Chronic Pruritus

O Prurido crónico é um sintoma que tem um impacto significativo na qualidade de vida dos doentes. Pode estar associado a um vasto conjunto de doenças e na maioria dos casos, é difícil conseguir um alívio completo da sintomatologia. A investigação da sua etiologia implica a colheita de uma história clínica meticulosa, bem com a realização do exame objectivo e de exames complementares de diagnóstico. O tratamento do prurido é frequentemente um desafio para o dermatologista e pode incluir a implementação de diferentes terapêuticas. Esta revisão pretende dar ênfase à abordagem clínica e às opções terapêuticas do doente com prurido crónico

Garch models for drug effects on patient heart rate, during general anaesthesia

A model that can describe the effect of anaesthetic drugs on patient’s heart rate (HR) is of great importance when considering haemodynamic stability under surgery. A Generalized Autoregressive Conditional Heteroscedasticity (GARCH) model was used to model HR considering the effect concentrations of the anaesthetic propofol and the analgesic remifentanil, using the clinical data of 16 patients. The model was able to capture the HR trend in all 16 patients with very small errors throughout the surgical time. A correlation was found between the GARCH parameters and patient baseline characteristics, leading to the possibility a patient adjusted adaptive model.info:eu-repo/semantics/publishedVersio

Revisiting the genetics of APOE

Apolipoprotein E (APOE) is a lipid-transport protein expressed in almost all tissues, including the brain. In addition to lipid delivery, brain APOE also regulates amyloid beta clearance and aggregation. In humans, there are three main isoforms, APOE2, APOE3 and APOE4, with structural differences that influence protein function. APOE4 is the most important genetic risk factor for Alzheimer’s disease and Dementia with Lewy bodies. In this review, we will focus on the genetic variability of APOE and its association with different diseases (mainly neurodegenerative, psychiatric and lipid-related). Despite the increasing number of studies, the association of APOE genetic variants with other neurological conditions beyond Alzheimer’s disease and Dementia with Lewy bodies is still far from clear. We will also discuss the association of different structural and functional aspects of APOE with different diseases, particularly the amyloid beta-dependent and-independent mechanisms, such as tau-mediated neurodegeneration, associated with Alzheimer’s disease pathogenesis. As the most significant genetic risk factor for Alzheimer’s disease, APOE has a central role in the risk assessment of this disease. Consequently, a better understanding of the impact of common and rare APOE variants will not only contribute to a more accurate risk management of these patients, but it will also clarify the potential of APOE as a therapeutic target

Treatment of Lupus Erythematosus of the Eyelids with Pulsed Dye Laser

info:eu-repo/semantics/publishedVersio

Drug Allergy with Cutaneous Manifestations. Diagnostic Approach

As reacções adversas a fármacos (RAF) representam um problema frequente na prática clínica. A alergia a fármacos resulta de mecanismos de hipersensibilidade imunológica e representa 6-10% do total de RAF. Clinicamente, as reacções alérgicas a fármacos podem ser classificadas como imediatas (tipo I) ou não-imediatas (com manifestações clínicas diversas e associadas sobretudo a reacções de tipo IV). Neste artigo são abordados aspectos gerais, nomeadamente os mecanismos imunopatogénicos implicados na alergia a fármacos e reactividade cruzada mas também as manifestações cutâneas mais relevantes, nomeadamente exantemas máculo-papulares, eritema fixo a fármacos (EFF), pustulose exantemática aguda generalizada (PEAG), síndrome de hipersensibilidade a fármacos (DRESS – drug rash with eosinophilia and systemic symptoms), síndrome de Stevens-Johnson/necrólise epidérmica tóxica (SSJ/NET). O papel dos testes cutâneos (epicutâneos ou intradérmicos de leitura tardia) na abordagem de reacções não-imediatas é também revisto. Os beta-lactâmicos (BL) são o grupo farmacológico mais frequentemente envolvido em reacções de hipersensibilidade imunológica e que mais dificuldades coloca na prática clínica diária, nomeadamente devido aos riscos de reactividade cruzada, pelo que é analisado em maior detalhe ao longo da revisão. A indução de tolerância a fármacos poderá ser considerada em casos selecionados, sobretudo quando na ausência de alternativas terapêuticas igualmente eficazes ou seguras

A dermatosis of pregnancy

info:eu-repo/semantics/publishedVersio

Evidence for inter- and intra-species biofilm formation variability among a small group of coagulase-negative staphylococci

Coagulase-negative staphylococci (CoNS) are common bacterial colonisers of the human skin. They are often involved in nosocomial infections due to biofilm formation in indwelling medical devices. While biofilm formation has been extensively studied in Staphylococcus epidermidis, little is known regarding other CoNS species. Here, biofilms from six different CoNS species were characterised in terms of biofilm composition and architecture. Interestingly, the ability to form a thick biofilm was not associated with any particular species, and high variability on biofilm accumulation was found within the same species. Cell viability assays also revealed different proportions of live and dead cells within biofilms formed by different species, although this parameter was particularly similar at the intra-species level. On the other hand, biofilm disruption assays demonstrated important inter- and intra-species differences regarding extracellular matrix composition. Lastly, confocal laser scanning microscopy (CLSM) experiments confirmed this variability, highlighting important differences and common features of CoNS biofilms. We hypothesised that the biofilm formation heterogeneity observed was rather associated with biofilm matrix composition than with cells themselves. Additionally, our results indicate that polysaccharides, DNA and proteins are fundamental pieces in the process of CoNS biofilm formation.This work was co-funded by FCT Strategic Project PEst-OE/EQB/LA0023/2013, FCT project RECI/BBB-EBI/0179/2012 (FCOMP-01-0124-FEDER-027462) and by QREN, FEDER, ON2 project NORTE-07-0124-FEDER-000027. NC is an Investigador FCT