Ocular and systemic risk markers for development of macular edema and proliferative retinopathy in Type 2 Diabetes : a five-year longitudinal study

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020Objetivo: Comparar o valor preditivo relativo de marcadores de risco sistémicos e oculares no desenvolvimento de edema macular diabético (EMD), considerando o edema macular clinicamente significativo (EMCS) e o edema com envolvimento do centro da mácula (EECM), e da retinopatia diabética proliferativa (RDP) em pessoas com diabetes mellitus tipo 2 (DM2). Plano da investigação e métodos: Pacientes com DM2 e retinopatia diabética não proliferativa ligeira foram seguidos prospectivamente durante um período de 5 anos. Realizaram-se exames à data de início, 6 meses após primeira visita e anualmente (melhor acuidade visual corrigida, fotografia do fundo ocular a cores e tomografia de coerência ótica). Progressão foi definida pelo desenvolvimento de um dos subtipos de EMD (EMCS e EECM) ou RDP. Avaliaram-se marcadores de risco sistémicos e oculares. Resultados: Dos 212 olhos/doentes com DM2 incluídos no estudo, 172 foram seguidas por um período de 5 anos ou até ao desenvolvimento de uma das complicações - 27 desenvolveram EMD ou RDP. Relativamente ao EMCS e à RDP, um valor mais alto de HbA1c foi o fator de risco sistémico mais importante. A análise multivariada incluindo os marcadores de risco oculares e a HbA1c revelou que o Turnover de microaneurismas (TAM) (HR:1,03; p<0.018) e a espessura central da retina (ECR) (HR:1,08; p<0,003) estavam associados a um aumento significativo da probabilidade do desenvolvimento de EMCS e/ou RDP, sendo que a ECR foi o único marcador de risco para EECM (HR:1,17; p<0,001). Conclusões: Neste estudo longitudinal de 5 anos de olhos com retinopatia ligeira em pessoas com DM2, o risco de desenvolver complicações visuais associou-se a marcadores de risco oculares, tais como TAM e ECR, enquanto a HbA1c foi o marcador sistémico identificado mais relevante.Objective: To compare the relative predictive value of ocular and systemic risk markers of development of diabetic macular edema (DME), considering both clinically significant macular edema (CSME) and center involved macular edema (CIME), and proliferative retinopathy (PDR) in persons with type 2 diabetes (T2D). Research Design and Methods: Patients with T2D and mild nonproliferative retinopathy (NPDR) were followed prospectively for a 5-year period. Examinations were performed at baseline, 6 months after first visit and annually (best corrected visual acuity, color fundus photography and optical coherence tomography (OCT)). Progression was identified by the development of the two subtypes of DME (CSME and CIME) or PDR. Systemic and ocular risk markers were evaluated. Results: Of the 212 eyes/patients with T2D included in the study, 172 were followed over a 5-year period or until the development of a study outcome. Twenty-seven developed DME or PDR. Regarding CSME and PDR development, a higher HbA1c was the most important systemic risk factor. A multivariate analysis including ocular risk markers and HbA1c revealed that Microaneurysm Turnover (MAT) (HR:1.03; p<0.018) and central retinal thickness (CRT) (HR:1.08; p<0.003) were significantly associated with an increased likelihood of development of CSME and/or PDR, with CRT measurements being the only risk marker for CIME (HR:1.17; p<0.001). Conclusions: In a 5-year longitudinal study of eyes with mild diabetic retinopathy, the risk of developing vision-threatening complications was associated with ocular risk markers such as MAT and CRT. HbA1c remained the most relevant systemic marker identified

Valorisation of Phosphorus-Saturated Constructed Wetlands for the Production of Sugarcane

Constructed wetlands (CW) are a clean and environmentally friendly alternative to conventional wastewater treatment methods, namely in the removal of the nutrients responsible for the eutrophication of receiving water bodies, as is the case of phosphorus compounds. The materials used as CW filling can directly contribute to the removal of phosphorus compounds from wastewater, but with the operating time they tend to become saturated and treatment efficiency decreases. In order to evaluate the viability of producing an energy crop in phosphorus-saturated CW, sugarcane growth was monitored in two pilot-scale CW filled with two different expanded clay aggregates used for 10 years in wastewater treatment. This paper presents the results obtained during the first year of plant development in the plant-cane cycle. Morphologic aspects of sugarcane growth, such as height and average diameter of stems, average leaf area and number of new sprouts, have been monitored. The results obtained are comparable with those cited in the literature for traditional cultivation. Dry biomass productivity of 26.6 ton per hectare per year can be achieved. Estimated sucrose productivity can reach 13.5 ton per hectare per year, and related bioethanol production potential can be between 2.4 and 7.6 cubic meters per hectare per year, depending on the CW filter media used. It is concluded that the cultivation of sugarcane in CW allows to extend the life of these systems by reusing fillers, and simultaneously is an alternative to produce bioethanol raw-material without the use of scarce resources such as arable land, fresh water and plant nutrients

Descriptive analysis of online roulette gamblers: segmentation of different gamblers based on their behavior using data mining algorithms

Dissertation presented as the partial requirement for obtaining a Master's degree in Data Science and Advanced Analytics, specialization in Data ScienceThe popularity of gambling activities has been increasing over the last decades, with onlinebased gambling being a key driver of its growth due to the ease of accessing online platforms. Consequently, there is a severe concern that the negative social impact of gambling arises, and regulatory agencies are identifying and managing those effects. In this context, a potential solution to address those effects is based on the concept of 'Responsible Gambling', which means playing consciously, with complete control of time and money. The present study aims to segment online gamblers based on their playing behaviors, differentiating groups as much as possible and ultimately identifying a cluster with players of concern. This is achieved using unsupervised learning algorithms such as K-Means, Hierarchical Clustering, or Self-Organizing Maps. The information on which this project is based reflects the activity on some of the Portuguese online gambling platforms over 2019. Available data covers multiple aspects such as the gambling institution, type of gambling, player identification, each player's total bets, and the following outcomes of it

Tumor fibroso localizado da pleura: análise de 11 novos casos

ABSTRACTWe present a retrospective revision of a pathology, rare in his incidence (5% of the pleural tumours) and singular in his characteristics, analyzing the presentation forms, surgical treatment and results.The solitary tumours of the pleura are a rare entity, whose biological behaviour is not related with immunohistochemical characteristics; although considered benign, they present sensitive recidivation index and metastization, independently of the volume that they present.The surgery is the only available treatment, and complete surgical excision is decisive.From August 1995 to January 2003, in the casuistry of the Department of Cardiothoracic Surgery in Santa Marta’s Hospital, were analyzed all the patients with the diagnosis of localized fibrous tumour of the pleura (TFLP). In this context, were identified 11 patients with a medium age of 57,54 years old, 6 of them females, in which the diagnosis of located fibrous tumour of the pleura was established; 6 of the tumours were classified as malignant.All the patients were submitted to surgical excision, with different techniques, without significant intra-operative mortality or intra-hospital morbidity, despite the difficulty of surgery in the most voluminous tumours (one of the tumours weight was 2,5 kg).The follow up elapsed between 4 and 84 months (average – 39,4 months).One patient died 13 months after the surgery, after several crises of lung embolism (that began without determinable relationship with the surgery or the initial pathology), despite the controlled ambulatory anti-coagulation.REV PORT PNEUMOL 2003; IX (6): 493-50

Fitness profiles of elite Portuguese rugby union players

The aim of this study was to describe the fitness profiles of senior elite Portuguese rugby players. Forty-six senior Portuguese rugby players, classified as backs (n=22; age 26.2±2.8) and forwards (n=24; age 26.7±2.9) were assessed during physical testing sessions carried out for the Portuguese National rugby team. The body composition, maximum strength and anaerobic capacity of players are hypothesized to be important physical characteristics as successful performance in rugby is predicated on the ability to undertake skilled behaviours both quickly and whilst withstanding large forces when in contact situations. No absolute differences were found between the backs and forwards for the speed performance variables although positional differences were found across all speeds when assessed relative to body mass since the forwards were significantly heavier. Coaches and the management team can use this information for monitoring progressive improvements in the physiological capacities of rugby players. These physical characteristics of elite rugby players provide normative profiles for specific positions and should form the basis of developmental programmes for adolescents