Intramural Vesical Leiomyoma in a Patient with a Pelvic Fibrous Tumour - Case Report

Introdução: O leiomioma vesical é um tumor benigno raro que representa,aproximadamente, 0,5% do total de neoplasias da bexiga. É frequentemente um achado imagiológico, sendo a sua localização e dimensões determinantes no desenvolvimento de sintomatologia e no tipo de procedimento a efectuar. Caso Clínico: Reporta-se o caso de um doente com queixas urinárias de disúria, polaquiúria e esforço miccional, inicialmente interpretadas como HBP. A investigação diagnóstica culminou com a enucleação de uma volumosa massa intramural da bexiga, com diagnóstico histológico de leiomioma, num doente com antecedentes de doença de Madelung e excisão prévia de um tumor fibroso paravesical. Discussão: O leiomioma vesical, embora apresentando características imagiológicas típicas, deve ser sempre biopsado para confirmação histológica da sua etiologia. O tumor fibroso pélvico apresenta sempre indicação cirúrgica pois, numa minoria de casos, pode apresentar comportamento agressivo com infiltração dos órgãos adjacentes

A comparison of course-related stressors in undergraduate problem-based learning (PBL) versus non-PBL medical programmes

Background: Medical students report high levels of stress related to their medical training as well as to other personal and financial factors. The aim of this study is to investigate whether there are differences in course-related stressors reported by medical students on undergraduate problem-based learning (PBL) and non-PBL programmes in the UK. Method: A cross-sectional study of second-year medical students in two UK medical schools (one PBL and one non-PBL programme) was conducted. A 16-question self-report questionnaire, derived from the Perceived Medical Student Stress Scale and the Higher Education Stress Inventory, was used to measure course-related stressors. Following univariate analysis of each stressor between groups, multivariate logistic regression was used to determine which stressors were the best predictors of each course type, while controlling for socio-demographic differences between the groups. Results: A total of 280 students responded. Compared to the non-PBL students (N = 197), the PBL students (N = 83) were significantly more likely to agree that: they did not know what the faculty expected of them (Odds Ratio (OR) = 0.38, p = 0.03); there were too many small group sessions facilitated only by students resulting in an unclear curriculum (OR = 0.04, p < 0.0001); and that there was a lack of opportunity to explore academic subjects of interest (OR = 0.40, p = 0.02). They were significantly more likely to disagree that: there was a lack of encouragement from teachers (OR = 3.11, p = 0.02); and that the medical course fostered a sense of anonymity and feelings of isolation amongst students (OR = 3.42, p = 0.008). Conclusion: There are significant differences in the perceived course-related stressors affecting medical students on PBL and non-PBL programmes. Course designers and student support services should therefore tailor their work to minimise, or help students cope with, the specific stressors on each course type to ensure optimum learning and wellbeing among our future doctors

Microalbuminuria predicts overt proteinuria among patients with HIV infection

This study examines the association between microalbuminuria and the development of proteinuria among HIV-infected persons

MtDNA population variation in Myalgic encephalomyelitis/Chronic fatigue syndrome in two populations: a study of mildly deleterious variants

Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS) is a debilitating condition. There is growing interest in a possible etiologic or pathogenic role of mitochondrial dysfunction and mitochondrial DNA (mtDNA) variation in ME/CFS. Supporting such a link, fatigue is common and often severe in patients with mitochondrial disease. We investigate the role of mtDNA variation in ME/CFS. No proven pathogenic mtDNA mutations were found. We then investigated population variation. Two cohorts were analysed, one from the UK (n = 89 moderately affected; 29 severely affected) and the other from South Africa (n = 143 moderately affected). For both cohorts, ME/CFS patients had an excess of individuals without a mildly deleterious population variant. The differences in population variation might reflect a mechanism important to the pathophysiology of ME/CFS

Numerical analysis of different heating systems for warm sheet metal forming

The main goal of this study is to present an analysis of different heating methods frequently used in laboratory scale and in the industrial practice to heat blanks at warm temperatures. In this context, the blank can be heated inside the forming tools (internal method) or using a heating system (external method). In order to perform this analysis, a finite element model is firstly validated with the simulation of the direct resistance system used in a Gleeble testing machine. The predicted temperature was compared with the temperature distribution recorded experimentally and a good agreement was found. Afterwards, a finite element model is used to predict the temperature distribution in the blank during the heating process, when using different heating methods. The analysis also includes the evaluation of a cooling phase associated to the transport phase for the external heating methods. The results of this analysis show that neglecting the heating phase and a transport phase could lead to inaccuracies in the simulation of the forming phase.The authors gratefully acknowledge the financial support of the Portuguese Foundation for Science and Technology (FCT) under project PTDC/EMS-TEC/1805/2012 and by FEDER funds through the program COMPETE—Programa Operacional Factores de Competitividade, under the project CENTRO-07-0224-FEDER-002001 (MT4MOBI). The authors would like to thank Prof. A. Andrade-Campos for helpful contributions on the development of the finite element code presented in this work.info:eu-repo/semantics/publishedVersio

Study of intrinsic risk factors for falls in institutionalized elderly people

Esta pesquisa teve como objetivo identificar a presença de fatores intrínsecos que predispõem a quedas em idosos moradores em instituições de longa permanência na cidade de Goiânia (GO). Trata-se de estudo descritivo transversal realizado em seis instituições de longa permanência para idosos existentes na cidade de Goiânia. A amostra da investigação constou de 95 idosos que atenderam aos critérios de inclusão e exclusão. Utilizou-se um questionário contendo dados clínicos relacionados às condições de saúde-doença; dados cognitivos; avaliação da capacidade para as atividades básicas de vida diária e avaliação do equilíbrio e marcha. Os idosos avaliados, no geral, apresentam vários fatores de risco, apontados pela literatura, para quedas, tais como: relato de dificuldade motora em membros inferiores (90%), déficit visual (81,1%), uso de três ou mais medicamentos (59,7%), suspeita de depressão (37,9%), falta de equilíbrio em apoio unipodal (37,9%) e altura do passo anormalmente diminuída (32,6%). As informações obtidas nos permitem apontar condições determinantes que aumentam a possibilidade dos eventos queda acontecerem na amostra estudada, sinalizando à necessidade de que estratégias de promoção de saúde, prevenção de agravos e reabilitação devam ser tomadas. _________________________________________________________________________________________ ABSTRACTThe objective of this research was to identify intrinsic risk factors that predispose elderly people living in long-term institutions in the city of Goiânia (GO) to falls. The present descriptive transversal study was carried out in six long-term institutions for seniors in the city of Goiânia. The investigated sample consisted of 95 elderly that fitted the inclusion and exclusion criteria. A questionnaire was used for collecting clinical data related to health-disease conditions; cognitive data; capacity to develop basic daily life activities and equilibrium and gait. In general terms, as pointed out the literature, the examined elderly presented different fall risk factors such as: motor difficulty in lower limbs (90%), visual deficit (81,1%), use of 3 or more kinds of medicines (59,7%), suspected depression (37,9%), lack of equilibrium/unstable unipodal support (37,9%) abnormally decreased height in step (32,6%). The obtained data allow us to set indicators for the increase in falls among the studied sample, demonstrating the need for creating strategies for health promotion, prevention of injuries and rehabilitation