Avaliar a prevalência da doença periodontal em gestantes e quantificar os valores de TNF-ALFA, IL-6 E, glicose salivar e capilar

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Alfa'-oxy enones and pyrrolidin-2,3-diones as efficient new templates in asymmetric organocatalytic Michael reactions

470 p.

Relación de la enzima alfa-amilasa salivar con la presencia de sintomatología psicopatologica internalizada auto- y hetero-observada en una muestra de niños y niñas de entre 7 y 12 años de edad: un estudio piloto.

Introducción: La medición de la actividad enzimática (AAAs) y del flujo de secreción (FSAAs) de la enzima alfa-amilasa salivar han sido propuestos por diversos grupos de investigación como posibles marcadores biológicos indirectos, no invasivos, y de bajo coste, del nivel de actividad noradrenérgica periférica/central. Dicha actividad noradrenérgica se sustenta, esencialmente, gracias a la actividad preponderante del denominado Sistema Locus Coeruleus-Noradrenalina (LC-NA), un sistema básico en la modulación de diversas funciones atencionales, cognitivas ejecutivas, así como en la regulación de los estados de ánimo. Material y Método: En nuestro estudio piloto (N = 13; 9 niños, 4 niñas; Edad media ± DT = 10,23 ± 1,53) se analizó la relación entre ambos marcadores salivares junto al parámetro flujo de secreción salivar total (registrados a lo largo de un proceso de evaluación neuropsicológica escolar) y diversas medidas auto (CDI; ansiedad, depresión y depresión total) y hetero-reportadas (escalas de psicopatología internalizada del TRF: ansiedad- depresión, depresión-aislamiento, alteraciones psicosomáticas y psicopatología internalizante total). Resultados: Los análisis estadísticos basados en el cálculo de coeficientes de correlación producto-momento de Pearson (de tipo parcial al controlar el efecto de la variable IMC), revelaron correlaciones estadísticamente significativas y directas entre el FSAAs y las puntuaciones en la escala ansiedad-depresión (p < 0,039) y psicopatología internalizante total del TRF (p < 0,012), así como una tendencia a la significación en el caso de las puntuaciones para la escala de alteraciones psicosomáticas (p = 0,054) de esa misma prueba. Del mismo modo, se observaron tendencias a la significación en la asociación directa entre las subescalas ansiedad-depresión (p = 0.065) y psicopatología internalizante total (p = 0.083) y la medida del flujo salivar total. Por otro lado, se observaron asociaciones inversas estadísticamente significativas entre la variable flujo salivar total y las puntuaciones de ansiedad (p < 0.01) y depresión total (p < 0.01) obtenidas a través del CDI. Discusión: Estos resultados preliminares de este estudio piloto abren una interesante línea de trabajo en nuestro laboratorio acerca de la utilidad de la medición de la AAAs, FSAAs y FST como posibles marcadores biológicos, no invasivos, y de bajo coste, aptos para su empleo con poblaciones pediátricas. Dichos marcadores, están relacionados con el grado de actividad noradrenérgica periférica/central desarrollada por el sistema LC y con la actividad del SNV, que a su vez están implicados en la regulación de los estados afectivos. Estudios recientes han mostrado bajos niveles basales de alfa-amilasa salivar en el caso de pacientes jóvenes diagnosticados de su primer episodio depresivo (Cubala y Landoski, 2014) y en participantes infantiles con mayor sintomatología depresiva heteroobservada (Vigil et al., 2006; Maldonado et al., 2014; Maldonado, enviado). Estos resultados complementan las observaciones realizadas anteriormente por nuestra laboratorio (Maldonado et al., 2014; Maldonado, enviado).

Santis Pagnini ... Isagogae ad sacras literas liber vnicus ; eiusdem Isagogae ad mysticos sacrae scripturae sensus libri XVIII / omnia nunc demum exactissima recognita, & emendatius typis excusa.

Descripción bibliográfica basada en: Pérez y Sacristán. Yuso, 4968

Plutarchi Chaeronei ... Opuscula moralia : quorum catalogum sequentis paginæ facie secunda reperies.

Marca tip. en port. (Baudrier. VIII, p. 43, n. 1 bis)

Analisi del ruolo del ritmo alfa nell'attenzione attraverso un modello neurocomputazionale.

Negli ultimi anni, la ricerca scientifica nell’ambito delle neuroscienze cognitive ha sempre più focalizzato il suo interesse nei confronti dei ritmi cerebrali, ovvero oscillazioni neurali registrabili attraverso tecniche di elettrocenfalografia. In questo lavoro si è investigato il ruolo del ritmo alpha (7-12 Hz) e, in seconda misura, del ritmo gamma (> 30 Hz) rispetto all’attenzione spaziale selettiva. In particolare, partendo da modelli di massa neurale esistenti, si è riusciti a sviluppare un nuovo modello che riesce a simulare un compito di attenzione spaziale sulla base dell’inibition timing hypothesis, che assegna alle onde alpha un ruolo essenziale al fine di trascurare gli stimoli non rilevanti rispetto al compito da svolgere. Successivamente, è stato indagato l’effetto sul modello di alcune degenerazioni neurali tipiche di una delle patologie maggiormente invalidanti, la schizofrenia. Nello specifico, sulla base di evidenze sperimentali che riportano un calo della potenza delle onde gamma nei soggetti schizofrenici a causa della degenerazione degli interneuroni inibitori con dinamica sinaptica veloce, si è riusciti a simulare la progressiva alterazione neurale indotta dalla schizofrenia in termini di incapacità di inibire gli stimoli interferenti.

Trasformazione digitale nei processi di misura e fatturazione - il caso azienda Alfa

Con il lancio di nuove applicazioni tecnologiche come l'Internet of Things, Big Data, Cloud computing e tecnologie mobili che stanno accelerando in maniera spropositata la velocità di cambiamento, i comportamenti, le abitudini e i modi di vivere sono completamente mutati nel favorire un mondo di tecnologie digitali che agevolino le operazioni quotidiane. Questi progressi stanno velocemente cambiando il modo in cui le aziende fanno business, con grandi ripercussioni in tutto quello che è il contesto aziendale, ma non solo. L’avvento della Digital Transformation ha incrementato questi fenomeni e la si potrebbe definire come causa scatenante di tutti i mutamenti che stiamo vivendo. La velocità e l’intensità del cambiamento ha effetti disruptive rispetto al passato, colpendo numerosi settori economici ed abitudini dei consumatori. L’obiettivo di questo elaborato è di analizzare la trasformazione digitale applicata al caso dell’azienda Alfa, comprendendone le potenzialità. In particolare, si vogliono studiare i principali risvolti portati da tale innovazione, le più importanti iniziative adottate in merito alle nuove tecnologie implementate e i benefici che queste portano in campo strategico, di business e cultura aziendale.

A pilot study of topiramate in children with Lennox-Gastaut syndrome

We conducted an open, add-on study with topiramate (TPM) as adjunctive therapy in Lennox-Gastaut syndrome (LGS), to assess the long-term efficacy and safety and to evaluate quality of life (QL) measurements in the chronic use of TPM. We studied 19 patients (11 male; age ranging from 4 to 14 years) with uncontrolled seizures receiving 2-3 anti-epileptic drugs. Patients were followed up to 36 months of treatment. A questionnaire was used to query parents about QL. Seven patients completed the study at 36 months and seizure frequency was reduced > 75% in 4, and < 50% in 3 patients. Two children became seizure free for more than 24 months. Most side effects were CNS related, with the most frequent being somnolence and anorexia. These were generally transient. One patient dropped-out due to powder in the urine. None of the patients required hospitalization. At 36 months, patients' alertness (2/7), interaction with environment (5/7), ability to perform daily activities (5/7), and verbal performance (6/7) improved on TPM. We conclude that TPM may be useful as adjunctive therapy in the treatment of LGS. The efficacy of TPM was maintained in long-term treatment in more than 40% of patients, long term safety was confirmed and QL improved on TPM.

Sexual dysfunction in epilepsy: identifying the psychological variables

In order to evaluate the psychological variables that affect sexual dysfunction (SD) in epilepsy, where compared 60 epileptics (Group 1) with 60 healthy individuals (Group 2), through the State-Trait Anxiety Inventory (Spielberger et al., 1970), Beck Depression Inventory (Beck, 1974) and Sexual Behavior Interview (Souza, 1995). Sexual dysfunction (SD), anxiety and depression were found more frequently in Group 1 than in Group 2 and were not related to sex. Variables such as the onset duration and frequency of seizures as well as the use to medication were not associated with SD. Temporal lobe epilepsy was related to SD (p = 0.035) but not to anxiety or depression. Anxiety and depression were related to SD in both groups. Perception in controlling the seizures was closely related to anxiety (p = 0) and depression (p = 0.009). We conclude that psychological factors play an important role in the alteration of sexual behavior in epileptics and that suitable attention must be given to the control of these variables.

Relação dose-dependente do uso crônico de fenitoína e atrofia cerebelar em pacientes com epilepsia

The chronic treatment with phenytoin or the acute intoxication by this drug may cause permanent cerebellar injury with atrophy of cerebellum vermis and hemispheres, which can be detected by neuroimaging studies. The aim of the present study was to investigate the correlation between the dosage and duration of treatment with phenytoin and the occurrence of cerebellar atrophy. Sixty-six patients were studied and had their tomographies analyzed for cerebellar atrophy. Of the 66 patients studied, 18 had moderate/severe atrophy, 15 had mild atrophy and 33 were considered to be normal. The patients with moderate/severe atrophy were those with higher exposure to phenytoin (longer duration of treatment and higher total dosage) showing statistically significant difference when compared to patients with mild atrophy or without atrophy (p=0.02). Further, the patients with moderate/severe atrophy had serum levels of phenytoin statistically higher than those of patients with mild atrophy or without atrophy (p = 0.008). There was no association between other antiepileptic drugs dosage or duration of treatment and degree of cerebellar atrophy. We also found that older patients had cerebellar atrophy more frequently, indicating that age or duration of the seizure disorder may also be important in the determination of cerebellar degeneration in these patients. We conclude that although there is a possibility that repeated seizures contribute to cerebellar damage, long term exposure to phenytoin, particularly in high doses and toxic serum levels, cause cerebellar atrophy.

Fibrodysplasia ossificans progressiva: case report

Fibrodysplasia ossificans progressiva is a rare genetic disease characterized by widespread soft tissue ossification and congenital stigmata of the extremities. We report on a male child followed for ten years since the age of 3 years and 9 months, when the diagnosis was made. He was born with bilateral hypoplasic hallux valgus and ventricular septal defect, corrected by transsternal approach when 32 months old. Restriction of neck mobility followed and foci of ectopic ossification appeared. Four crises of disease exacerbation were treated with oral prednisone and/or other antiinflammatory drugs. Sodium etidronate 5 to 10 mg/kg/day was prescribed intermittently during about six years but was discontinued due to osteopenia. The disease course has been relentless, with severe movement restriction including the chest wall. A review showed few similar case reports in the Brazilian literature. We revisit the criteria for diagnosis and the essentials of management and treatment.

The G209A mutation in the alpha-synuclein gene in Brazilian families with Parkinson's disease

A missense G209A mutation of the alpha-synuclein gene was recently described in a large Contursi kindred with Parkinson's disease (PD). The objective of this study is to determine if the mutation G209A of the alpha-synuclein gene was present in 10 Brazilian families with PD. PD patients were recruited from movement disorders clinics of Brazil. A family history with two or more affected in relatives was the inclusion criterion for this study. The alpha-synuclein G209A mutation assay was made using polymerase chain reaction and the restriction enzyme Tsp45I. Ten patients from 10 unrelated families were studied. The mean age of PD onset was 42.7 years old. We did not find the G209A mutation in our 10 families with PD. Our results suggest that alpha-synuclein mutation G209A is uncommon in Brazilian PD families.

Síndrome de Down e Moyamoya: estudo através de metanálise

We present a clinic-epidemiological study of two patients and meta-analysis (period 1977-2000 ) of the co-morbidity of the Down syndrome (DS) and moyamoya syndrome (MMS). Among the 42 patients listed in this survey, meta-analysis permitted to find the highest number of publications by researchers from Japan and United States, followed by Brazil and Italy; prevalence of cerebrovascular disease in suckling and pre school children; first symptomatology was hemiparesis (78.6%), speech disorders (26.2%); ischemic infarction (76.2%); recurring ischemic episodes (62%); bilateral impairment (83.3%). This analysis led to the conclusion that in the clinic-neurological investigation of DS patients with acute hemiparesis episodes, MMS should be included as the most probable diagnosis.

Acute psychotic disorders induced by topiramate: report of two cases

We report on two epileptic patients who developed acute psychosis after the use of topiramate (TPM). One patient exhibited severe psychomotor agitation, heteroaggressiveness, auditory and visual hallucinations as well as severe paranoid and mystic delusions. The other patient had psychomotor agitation, depersonalization, derealization, severe anxiety and deluded that he was losing his memory. Both patients had to be taken to the casualty room. After interruption of TPM in one patient and reduction of dose in the other, a full remission of the psychotic symptoms was obtained without the need of antipsychotic drugs. Clinicians should be aware of the possibility of development of acute psychotic symptoms in patients undergoing TPM treatment.