Prepresiliência das famílias com filhos deficientes

Realizing the fact that despite having a disabled child and for families that constitute a painful experience, they are able to respond positively to adversity that arise and offer risk to its homeostasis, demonstrating resilient families are afforded the preparation of this study whose objectives were: to determine the levels of resilience of families with disabled children, to analyze factors that may interfere with the levels of resilience of families with disabled children and check if there are differences between the levels of resilience of families with disabled children and families with children with serious health problems or conical. The method used in the study was a quantitative and descriptive-correlational and not experimental type. Data were collected from an accidental non-probabilistic sample of parents/families of children with disabilities or serious or chronic diseases, which constitute the two groups of households (with and without disabilities) in our sample, followed by consulting a Department of Pediatrics totaling one hundred and eighty-six. The data collection instrument used was a questionnaire. Based on the data we found that these families mostly have average levels of resilience, with no record of low levels of resilience. The family resilience is not related to family characteristics, the characteristics of the disability, family and social support available, relating only to one of the dimensions that integrates family functioning, family satisfaction. Comparing the resilience levels of the two groups of families, we found no significant difference.Perceber o facto de apesar de terem um filho deficiente e isso constituir para as famílias uma experiência penosa, estas serem capazes de responder de forma positiva às adversidades que surgem, demostrando serem famílias resilientes, originou a elaboração deste estudo, cujos objetivos foram: determinar os níveis de resiliência das famílias com filhos deficientes; analisar fatores que interferem com os níveis de resiliência das famílias com filhos deficientes e verificar se há diferença entre os níveis de resiliência das famílias com filhos deficientes e das famílias com filhos com problemas de saúde graves ou cónicos. O método utilizado na pesquisa foi do tipo quantitativo, descritivo-correlacional e não experimental. Os dados foram colhidos junto de uma amostra não probabilística acidental de pais/famílias de crianças com deficiência ou doenças graves ou crónicas, que constituíram os dois grupos de famílias (com e sem deficiência) da nossa amostra, acompanhadas na consulta de um Serviço de Pediatria, num total de cento e oitenta e seis. O instrumento de colheita de dados utilizado foi o questionário. Com base nos dados obtidos constatámos que estas famílias têm maioritariamente níveis de resiliência médios, não havendo registo de níveis de resiliência baixos. A resiliência familiar não se encontra relacionada com as características familiares, as características da deficiência e o suporte familiar e social disponível, relacionando-se apenas com uma das dimensões que integra o funcionamento familiar, a satisfação familiar. Comparando os níveis de resiliência dos dois grupos de famílias, constatámos não haver diferença significativa

Resiliencia das famílias com filhos deficientes

Realizing the fact that despite having a disabled child and for families that constitute a painful experience, they are able to respond positively to adversity that arise and offer risk to its homeostasis, demonstrating resilient families are afforded the preparation of this study whose objectives were: to determine the levels of resilience of families with disabled children, to analyze factors that may interfere with the levels of resilience of families with disabled children and check if there are differences between the levels of resilience of families with disabled children and families with children with serious health problems or conical. The method used in the study was a quantitative and descriptive-correlational and not experimental type. Data were collected from an accidental non-probabilistic sample of parents/families of children with disabilities or serious or chronic diseases, which constitute the two groups of households (with and without disabilities) in our sample, followed by consulting a Department of Pediatrics totaling one hundred and eighty-six. The data collection instrument used was a questionnaire. Based on the data we found that these families mostly have average levels of resilience, with no record of low levels of resilience. The family resilience is not related to family characteristics, the characteristics of the disability, family and social support available, relating only to one of the dimensions that integrates family functioning, family satisfaction. Comparing the resilience levels of the two groups of families, we found no significant difference.Perceber o facto de apesar de terem um filho deficiente e isso constituir para as famílias uma experiência penosa, estas serem capazes de responder de forma positiva às adversidades que surgem, demostrando serem famílias resilientes, originou a elaboração deste estudo, cujos objetivos foram: determinar os níveis de resiliência das famílias com filhos deficientes; analisar fatores que interferem com os níveis de resiliência das famílias com filhos deficientes e verificar se há diferença entre os níveis de resiliência das famílias com filhos deficientes e das famílias com filhos com problemas de saúde graves ou cónicos. O método utilizado na pesquisa foi do tipo quantitativo, descritivo-correlacional e não experimental. Os dados foram colhidos junto de uma amostra não probabilística acidental de pais/famílias de crianças com deficiência ou doenças graves ou crónicas, que constituíram os dois grupos de famílias (com e sem deficiência) da nossa amostra, acompanhadas na consulta de um Serviço de Pediatria, num total de cento e oitenta e seis. O instrumento de colheita de dados utilizado foi o questionário. Com base nos dados obtidos constatámos que estas famílias têm maioritariamente níveis de resiliência médios, não havendo registo de níveis de resiliência baixos. A resiliência familiar não se encontra relacionada com as características familiares, as características da deficiência e o suporte familiar e social disponível, relacionando- se apenas com uma das dimensões que integra o funcionamento familiar, a satisfação familiar. Comparando os níveis de resiliência dos dois grupos de famílias, constatámos não haver diferença significativa

Cardiovascular complications related to cocaine use: case report

BACKGROUND AND OBJECTIVES: Cocaine is the most commonly used illicit drug and its acute and chronic effects are related to a variety of physiological changes, mainly in the cardiovascular system. This study is a case report of a patient with cardiomyopathy related to cocaine use. CASE REPORT: A 19 year old men, who has been using cocaine and crack since 15 years old, was admitted to the emergency department (ED) in February 2006 with progressive dyspnea during minimal efforts and bloody expectoration. During the physical exam it was observed legs edema, jugular stasis and dyspnea at rest. The echocardiogram demonstrated left ventricular hypocinesia, a 17 mm ventricular thrombus and a 12% ejection fraction. A bleeding from the left upper lobe was identified during a pulmonary bronchoscopy which was treated with arterial embolization. After 48h of the procedure, the patient was asymptomatic and an antithrombotic treatment with warfarin and enoxaparin was started. No obstruction was found at the cineangiography and the patient was discharged after clinical improvement. The patient was admitted again to the intensive care unit in July with intense chest pain and dyspnea at rest. A new cineangiography was performed and it was observed occlusion in the anterior descendent coronary artery. CONCLUSIONS: The cocaine acute effects are commonly seen at the ED but the chronic effects, as the cardiovascular manifestations, can take longer to be correlated as a side effect of cocaine use. Its prolonged use is related to left ventricular systolic dysfunction due to hypertrophy or myocardial dilation, atherosclerosis, arrhythmias, myocyte apoptosis and sympathetic damage.JUSTIFICATIVA E OBJETIVOS: A cocaína é uma droga ilícita amplamente utilizada e o seu uso tem sido associado a efeitos decorrentes da toxicidade aguda e crônica em praticamente todos os órgãos, particularmente no sistema cardiovascular. Este artigo visou descrever um caso de cardiomiopatia em paciente jovem usuário crônico de cocaína. RELATO DO CASO: Paciente do sexo masculino, 19 anos, usuário de cocaína por inalação e crack desde os 15 anos de idade. Foi internado em fevereiro de 2006 devido a dispnéia progressiva aos mínimos esforços e expectoração sanguinolenta. Ao exame físico apresentava edema nos membros inferiores, estase jugular e dispnéia em repouso. Foram observados no ecocardiograma: dilatação das quatro câmaras cardíacas, com hipocinesia difusa de ventrículo esquerdo (VE), trombo mural em VE de 17 mm e fração de ejeção de 12%. Realizada broncoscopia pulmonar que identificou sangramento em língula ativo, tratado com embolização. Após 48h do procedimento, o paciente manteve-se assintomático e sem expectoração sanguinolenta. Iniciado tratamento antitrombótico com warfarina e enoxaparina. A cineangiocoronariografia não evidenciou lesões obstrutivas e o paciente recebeu alta após melhora clínica. Re-internado em julho de 2006 com dor precordial de forte intensidade e dispnéia de repouso. Nova cineangiocoronariografia evidenciou oclusão de terço médio da artéria descendente anterior. CONCLUSÕES: Os efeitos agudos da cocaína freqüentemente motivam atendimento de emergência. Já as suas manifestações crônicas, como as doenças cardiovasculares, podem produzir alterações de difícil correlação futura ao seu consumo prévio. O uso prolongado da cocaína está relacionado à alteração da função sistólica ventricular esquerda por hipertrofia ou dilatação miocárdica, aterosclerose, disritmias cardíacas, apoptose de cardiomiócitos e lesão simpática.UNIFESPUniversidade São FranciscoUNIFESPSciEL

Single nucleotide polymorphisms from Theobroma cacao expressed sequence tags associated with witches' broom disease in cacao

In order to increase the efficiency of cacao tree resistance to witches¿ broom disease, which is caused by Moniliophthora perniciosa (Tricholomataceae), we looked for molecular markers that could help in the selection of resistant cacao genotypes. Among the different markers useful for developing marker-assisted selection, single nucleotide polymorphisms (SNPs) constitute the most common type of sequence difference between alleles and can be easily detected by in silico analysis from expressed sequence tag libraries. We report the first detection and analysis of SNPs from cacao-M. perniciosa interaction expressed sequence tags, using bioinformatics. Selection based on analysis of these SNPs should be useful for developing cacao varieties resistant to this devastating disease. (Résumé d'auteur

Modelling of smart irrigation with replan and redistribution algorithms

It is a priority develop intelligent irrigation systems to save water. Using optimal control formulations and techniques, the water consumption can be made to follow more closely the hydrological needs of the crop, taking into account current weather conditions. Here, the mathematical model presented by the authors in previous publications is improved. This new model incorporates new features like the slope of the soil, the possibility to include a percentage of water losses due to runoff, and a percentage of water losses if the soil is on the field capacity. A new and efficient replan strategy is applied tacking into account the data measured from moisture sensors, to ensure that hydric needs of the crop is fulfilled. A new approach to deal with multiple irrigation points is also proposed. It allows to redistribute the available water in the case an irrigation point is not able to provide the water needed.FEDER/COMPETE/NORTE2020/POCI/FCT funds through grants [UID/EEA/-00147/20 13/UID/IEEA/00147/ 006933-SYSTEC], project, To CHAIR – [POCI-01-0145-FEDER028247] and [UPWIND - POCI-FEDER-FCT -31447]. This work was also supported by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding [UID/FIS/04650/2019], [UIDB/00013/2020] and [UIDP/00013/2020 of CMAT-UM]

Analysis of EGFR Overexpression, EGFR gene amplification and the EGFRvIII Mutation in portuguese high-grade gliomas

Background: Patients with malignant gliomas do not respond to any current therapy. Epidermal growth factor receptor (EGFR) controls several oncogenic processes, being frequently up-regulated in gliomas due to overexpression, gene amplification and gene mutation. EGFR inhibitors are being tried in gliomas, yet the molecular determinants of therapeutic response are unclear. Materials and Methods: EGFR overexpression, EGFRvIII mutation and EGFR amplification were determined by immunohistochemistry and chromogenic in situ hybridization (CISH) in 27 primary glioblastomas (GBM), 24 anaplastic oligodendrogliomas (AO) and four anaplastic oligoastrocytomas (AOA). Results: EGFR overexpression was associated with EGFR amplification, being found in 48% and 53% GBM, 33% and 40% AO and 75% and 67% AOA, respectively. EGFRvIII was found in 22% GBM, 8% AO and was absent in AOA. No association was observed between EGFR alterations and patient survival. Conclusion: We characterized, for the first time, EGFR molecular alterations in Portuguese patients with malignant glioma and identified a subpopulation of patients presenting putative biomarkers for EGFR-based therapies

Intensive care of postoperative patients in bariatric surgery

BACKGROUND AND OBJECTIVES: Obesity is an epidemic disease reaching more than 300 million people all over the world. Its prevalence has increased during the past few years and according to some studies its mortality in the critically ill patient seems to be much higher, especially among patients who were submitted to surgery. This study has as objective to discuss some particularities of managing obese patients in the intensive care unit after bariatric surgery. CONTENTS: The rate of obese patient in the ICU ranges from 9% to 26% and the increase in the number of bariatric surgeries has raised the number of obese patients in the ICU. It is important to know the physiopathology of obesity and to treat its particularities during the postoperative care. Such as pulmonary restriction, that causes an increase in pulmonary complications, coronary artery disease and thromboembolic events. CONCLUSIONS: The number of patients that undergo to bariatric surgery has increased; therefore, the number of obese patients in the ICU has also risen. Different physiological events and complications in obese patients are challenges to clinical practice. The knowledge of obese physiopathology helps in the managing routine procedures and complications after bariatric surgery.JUSTIFICATIVA E OBJETIVOS: A obesidade é considerada uma epidemia e afeta mais de 300 milhões de pessoas no mundo. A sua prevalência vem aumentando significativamente nos últimos anos e a mortalidade do paciente obeso crítico, em alguns estudos, mostra-se maior, especialmente em pacientes cirúrgicos que necessitam de UTI. Este estudo teve como objetivo ressaltar as particularidades das condutas em Medicina Intensiva no pós-operatório do paciente obeso submetido à cirurgia bariátrica. CONTEÚDO: A taxa dos pacientes obesos na UTI é de 9% a 26% e o aumento no número de cirurgias bariá­tricas tem elevado o fluxo de obesos internados em UTI. A obesidade tem várias particularidades fisiopatológicas que devem ser conhecidas para melhor manuseio pós-operatório. Entre elas estão as restrições pulmonares, que leva ao aumento do número de complicações, o fator de risco para síndrome coronariana aguda eventos trombóticos. CONCLUSÕES: O número de pacientes submetidos à cirurgia bariátrica está aumentando, o que leva a maior número de pacientes obesos internados na UTI. As alterações fisiológicas da obesidade, juntamente com as complicações de um paciente crítico, são desafios para a prática médica. Portanto, é relevante conhecer a fisiopatologia da obesidade, o tratamento rotineiro das complicações no pós-operatório de cirurgia bariátrica.UNIFESP Clínica MédicaClínica Médica da UNIFESP UTIAMIB-AMBInstituto Dante Pazzanese de CardiologiaUNIFESP, Clínica MédicaClínica Médica da UNIFESP, UTISciEL

Monocytes as Endothelial Progenitor Cells (EPCs), Another Brick in the Wall to Disentangle Tumor Angiogenesis

The project was funded by IPOLFG, EPE, by iNOVA4Health (UID/Multi/04462/2019) a program financially supported by Fundação para a Ciência e Tecnologia/Ministério da Educação e Ciência, through national funds and co-funded by FEDER under the PT2020 Partnership Agreement and by Fundação para a Ciência eTecnologia (PhD student fellowship: PD/BD/128337/2017).Bone marrow contains endothelial progenitor cells (EPCs) that, upon pro-angiogenic stimuli, migrate and differentiate into endothelial cells (ECs) and contribute to re-endothelialization and neo-vascularization. There are currently no reliable markers to characterize EPCs, leading to their inaccurate identification. In the past, we showed that, in a panel of tumors, some cells on the vessel wall co-expressed CD14 (monocytic marker) and CD31 (EC marker), indicating a putative differentiation route of monocytes into ECs. Herein, we disclosed monocytes as potential EPCs, using in vitro and in vivo models, and also addressed the cancer context. Monocytes acquired the capacity to express ECs markers and were able to be incorporated into blood vessels, contributing to cancer progression, by being incorporated in tumor neo-vasculature. Reactive oxygen species (ROS) push monocytes to EC differentiation, and this phenotype is reverted by cysteine (a scavenger and precursor of glutathione), which indicates that angiogenesis is controlled by the interplay between the oxidative stress and the scavenging capacity of the tumor microenvironment.publishersversionpublishe

Cost Analysis Of Multiple Sclerosis In Brazil: A Cross-sectional Multicenter Study

Multiple sclerosis (MS) is a central nervous system disease associated with irreversible progression of disability, which imposes a substantial socioeconomic onus. The objective of this study was to determine the economic impact of multiple sclerosis from the Brazilian household and healthcare system perspectives. Secondary objectives were to assess the impact of fatigue on daily living and health-related quality of life (HRQL) of MS patients. Methods: This is a cross-sectional study in which Brazilian eligible patients attending eight major MS specialized sites answered an interview capturing data on demographics, disease characteristics and severity, comorbidities, resource utilization, fatigue, utilities and health-related quality of life from November/2011 to May/2012. Costs were assessed considering a prevalence-based approach within 1 year of resource consumption and were estimated by multiplying the amount used by the corresponding unit cost. Patients were classified as having mild, moderate or severe disability according to the Expanded Disability Status Scale (EDSS). Results: In total, 210 patients who met eligibility criteria were included, 40 % had mild, 43 % moderate and 16 % severe disability; disability level was missing for 1 %. The average total direct cost per year was USD 19,012.32 (SD = 10,465.96), and no statistically significant differences were not observed according to MS disability level (p = 0.398). The use of disease modifying therapies (DMTs) corresponded to the majority of direct expenditures, especially among those patients with lower levels of disability, representing around 90 % of total costs for mild and moderate MS patients. It was also observed that expenses with medical (except DMTs) and non-medical resources are higher among patients with more severe disease. Worsening disability also had an important influence on health-related quality of life and self-perceived impact of fatigue on daily living. Conclusion: Our data demonstrates the significant economic impact of MS on both Brazilian household and health system, in terms of DMTs and other disease management costs. When patients move upwards on the disease severity scale, costs with health resources other than drugs are significantly increased.16Novartis Biociencias S.A

Advanced electrically conductive adhesives for high complexity PCB assembly

Electronic packaging, or assembly of packed electronic components on printed circuit boards, present challenges that require innovative solder pastes and electrically conductive adhesives to face the increasing complexity of PCB assembly, with denser board occupation and demanding thermal management during assembly. Our aim is to prepare carbon particle based conductive adhesives. The first step to achieve this goal was to prepare composites with epoxy resin and a variety of nano to micron scale carbon particle, produced by mixing on a three roll mill. The percolation threshold for each particle type was determined as well as the conductivity level reached after percolation.This research is sponsored by the Portugal Incentive System for Research and Technological Development. Project in co-promotion nº 002814/2015 (iFACTORY 2015-2018)