, devendo ser activamente exploradas e tratadas.-------------- ABSTRACT: Introduction: primary focal dystonia is an idiopathic movement disorder that manifests as involuntary, sustained contraction of muscular groups, leading to abnormal and often painful postures of the affected body part. Treatment is symptomatic, usually with local intramuscular injections of botulinum toxin. The neurobiology of primary focal dystonia remains unclear. Structural and functional neuroimaging studies have revealed subtle changes in striatal and cortical-basal pathway anatomy and function. The most consistent findings involve increased volume and metabolic activity of the putamen and of motor, pre-motor and somato-sensitive cortical areas. As a whole, these changes have been interpreted as reflecting a failure of striatal inhibitory control over automatic motor programs sustained by cortical-basal pathways. The last years have witnessed an increasing interest for the possible non-motor – mainly psychiatric and cognitive – manifestations of primary focal dystonia. The possible association of primary focal dystonia with obsessive-compulsive disorder (OCD) has raised particular interest. The neurobiology of the two disorders has indeed remarkable similarities: structural and functional neuroimaging studies in OCD have revealed increased volume and metabolic activity of the striatum and orbital-frontal cortex, again pointing to a disruption of inhibitory control of automatic cognitive and behavioural programs by the striatum. Objectives: 1. To explore the prevalence and severity of psychopathology – with a special emphasis on obsessive-compulsive symptoms (OCS) – in a sample of patients with primary focal dystonia;2. To explore the nature and severity of possible cognitive dysfunction in a sample of patients with primary focal dystonia; 3. To explore the possible association between dystonia severity, psychiatric symptom severity, and cognitive performance, in a sample of patients with primary focal dystonia. Methods: cross-sectional, case-control, descriptive study. Cases: forty-five consecutive, primary pure focal dystonia patients recruited from the Portuguese Dystonia Association case register (fifteen patients with blepharospasm, 15 with cervical dystonia and 15 with writer’s cramp). Inclusion criteria were: age = 18; primary pure focal, late-onset dystonia (excluding possible or probable psychogenic dystonia according to the Fahn & Williams criteria); normal copper metabolism and Magnetic Resonance Imaging. Diseased controls: forty-six consecutive subjects from our hospital case register (15 patients with hemi-facial spasm; 14 with cervical spondilarthropathy and cervical spinal root compression; 17 with carpal tunnel syndrome). Healthy controls were 30 volunteers.Exclusion criteria for all groups: Mini-Mental State Examination score below the validated cut-off for the Portuguese population (<23 for education between 1 and 11 years; <28 for education >11 years); use of anti-cholinergics, neuroleptics, selective serotonin reuptake inhibitors, triciclic or tetraciclic antidepressants. Assessment: neurological assessment: complete medical and neurological history and physical examination; dystonia severity scoring with the Unified Dystonia Rating Scale. Psychiatric assessment:Symptom Check-List-90-Revised; 60 minute-long psychiatric interview, including Mini-International Neuropsychiatric Interview (MINI), version 4.4 (validated Portuguese version), extended with the sections for life-time major depressive disorder and life-time alcohol and substance abuse disorder from MINI-Plus version 5.0.0; Yale-Brown Obsessive-Compulsive Symptom Checklist and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Cognitive assessment: Wisconsin Card Sorting Test (WCST; cognitive set-shifting ability); Stroop Test (response inhibition); Block Assembly Test(visual-constructive ability); Benton’s Visual Retention Test (visual-spatial working memory). Statistic analysis: Data were analyzed with SPSS for Windows version 13. Proportions were compared using Chi-Square test, or Fisher’s exact test when appropriate. Student’s t-test or Mann-Whitney’s U test (or Wilcoxon’s teste in the case of matched samples) were used for two-group comparisons. P-values were corrected for multiple comparisons. One-way ANOVA with Bonferroni post-hoc analysis (interval data), or the Kruskal-Wallis Test (ordinal data), were used for three-group comparisons. Associations were analysed with Pearson’s or Spearman’s correlation coefficients, canonical correlations, path analysis and logistic regression analysis. Alpha was set at 0.05. Results: Dystonia patients had higher Yale-Brown Obsessive-Compulsive Symptom scores than both control groups. 24.4% of primary dystonia patients had a Y-BOCS score > 16. These patients were predominantly women; they had longer disease duration, and showed a predominance of hygiene-related OCS. The two groups with chronic disease had higher anxiety, somatization and global psychopathology scores than healthy subjects. Primary dystonia patients undergoing treatment with botulinum toxin had lower anxiety, phobia, somatization and depression scores than their untreated counterparts, but similar Y-BOCS scores. Sixty percent of primary dystonia patients had at least one lifetime psychiatric diagnosis. The odds of having a currently active psychiatric diagnosis were lower in botulinum toxin treated patients, and increased with dystonia severity. The prevalence of OCD was 6.7%, and the lifetime prevalence of major depression was 37.7%. Primary dystonia patients had a lower performance than the two control groups in both the WCST and Benton’s Visual Retention Test, mainly due to an excess of perseveration errors. Primary dystonia patients with Y-BOCS score > 16 had much higher perseveration error and perseveration response scores than dystonia patients with Y-BOCS = 16. Correlation and path analysis showed that, in the primary dystonia group, dystonia severity, along with age and education, was the main factor influencing cognitive performance. Discussion: our study is the first description ever of concomitant significant OCS and cognitive impairment in primary dystonia patients. Our results confirm that primary dystonia is specifically associated with obsessive-compulsive psychopathology. They also confirm that primary focal dystonia patients are at a higher risk of developing anxious and depressive psychiatric morbidity. Treatment with botulinum toxin decreases this risk, but does not influence OCS. Primary focal dystonia patients with significant OCS may constitute a particular subgroup. They are predominantly women, with higher disease duration (but not severity) and a predominance of hygiene related OCS.In terms of cognitive performance, primary focal dystonia patients have significant deficits involving set-shifting ability and visual-spatial working memory. The latter result from an essentially executive deficit, rather than from a primary visual-constructive apraxia or perceptual deficit. Furthermore, cognitive flexibility difficulties were more prominent in the subset of primary dystonia patients with significant OCS. The cognitive dysfunction found in dystonia patients is not attributable to depressive psychopathology or motor disability, as their performance was significantly lower than that of similarly impaired diseased controls. Our results suggest that OCS in primary focal dystonia are a direct, primary manifestation of the motor disorder’s neurobiology. The predominance of hygiene-related symptoms and the disexecutive pattern of cognitive impairment – set-shifting and visual-spatial working memory deficits – suggest that the dorsal-lateral cortical-basal pathway may play a decisive role in the triple association of motor dysfunction, OCS and cognitive impairment. Conclusions: primary focal dystonia is a complex neuropsychiatric syndrome with significant non- -motor manifestations, namely cognitive executive deficits and obsessive-compulsive symptoms.Clinically, our results show that PFD patients may have needs for care that extend far beyond a merely motor disability and must be actively searched for and treated.

Recent droughts and the impact of North Atlantic Oscillation in Iberia; a spatiotemporal analysis based on vegetation temperature condition Index (VTCI)

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Ocular Pulse Amplitude and Doppler Waveform Analysis in Glaucoma Patients

PURPOSE: To determine the correlation between ocular blood flow velocities and ocular pulse amplitude (OPA) in glaucoma patients using colour Doppler imaging (CDI) waveform analysis. METHOD: A prospective, observer-masked, case-control study was performed. OPA and blood flow variables from central retinal artery and vein (CRA, CRV), nasal and temporal short posterior ciliary arteries (NPCA, TPCA) and ophthalmic artery (OA) were obtained through dynamic contour tonometry and CDI, respectively. Univariate and multiple regression analyses were performed to explore the correlations between OPA and retrobulbar CDI waveform and systemic cardiovascular parameters (blood pressure, blood pressure amplitude, mean ocular perfusion pressure and peripheral pulse). RESULTS: One hundred and ninety-two patients were included [healthy controls: 55; primary open-angle glaucoma (POAG): 74; normal-tension glaucoma (NTG): 63]. OPA was statistically different between groups (Healthy: 3.17 ± 1.2 mmHg; NTG: 2.58 ± 1.2 mmHg; POAG: 2.60 ± 1.1 mmHg; p < 0.01), but not between the glaucoma groups (p = 0.60). Multiple regression models to explain OPA variance were made for each cohort (healthy: p < 0.001, r = 0.605; NTG: p = 0.003, r = 0.372; POAG: p < 0.001, r = 0.412). OPA was independently associated with retrobulbar CDI parameters in the healthy subjects and POAG patients (healthy CRV resistance index: β = 3.37, CI: 0.16-6.59; healthy NPCA mean systolic/diastolic velocity ratio: β = 1.34, CI: 0.52-2.15; POAG TPCA mean systolic velocity: β = 0.14, CI 0.05-0.23). OPA in the NTG group was associated with diastolic blood pressure and pulse rate (β = -0.04, CI: -0.06 to -0.01; β = -0.04, CI: -0.06 to -0.001, respectively). CONCLUSIONS: Vascular-related models provide a better explanation to OPA variance in healthy individuals than in glaucoma patients. The variables that influence OPA seem to be different in healthy, POAG and NTG patients.

The Future of services: Uncovering latent needs through trend analysis

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

Health expenditures in the OECD: A political economy analysis using structural breaks

A Masters Thesis, presented as part of the requirements for the award of a Research Masters Degree in Economics from NOVA – School of Business and Economics

Multivariate analysis applied to clinical analysis data

Dissertação para obtenção do Grau de Mestre em Engenharia e Gestão Industrial

Molecular analysis and dimorphism of azole-susceptible and resistant Candida albicans isolates

INTRODUCTION: Candida albicans is responsible for superficial or systemic infections known as candidiasis, which may be found in infected tissue as unicellular budding yeasts, hyphae, or pseudohyphae. In this study, the effects of both fluconazole and itraconazole antifungal agents on the hyphal formation and genotypic characterization of C. albicans isolates classified as either susceptible or resistant were investigated. METHODS: The hyphal production of five C. albicans isolates under the action of antifungal agents was investigated by culturing yeast on growth medium and on hyphal induction medium. The genotypic characterization was carried out for 13 isolates of C. albicans using the random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) method. RESULTS: The dimorphism analysis showed that the hyphal formation was higher in resistant than in the susceptible isolates to both azoles. The RAPD-PCR method identified the formation of two different groups. In group A, four resistant and two susceptible isolates were clustered, and in group B, one resistant and six susceptible isolates were clustered. CONCLUSIONS: Considering that hyphal formation was higher in resistant isolates in the presence of azole drugs, we confirmed that the hyphal production is closely related to susceptibility to azoles. These drugs may affect the morphogenesis of C. albicans depending on their susceptibility to these drugs. In relation to RAPD-PCR, most resistant isolates classified in group A and susceptible isolates in group B demonstrated that this method presented a similar standard between the two groups, suggesting that by this technique, a strong correlation between genotypes and fluconazole-resistant samples may be found.

Analysis of sandflies (Diptera: Psychodidae) in Barra do Garças, State of Mato Grosso, Brazil, and the influence of environmental variables on the vector density of Lutzomyia longipalpis (Lutz & Neiva, 1912)

INTRODUCTION: Leishmaniasis is an infectious and parasitic zoonotic, non-contagious, vector-borne disease caused by protozoa of the genus Leishmania. In Brazil, the major vector of Leishmania (Leishmania) infantum chagasi (Cunha & Chagas, 1934) is Lutzomyia longipalpis. Barra do Garças, State of Mato Grosso, was designated as a priority area by the Brazilian Ministry of Health for american visceral leishmaniasis, and it is important to identify the vector species present in this municipality. Our objective was to raise sandflies and study the influence of environmental variables on the vector density of Lutzomyia longipalpis. METHODS: We performed entomological monitoring in 3 districts using Centers for Disease Control and Prevention (CDC) light traps and recorded human cases of american visceral leishmaniasis in the city. We calculated the relative frequency and richness of sandflies and applied a transfer function model to the vector density correlate with relative humidity. RESULTS: The sandfly population was composed of 2 genera and 27 species, totaling 8,097 individuals. Monitoring identified Lutzomyia longipalpis (44%), followed by Lutzomyia lenti (18.9%), Lutzomyia whitmani (13.9%), Lutzomyia carmelinoi (9.1%), Lutzomyia evandroi (5.1%), Lutzomyia termitophila (3.3%), Lutzomyia sordellii (1.9%), and 20 other species (<4%). The male:female ratio was 3.5:1. We observed high species diversity (Dα = 6.65). Lutzomyia longipalpis showed occurrence peaks during the rainy season; there was a temporal correlation with humidity, but not with frequency or temperature. CONCLUSIONS: The presence of Lutzomyia longipalpis in the urban area of Barra do Garças underscores the changing disease profile, which was previously restricted to the wild environment.

Urinary tract infection in full-term newborn infants: risk factor analysis

OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (p<0.05). Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

Analysis of factors and drivers in graduates success among Portugal, India and Italy- extracurricular activities before university

Field lab: Business project

Return on assets in the Tobacco Industry analysis of the four main Tobacco Manufacturers

This paper studies operating profitability drivers in the Four Main Tobacco Manufacturers for the period 2004-2014. The operating profitability is analyzed as return on assets (ROA) based on the DuPont Extended Model breakdown in degree of operational risk, gross sales margin and assets turnover. The sources of ROA are market share and price strategies appraised through the drivers: firm-size, global value and strategic choices. Using consolidated data, results suggest that firm-size and global value holds a positive relationship with ROA. Also innovation through less harmful tobacco products can lead to better ROA despite no correlation between R&D and ROA.

Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses

METHODS: Refractive lens exchange was performed with implantation of an AT Lisa 839M (trifocal) or 909MP (bifocal toric) IOL, the latter if corneal astigmatism was more than 0.75 diopter (D). The postoperative visual and refractive outcomes were evaluated. A prototype light-distortion analyzer was used to quantify the postoperative light-distortion indices. A control group of eyes in which a Tecnis ZCB00 1-piece monofocal IOL was implanted had the same examinations. RESULTS: A trifocal or bifocal toric IOL was implanted in 66 eyes. The control IOL was implanted in 18 eyes. All 3 groups obtained a significant improvement in uncorrected distance visual acuity (UDVA) (P < .001) and corrected distance visual acuity (CDVA) (P Z .001). The mean uncorrected near visual acuity (UNVA) was 0.123 logMAR with the trifocal IOL and 0.130 logMAR with the bifocal toric IOL. The residual refractive cylinder was less than 1.00 D in 86.7% of cases with the toric IOL. The mean light-distortion index was significantly higher in the multifocal IOL groups than in the monofocal group (P < .001), although no correlation was found between the light-distortion index and CDVA. CONCLUSIONS: The multifocal IOLs provided excellent UDVA and functional UNVA despite increased light-distortion indices. The light-distortion analyzer reliably quantified a subjective component of vision distinct from visual acuity; it may become a useful adjunct in the evaluation of visual quality obtained with multifocal IOLs.

Puberty in male collared peccary (Pecari tajacu) determined by quantitative analysis of spermatogenic cells

Biological studies are necessary for the management of wildlife in captivity, and knowledge of reproduction is one of the important features for increasing production. The objective of the research was to determine the age at which male collared peccaries reach puberty. Testicular samples of 15 animals, aged 7 to 16 months, distributed into five groups (G1, G2, G3, G4 and G5) were used. The testes showed considerably increased weight, length and width (p < 0.05) from G1 to G3, whereas, from this group onward, the development of this organ was slower. There was positive correlation (p < 0.001) between the following testicular parameters: weight and length (r = 0.97), weight and width (r = 0.88), length and width (r = 0.92). Regarding the diameter of seminiferous tubules, an increase was observed (p < 0.05) from G1 to G4. The total number of spermatogenic cells increased significantly (p < 0.05) until G3 and then it stabilized. There was also positive correlation between testis weight and tubular diameter (r = 0.99, p < 0.001), and testis weight and spermatogenic cells (r = 0.98, p < 0.001). The number of Sertoli cells decreased significantly (p < 0.05) from G1, when they were undifferentiated as support cells, to G5, when they occurred together with the complete line of spermatic cells. The results demonstrate that the reproductive development of peccaries can be classified into the following stages: impuberty (G1, 7-8 months); pre-pubertal (G2, 9-10 months); pubertal (G3, 11-12 months); post-pubertal 1 (G4, 13-14 months); and post-pubertal 2 (G5, 15-16 months). Based on the histological analyses, puberty in the male collared peccary was determined to occur between 11 and 12 months of age.

Ichthyometry and electrical bioimpedance analysis to estimate the body composition of tambatinga

Body composition analysis is relevant to characterize the nutritional requirements and finishing phase of fish. The aim of this study was to investigate the relationship between ichthyometric (weight, total and standard length, density and yields), bromatological (fat, protein, ash and water content) and bioelectrical-impedance-analysis (BIA) (resistance, reactance, phase angle and composition indexes) variables in the hybrid tambatinga (Colossoma macropomum × Piaractus brachypomus). In a non-fertilized vivarium, 520 juveniles were housed and fed commercial rations. Then, 136 days after hatching (DAH), 15 fish with an average weight of 37.69 g and average total length of 12.96 cm were randomly chosen, anesthetized (eugenol) and subjected to the first of fourteen fortnightly assessments (BIA and biometry). After euthanasia, the following parts were weighed: whole carcass with the head, fillet, and skin (WC); fillet with skin (FS); and the remainder of the carcass with the head (CH). Together, FS and CH were ground and homogenized for the bromatological analyses. Estimates of the body composition and yields of tambatinga, with models including ichthyometric and BIA variables, showed correlation coefficients ranging from 0.81 (for the FS yield) to 1,00 (for the total ash). Similarly, models that included only BIA variables had correlation coefficients ranging from 0.81 (FS and CH yields) to 0.98 (for the total ash). Therefore, in tambatinga, the BIA technique allows the estimation of the yield of the fillet with skin and the body composition (water content, fat, ash, and protein). The best models combine ichthyometric and BIA variables.

Longitudinal analysis of tumor marker CEA of breast cancer patients from Braga's hospital

Allied to an epidemiological study of population of the Senology Unit of Braga’s Hospital that have been diagnosed with malignant breast cancer, we describe the progression in time of repeated measurements of tumor marker Carcinoembryonic antigen (CEA). Our main purpose is to describe the progression of this tumor marker as a function of possible risk factors and, hence, to understand how these risk factors influences that progression. The response variable, values of CEA, was analyzed making use of longitudinal models, testing for different correlation structures. The same covariates used in a previous survival analysis were considered in the longitudinal model. The reference time used was time from diagnose until death from breast cancer. For diagnostic of the models fitted we have used empirical and theoretical variograms. To evaluate the fixed term of the longitudinal model we have tested for a changing point on the effect of time on the tumor marker progression. A longitudinal model was also fitted only to the subset of patients that died from breast cancer, using the reference time as time from date of death until blood test.