6,762 research outputs found
Red blood cell distribution width predicts myocardial infarction and mortality after vascular surgery - A prospective cohort study
Introdução: Os parâmetros hematológicos, nomeadamente o coeficiente de variação da amplitude de distribuição dos glóbulos rubros e o desvio padrão da amplitude de distribuição dos glóbulos rubros, têm demonstrado em vários estudos uma forte correlação com eventos cardiovasculares adversos major e morte após cirurgia. Este estudo tem como objetivo investigar a associação entre os parâmetros hematológicos no pré-operatório e a ocorrência de eventos adversos no pós-operatório, incluindo enfarte do miocárdio e mortalidade.
Métodos: Todos os doentes adultos submetidos a cirurgia vascular arterial eletiva desde Janeiro até Abril de 2015 num hospital universitário foram incluídos neste estudo coorte observacional prospetivo. O outcome primário foi morte após 30 dias desde o dia da cirurgia. O outcome secundário foi enfarte do miocárdio após 30 dias desde o dia da cirurgia.
Resultados: Na análise univariada de mortalidade, a prevalência de fibrilação auricular, doença renal crónica e estado funcional dependente foi superior em doentes falecidos. Após a análise multivariada, a idade (OR ajustado de 1.08, 95%CI 1.01-1.15, p=0.027) e o desvio padrão da amplitude de distribuição dos glóbulos rubros (OR ajustado 1.08, 95%CI 1.01-1.16, p=0.032) subsistiram como fatores independentes de mortalidade. Na análise univariada de enfarte do miocárdio, a prevalência de diabetes, doença renal crónica, estado funcional dependente, estado físico ASA IV e medicação com insulina foi mais elevada em doentes com episódio de enfarte no pós-operatório. Na análise multivariada de enfarte do miocárdio, o estado funcional dependente (OR ajustado de 4.8, 95%CI 1.6-15.0, p=0.007), a medicação com insulina (OR ajustado de 4.4, 95%CI 1.5-12.6, p=0.007), e o desvio padrão da amplitude de distribuição dos glóbulos rubros (OR ajustado de 1.1, 95%CI 1.02-1.19, p=0.020) foram preditores independentes.
Conclusão: A amplitude de distribuição dos glóbulos rubros pode desempenhar um papel importante na avaliação peri-operatória dos doentes submetidos a cirurgia vascular. O desvio padrão da amplitude de distribuição dos glóbulos rubros é um preditor independente de enfarte do miocárdio e mortalidade após cirurgia vascular, e como tal, pode fornecer informação valiosa para a prevenção e gestão atempada de eventos cardiovasculares adversos.Background: Hematological parameters, such as the red blood cell distribution width-coefficient variation (RDW-CV) and red blood cell distribution width-standard deviation (RDW-SD), have been shown to be strongly correlated with major adverse cardiovascular events and death after surgery. This study aims to investigate the association between preoperative hematological parameters and postoperative outcomes, including MI and all-cause mortality.
Methods: All adult consecutive patients submitted to elective arterial vascular surgery from January to April 2015 at a university hospital were included in this prospective observational cohort study. The primary outcome was 30-day all-cause mortality. The secondary outcome was 30-day myocardial infarction (MI).
Results: In the univariate analysis of mortality, the prevalence of atrial fibrillation, chronic kidney disease (CKD) and dependent functional status was higher in deceased patients. After multivariable analysis, age (adjusted OR 1.08, 95%CI 1.01-1.15, p=0.027) and RDW-SD (adjusted OR 1.08, 95%CI 1.01-1.16, p=0.032) remained independent predictors of mortality. In the univariate analysis of MI, the prevalence of Diabetes, CKD, dependent functional status, ASA physical status IV and insulin medication was higher in patients with postoperative MI. After multivariable analysis, dependent functional status (adjusted OR 4.8, 95%CI 1.6-15.0, p=0.007), insulin medication (adjusted OR 4.4, 95%CI 1.5-12.6, p=0.007) and RDW-SD (adjusted OR 1.10, 95%CI 1.02-1.19, p=0.020) were independent predictors of MI.
Conclusion: RDW may play an important role in the perioperative evaluation of patients submitted to vascular surgery. RDW-SD independently predicts postoperative MI and mortality, and as such, it may provide valuable information for the prevention and early management of adverse cardiovascular outcomes
Functionalization of Silica Surfaces: Influence in Naproxen Molecular Mobility and Release Profile
This work aimed to improve aqueous drug solubility by amorphization upon loading in silica porous matrixes and stabilize it in the amorphous form. Naproxen was chosen as the target material, a practically insoluble pharmaceutical drug, with anti-pyretic and anti-inflammatory properties. To evaluate the influence of guest-host interactions in the drug delivery, two silica matrixes were synthesized differing in their surface composition: unmodified MCM-41 mainly with surface silanol groups and MCM-41_Func caped with methyl groups. The surface area modification with methyl groups was confirmed by attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), thermogravimetric analysis (TGA) and nuclear magnetic resonance (NMR). Textural analysis showed narrow pore diameter distributions centered at 3.0 and 2.9 nm, respectively.
To evaluate the guest’s physical state, different techniques were used as: differential scanning calorimetry (DSC), dielectric relaxation spectroscopy (DRS) and attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy. These analyses showed that naproxen was successful incorporated in the both silica. The naproxen’s amorphization was confirmed by the DSC detection of the glass transition, located in between ~0ºC and 22ºC. However, crystallization and melting are always observed, nonetheless in low extent (~6 % of crystallization degree).
The mobility of the amorphous pharmaceutical drug incorporated inside these silica pores, was probed by DRS, allowing estimating a dielectric glass transition temperature in good agreement with the calorimetric one and revealing a higher mobility for the hydrated unmodified composite. It was shown that this mobility enhancement controls the drug delivery, monitored by ultraviolet spectroscopy, which revealed to be faster in the unmodified matrix.
The studied composites show promising behavior as controlled drug delivery systems
Habitat selection by free-roaming domestic dogs in Indonesia : rural versus urban setting
Dissertação de Mestrado Integrado em Medicina VeterináriaFree-roaming domestic dogs (FRDD) greatly impact human public health, known for playing key roles in the transmission of numerous zoonotic diseases. Dogs are responsible for 99% of human rabies cases worldwide and FRDD are particularly important as the main source for rabies transmission to humans. Dog-mediated rabies lays a heavy economic, environmental and social burden on human communities, especially on those most vulnerable. Sixty percent of dog-mediated rabies human fatalities worldwide occur in Asia with Indonesia registering, per year, the fourth highest human rabies cases number of the continent. Improved rabies control programs can be attained through the study of dogs’ movements within their available habitat. Yet, little is known about FRDD habitat requirements, particularly in Indonesia.
By analysing data on 109 FRDD in two distinct habitats, this project aimed to investigate resources meaningful to FRDD habitat selection in relation to anthropogenic and geographical characteristics in a rural and urban landscape. In particular, we assess whether FRDD select habitat resources differently according to the setting. The chosen methodology employed was spatial mixed effects logistic regression models which, by having as outcome the presence or absence of FRDD in the available habitat resources, provides insight on which resources dogs are more likely to be found and are therefore preferred.
Habitat selection by FRDD disclosed slightly different preferences according to the setting. The most sought-after resources in both study sites were the buildings and roads. Vegetation covered areas were positively associated with FRDD presence in the semi-urban, but not in the rural study site. Nevertheless, in the semi-urban area, FRDD preferred the beach over vegetation covered areas. Slope, in the rural setting, and sea, in the semi-urban area, were identified as being negatively associated with the presence of FRDD.
Although these results should not be incautiously extrapolated to other regions and should be interpreted keeping in mind the Indonesian context, these results are still novel and relevant to future rabies control actions.RESUMO - Seleção de Habitat por Cães Domésticos Errantes na Indonésia – Contexto rural versus contexto urbano - Cães domésticos errantes têm um impacto nefasto na Saúde Pública Humana, sendo cruciais na transmissão de inúmeras doenças zoonóticas. Os cães são responsáveis por 99% dos casos de raiva humana registados a nível mundial e, os cães domésticos errantes são a causa principal de transmissão de raiva para o Homem. A raiva humana transmitida por cães impõe um pesado fardo económico, social e ambiental sobre as comunidades humanas. Sessenta porcento das mortes humanas por raiva transmitida por cães ocorre na Ásia e a Indonésia regista, por ano, o quarto número mais elevado de casos de raiva humana no continente. Programas mais adequados de controlo da raiva podem ser conseguidos através do estudo sobre como os cães se movem dentro do seu habitat. No entanto, pouco ou nada se sabe sobre os requisitos de habitat dos cães domésticos errantes, em particular na Indonésia.
Através da análise de 109 cães domésticos errantes em dois habitats (ambiente rural e ambiente urbano), este projeto investigou quais os recursos significativos na seleção de habitat por estes cães. Especificamente, avaliou se a seleção de habitat por estes cães difere entre o ambiente rural e urbano. A metodologia empregue neste estudo foram modelos mistos espaciais de regressão logística que, ao utilizarem a presença/ausência do cão num determinado recurso do habitat, permitem inferir sobre quais os recursos onde os cães mais provavelmente se encontram, sendo por isso preferidos pelos mesmos.
A seleção de habitat por cães domésticos errantes revelou diferenças ligeiras de acordo com o espaço geográfico em análise. O recurso mais procurado em ambos os espaços geográficos foram os edifícios e as estradas. Áreas cobertas por vegetação estão positivamente associadas com a presença de cães no ambiente urbano, mas não em ambiente rural. No entanto, na área urbana, os cães preferiram a praia a zonas cobertas por vegetação. O declive, na área rural, e o mar, na área urbana, estão negativamente associados com a presença de cães.
Apesar destes resultados terem de ser interpretados tendo em conta o contexto indonésio e não poderem ser extrapolados incautamente para outras zonas do mundo, são ainda relevantes para ações de controlo da raiva transmitida por cães.N/
AlgaeCoat: Development of edible coatings from marine-based extracts. A Market Strategy
The present work aims to study a go-to-market strategy and validate the pilot-scale
functionality of AlgaeCoat – a marine extract with anti-browning activity – used as a post-harvest
treatment in minimally processed ‘Cripps Pink’ apple (MP apple) in order to extend its shelf-life,
while preserving its freshness and visual appeal.
Therefore, this entirely natural formulation – composed uniquely by Codium tomentosum and
distilled water – could replace synthetic additives (widely used in Food Industry) potentially
harmful for consumer’s health.
Previous research projects published by MARE-IPLeiria team (Augusto, Simões, Pedrosa, &
Silva, 2016) validated the efficacy of this solution at laboratorial level, demonstrating an
inhibitory effect of the extract over polyphenoloxidase (PPO) and peroxidase (POD) enzymes,
resulting in the reduction of apple’s browning index (BI) and also in the preservation of apple’s
mechanical properties (texture and firmness) during a 20 days’ storage, at 4 ± 2°C. However, after
scale-up, the results revealed some limitations, indicating a need for the optimization of pilotscale
extraction and application conditions.
In 2016, Europe accounted for the major share (28.1%) in the global Food Preservatives
market, registering a predicted value of US 950 million (» €792 million) by 2021, with a Compound Annual Growth Rate (CAGR) of
2.25% between 2016 and 2021.
Additionally, the demand for natural, organic foods, free of synthetic and complex ingredients,
as well as for ready-to-eat products, has been increasing and it’s expected to stimulate the
development of new, natural additives, revolutionizing Food Additives market
Spatial Analysis of Small Ruminants Brucellosis Occurrence in Trás-os-Montes and Alto Douro, 2010-2014
A hora do banho- a influência das guardas ilustradas na interpretação do albúm narrativo para crianças
Performance of healthcare organizations: contributing variables to efficiency and quality
The transition from volume-based healthcare to value-based healthcare has been the major challenge of National Health Systems. Nevertheless, some variables that might contribute to bring together healthcare professionals and healthcare challenges have been overlooked. Study A, the first of three studies, conducted in a primary healthcare setting, revealed that perceived and objective organizational performance is predicted by sense of community, which simultaneously mediates the relationship between workgroup and performance. Study B provides a definition of hospital organizational integration (HOI) by exploring which change initiatives undertaken by hospitals are contributing to healthcare integration and by explaining how these initiatives are connecting and bringing together different levels of healthcare. Study C concludes that HOI increases both sides of organizational outcomes: efficiency and quality. The study also revealed that relational coordination (RC) only produces a positive impact on quality (perceived performance) and that the influence of HOI and RC on performance is mediated by workplace spirituality and work engagement
- …