Infectious etiology in inflammatory bowel disease – participation of mycobacterium avium subsp. paratuberculosis and adherent-invasive strains of escherichia coli

Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Ciências da NutriçãoInflammatory Bowel Disease (IBD) includes Crohn’s Disease (CD) and Ulcerative Colitis (UC), with its etiology still to be established. IBD has been suggested to be an interaction between genetic susceptible host, microbiome interactions and induction of an abnormal immune response. This study proposes to evaluate the multiple literature present and understand the possible activity of bacteria. There have been identified multiple polymorphisms in CD and UC patients, from multiple agents related with immune response. These polymorphisms also seem to be useful for the colonization of specific bacteria, like Mycobacterium avium. Paratuberculosis (MAP) and Adherent-Invasive Escherichia Coli (AIEC) that seem to be involved in the IBD etiology as a causative agent or as an opportunist pathogen of the genetic susceptibility, however this involvement is still unclear and the studies until now are ambiguous when compared with each other. Moreover, environmental factors like diet seem to be involved in the development of IBD, especially when considered the high prevalence and increase of IBD in western countries and newly westernized countries, respectively. Concluding that a western diet is a participant in the development of IBD. On the other side with the presence of plantbased diet it could be used as a therapeutic agent granting remission in IBD.A Doença Inflamatória Intestinal (DII) inclui a Doença de Crohn(DC) e a Colite Ulcerosa(CU), estando a sua etiologia por estabelecer. DII encontra-se associada a uma interação entre hospedeiros geneticamente suscetíveis, interações do microbiota e a presença de uma resposta inflamatória exacerbada. Com este estudo pretendeu-se avaliar a literatura existente e estabelecer uma ligação entre a etiologia e a atividade de agentes microbianos. Foram identificados com maior frequência em pacientes com DC e CU, a presença um leque variado de polimorfismos, relacionados com os agentes eretores da resposta imune. Estes apresentam-se com ferramentas uteis para a colonização de bactérias como Mycobacterium avium. Paratuberculosis (MAP) e Adherent-Invasive Escherichia Coli (AIEC), que tem sido ligada à etiologia da DII como agentes causadores ou potenciais patogénios oportunistas. Contudo, a informação existente é ambígua não permitindo concluir a causalidade destes microrganismos. Adicionalmente, a o estudo de fatores ambientais com à dieta apresentam-se envolvidos no desenvolvimento da DII, especialmente quando considera a elevada prevalência e aumento da DII em “Western Countries” e em “Newly-Westernized Countires”, respetivamente. Levando a concluir que uma dieta ocidental é um fator de risco para o desenvolvimento da DII, realçando-se assim a dietas de base-vegetal como potenciais agentes terapêuticos para a remissão da DII.N/

Robust design of a passive wind turbine system

The effectiveness of full passive Wind Turbine (WT) systems has been recently demonstrated. Such low cost and reliable structures without active control and with a minimum number of sensors can be efficient only if the system design parameters are mutually adapted through an integrated optimal design approach. Even if there is a good agreement between theoretical design models and an experimental prototype, it is relevant to evaluate the WT efficiency with respect to design variable variations. Thus, this work is devoted more specifically to the sensitivity analysis of a passive WT system according to electrical variable variations of the Permanent Magnet Synchronous Generator (PMSG). It also investigates the interest of a robust design approach for reducing the sensitivity of the WT efficiency to specific variable variations

More Electricity in the Air: Toward Optimized Electrical Networks Embedded in More-Electrical Aircraft.

Along with the main trends and future challenges of electrical networks embedded in more-electrical aircraft, this article also focuses on optimization efforts in the field of industrial electronics and energy conversion. Optimization can be achieved by the means of expertise or from classical analysis methods, especially those based on simulations. However, novel approaches based on optimization algorithms, so-called integrated design by optimization, are becoming increasingly mature and will become particularly powerful if subsequent efforts are made in terms of modeling for design. In the first part, the current context and new standards of the more-electrical aircraft are summarized. The second part deals with the new trends and challenges of more electrical aircraft, with an emphasis on reversible and hybrid high-voltage dc networks including new storage devices. However, this discussion will mainly focus on systems optimization. Methodological orientations toward integrated optimal design are discussed with representative examples, such as for an environmental conditioning system (ECS)

Impact of the transradial approach in the occurrence of major bleeding in elderly patients undergoing percutaneous coronary intervention

ABSTRACTBackgroundThe occurrence of major bleeding after percutaneous coronary intervention (PCI) is associated to higher morbidity and mortality, and advanced age is one of its main predictors. The aim of this analysis was to evaluate the impact of the use of the transradial approach in the incidence of bleeding complications in elderly patients undergoing PCI.MethodsConsecutive and controlled registry including patients over 60 years of age undergoing PCI by transradial approach. Angiographic procedure success, technical failure, and the incidence of ischemic adverse events and major bleeding were evaluated.ResultsBetween May 2008 and December 2010, 707 elderly patients underwent PCI, of whom 635 (89.8%) used the transradial approach. Mean age was 69.9±7.2 years, 11.5% were>80 years of age, 39.7% were female and 30.9% had diabetes mellitus. Acute ischemic syndrome accounted for 72% of clinical indications. The angiographic success rate was 96.8% with a crossover rate of 2.8%. The in-hospital mortality rate was 2.4%, myocardial infarction occurred in 0.9%, stroke in 0.3% and stent thrombosis in 0.9%. Hematomas were reported in 1.6% of procedures, with a major bleeding rate of 0.8%.ConclusionsIn elderly patients undergoing PCI, representing the real-world practice and at a high risk for bleeding, the use of the transradial approach was associated with a low major bleeding rate

Fondaparinux in Percutaneous Coronary Intervention for the Treatment of Acute Coronary Syndrome

ABSTRACTBackgroundFondaparinux is an agent that has a well-established safety and efficacy profile in the treatment of non-ST segment elevation acute coronary syndromes. When used alone, however, it is associated with a higher incidence of thrombotic complications during invasive coronary procedures, requiring the supplementation of an anti-IIa agent. This study aimed to evaluate the efficacy and safety of percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndromes that were previously treated with fondaparinux.MethodsThis was a prospective, controlled registry, enrolling 127 consecutive patients submitted to an early invasive stratification during treatment with fondaparinux with the supplementation of intravenous unfractionated heparin at a dose of 85 U/kg at the time of PCI.ResultsThe composite primary endpoint rate, including death, acute myocardial infarction, stroke, stent thrombosis, or emergency myocardial revascularisation was 3.2%. The cumulative incidence of major bleeding and vascular complications was 3.2%. There were no cases of guide catheter thrombosis or abrupt vessel closure.ConclusionsPCI in patients with acute coronary syndromes receiving fondaparinux was associated with a low rate of major adverse cardiovascular ischaemic events and severe haemorrhagic complications. Supplementation with unfractionated heparin during the invasive procedures eliminated the risk of catheter-related thrombosis

Evaluation of a preventive intervention in alcoholic and non-alcoholic drivers: a pilot study

In this pilot study, we evaluated the drinking and driving behavior and the concepts of selfassessment on this theme of people who had consumed alcohol and intended to drive a motor vehicle after leaving bars and restaurants. We also evaluated the efficacy of a preventive intervention on their future behavior. The participants had their blood alcohol concentration (BAC) evaluated, answered a questionnaire and received a booklet during a very brief intervention. Most of the participants (69%) had BAC below the legally permitted level, and 31% above it. One month later, they answered the questionnaire once more and no significant reduction was observed in the use of alcohol before driving after the intervention, indicating the need for more effective interventions.En este estudio piloto evaluamos los comportamientos de consumo de alcohol y los conceptosde autocrítica sobre este tema en personas con intención de conducir un vehículo automotordespués de salir de bares y restaurantes. También evaluamos la efcacia de una intervenciónpreventiva en comportamiento futuro de beber y conducir. Nosotros evaluamos el nivelde alcoholemia en la sangre (BAC) de los participantes, seguido de un cuestionario. Losparticipantes también recibieron durante la intervención un prospecto con información acercadel consumo de alcohol e accidentes de tráfco. La mayoría de los participantes (69%) estabanpor debajo de los límites legales de BAC y el 31% por encima de este límite. Después de unmes, el cuestionario se aplicó de nuevo y no detectamos ninguna reducción en la conductade beber y conducir, indicando la necesidad de intervenciones más efcaces.Neste estudo piloto avaliamos os comportamentos de beber e dirigir e os conceitos de autocrítica sobre este tema em indivíduos que pretendiam dirigir após a saída de bares e restaurantes. Também avaliamos a eficácia de uma intervenção preventiva em seus comportamentos futuros de beber e dirigir. Os participantes tiveram seus níveis de alcoolemia (BAC) avaliados e responderam um questionário, recebendo um folheto informativo durante a intervenção breve. A maioria dos participantes (69%) apresentaram BAC abaixo dos limites criminais estabelecidos por lei e 31% acima deste limite. Após um mês, o questionário foi novamente aplicado e não se observou redução significativa no comportamento de beber e dirigir após um mês, indicando a necessidade de intervenções mais efetivas

Cognitive Aspects of Fetal Alcohol Syndrome in Young Adults: Two Case Studies

Fetal Alcohol Syndrome (FAS) includes a specific pattern of cognitive deficits, including language and speech disorders. Two adult participants were studied by means of the Examination of Language Test and a battery of complementary tests to evaluate oral and written language. Our data indicated great results of the participant who had psychopedagogical and speech-language assistance than the other who did not receive none intervention. These findings suggest that early diagnosis and intervention are crucial to minimize sequelae in FAS.A Síndrome Fetal Alcóolica (SFA) inclui um padrão de déficit cognitivo, incluindo alterações de linguagem e fala. Estudou-se dois participantes adultos que foram diagnosticados com SFA na infância por meio do Teste de Exame de Linguagem e de uma bateria de testes complementares para avaliar aspectos da linguagem oral e escrita. Os dados indicaram que o participante que recebeu uma intervenção psicopedagógica apresentou melhores resultados que aquele que não tinha recebido nenhuma intervenção. Estes achados indicam que um diagnóstico precoce é fundamental para minimizar as sequelas da SFA

Hospitalizações no Brasil pelas estimativas da Pesquisa Nacional de Saúde, 2013 e 2019

OBJETIVO: Comparar o perfil e a prevalência das hospitalizações no Brasil com base nas estimativas da Pesquisa Nacional de Saúde (PNS), 2013 e 2019. MÉTODOS: Estudo transversal seriado que utilizou os dados das PNS 2013 e PNS 2019. O desfecho foi ter ficado internado por 24 horas ou mais nos últimos 12 meses. Calculamos a proporção da população nas diversas categorias de faixa etária, de presença ou ausência de doenças crônicas e de percepção do estado de saúde. Estimamos o número total de hospitalizações e a proporção correspondente a cada categoria de faixa etária, de doença crônica e de percepção do estado de saúde. Calculamos a prevalência de internação segundo fatores geográficos, socioeconômicos e condições de saúde. Comparamos as estimativas das duas edições da PNS utilizando o teste t de Student para amostras independentes. Consideramos as diferenças significativas quando o valor de p foi menor que 0,01. E finalmente comparamos as estimativas de hospitalização com os dados administrativos para avaliar a consistência dos dados. RESULTADOS: Observamos que a proporção de doentes crônicos na população passou de 15,04% para 31,48%. Este grupo foi responsável por 36,76% do total de internações em 2013 e de 57,61% em 2019. A prevalência de hospitalizações aumentou significativamente entre os dois inquéritos e os incrementos foram maiores na região Sudeste e entre pessoas que possuem plano de saúde privado. Foi encontrada uma discrepância entre os dados administrativos e as estimativas dos inquéritos. As internações obstétricas e as internações por plano de saúde foram subestimadas. CONCLUSÃO: Houve um aumento nas taxas globais de hospitalização no período compreendido entre as PNS 2013 e 2019, especialmente entre as pessoas com melhor acesso aos serviços de saúde. O perfil de hospitalização também mudou – na PNS 2013 predominaram internações de pessoas sem doenças crônicas. Isto se inverteu na PNS 2019.OBJECTIVE: To c ompare t he profile a nd prevalence of hospitalizations i n B razil b ased on estimates from the National Health Survey (PNS), 2013 and 2019. METHODS: A cross-sectional study that used data from the 2013 PNS and the 2019 PNS. The outcome was having been hospitalized for 24 hours or more in the last 12 months. We calculated the proportion of the population in different categories of age group, presence or absence of chronic diseases, and perception of health status. We estimated the total number of hospitalizations and the proportion corresponding to each category of age group, chronic disease, and perceived health status. We calculated the prevalence of hospitalization according to geographic, socioeconomic, and health conditions. We compared the estimates of two editions of the PNS using Student’s t-test for independent samples. We considered significant differences when the p-value was less than 0.01. And finally, we compared hospitalization estimates with administrative data to assess data consistency. RESULTS: We observed that the proportion of chronically ill people in the population increased from 15.04% to 31.48%. This group was responsible for 36.76% of the total number of hospitalizations in 2013 and 57.61% in 2019. The prevalence of hospitalizations increased significantly between the two surveys and the increases were higher in the Southeast region and among people who have private health insurance. A discrepancy was found between administrative data and survey estimates. Obstetric hospitalizations and health insurance hospitalizations were underestimated. CONCLUSION: There was an increase in overall hospitalization rates in the period between the PNS 2013 and PNS 2019, especially among people with better access to health services. The hospitalization profile also changed—in the 2013 PNS, hospitalizations of people without chronic diseases predominated. This was reversed in PNS 2019