A relação de ajuda ao doente em fim de vida e família: o enfermeiro e o cuidar em fim de vida

Os cuidados ao doente em fim de vida tornam-se difíceis de suportar pelas pessoas envolvidas, pois, para além da sobrecarga física, existe um grande desgaste psicológico e emocional, pelo que se torna importante um acompanhamento e apoio por parte dos profissionais de saúde. A relação de ajuda é um elemento decisivo na atividade dos enfermeiros, desempenhando um papel central na resposta às necessidades concretas do doente em fim de vida e sua família. O objectivo do estudo foi identificar necessidades e dificuldades que os enfermeiros enfrentam no contexto da relação de ajuda ao doente em fim de vida e família. A metodologia utilizada foi a Revisão Sistemática da Literatura sendo aplicada a metodologia PICO. Recorreu-se às bases de dados B-on, LILACS e Scielo, tendo sido reunidos 14 artigos e analisados 7. Os resultados mostraram que muitos enfermeiros sentem dificuldade em comunicar com doentes terminais, apesar de valorizarem as relações interpessoais relacionadas com a comunicação, o conforto, o apoio e acompanhamento e as técnicas de alívio do sofrimento do doente e família, direcionadas para a gestão da dor e sofrimento. A falta de formação em cuidados paliativos é evidente, sendo que o desempenho das competências relacionais de ajuda está correlacionado com a formação que os enfermeiros desenvolvem acerca da relação de ajuda. As principais conclusões a que o estudo chegou foram que apesar da dedicação dos enfermeiros a relação de ajuda ao doente terminal e família nem sempre é conseguida. O desenvolvimento pessoal e profissional, o modo como gerem as dificuldades pessoais e relacionais com o doente e família no contexto de fim de vida, são considerados como os ingredientes major ao nível do cuidar e da relação de ajuda profissional.info:eu-repo/semantics/publishedVersio

A Genetic Analytics Approach for Risk Variant Identification to Support Intervention Strategies for People Susceptible to Polygenic Obesity and Overweigh

Obesity is a growing epidemic that has increased steadily over the past several decades. It affects significant parts of the global population and this has resulted in obesity being high on the political agenda in many countries. It represents one of the most difficult clinical and public health challenges worldwide. While eating healthy and exercising regularly are obvious ways to combat obesity, there is a need to understand the underlying genetic constructs and pathways that lead to the manifestation of obesity and their susceptibility metrics in specific individuals. In particular, the interpretation of genetic profiles will allow for the identification of Deoxyribonucleic Acid variations, known as Single Nucleotide Polymorphism, associated with traits directly linked to obesity and validated with Genome-Wide Association Studies. Using a robust data science methodology, this paper uses a subset of the TwinsUK dataset that contains genetic data from extremely obese individuals with a BMI≥40, to identify significant obesity traits for potential use in genetic screening for disease risk prediction. The approach posits a framework for methodical risk variant identification to support intervention strategies that will help mitigate long-term adverse health outcomes in people susceptible to obesity and overweight

Standerd cervical mediastinoscopy in the diagnosis of mediastinal mass in Ghazi Al-Hariri Hospital

Background: Mediastinoscopy is an integral part in the diagnosis of mediastinal mass. The most common indications for mediastinoscopy is for tissue sampling and determining the extent of lung cancer. Objectives: To validate our experience with standard cervical mediastinoscopy and to evaluate the usefulness of cervical mediastinoscopy in the assessing the mediastinal diseases when imaging modalities are none diagnostic. Material and Methods: A retrospective study of 16 patients between January 2012 and July 2014. Mediastinoscopy was indicated for diagnostic staging of nodal disease related to lung cancer in 8 patients (group I) and for isolated mediastinal lymphadenopathy in 8 patients (group II) Results: There were 11 males and 5 females, with a mean age of 47 years. The mean operative time was 30 minutes and the mean hospital stay was 8 hours. In lung cancer (group I) there was positive results in 3 patients and negative results in 5 patients. In patients with isolated mediastinal lymphadenopathy (group II), TB was the commonest diagnosis. There was no surgical related morbidity or mortality in our study. The sensitivity and specificity of standard cervical mediastinoscopy in this study was 100% Conclusion: Standard cervical mediastinoscopy is safe in the hands of well trained persons and needs a good knowledge of the anatomy of the region, cost effective, highly specific and still the first investigation of choice in the diagnosis of mediastinal nodal involvement

Association Mapping Approach into Type 2 Diabetes using Biomarkers and Clinical Data

The global growth in incidence of Type 2 Diabetes (T2D) has become a major international health concern. As such, understanding the aetiology of Type 2 Diabetes is vital. This paper investigates a variety of statistical method-ologies at various level of complexity to analyse genotype data and identify bi-omarkers that show evidence of increase susceptibility to T2D and related traits. A critical overview of several selected statistical methods for population-based association mapping particularly case-control genetic association analysis is pre-sented. A discussion on a dataset accessed in this paper that includes 3435 female subjects for cases and controls with genotype information across 879071 Single Nucleotide Polymorphism (SNPs) is presented. Quality control steps into the dataset through pre-processing phase are performed to remove samples and markers that failed the quality control test. Association analysis is discussed to address which statistical method can be appropriate to the dataset. Our genetic association analysis produces promising results and indicated that Allelic asso-ciation test showed one SNP above the genome-wide significance threshold of 5×10−8 which is rs10519107 (Odds Ratio (OR)=0.7409,P−Value (P)=1.813×10−9), While, there are several SNPs above the suggestive association threshold of 5×10−6 these SNPs could worth further investigation. Furthermore, Logistic Regression analysis adjusted for multiple confounder factors indicated that none of the genotyped SNPs has passed genome-wide significance threshold of 5×10−8 . Nevertheless, four SNPs (rs10519107, rs4368343, rs6848779, rs11729955) have passed suggestive association threshold

Acute Liver Failure (ALF) in Pregnancy: How Much Is Pregnancy Related?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163471/1/hep31144.pd

Investigation of antioxidant effects of rosmarinic acid on liver, lung and kidney in rats: a biochemical and histopathological study

Background: The aim of the study was to investigate the protective effects of rosmarinic acid in rats exposed to hepatic ischaemia/reperfusion (I/R) injury. Materials and methods: Thirty-two rats were randomly classified into four groups of 8 rats each: laparotomy without medication, rosmarinic acid (dose of 50 mg/kg via oral gavage) followed by laparotomy, laparotomy followed by hepatic I/R, and hepatic I/R with rosmarinic acid. Serum aspartate aminotransferase, alaninę aminotransferase, and malondialdehyde levels and total oxidant activity and total antioxidant capacity levels of the liver, lung, and kidney were assessed. The histopathologic assessment was also performed. Results: Rosmarinic acid significantly reduced liver function test parameters and decreased oxidative stress and abnormal histopathologic findings in the liver. The oxidative stress in the lung significantly increased in the I/R group but significantly decreased in the I/R + rosmarinic acid group due to the addition of rosmarinic acid. Rosmarinic acid led to no reduction in oxidative stress in kidney following hepatic I/R injury. There were no statistically significant differences among the groups regarding histopathologic changes in kidney and lung sections. Conclusions: Rosmarinic acid has antioxidant properties and is an effective hepatoprotective agent. However, although rosmarinic acid provides useful effects in the lung by increasing antioxidant capacity and reducing oxidative stress after I/R injury, it does not ameliorate histopathologic changes. These findings suggest that rosmarinic acid is likely to provide favourable outcomes in the treatment of hepatic I/R injury

Partisan Asymmetries in Online Political Activity

We examine partisan differences in the behavior, communication patterns and social interactions of more than 18,000 politically-active Twitter users to produce evidence that points to changing levels of partisan engagement with the American online political landscape. Analysis of a network defined by the communication activity of these users in proximity to the 2010 midterm congressional elections reveals a highly segregated, well clustered partisan community structure. Using cluster membership as a high-fidelity (87% accuracy) proxy for political affiliation, we characterize a wide range of differences in the behavior, communication and social connectivity of left- and right-leaning Twitter users. We find that in contrast to the online political dynamics of the 2008 campaign, right-leaning Twitter users exhibit greater levels of political activity, a more tightly interconnected social structure, and a communication network topology that facilitates the rapid and broad dissemination of political information.Comment: 17 pages, 10 figures, 6 table

Endothelial Progenitor Cells influence acute and subacute stroke hemodynamics

BACKGROUND: Endothelial Progenitor Cells (EPCs) are a circulating stem cell population with in vivo capacity of promoting angiogenesis after ischemic events. Despite the promising preclinical data, their potential integration with reperfusion therapies and hemodynamic evolution of stroke patients is still unknown. Our aim was to determine the association of EPCs with acute, subacute and chronic hemodynamic features. METHODS: In this prospective study, we included consecutive patients with ages between 18 and 80years and non-lacunar ischemic stroke within the territory of a middle cerebral artery. All patients were subject to hemodynamic evaluation by ultrasound at baseline, seven days and three months. We quantified cerebral blood flow (CBF) and assessed early recanalization and collateral flow. Hemorrhagic transformation was graded in Magnetic Resonance imaging performed at seven days. EPCs were isolated from peripheral venous blood collected in the first 24h and seven days, counted and submitted to functional in vitro tests. RESULTS: We included 45 patients with a median age of 70±10years. The angiogenic and migratory capacities of EPCs were associated with increased collateral flow in the acute stage and day seven CBF, without statistically significant associations with recanalization nor haemorrhagic transformation. The number of EPCs was not associated with any hemodynamic variable. CONCLUSIONS: The functional properties of EPCs are associated with acute and subacute stroke hemodynamics, with no effect on haemorrhagic transformation.info:eu-repo/semantics/publishedVersio