Hypocalcaemia as a Reversible Cause of Acute Heart Failure in a Long-Term Survivor of Childhood Cancer

Hypocalcaemia is known for its neuromuscular symptoms, which are rapidly alleviated by intravenous supplementation. Calcium is also essential for both cardiac cell excitability and contraction. We present a case of acute heart failure due to hypocalcaemia in a young male with a complex medical history

Significados de trabalho em pessoas com dificuldades intelectuais e desenvolvimentais: emprego protegido vs emprego normal

Tese de doutoramento, Psicologia, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2015O principal objetivo desta pesquisa foi estudar o significado do trabalho e relações sociais pessoais de pessoas com Dificuldades Intelectuais e Desenvolvimentais (DID). Consideraram-se diferenças de resultados em função das variáveis demográficas género e tipologia de emprego (emprego protegido e emprego normal). Foram entrevistados 40 participantes integrados em regime de emprego protegido e em regime de emprego normal. As respostas a entrevistas semiestruturadas foram analisadas usando a Consensual Qualitative Research (Hill, Thompson, & Williams, 1997). Os resultados evidenciaram oito domínios referentes ao significado do trabalho na vida das pessoas com DID: (1) Conceções de trabalho; (2) Razões para trabalhar; (3) O que aprendeu com a família sobre trabalho; (4) Satisfação face ao trabalho; (5) Insatisfação face ao trabalho; (6) Barreiras da carreira; (7) Apoios da carreira; (8) Planos de carreira. Sobressaem igualmente quatro domínios relativos às relações pessoais das pessoas com DID: (1) Relações pessoais e trabalho; (2) Relações pessoais e família; (3) Relações Pessoais no geral; (4) Convívio nos tempos livres. Os resultados revelaram que, tipicamente, as pessoas com DID salientam o conceito e importância do trabalho associado ao facto deste promover autonomia, independência, subsistência do próprio e da família, autonomia financeira, sentimento de utilidade, bem-estar, ocupação e rotina (Resultado), traduzindo as aprendizagens que fizeram com os seus familiares significativos. Á semelhança das pessoas em geral, o estudo reenvia para a centralidade do trabalho na pessoa com DID, que decorre do facto do trabalho facilitar a autodeterminação, cumprindo igualmente necessidades de sobrevivência. Já os resultados do estudo das relações sociais pessoais salientam a importância do trabalho enquanto contexto de promoção da inclusão social. Os relacionamentos e o convívio estabelecidos com os colegas de trabalho contribuem para combater o isolamento social e promover sentimento de pertença, sendo a única oportunidade de interação social para algumas destas pessoas. Em ambos os estudos não se observam diferença relevantes de género e de tipologia de emprego

Da formação para o mundo real do trabalho: o papel mediador do suporte social na avaliação da eficácia da formação

ProjectoO presente estudo tem como principal objectivo contribuir para o conhecimento de factores que podem afectar a eficácia da formação. Assim, após apresentar-se uma revisão bibliográfica aprofundada sobre esta temática, reforçou-se a importância de cinco factores, que na literatura, se demonstraram determinantes na avaliação da eficácia da formação e consequentemente da sua transferência para o local de trabalho – Percepção da validade do conteúdo; Design da transferência; Suporte Social; Motivação para melhorar o trabalho através da aprendizagem e Transferência positiva. Neste estudo participaram 202 colaboradores da Empresa AXA seguros Portugal, de ambos os sexos e com idades compreendidas entre os 18 e os 60 anos, que tiveram formação nesta organização, e que ao responderem ao questionário de autopreenchimento proposto neste estudo, permitiram que, empiricamente, este evidencia-se a relação dos factores referidos anteriormente. Ou seja, a relação entre a Percepção da validade do conteúdo e o Design da transferência com a Motivação para melhorar o trabalho através da aprendizagem, sendo que nestas relações evidenciou-se também o papel mediador do Suporte Social; e a relação entre a Motivação para melhorar o trabalho através da aprendizagem e a Transferência positiva. Os resultados obtidos através deste estudo permitem, assim, um enriquecimento da literatura e evidenciam estratégias que permitem aumentar a eficácia da formação nas organizações.The present study has as main objective to contribute to the knowledge of factors that may affect the effectiveness of training. Thus, after presenting a thorough review of the literature on this subject, it was reinforced the importance of five factors, which in the literature proved to be crucial in assessing the effectiveness of training and hence its transfer to the workplace - Perception of the content validity, Transfer design, Social Support, Motivation to improve work through learning and positive transfer. This study involved 202 employees of the insurance company AXA Portugal, of both sexes and aged between 18 and 60, who had training in this organization and who responded to a self-report questionnaire proposed, which allowed that the study, empirically, shows the relationship of the factors mentioned above. That is the relationship between the perception of the validity of the content and transfer design with the motivation to improve work through learning. This relationship also demonstrates the mediating role of social support and the relationship between motivation to improve work through learning and positive transfer. Thusly, the results obtained in this study allow an enrichment of the literature and evidence strategies to increase the effectiveness of training in organizations

Effect of saline load and metoclopramide on the renal dopaminergic system in patients with heart failure and healthy controls

Dopamine of renal origin has natriuretic/diuretic actions by activating D-1-like receptors of the nephron. Saline load increases renal dopamine production and natriuresis in healthy subjects, and, under these conditions, the activation of D-2-like receptors also produces natriuresis/diuresis. Metoclopramide is a D-2-like receptor antagonist. Patients with heart failure (HF) have an increased renal dopamine-synthesizing efficiency. However, the effect of salt loading was not explored in HE We hypothesized that HF patients respond to salt loading with increased production of renal dopamine and that metoclopramide antagonizes this response. This was a randomized, controlled, crossover study exploring the effect of NaCl and metoclopramide on renal dopaminergic, sympathetic, renin-angiotensin-aldosterone, and arginine-vasopressin (AVP) systems activity on sodium handling in 9 HF patients and 9 controls. NaCl markedly increased renal dopamine production and natriuresis in both groups. Metoclopramide blunted these responses in HF patients but not in controls. NaCl decreased renin and aldosterone plasma levels in controls but not in HF patients. In these patients B-type natriuretic peptide (BNP) levels increased, but AVP was not affected. HF patients respond to salt loading with increased natriuresis. However, the mechanisms for this response are different from those found in healthy subjects. Metoclopramide has antinatriuretic effects only in HF patients

Indirect calibration between clinical observers - application to the New York Heart Association functional classification system

<p>Abstract</p> <p>Background</p> <p>Previous studies showed an inter-observer agreement for the NYHA classification of approximately 55%. The aim of this study was to calibrate the New York Heart Association (NYHA) classification system between observers, increasing its reliability.</p> <p>Results</p> <p>Among 1136 community-dwellers in Porto, Portugal, aged ≥ 45 years, 265 reporting breathlessness answered a 4-item questionnaire to characterize symptom severity. The questionnaire was administered by 7 physicians who also classified the subject's functional capacity according to NYHA. Each subject was assessed by one physician. We calibrated NYHA classifications by the concurrent method, using 1-parameter logistic graded response model. Discrepancies between observers were assessed by differences in ability thresholds between NYHA classes I-II and II-III. The ability estimated by the model was used to predict the NYHA classification for each observer.</p> <p>Estimates of the first and second thresholds for each observer ranged from -1.92 to 0.46 and from 1.42 to 2.30, respectively. The agreement between estimated ability and the observers' NYHA classification was 88% (kappa = 0.61).</p> <p>Conclusions</p> <p>The study objectively indicates the main reason why several studies have reported low inter-observer is the existence of discrepant thresholds between observers in the definition of NYHA classes. The concurrent method can be used to minimize the reliability problem of NYHA classification.</p

Identidade e sexualidade na pessoa com debilidade

Dissertação de Mestrado em Psicopatologia e Psicologia ClínicaInexistent

Knockdown of STEAP1 inhibits cell growth and induces apoptosis in LNCaP prostate cancer cells counteracting the effect of androgens

Six transmembrane epithelial antigen of the prostate 1 (STEAP1) is overexpressed in numerous types of tumors, especially in prostate cancer. STEAP1 is located in the plasma membrane of epithelial cells and may play an important role in inter- and intracellular communication. Several studies suggest STEAP1 as a potential biomarker and an immunotherapeutic target for prostate cancer. However, the role of STEAP1 in cell proliferation and apoptosis remains unclear. Therefore, the role of STEAP1 in prostate cancer cells proliferation and apoptosis was determined by inducing STEAP1 gene knockdown in LNCaP cells. In addition, the effect of DHT on the proliferation of LNCaP cells knocked down for STEAP1 gene was evaluated. Our results demonstrated that silencing the STEAP1 gene reduces LNCaP cell viability and proliferation, while inducing apoptosis. In addition, we showed that the cellular and molecular effects of STEAP1 gene knockdown may be independent of DHT treatment, and blocking STEAP1 may reveal to be an appropriate strategy to activate apoptosis in cancer cells, as well as to prevent the proliferative and anti-apoptotic effects of DHT in prostate cancer.SCOPUS: ar.jinfo:eu-repo/semantics/publishe