How Patients Die in Internal Medicine Wards: a Retrospective Study

Os doentes com doença crónica avançada são uma presença diária nas enfermarias de Medicina Interna, não existindo um protocolo de intervenção universal e uniforme. Este estudo pretende ser uma primeira abordagem para avaliar a forma como tratamos e cuidamos destes doentes, quer de etiologia neoplásica, quer de outras doenças crónicas, igualmente consumptivas, como demência, insuficiência cardíaca, VIH/SIDA, doença pulmonar crónica obstrutiva (DPCO). Foram recolhidas informações retrospectivas dos processos clínicos acerca das atitudes e tratamentos prestados a 285 doentes falecidos em 16 meses num hospital de agudos em Lisboa. A caracterização epidemiológica da população foi a esperada, com predomínio de população idosa, dependente, com prevalência de doenças cardíacas e acidentes vasculares cerebrais (AVC), como diagnósticos principais, seguidas de demência e doenças respiratórias. Do total de falecimentos, 73% foram esperados, mas destes apenas 44% dos doentes estavam integrados em cuidados paliativos. A dor foi avaliada principalmente em doentes de foro neoplásico, sendo a analgesia administrada em 77% dos casos. A decisão de receberem cuidados paliativos foi discutida com a família em 26% dos doentes, mas não foi em nenhum caso discutido com o próprio doente. Consideramos que é necessário formação e informação para uma abordagem mais sistematizada do doente com doença crónica avançada e das suas necessidades. A definição explícita das expectativas de vida e uma abordagem sistemática da pesquisa de dor em todos estes, é necessária para garantir melhor qualidade dos cuidados prestados em fim de vida

Food supplements for weight loss: monitoring of metallic and non-metallic impurities

Poster presented at the 37th ESPEN Congress (European Society for Clinical Nutrition). 5-8 September 2015, Lisbon, Portuga

Analysis of elemental impurities by WDXRF in pharmaceuticals and dietary supplements

Poster presented at the Colloquium Spectroscopicum Internationale XXXIX. 30 Aug - 3 Sept 2015, Figueira da Foz, Coimbra, PORTUGA

Interaction between Arbuscular Mycorrhizal Fungi and rhizobia on the growth of subclover under Mn toxicity: The role of Extraradical Mycelium.

When Arbuscular Mycorrhizal (AM) colonization started from an intact extraradical mycelium (ERM) its bioprotective effect on subclover was enhanced in comparison with other sources of inoculum. The presence in the soil of an intact ERM, developed previously on mycotrophic plants tolerant to Mn toxicity, resulted in the earlier colonization of subclover, reduced Mn concentration in the roots, improved development and activity of root nodules, and enhanced N acquisition

Managing arbuscular mycorrhizal fungi for bioprotection: Mn toxicity

We investigated whether an intact extraradical mycelium (ERM) is more effective than other forms of propagule from indigenous arbuscular mycorrhizal fungi (AMF) in providing protection against stress to a host plant. The response of wheat (Triticum aestivum L.) to Mn toxicity was studied in a two-phase greenhouse experiment. In Phase 1, four Mn tolerant species from the natural vegetation, ranging from strongly mycotrophic to non- or weakly mycotrophic, were grown to develop different amounts of ERM. Wheat was then planted (Phase 2) with the ERM fragmented by sieving (Disturbed Treatment) or kept intact with no prior soil disturbance (Undisturbed Treatment). The growth of wheat was doubled by earlier and faster mycorrhizal colonization (AC) in the presence of an intact ERM at planting. There was a positive correlation between plant growth and the reduction of Mn and enhancement of P and S uptake into shoots. However, the growth of plants in undisturbed soil was significantly affected by the ERM developer species, which was not explained by differences in AC. Colonization starting from an intact ERM greatly enhanced the potential of AMF for protection against Mn toxicity. However, the degree of protection depended on the plant previously grown to develop the ERM, suggesting that there may be functional diversity within the ERM developed by mycotrophic plants of the natural vegetation

Efficiency of Brownian Motors

The efficiency of different types of Brownian motors is calculated analytically and numerically. We find that motors based on flashing ratchets present a low efficiency and an unavoidable entropy production. On the other hand, a certain class of motors based on adiabatically changing potentials, named reversible ratchets, exhibit a higher efficiency and the entropy production can be arbitrarily reduced.Comment: LaTeX 209, 6 pages, 7 postscript figures, uses psfi

Effective models of quantum gravity induced by Planck scale modifications in the covariant quantum algebra

In this paper we introduce a modified covariant quantum algebra based in the so-called Quesne-Tkachuk algebra. By means of a deformation procedure we arrive at a class of higher derivative models of gravity. The study of the particle spectra of these models reveals an equivalence with the physical content of the well-known renormalizable and super-renormalizable higher derivative gravities. The particle spectrum exhibits the presence of spurious complex ghosts and, in light of this problem, we suggest an interesting interpretation in the context of minimal length theories. Also, a discussion regarding the non-relativistic potential energy is proposed.Comment: Small corrections were made; improved figures; results unchanged; published versio

Metabolic factors in obesity

Obesity has a rising prevalence in children and adolescents, affecting 30% of the paediatric population in Portugal. Leptin is an important hormone involved in the pathogenesis of obesity and has been under investigation as a risk marker for future complications. AIMS: 1. To evaluate the relation between serum leptin levels and body mass index (BMI) and height. 2. To compare leptin levels in obese and non-obese children. 3. To evaluate the relation between leptin levels and insulin resistance index. METHODS: Cross-sectional study, using a sample of 70 obese children and a control group of 53 non-obese children. Obesity was defined as BMI standard deviation > 2 for age and sex. In the obese group we assessed sex, age, BMI SDS and height SDS for age and sex, and serum levels of glucose, insulin and leptin. In the control group were obtained BMI SDS and height SDS for age and sex and leptin levels. Data were analysed using SPSS 12. RESULTS: The mean age of obese and non-obese children was 10.3 +/- 2.9 versus 10.9 +/- 3.5 years. In the obese group, 32 (45.7%) were boys versus 18 (31.0%) in the non-obese group. BMI SDS in the obese group was 3.12 +/- 0.60 versus 0.20 +/- 0.99 in the non-obese group (p < 0.001). Leptin levels showed a positive correlation with BMI SDS (r = 0.69; p < 0.001) and height SDS (r = 0.31; p < 0.001). When comparing leptin levels between obese and non-obese groups, we found a significant difference in boys (50.7 +/- 27.3 versus 7.0 +/- 6.8 ng/ml; p < 0.001) and in girls (57.6 +/- 25.5 versus 16.5 +/- 10.3 ng/ml; p < 0.001). In the nonobese group, leptin levels were lower in boys. This difference was not seen in the obese group. Leptin showed a positive correlation with insulin resistance index in boys (r = 0.45, p = 0.05), but not in girls. CONCLUSIONS: This study has confirmed a positive correlation between leptin levels and BMI SDS. In obese children elevated leptin is associated with central resistance to its action. The positive correlation of leptin with insulin resistance index may suggest a major role of leptin in insulin resistance.info:eu-repo/semantics/publishedVersio