Alterações genéticas com interesse prognóstico nas doenças mieloproliferativas crónicas bcr-abl negativas

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Doenças cardiovasculares, padrão de comportamento tipo A, hostilidade e ira

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Doenças neurológicas

As convulsões são o problema neurológico mais comum nos animais de companhia. Convulsão é o quadro clínico gerado por descargas elétricas paroxísticas, descontroladas e transitórias nos neurónios do encéfalo, levando a alterações da consciência, atividade motora, funções viscerais, perceção sensorial, conduta e memória. A anamnese é muito importante para o diagnóstico, pois é o proprietário quem na maioria das vezes presencia o evento e, os dados obtidos podem auxiliar no plano de diagnóstico e terapêutico. É importante reconhecer, no entanto, que esta informação é coadjuvante ao exame neurológico. As convulsões podem ter causas extracranianas (ex: metabólicas e toxicas), intracranianas (ex: traumatismos, enfermidades infeciosas, malformações congénitas) e idiopáticas (epilepsia idiopática). É fundamental tentar identificar a causa das convulsões através da realização do exame clínico e neurológico, com atenção especial aos sistemas cardio-circulatório, respiratório, digestivo e urinário. Devem ser realizados exames complementares adequados (hemograma, urianálise, enzimas hepáticas, ureia, creatinina, glicemia, sorologias, reação em cadeia de polimerase, radiografias torácicas, ultrassonografia, tomografia computorizada e ressonância magnética quando disponíveis). O objetivo do tratamento antiepilético é controlar as convulsões sem efeitos adversos, no entanto, o clínico apenas pode tentar reduzir a frequência e severidade das convulsões a um nível que não comprometa substancialmente a qualidade de vida do animal e dos proprietários, evitando efeitos secundários.

Critérios de diagnóstico e aproximação terapêutica das doenças peri-implantares

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

Diagnóstico e tratamento de doenças peri-implantares: conceitos atuais

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

Envelhecimento saudável e doenças não comunicáveis: um projeto de literacia e educação para a saúde

O processo de envelhecimento inerente a cada pessoa encontra-se, intimamente, associado a uma perda de capacidades, tanto a nível físico como a nível cognitivo. No entanto, a perda de faculdades poderá ser atenuada e ou retardada através da atividade física e da aprendizagem no âmbito da literacia e educação para hábitos saudáveis. Participantes. Num grupo de 46 residentes do Bairro Norton de Matos, com idades compreendidas entre os 45 e os 94 anos, foram avaliados hábitos de vida, fatores de risco e nível de literacia em saúde. Verificou-se que associado ao processo de envelhecimento, surge o sedentarismo, o isolamento e o aparecimento e/ou agravamento de doenças não comunicáveis, principalmente em pessoas cujo nível de literacia em saúde é mais baixo. Método. Realizado um conjunto de ações sobre nutrição, literacia em saúde e aconselhamento sobre atividade física na hipertensão, nas dislipidémias e na síndrome metabólica e caminhadas orientadas num circuito pré-definido no referido bairro. Resultados. Foi evidente o grande empenho das entidades locais (Liga dos Amigos do Centro de Saúde do Bairro Norton de Matos e do próprio Centro Norton de Matos) para a concretização deste projeto. Com o decorrer das sessões o número de participantes foi aumentando o que leva a crer que é importante consciencializar, sensibilizar e criar empatia com a comunidade, de forma que esta se torne mais participativa e ativa no que respeita à sua saúde. Os resultados obtidos, fizeram-nos desenvolver estratégias que garantam a sua continuidade, nomeadamente, a formação de futuros voluntários que desejem colaborar nesta comunidade ou reproduzir o projeto noutra comunidade com características idênticas. Conclusão. Os resultados obtidos foram muito satisfatórios, tendo o Projeto tido uma projeção surpreendente e instigadora para a sua continuidade no mesmo local, mas também replicá-lo em comunidades com características semelhantes.

Ensaio dermosographico ou Succinta e systematica descripção das doenças cutaneas, conforme os principios e observações dos doutores Willan, e Bateman ... /

Mode of access: Internet.

INTERVENÇÕES FISIOTERAPÊUTICAS NUM CONTEXTO LÚDICO JUNTO A CRIANÇAS COM DOENÇAS RESPIRATÓRIAS CRÔNICAS

Verifica-se hoje em dia o aumento da incidência de problemas pulmonares que ocasiona internações hospitalares infantis com maior freqüência. Este projeto baseia-se na visão biopsicossocial da Psicologia da Saúde e leva em conta a valorização de atividades do cotidiano da criança, como o brincar, para sua recuperação. Tem por objetivo principal investigar se a utilização de técnicas interventivas lúdicas em fisioterapia contribui para a melhora dos níveis de oxigenação de crianças asmáticas e por objetivos específicos traçar um breve perfil clínico da criança que procura o Ambulatório de Alergia e Imunologia da Faculdade de Medicina do ABC e verificar a adesão da criança com problemas respiratórios a uma intervenção fisioterapêutica lúdica da criança. A análise qualitativa da intervenção lúdica registra grande envolvimento e participação prazerosa das crianças e ampla aceitação dos pais. Estes resultados sugerem que novas pesquisas sejam realizadas a respeito de intervenções lúdicas em fisioterapia. Utiliza-se de método avaliativo-interventivo quase-experimental. Seus participantes são 58 crianças de ambos os sexos com idade de quatro a 11 anos com as patologias de asma brônquica, bronquite e rinite alérgica, sem a presença da crise. Desenvolve-se por meio de sessão única com cada paciente, com avaliação antes e após da intervenção fisioterápica lúdica por meio das aferições dos sinais vitais, (PA, FC, FR,T°C, incluindo oximetria de pulso e PFE) técnicas de aquecimento, alongamento torácico, fortalecimento abdominal e expansão torácica. Realiza análise qualitativa da responsividade das crianças às técnicas interventivas empregadas no contexto lúdico. Os resultados a respeito do perfil clinico indicam maior incidência de Asma, com 44 casos (75,8620 %), para 11 casos de Rinite (18,9655 %) e apenas três de Bronquite (5,1724 %). Os dados relativos a PA, FC, FR,T°C e ao PFE mostram-se dentro da normalidade. Este estudo não constata diferença significativa em relação ao nível de saturação de O2 após a intervenção lúdica. Quanto à adesão, 55,2 % dos participantes aderiram, sendo que a não adesão deu-se por motivos particulares alegados pelos responsáveis ou indisposição da criança, de dor de cabeça, sonolência e/ou vômito. A análise qualitativa da intervenção lúdica registra grande envolvimento e participação prazerosa das crianças e ampla aceitação dos pais. Estes resultados sugerem que novas pesquisas sejam realizadas a respeito de intervenções lúdicas em fisioterapia.(AU)

A comunidade zooplanctônica como bioindicadora do estado trófico de reservatórios da região semiárida tropical

E utrophication in continental aquatic ecosystems and the following deterioration of water quality are some of the greatest problems to be solved in this century. Due to their own peculiarities reservoirs from semi - arid regions constitute a great challenge to water management because of their greater vulnerability to eutrophication process. I dentification of biolo gical community components that may be used as bioindicators is important to allow an early detection of adverse changes, and also to provide subsidies for management and conservation actions. The aim of the present study is to evaluate the potential of zo oplankton community as bioindicator of the trophic state of two reservoirs belonging to the Piranhas - Açu basin, RN, Brazil: Boqueirão de Parelhas and Passagem das Traíras. Monthly sampling s of both systems were carried out in both systems during the period of January to December. Measurements were performed for temperature, pH, dissolved oxygen and water electrical conductivity besides water samples collection for nutrients, suspended solids, chlorophyll - a and zooplankton analyses. T axonomic composition of zooplankton , density and biomass were analysed. Trophic state index, ABC curves , W statistic and the Calanoida: Cyclopoida ratio were also obtained. The results evidenced that Boqueirão de Parelhas reservoir was a mesotrophic sy stem, and Passagem das Traíras r eservoir was eutrophic. In both reservoirs zooplankton community had low species richness, mostly constituted by tolerant species which have wide geographical distribution, as well the dominance of the rotifers Brachionus havanaensis , B. calyciflo rus and Keratella tropica ; of the calanoid copepods Notodiaptomus cearensis and N. iheringi ; cyclopoid copepod Thermocyclops decipiens, and of the cladocerans Ceriodaphnia cornuta and Diaphanosoma spinulosum . Among the biological indices the ABC curves fo r the zooplankton community indicated a moderate dis turbance in both reservoirs, th e Calanoida: Cyclopoida ration indicated not impacted environments , e xcept during the end of the study to the reservoir Passagem das Traíras . It was concluded that the indices used are good indicators of disturbance and alteration in the community, however they are not good indicators for monitoring the trophic state of the studied reservoirs due to the simultaneous occurrence of other factors selecting species, as the c oncentration of ions and high turbidity, which are part of the reservoir characteristics of semiarid.

Estudo paramétrico da injeção de polímeros em reservatórios de petróleo

Developing an efficient methodology for oil recovery is extremely important . Within the range of enh anced oil recovery, known as EOR, the injection of polymer solutions becomes effective in controlling the mobility of displacing fluid . This method consists of adding polymers to the injection water to increase its viscosity, so that more water diffuses in to the porous medium and increasing the sweep efficiency in the reservoir. This work is studied by numerical simulation , application of the injection polymer solution in a homogeneous reservoir , semisynthetic with similar characteristics to the reservoirs of the Brazilian Northeast , numerical simulations were performed using thermal simulator STARS from CMG (Computer Modelling Group ). The study aimed to analyze the influence of some parameters on the behavior of reservoir oil production, with the response to cumulative production. Simulations were performed to analyze the influence of water injection, polymer solution and alternating injection of water banks and polymer solution, comparing the results for each simulated condition. The primary outcomes were: oil viscosity, percentage of injected polymer, polymer viscosity and flow rate of water injection. The evaluation of the influence of variables consisted of a complete experimental design followed a Pareto analysis for the purpose of pointing out which va riables would be most influential on the response represented b y the cumulative oil production . It was found that all variables significantly influenced the recovery of oil and the injection of polymer solution on an ongoing basis is more efficient for the cumulative production compared to oil recovery by continuous water injection. The primary recovery show ed low levels of oil production , water injection significantly improves the pro duction of oil in the reservoir , but the injection of polymer solution em erges as a new methodology to increase the production of oil, increasing the life of the well and possible reduction of water produced.

Efeito da seca na dinâmica dos grupos funcionais fitoplanctônicos em reservatórios eutróficos do semiárido

Reservoirs are the main sources of surface water in Brazil´s semiarid region. The majority of these water supplies, however, are compromised by eutrophication. A severe drought in 2012 contributed to significant losses in water volume, influencing the availability of resources (nutrients and light) for phytoplankton. The aim of this study is to understand the dynamics of the functional groups of phytoplankton and the factors that affect them during a severe drought in the semiarid reservoirs of the northeast. We therefore studied the Dourado, Gargalheiras and Passagem das Traíras reservoirs in Rio Grande do Norte from January 2012 to January 2013. The effect of drought favoured homogeneity within the reservoir, in relation to biotic and abiotic variables, notably the absence of water supply given the lack of flow from its tributaries (intermittent river). The phytoplankton functional groups of bloomforming cyanobacteria (SN, S1 and M) dominated throughout the year 2012, in both the shallow and deep areas of the three reservoirs studied. The groups were related to high concentrations of volatile solids, total phosphorus and ammonia, and high turbidity. Cylindrospermopsis raciborskii (SN group) was the species with the greatest biomass in the three reservoirs. M group (Sphaerocavum brasiliense) performed better in shallow waters with more available phosphorus. Our data showed that high concentrations of nutrients and low availability of light, besides the stability of the water column due to lack of flow and the system´s high residence time, favoured the dominance of bloom-forming cyanobacteria groups, especially those tolerant to shadow

Determinantes genéticos e ambientais das doenças hipertensivas da gravidez

The development of complex diseases such as preeclampsia are determined by both environmental and genetic factors, but there is also interaction among these factors. Preeclampsia is a pregnancy-specific disorder characterized by de-novo hypertension and proteinuria after 20th week of gestation. There is a broad spectrum of clinical presentations related to hypertensive disorders of pregnancy (HDP) that can range from mild preeclampsia to eclampsia (seizures) or HELLP syndrome (Hemolysis, Elevation of Liver enzymes, Low Platelets). Those clinical outcomes might be linked to different pathological mechanisms. Our work aims to identify factors (i.e. genes and environmental) associated with the HDP’s clinical spectrum. Using a case-control approach, we selected a total of 1498 pregnant women for epidemiological and genetic studies, encompassing 755 normotensive (control); 518 preeclampsia; 84 eclampsia; and 141 HELLP. Women were genotyped for 18 SNPs across 5 candidate genes (FLT1, ACVR2A, ERAP1, ERAP2 and LNPEP). For the environmental factors, we found maternal age, parity status and pre-gestational body mass index as important risk factors associated with disease. Genes were associated in a phenotype-specific manner: ACVR2A with early preeclampsia (rs1424954, p=0.002); FLT1 with HELLP syndrome (rs9513095, p=0.003); and ERAP1 with eclampsia (rs30187, p=0.03). Our results suggest that different genetic mechanisms along with specific environmental factors might determine the clinical spectrum of HDP. In addition, phenotype refinement seems to be an essential step in the search for complex disease genes

Análise espacial de reservatórios usando DFA de dados geofísicos

This research aims to set whether is possible to build spatial patterns over oil fields using DFA (Detrended Fluctuation Analysis) of the following well logs: sonic, density, porosity, resistivity and gamma ray. It was employed in the analysis a set of 54 well logs from the oil field of Campos dos Namorados, RJ, Brazil. To check for spatial correlation, it was employed the Mantel test between the matrix of geographic distance and the matrix of the difference of DFA exponents of the well logs. The null hypothesis assumes the absence of spatial structures that means no correlation between the matrix of Euclidean distance and the matrix of DFA differences. Our analysis indicate that the sonic (p=0.18) and the density (p=0.26) were the profiles that show tendency to correlation, or weak correlation. A complementary analysis using contour plot also has suggested that the sonic and the density are the most suitable with geophysical quantities for the construction of spatial structures corroborating the results of Mantel test

Influência de eventos hidrológicos extremos na qualidade da água de reservatórios na região tropical semiárida

Reservoirs are artificial ecosystems, intermediate between rivers and lakes, with diferent morphological and hydrological characteristics that can provide many important benefits to society. However, the use of this water for human consumption, watering livestock, leisure, irrigated agricultural production and pisciculture development, directly influence the increase loading of nutrients to aquatic environments and contribute to acceleration of eutrophication. Furthermore, global climate models are predicting a higher occurrence of extreme events such as floods and severe droughts, which will create hydrological stresses in lakes. In the semiarid northeast we can see the occurrence of these events, the drought of the years 2012, 2013 and 2014 was the worst drought in 60 years, according to the National Water Agency (ANA). Thus, this study aimed to evaluate the quality of the semiarid tropical water sources, identifying temporal patterns in periods with extreme hydrological events (floods and severe droughts). The study results showed that Gargalheiras and Cruzeta reservoirs presented significative changes in the limnological variables between rain and severe drought periods, with better appearance and in the most of the water quality variables in the rainy season and higher nutrientes concentrations and high electrical conductivity values in severe season, indicating decay of its quality. However, we found diferent behaviors between the reservoirs in severe drought. While Gargalheiras showed a typical behavior of the region, with high concentrations of algal biomass, indicating the worsening eutrophication, Cruzeta demonstrated a colapse in the total phytoplankton biomass, evidenced by the decrease in chla concentrations. This fact occurred because the low depth and proximity with the sediment facilited the inorganic solids resuspension and, consequently, resulted in turbid water column and light by limitation. In addition, the different behaviors between the reservoirs indicate that the responses of these environments problems such as extreme events must take into account factors such the region climate, size, depth of the reservoir and the basin characteristics.

Características bioativas, funcionais e efeito protetor do resíduo desidratado de camu-camu (Myrciaria dubia H.B.K. (McVaugh)) sobre doenças degenerativas utilizando modelos in vivo C. elegans

Camu-camu (Myrciaria dubia H.B.K. (McVaugh)) is a native Amazon fruit, recognized worldwide as one of the main natural sources of ascorbic acid. Due to its great acidity, this fruit is generally consumed after processing into juice or as ingredient in food preparations. As a co-product of the camu-camu processing, a significant amount of agroindustrial residue is generated. Despite the studies showing the bioactive value and biological potential of the fruit, few studies have approached the possible processing techniques, transformation and preservation of camu-camu fruits and its agroindustrial pomace. Therefore, the present work has the objective of evaluating two different drying processes applied to camu-camu pomace (peel and seeds with residual pulp), freeze drying and hot air drying, in order to obtain a functional fruit product. This thesis was divided into three stages: the first one shows the studies related to the freeze drying and hot air drying, where we demonstrated the impact of the selected drying techniques on the bioactive components of camu-camu, taking the fresh pomace as the control group. Among the investigated conditions, the groups obtained at 50ºC and 4 m/s (SC50) and 80ºC and 6 m/s (SC80) were selected as for further studies, based on their ascorbic acid final content and Folin-Ciocalteau reducing capacity. In addition to SC50 and SC80, the fresh pomace (RF) and freeze dried (RL) samples were also evaluated in these further stages of the research. Overall, the results show higher bioactive concentration in the RF samples, followed by RL, SC50 and SC80. On the second step of the research, the antioxidant, antimicrobial and antienzymatic activities were evaluated and the same tendency was observed. It was also reported, for the first time in the literature, the presence of syringic acid in dried camu-camu pomace. In the third and final stage of the research, it was investigated the effect of dried camu-camu on aging and neuroprotective disorders, using the in vivo model C.elegans. It was observed that camu-camu extracts were able to modulate important signaling genes relevant to thermal and oxidative stresses (p < 0.05). The polar acid, polar basic and polar neutral fractions obtained from the low molecular extracts of SC50 were able to extend the lifespan of wild type N2 C. elegans in 20% and 13% (p < 0.001). Results also showed that the paralysis induced by the β1-42 amyloid was significantly (p < 0.0001) retarded in CL4176 worms. Similarly, the camu-camu extracts attenuated the dopaminergic induction associated to Parkinson’s disease. Finally, a global analysis of the data presented here reveal that the camu-camu pomace, a co-product obtained from the industrial processing of a native Brazilian fruit, is a relevant natural source of health relevant compounds. This thesis, shows for the first time, the multifunctionality of camu-camu pomace, a natural resource still underexploited for scientific, commercial and technological purposes.