Efeitos imediatos da MWM na dor, amplitude de movimento e funcionalidade, na osteoartrite da anca.

Introdução: A mobilização com movimento (MWM), segundo o Conceito Mulligan tem apresentado bons resultados na melhoria da dor, amplitude de movimento e funcionalidade em diversas disfunções. No entanto, existem poucos estudos sobre a articulação da anca e, até este momento, não foi avaliada a sua efetividade em indivíduos com osteoartrite da anca. Objectivo(s): Avaliar os efeitos imediatos da técnica de MWM na dor, na amplitude de movimento e na função física em indivíduos com osteoartrite da anca. Métodos: Foram incluídos 40 participantes com osteoartrite da anca, divididas de forma aleatória em dois grupos (experimental e placebo). Foram avaliadas as amplitudes de movimento de flexão e rotação medial da anca recorrendo ao goniómetro universal, a intensidade da dor através da Escala Numérica da Dor e a funcionalidade através de testes de função física, antes e imediatamente após a intervenção. Para o tratamento estatístico, foi utilizado um nível de significância de 0,05. Resultados: A aplicação de MWM resultou em diferenças significativas, com redução da dor na Escala Numérica da Dor (p=0,005), um aumento de amplitude de movimento de flexão (p=0,001) e de rotação medial (p=0,011), uma diminuição nos tempos dos testes de função física, o teste Timed “Up and Go” (p=0,037) e o teste “40m Self Placed Walk” (p=0,019), e um aumento nas repetições do teste ―30 seg Sit to Stand” (p=0,009), comparativamente ao grupo placebo. Conclusão: Os resultados sugerem que a técnica MWM parece produzir um efeito imediato significativo na diminuição da dor, aumento de amplitude articular e melhoria da função física em indivíduos com osteoartrite da anca. Este efeito foi maior para dor, para as amplitudes de movimento e para o teste de função física - ―30 seg Sit to Stand” quando se analisou a magnitude do efeito.Background: The mobilization with movement (MWM) developed by Mulligan, has shown good results in improving pain, range of motion and function in various disorders. However, few studies exist on the hip joint and, so far, has not been evaluated its effectiveness in patients with osteoarthritis of the hip. Aim(s): To evaluate the immediate effects of MWM, on pain intensity, range of motion and physical function in individuals with osteoarthritis of the hip. Methods: 40 participants were included with osteoarthritis of the hip, divided randomly into two groups (placebo and experimental). Were evaluated the range of motion of flexion and medial rotation of hip using the universal goniometer, pain intensity using the Numerical Pain Scale and functionality were evaluated by physical function tests before and immediately after the intervention. For statistical analysis, a significance level of 0.05 was used. Results: The MWM application resulted in a significant difference in reduction of pain, Numerical Pain Scale (p = 0.005), increase in range of motion in flexion (p = 0.001) and medial rotation (p = 0.011), a decrease in times of physical function tests for Timed “Up and Go‖(p = 0.037) and the “40m Self Placed Walk” (p = 0.019) and an increase in the repetitions ―30 seg Sit to Stand” (p = 0.009) compared to placebo group. Conclusion: The results suggest that the MWM technique appears to have a significant and immediate effect on the reduction of pain, increase joint range and improving physical function in patients with osteoarthritis of the hip. This effect was greater for pain, for range of motion and the physical function test - ―30 seg Sit to Stand”, when we analyzed the magnitude of the effect

Avaliação da expressão do recetor HER-2 em carcinomas mamários caninos

Dissertação de Mestrado Integrado em Medicina VeterináriaOs tumores mamários são a segunda neoplasia mais comum no Cão, sendo a mais frequente na cadela, representando assim uma afeção de enorme importância em Medicina Veterinária. Recentemente, devido aos avanços na área da Biologia Molecular e à introdução de novos tratamentos no combate a esta doença na Mulher, aumentou o interesse na investigação e no desenvolvimento de conhecimento sobre os diferentes subtipos moleculares, em especial, os tumores que sobrexpressam HER-2 (HER-2+), na cadela. Na Mulher, os tumores que sobrexpressam HER-2 representam 20% a 30% da totalidade dos tumores mamários malignos e estão associados a um crescimento agressivo e prognóstico reservado. Na cadela, a percentagem de tumores HER-2+ parece variar entre os 8,3% e os 40%, mas a influência da sobrexpressão deste recetor no prognóstico ainda não está totalmente esclarecida devido à falta de uniformização da técnica de imunohistoquímica (IHQ) em tecidos caninos. Assim, este estudo teve como objetivo, a otimização da deteção de HER-2 nesta espécie, o esclarecimento do cenário epidemiológico dos tumores mamários caninos (TMC) HER-2+ e, com isto, a descrição de um putativo modelo biológico para o estudo de tumores mamários HER-2+ da Mulher. Utilizando a técnica de imunohistoquímica, foram testados quatro anticorpos (CB11, 4B5, TAB250 e SP3) e diferentes protocolos de recuperação antigénica. Apenas os anticorpos que reconhecem o domínio intracelular detetaram o recetor HER-2 da cadela. Foi identificada na amostra em estudo, uma sobrexpressão de HER-2 entre 19% e 40,5% dos TMC, dependendo do anticorpo. Não houve relação entre a sobrexpressão do recetor HER-2, o grau de malignidade, o tipo histológico do tumor ou outros indicadores de mau prognóstico. Uma vez que foi identificada sobrexpressão de HER-2 e, implicitamente, reatividade cruzada dos anticorpos anti-HER-2 humano com o recetor homólogo do Cão, conclui-se que a cadela poderá vir a ser utilizada como modelo biológico em estudos de Oncologia Comparada. Este facto irá contribuir para que se aprofunde o conhecimento nesta doença e que se apliquem novas abordagens terapêuticas no tratamento dos tumores mamários caninos em Medicina Veterinária.Abstract - EVALUATION OF HER -2 EXPRESSION IN CANINE MAMMARY CARCINOMA - Mammary tumours are the second most common neoplasm in Dog and the commonest tumour in the female dog, thus representing a disease with major importance in Veterinary Medicine. Recently, due to new insights in the Molecular Biology field and the introduction of new treatment options for cancer in Woman, the interest in the investigation and development of the knowledge about the molecular subtypes, especially HER-2 overexpressing tumours in the female dog, increased. Regarding woman, the HER-2 overexpressing tumours represent 20% to 30% of all breast cancer and are correlated with aggressive behaviour and poor prognosis. As for female dogs, the percentage of HER-2+ tumours seems to range between 8.3% and 40%, but the influence of this receptor’s overexpression on prognosis is still unclear due to the lack of immunohistochemistry technic standardization in canine tissues. Thus, this study’s purpose was to optimize HER-2 detection in this species, to find new insights about the HER-2+ canine mammary tumours epidemiological scenario, and in the process, to describe a putative biological model for HER-2+ mammary tumours investigation in Woman. We tested four antibodies (CB11, 4B5, TAB250 and SP3) and different antigenic retrievals protocols using the immunohistochemistry technic. HER-2 receptor was only measured with antibodies that target the intracellular domain (4B5 and CB11). HER-2 overexpression in the study sample was 19% and 40.5% of the canine mammary tumours. HER-2 overexpression was not correlated with the histological grade, tumour type and other established indicators of poor prognosis. Due to the identified HER-2 overexpression and cross-reactivity of the human anti-HER-2 antibodies with the homologous receptor in Dog, we conclude that the female dog might be used as a biological model for Comparative Oncology investigation. This will contribute to a better understating of this disease as well as to new therapeutic strategies in the treatment of the mammary gland tumours in Veterinary Medicine

Aplicação do Modelo de Aceitação de Tecnologia (TAM) em SAP Fiori

Um sistema ERP é uma infraestrutura que pode assistir a empresa a integrar informação de todos os departamentos internos dos fornecedores e clientes. Liga todas as áreas internas da empresa, funções e processos, tantos os internos como externos, de forma a criar relações entre fornecedores e clientes. Os ERP também permitem que a informação seja partilhada entre diferentes parceiros, suporta a eficiência de fornecer a cadeia de abastecimento e melhorar o fluxo de informação. Isto deverá permitir os gestores tomarem melhores decisões baseadas numa informação mais precisa e atualizada (Al-Mashari & Zairi, 2000). Os sistemas ERP foram introduzidos por fornecedores de ERP como a SAP (Systeme, Anwendungen, Produkt in der Datenverarbeitung), Olacle, PeopleSoft, e outros sistemas, que forneciam uma plataforma singular e integrada, permitindo assim às empresas, obter vantagem competitiva e competir globalmente (Loonam & McDonagh, 2005). De forma a melhorar a eficiência e eficácia do uso do sistema ERP, as organizações necessitam de perceber quais os fatores que influenciam a satisfação do utilizador. Nesta área, o modelo de aceitação de tecnologia (TAM) é um dos modelos mais utilizados para explicar a intenção comportamental e o uso de determinada tecnologia. TAM pode também melhorar a compreender de como os fatores que influenciam o uso de determinada tecnologia podem aumentar a eficácia e eficiência no sistema ERP (Shih et al, 2009). Neste trabalho foi realizado um estudo de caso em duas empresas da implementação do SAP Fiori. Procedeu-se à descrição As-Is e To-Be do processo no qual o SAP Fiori foi implementado. Foram também identificadas as vantagens e desvantagens na utilização de SAP Fiori. O modelo de aceitação de tecnologia (TAM) foi utilizado de forma a compreender quais os aspetos que mais influenciam os utilizadores a considerarem ou não o SAP Fiori como uma mais-valia, e de que forma é que ele vem ou não otimizar as tarefas dos utilizadores. Em TAM existem duas variáveis que vão influenciar a aceitação de uma tecnologia, que são: A facilidade de uso percebida e a utilidade percebida. Com este projeto podemos então constatar que após a implementação de SAP Fiori algumas das tarefas realizadas pelos utilizadores tornaram-se mais fáceis, realizadas de forma mais rápida e intuitiva. Tendo em conta o modelo de aceitação de tecnologia, o fator que mais influencia a facilidade de uso percebida é ser uma aplicação simples e fácil de usar; já para a utilidade percebida, o segundo fator que mais influencia esta variável é a possibilidade de realizar algumas das tarefas do dia-a-dia usando um dispositivo mobile, a mobilidade é então identificada como a grande utilidade desta implementação desta nova aplicação.An ERP system is a technology infrastructure that can assist a company in integrating information from all internal departments with suppliers and customers. It links all areas of a company’s internal functions and processes with the external ones in order to create a close relationship between customers and suppliers. ERP also allows information to be shared between different partners, supports the effectiveness of the supply chain management, and improves the flow of information. These should enable managers to make better decisions based on more accurate and up-to-date information (Al-Mashari & Zairi, 2000). The ERP system was introduced by ERP providers, such as SAP (Systeme, Anwendungen, Produkt in der Datenverarbeitung) (Systems, Applications, & Products in Data Processing), Oracle, PeopleSoft, and others to eradicate legacy system problems, provide single and integrated technological platform, and thereby assist companies in gaining a competitive advantage and thus competing globally. However, implementing ERP system requires changes in the organizational culture as a whole, takes a long time to implement, and consumes a considerable amount of money. Therefore, companies need to know clearly what ERP system is and in what ways the system could affect the company before thinking of implementing the system (Loonam & McDonagh, 2005). To improve the efficiency and effectiveness of ERP system use, organizations need to research the factors that impact user satisfaction. In this area, the technological acceptance model (TAM) is one of the most widely used models for explaining the behavioral intention and actual usage and can improve our understanding of how influence on actual usage could help increase efficiency and effectiveness of ERP system use. In this project was made a case study in two companies that implemented SAP Fiori. The As-Is and To-Be description of the process in which SAP Fiori was implemented was performed. The advantages and disadvantages of using SAP Fiori were also identified. The Technology Acceptance Model (TAM) has been used in order to understand the aspects that most influence users to consider SAP Fiori as an added value, and how it optimizes the tasks of users. TAM has two variables that will influence the acceptance of a technology, which are: perceived ease of use and perceived utility

A obra ficcional e jornalística de Henry Mayhew ou a outra face do vitorianismo

Realizada num contexto de confiança, prosperidade e preocupação com bem estar das massas, a Great Exibition de 1851 foi entendida pelo homem coevo como um monumento à sua capacidade imensa de se aperfeiçoar e de dominar o mundo. A Grande Exposição Mundial assumiu-se como a bandeira, tanto a nível interno como a nível externo, da afirmação das glórias recém-alcançadas pela aliança da política imperialista inglesa com os últimos avanços tecnológicos. Contudo este processo de afirmação não deixou de se alimentar de paradoxos que nesta dissertação se pretendeu desvendar. Apoiando-se na leitura de duas obras de Henry Mayhew - uma de cariz ficcional (1851: or the adventures of Mr. and Mrs. Sandboys and family) e outra de índole jornalística (London Labour & The London Poor) propôs-se nesta dissertação revelar as contradições da Inglaterra do dealbar da segunda metade do século XIX, a vários níveis. (...

Punctate Inner Choroidopathy: A Systematic Review

This article reviews clinically relevant data regarding punctate inner choroidopathy, mainly the various treatment options. Punctate inner choroidopathy is an uncommon, inflammatory, multifocal chorioretinopathy affecting mostly young myopic women. It is characterized by the presence of multiple, small, well-defined, yellow-white fundus lesions, in the absence of intraocular inflammation. We describe etiology, clinical findings and ancillary tests that help in the diagnosis and detection of complications. Treatment options that have been used to manage patients with PIC and CNV include immunosuppressants, corticoids, laser photocoagulation, photodynamic therapy, intravitreal anti-VEGF agents and submacular surgery

Refractory Coats’ Disease of Adult Onset

Purpose: We present the case of an 18-year-old Caucasian male with a unilateral macular star and retinal vascular anomalies compatible with adult onset Coats’ disease. Methods: Diagnosis was based on fundoscopic, fluorescein angiography and optical coherence tomography findings. Results: The patient presented to our emergency department with complaints of low vision in his left eye (LE) detected 10 days before. The best-corrected visual acuity in the LE was 20/50. Fundoscopy of the LE evidenced a complete macular star. Optical coherence tomography showed increased retinal thickness, infiltration of the retinal wall, and detachment of the neuroepithelium. Angiography revealed no appreciable diffusion in the macula. Above the superior temporal (ST) arcade, anomalies in the retinal vasculature were found, with interruption of the peripheral vessels and vessels which were ‘sausage’-like. After 1 month, the LE vision evolved to hand movements. Laser photocoagulation was performed in the ST quadrant. Intravitreal injection of bevacizumab 1.25 mg/0.05 ml and photodynamic therapy were performed without any significant changes, progression of ST serous detachment of the neuroepithelium, and finally progression to macular fibrosis. Discussion: Coats’ disease is usually diagnosed in childhood, but rare cases may occur in adults. Those cases usually have a more indolent course which was not observed in our patient. When there is macular involvement, prognosis is more guarded, despite treatment

Punctate Inner Choroidopathy: A Systematic Review

This article reviews clinically relevant data regarding punctate inner choroidopathy, mainly the various treatment options. Punctate inner choroidopathy is an uncommon, inflammatory, multifocal chorioretinopathy affecting mostly young myopic women. It is characterized by the presence of multiple, small, well-defined, yellow-white fundus lesions, in the absence of intraocular inflammation. We describe etiology, clinical findings and ancillary tests that help in the diagnosis and detection of complications. Treatment options that have been used to manage patients with PIC and CNV include immunosuppressants, corticoids, laser photocoagulation, photodynamic therapy, intravitreal anti-VEGF agents and submacular surgery

Cutting Edge of Traumatic Maculopathy with Spectral-domain Optical Coherence Tomography – A Review

This article reviews clinically relevant data regarding traumatic maculopathy (TM), frequently observed in clinical practice, especially due to sport or traffic accident injuries. It is characterized by transient gray-whitish retinal coloration and reduction of visual acuity (VA) with closed, blunt object globe trauma of their prior. It may be limited to the posterior pole (Berlin’s edema), or peripheral areas of the retina. Spectral-domain optical coherence tomography (SD-OCT) provides detail insight using high resolution cross-sectional tomographs of the ocular tissue. It is a potent non-invasive tool for the clinician to follow-up. Clinicians are, thereby empowered with a tool that enables evaluation of the retinal status and allows for prediction of the prognosis. Spectral-domain optical coherence tomography supports the idea that the major site of injury is in the photoreceptor and layers of the retinal pigment epithelium (RPE). Depending on the severity of the trauma, SD-OCT may reveal differential optical densities of intraretinal spaces ranging from disappearance of the thin hyporeflective optical space in mild lesions, or areas of disruption of the inner segment/outer segment (IS/OS) junction and hyperreflectivity of the overlying retina, pigment disorders and retinal atrophy, in more severe cases. The prognosis for recovery of vision is generally good, and improvement occurs within 3-4 weeks

Cutting Edge of Traumatic Maculopathy with Spectral-domain Optical Coherence Tomography – A Review

This article reviews clinically relevant data regarding traumatic maculopathy (TM), frequently observed in clinical practice, especially due to sport or traffic accident injuries. It is characterized by transient gray-whitish retinal coloration and reduction of visual acuity (VA) with closed, blunt object globe trauma of their prior. It may be limited to the posterior pole (Berlin’s edema), or peripheral areas of the retina. Spectral-domain optical coherence tomography (SD-OCT) provides detail insight using high resolution cross-sectional tomographs of the ocular tissue. It is a potent non-invasive tool for the clinician to follow-up. Clinicians are, thereby empowered with a tool that enables evaluation of the retinal status and allows for prediction of the prognosis. Spectral-domain optical coherence tomography supports the idea that the major site of injury is in the photoreceptor and layers of the retinal pigment epithelium (RPE). Depending on the severity of the trauma, SD-OCT may reveal differential optical densities of intraretinal spaces ranging from disappearance of the thin hyporeflective optical space in mild lesions, or areas of disruption of the inner segment/outer segment (IS/OS) junction and hyperreflectivity of the overlying retina, pigment disorders and retinal atrophy, in more severe cases. The prognosis for recovery of vision is generally good, and improvement occurs within 3-4 weeks

Comparison of short-term effects of mobilization with movement and Kinesiotaping on pain, function and balance in patellofemoral pain

© 2017 Turkish Association of Orthopaedics and Traumatology Objective The aim of this study was to compare the short-term effects of Mobilization with movement (MWM) and Kinesiotaping (KT) on patients with patellofemoral pain (PFP) respect to pain, function and balance. Methods Thirty-five female patients diagnosed with unilateral PFP were assigned into 2 groups. The first group (n = 18) received two techniques of MWM intervention (Straight Leg-Raise with Traction and Tibial Gliding) while KT was applied to the other group (n = 17). Both groups received 4 sessions of treatment twice a week for a period of 2 weeks with a 6-week-home exercise program. Pain severity, knee range of motion, hamstring flexibility, and physical performance (10-step stair climbing test, timed up and go test), Kujala Patellofemoral Pain Scoring and Y-Balance test were assessed. These outcomes were evaluated before the treatment, 45 min after the initial treatment, at the end of the 4-session-treatment during 2-week period and 6 weeks later in both groups. Results Both treatment groups had statistically significant improvements on pain, function and balance (p < 0.05). Pain at rest (p = 0.008) and the hamstring muscle flexibility (p = 0.027) were demonstrated significant improvements in favor of MWM group. Conclusions Our results demonstrated similar results for both treatment techniques in terms of pain, function and balance. The MWM technique with exercise had a short-term favorable effect on pain at rest and hamstring muscle flexibility than the KT technique with exercise in patients with PFP. Level of evidence Level I, therapeutic study