Catheter-associated urinary tract infection in medical patients of a Portuguese hospital: incidence and risk factors

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Hypothalamic Deep Brain Stimulation Reduces Weight Gain in an Obesity-Animal Model

Prior studies of appetite regulatory networks, primarily in rodents, have established that targeted electrical stimulation of ventromedial hypothalamus (VMH) can alter food intake patterns and metabolic homeostasis. Consideration of this method for weight modulation in humans with severe overeating disorders and morbid obesity can be further advanced by modeling procedures and assessing endpoints that can provide preclinical data on efficacy and safety. In this study we adapted human deep brain stimulation (DBS) stereotactic methods and instrumentation to demonstrate in a large animal model the modulation of weight gain with VMH-DBS. Female Göttingen minipigs were used because of their dietary habits, physiologic characteristics, and brain structures that resemble those of primates. Further, these animals become obese on extra-feeding regimens. DBS electrodes were first bilaterally implanted into the VMH of the animals (n = 8) which were then maintained on a restricted food regimen for 1 mo following the surgery. The daily amount of food was then doubled for the next 2 mo in all animals to produce obesity associated with extra calorie intake, with half of the animals (n = 4) concurrently receiving continuous low frequency (50 Hz) VMH-DBS. Adverse motoric or behavioral effects were not observed subsequent to the surgical procedure or during the DBS period. Throughout this 2 mo DBS period, all animals consumed the doubled amount of daily food. However, the animals that had received VMH-DBS showed a cumulative weight gain (6.1±0.4 kg; mean ± SEM) that was lower than the nonstimulated VMH-DBS animals (9.4±1.3 kg; p<0.05), suggestive of a DBS-associated increase in metabolic rate. These results in a porcine obesity model demonstrate the efficacy and behavioral safety of a low frequency VMH-DBS application as a potential clinical strategy for modulation of body weight

The use of technology and information systems in a quality improvement project developed in a Portuguese Internal Medicine Department: innovative ideas from RITUAL project

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Hypothalamic deep brain stimulation reduces weight gain in an obesity-animal model. PLoS One 7

Abstract Prior studies of appetite regulatory networks, primarily in rodents, have established that targeted electrical stimulation of ventromedial hypothalamus (VMH) can alter food intake patterns and metabolic homeostasis. Consideration of this method for weight modulation in humans with severe overeating disorders and morbid obesity can be further advanced by modeling procedures and assessing endpoints that can provide preclinical data on efficacy and safety. In this study we adapted human deep brain stimulation (DBS) stereotactic methods and instrumentation to demonstrate in a large animal model the modulation of weight gain with VMH-DBS. Female Gö ttingen minipigs were used because of their dietary habits, physiologic characteristics, and brain structures that resemble those of primates. Further, these animals become obese on extra-feeding regimens. DBS electrodes were first bilaterally implanted into the VMH of the animals (n = 8) which were then maintained on a restricted food regimen for 1 mo following the surgery. The daily amount of food was then doubled for the next 2 mo in all animals to produce obesity associated with extra calorie intake, with half of the animals (n = 4) concurrently receiving continuous low frequency (50 Hz) VMH-DBS. Adverse motoric or behavioral effects were not observed subsequent to the surgical procedure or during the DBS period. Throughout this 2 mo DBS period, all animals consumed the doubled amount of daily food. However, the animals that had received VMH-DBS showed a cumulative weight gain (6.160.4 kg; mean 6 SEM) that was lower than the nonstimulated VMH-DBS animals (9.461.3 kg; p,0.05), suggestive of a DBS-associated increase in metabolic rate. These results in a porcine obesity model demonstrate the efficacy and behavioral safety of a low frequency VMH-DBS application as a potential clinical strategy for modulation of body weight

Emergency department contribution to HCV elimination in the Iberian Peninsula

Background: Undiagnosed cases of hepatitis C virus (HCV) infection result in significant morbidity and mortality, further transmission, and increased public health costs. Testing in emergency departments (EDs) is an opportunity to expand HCV screening. The goal of this project was to increase the proportion of eligible patients screened for HCV in urban areas. Methods: An opportunistic automated HCV screening program was implemented in the EDs of 4 public hospitals in Spain and Portugal at different periods between 2018 and 2023. HCV prevalence was prospectively evaluated, and single-step or reflex testing was used for confirmation in the same sample. Results: More than 90% of the population eligible for testing were screened in the participating centers. We found HCV antibody seroprevalence rates ranging from 0.6 to 3.9%, with between 19 and 53% of viremic individuals. Conclusions: Opportunistic HCV screening in EDs is feasible, does not disrupt ED activities, is highly effective in increasing diagnosis, and contributes to WHO's HCV elimination goals.info:eu-repo/semantics/publishedVersio

Vivências e perspectivas maternas na internação do filho prematuro em Unidade de Tratamento Intensivo Neonatal

O estudo teve o objetivo de apreender o motivo para a permanência materna no hospital durante a internação do filho prematuro em Unidade de Terapia Intensiva Neonatal. A pesquisa foi realizada com doze mães de recém-nascidos prematuros numa maternidade municipal do Rio de Janeiro em 2007. Adotou-se como suporte metodológico a Fenomenologia Sociológica de Alfred Schütz. A entrevista fenomenológica foi utilizada para captar o discurso das mães, cuja ação intencional foi desvelada mediante as seguintes categorias: Cuidar do filho - enfrentando o desafio de ter um pequeno bebê; Ficar perto do filho prematuro - a presença materna contribuindo para a sua recuperação mais rápida; Ajuda recíproca entre as mães - é a esperança reforçada a cada dia. O alojamento de mães destaca-se como iniciativa inovadora e relevante durante a internação dos filhos prematuros, sendo considerado um espaço de convivências, troca de experiências e apoio mútuo, na longa e difícil permanência hospitalar.El estudio tuvo por objetivo comprender el motivo para la permanencia materna en el hospital durante la internación del hijo prematuro en Unidad de Terapia Intensiva Neonatal. Se efectuó con doce madres de recién nacidos prematuros, en un hospital maternidad municipal de Rio de Janeiro, Brasil, en 2007. Se adoptó como soporte metodológico la Fenomenología Sociológica de Alfred Schütz. La entrevista fenomenológica se utilizó para colectar el testimonio de las madres cuya acción intencional fue determinada a través de las siguientes categorías: Cuidar del hijo - enfrentando el desafío de tener un pequeño bebé; Estar cerca del hijo prematuro - la presencia materna contribuyendo a una más rápida recuperación; Ayuda recíproca entre las madres - la esperanza es reforzada cada día. El alojamiento de madres se destaca como iniciativa innovadora y relevante para ellas durante la internación de sus hijos prematuros, considerándose un espacio de convivencias, intercambio de experiencias y apoyo mutuo en la larga y difícil permanencia hospitalaria.The purpose of this study was to learn the reason why mothers remain at the hospital throughout the stay of their premature infant at the Neonatal Intensive Care Unit. The study was performed with twelve mothers to premature newborns at a municipal maternity hospital in Rio de Janeiro, in 2007. The methodological support used in the study was the Sociological Phenomenology of Alfred Schütz. The phenomenological interview was used to capture the mothers' discourse, whose intentional action was unveiled through the following categories: Taking care of the child - dealing with the challenge of having a small baby; Staying near the premature child - the mother's presence helps the child's recovery to be faster; Reciprocal help among mothers - reinforcing hope every day. Rooming-in care stands out as an innovative and relevant initiative during the hospital stay of preterm infants, and it is considered an environment for living together, sharing experiences, and giving mutual support throughout the long and difficult stay at the hospital