Retrospective evaluation of implant-supported overdenture treatments: prosthetic complications

Objectives: The objectives of this work are to determine the prevalence of prosthetic complications in implant-supported overdentures, and to compare the maintenance needs of retentive bar-clip and independent abutment systems.Methods: Thirty-seven patients, with 43 implant-supported overdentures (23 maxillary and 20 mandibular) with different retention systems (bar-clip and independent abutments), were clinically evaluated. The total number of maintenance visits and their causes were taken from the clinical file of patients and were evaluated retrospectively. Statistical analysis was done with IBM (R) SPSS (R) vs.22.0 software, considering alpha = 0.05 and using Fisher exact test, Mann-Whitney test and Spearman correlation.Results: Treatments with implant-supported overdentures present a high frequency of prosthetic complications: substitution of retainers (79.1%), overdenture repair or rebasing (53.5%), gingival hyperplasia (34.9%), tightening or fractured screws (20.9%), replacement of the prosthesis (16.3%), changing of retentive system (9.3%) and infrastructure fracture (4.7%). There are significant associations with bar system for gingival hyperplasia and for replacing clips, and with location in the maxilla for replacement of prosthesis and retainers. There are no differences between retentive systems for the number of annual visits.Conclusions: Prosthetic long-term evaluation of treatment with implant overdentures can provide useful guidance to the dentist in the selection of the number of supporting implants, the retentive system and the design of the removable prosthesis.info:eu-repo/semantics/publishedVersio

Proteolytic systems and AMP-activated protein kinase are critical targets of acute myeloid leukemia therapeutic approaches

The therapeutic strategies against acute myeloid leukemia (AML) have hardly been modified over four decades. Although resulting in a favorable outcome in young patients, older individuals, the most affected population, do not respond adequately to therapy. Intriguingly, the mechanisms responsible for AML cells chemoresistance/ susceptibility are still elusive. Mounting evidence has shed light on the relevance of proteolytic systems (autophagy and ubiquitin-proteasome system, UPS), as well as the AMPK pathway, in AML biology and treatment, but their exact role is still controversial. Herein, two AML cell lines (HL-60 and KG-1) were exposed to conventional chemotherapeutic agents (cytarabine and/or doxorubicin) to assess the relevance of autophagy and UPS on AML cells’ response to antileukemia drugs. Our results clearly showed that the antileukemia agents target both proteolytic systems and the AMPK pathway. Doxorubicin enhanced UPS activity while drugs’ combination blocked autophagy specifically on HL-60 cells. In contrast, KG-1 cells responded in a more subtle manner to the drugs tested consistent with the higher UPS activity of these cells. In addition, the data demonstrates that autophagy may play a protective role depending on AML subtype. Specific modulators of autophagy and UPS are, therefore, promising targets for combining with standard therapeutic interventions in some AML subtypes.We would like to acknowledge Dr. Agostinho Carvalho and Dr. Manuel Guerreiro (Hospital da Arrabida, Vila Nova de Gaia, Portugal) for the critical review and discussion of the manuscript and for the work support. This work was supported by FCT - Fundacao para a Ciencia e Tecnologia (PTDC/BIA-MIC/114116/2009). A.F., O.P. and B.S.M. have fellowships from FCT (SFRH/BD/51991/2012, SFRH/BD/52292/2013, and SFRH/BPD/90533/2012, respectively). M.M.A. was supported by CCDR-N (QREN) in the scope of the project "Integration of cutting-edge health science research and ground-breaking technologies for the development of new clinically useful therapies, tissue regeneration strategies, advanced prophylactic measures and diagnosis methods - (N-01-01-01-24-01-07) - RL5" (UMINHO/BI/245/2013)

Depressão e ideação suicida na adolescência: implementação e avaliação de um programa de intervenção

Objective: To develop, implement and evaluate a suicide prevention program aimed at adolescents.Material and Methods: A quasi-experimental study, before and after, with adolescents from an educational institution in São Luís, Maranhão, Brazil. The study followed the stages of development, implementation and evaluation of a suicide prevention intervention program. Three assessment instruments were administered before and after the intervention: Beck's Suicidal Ideation Scale; Beck's Depression Inventory and Beck's Hopelessness Scale. Results: Before the intervention, 102 adolescents participated, 30 (29.4%) had suicidal ideation and depressive symptoms. After the intervention the instruments were applied to the 30 selected adolescents, 12 (40.0%) continued with ideation. Prior to intervention, the average Depression Inventory was 23.83 and then 7.17 (p <0.0001). As for hopelessness, the average obtained before was 7.23 and then 2.17 (p <0.0001); Regarding suicidal ideation, the average obtained before was 10.50 and then 2.57 (p <0.0001). Conclusion: There was a decrease in depressive symptoms, hopelessness and suicidal ideation after the implementation of the elaborated intervention program.Objetivo: Desarrollar, implementar y evaluar un programa de prevención del suicidio dirigido a adolescentes.Materiales y Métodos: Estudio cuasi experimental, del tipo antes y después, con adolescentes de una institución educativa en São Luís, Maranhão, Brasil. El estudio siguió las etapas de desarrollo, implementación y evaluación de un programa de intervención para la prevención del suicidio. Se administraron tres instrumentos de evaluación antes y después de la intervención: la escala de ideación suicida de Beck; el Inventario de Depresión de Beck y la Escala de Desesperanza de Beck.Resultados: Antes de la intervención, participaron 102 adolescentes, 30 (29.4%) tenían ideación suicida y síntomas depresivos. Después de la intervención, los instrumentos se aplicaron a los 30 adolescentes seleccionados, 12 (40.0%) continuaron con la ideación. Antes de la intervención, el Inventario de depresión promedio fue de 23.83 y luego de 7.17 (p <0.0001). En cuanto a la desesperanza, el promedio obtenido antes fue 7.23 y luego 2.17 (p <0.0001); Con respecto a la ideación suicida, el promedio obtenido antes fue de 10.50 y luego de 2.57 (p <0.0001).Conclusión: Hubo una disminución en los síntomas depresivos, la desesperanza y la ideación suicida después de la implementación del elaborado programa de intervención.Objetivo: Analisar os resultados do desenvolvimento e implementação de um programa de prevenção do suicidio dirigido a adolescentes.Materiais e Métodos: Estudo quase experiemntal, do tipo antes e depois, com adolescentes de uma Instituição de Ensino em São Luís, Maranhão, Brasil. O estudo seguiu as etpas de desenvolvimento, implementação e avaliação de um programa de intervenção direcionado a prevenção do suicídio. Foram administrados três instrumentos de avaliação, antes e após a intervenção: a Escala de Ideação Suicida de Beck; o Inventário de Depressão de Beck e a Escala de Desesperança de Beck.Resultados: Antes da intervenção participaram 102 adolescentes, 30 (29,4%) apresentaram ideação suicida e sintomatologia depressiva. Após a intervenção os instrumentos foram aplicados para os 30 adolescentes selecionados, 12 (40,0%) continuaram com ideação. Antes da intervenção a média do Inventário de Depressão foi de 23,83 e depois 7,17 (p<0,0001). Quanto à desesperança, a média obtida antes foi 7.23 e depois 2,17 (p<0,0001); No que diz respeito à ideação suicida, a média obtida antes foi 10,50 e depois foi 2,57 (p<0,0001).Conclusão: Ocorreu uma diminuição da sintomatologia depressiva, da desesperança e da ideação suicida após a implementação do programa de intervenção elaborado

Indicador integrado para análise dos custos externos do tráfego rodoviário

A mobilidade sustentável é atualmente um desafio amplamente promovido. Neste âmbito, os sistemas inteligentes de transportes apresentam potencial na mitigação das diferentes externalidades do tráfego relacionadas com os impactes no ambiente, sociedade e economia. Em particular, os sistemas inteligentes de identificação de rotas (eco-navegação) fornecem informação para uma escolha de rota adequada e permitem reduzir os níveis de congestionamento, consumo de energia e emissões. O principal objetivo deste artigo consiste em apresentar uma metodologia para um indicador capaz de integrar os impactes do tráfego rodoviário, que possa ser aplicável a um sistema avançado de gestão de tráfego. Assim, são avaliados os custos inerentes às emissões e concentrações de poluentes na atmosfera, o congestionamento, o ruído e a segurança rodoviária, ajustados a contextos locais

Road traffic externalities indicator based on external costs of transport

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Ecoindicador de integração de impactes de tráfego rodoviário: perspetiva de análise dos custos externos

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A Cross-Sectional Survey-Based Study of Medical Oncologists

Funding Information: We would like to thank Andrea Bothwell who wrote the manuscript outline and first draft on behalf of Springer Healthcare Communications. We also thank Prof. Carina Silva (ESTEsL – Escola Superior de Tecnologias de Saúde de Lisboa) who performed the preliminary statistical analysis of this study. This medical writing assistance and statistical analysis was funded by CUF Oncologia. Funding Information: Diogo Alpuim Costa has received honoraria from the Portuguese Navy, CUF Oncologia, and NTT DATA, and has served as a speaker, advisory board member, or has received research or education funding from CUF Oncologia, AstraZeneca, Hoffmann-La Roche, Merck KGaA, Novartis, Pfizer, Uriage, Daiichi Sankyo, Gilead, Merck Sharp & Dohme, Nanobiotix, Puma Biotechnology Inc., Sanofi, and Seagen Inc. Margarida Brito has participated as advisory board member for Roche, Novartis, Merck Sharp & Dohme, and Pfizer. Mário Fontes-Sousa has served as a speaker or advisory board member for Bristol Myers Squibb, Daiichi Sankyo, Gilead, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and Servier. Diogo Martins-Branco received honoraria and advisory board fees from Janssen, Pfizer, Merck Sharp & Dohme, Angelini, AstraZeneca, and Novartis, meeting and travel grants from LEO Farmacêuticos, Merck Sharp & Dohme, Ipsen, Janssen, and Roche, and institutional grants from F. Hoffmann-La Roche Ltd. José Guilherme Gonçalves Nobre, João Paulo Fernandes, Marta Vaz Batista, Ana Simas, Carolina Sales, Helena Gouveia, Leonor Abreu Ribeiro, Andreia Coelho, Mariana Inácio, André Cruz, Mónica Mariano, Joana Savva-Bordalo, Ricardo Fernandes, André Oliveira, Andreia Chaves, Mafalda Sampaio-Alves, and Noémia Afonso have nothing to declare. Publisher Copyright: © 2022, The Author(s).Introduction: Cancer care providers have faced many challenges in delivering safe care for patients during the COVID-19 pandemic. This cross-sectional survey-based study investigated the impact of the pandemic on clinical practices of Portuguese medical oncologists caring for patients with breast cancer. Methods: An anonymous online survey comprising 42 questions gathered information regarding COVID-19 testing, treatment in (neo)adjuvant and metastatic settings, and other aspects of breast cancer management. Practices before and during the pandemic were compared, and potential differences in outcomes according to respondents’ regions, case volumes, and practice type were explored. Results: Of 129 respondents, 108 worked in the public health system, giving a representative national picture of the impact of the COVID-19 pandemic on breast cancer management. Seventy-one percent of respondents reported a reduction in visits for new cases of breast cancer, and there was a shift towards increased use of telemedicine. Clinical decision-making was largely unaffected in the most aggressive indications (i.e., triple-negative, HER2-positive, visceral crisis). The use of neoadjuvant therapy increased when access to surgery was difficult, whereas dose-dense regimens decreased, and cyclin-dependent kinase 4/6 inhibitor treatment decreased for less aggressive disease and increased for more aggressive disease. The use of oral formulations and metronomic chemotherapy regimens increased, and clinical trial participation decreased. Some differences by respondents’ region and case volume were noted. Conclusion: Medical oncologists in Portugal implemented many changes during the COVID-19 pandemic, most of which were logical and reasonable responses to the current healthcare emergency; however, the true impact on patient outcomes remains unknown.publishersversionepub_ahead_of_prin