The potential role of peak nasal inspiratory flow to evaluate active sinonasal inflammation and disease severity

Although the pathophysiology of nasal polyposis is incompletely understood, rhinologists have seldom studied it with rhinomanometry or peak nasal inspiratory flow (PNIF) due to technical limitations and the perception that polyp size might impair reproducibility and the usefulness of recordings. The objective of this study is to assess how measures of rhinomanometry and PNIF relate to disease activity. Nineteen patients with polyps, 15 patients with chronic sinusitis without polyps and 11 negative controls were evaluated with active anterior rhinomanometry and PNIF. Sinusitis and polyp patients were re-evaluated after medical treatment. Polyp patients had the highest median Lund-Mackay score (14) and a median Johansen score of 1. PNIF and its variation after treatment were also lowest in this group (median 90 L/min before and after treatment; median variation of 0 L/min). Nasal resistance was similar between groups, and only correlated with Johansen score (Spearman = 0.517, p = 0.048) after treatment. Our study suggests that evaluating polyp patients using rhinomanometry and PNIF may provide useful and reproducible data. Several findings considered together suggest that polyp size is not the main determinant of nasal functional changes in these patients, warranting further studies to verify whether PNIF changes reflect sinus inflammation or merely airway obstruction.publishersversionpublishe

Budesonide Reverses Lung Hyperinflation in Childhood Asthma: a Controlled Study

Budesonide (800 mg bid, for 2 months) was administered to 12 asthmatic children (mean age, 11.293.3 years) with lung hyperinflation (TGV]130% predicted and:or RV]140% predicted) in a randomised, placebo controlled, double blind, crossover study. Body plethysmography (panting frequency controlled at 1·s 1) was performed at the beginning, 2 months afterwards (before crossover) and at the end of the study. Budesonide significantly reduced TGV (2.3590.90 l BTPS or 126924% predicted) compared with placebo (2.5491.08 l BTPS, P 0.014 or 140921% predicted, PB0.05). In addition, budesonide significantly increased mean specific conductance (0.0690.02 cm H2O 1 l s 1 to 0.0790.01 cm H2O 1 l s 1, PB0.05). It was concluded that budesonide reduced lung hyperinflation most likely by decreasing airway inflammation

An adverse effect of intense exercise?

Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.Regular physical exercise is responsible for various health benefits, and is recommended for primary and secondary cardiovascular (CV) prevention. Despite these recognized benefits, various clinical events can occur in athletes, including acute myocardial infarction and sudden cardiac death (SCD); the main cause of SCD in veteran athletes is coronary artery disease (CAD). The relationship between intense exercise training and CAD is controversial, and a U-shaped association has been hypothesized. If this is the case, screening for subclinical CAD in older athletes may be justified, and various different methodologies have been proposed. However, the methodology for screening veteran athletes is not consensual, and several markers of CAD, in addition to clinical CV risk factors, could improve risk stratification in this population. In the present paper we review the published data on CAD in athletes, focusing on the relationship between the dose of exercise and CAD, as well as the implications for pre-participation screening of veteran athletes.publishersversionpublishe

Função Respiratória na Criança em Idade Pré-Escolar

A avaliação funcional respiratória é fundamental para a avaliação do doente com diversas patologias, nomeadamente respiratória, sendo corrente o seu uso em adultos e em crianças em idade escolar. Embora para o lactente tenham sido investigados vários métodos nas últimas décadas, a criança em idade pré-escolar tem permanecido como inacessível, pela necessidade de colaboração e pela impraticabilidade de sedação. Os autores descrevem os avanços em avaliação funcional respiratória nos últimos anos, nesta faixa etária, nas técnicas de espirometria e pletismografia, explicitando a sua fundamentação teórica, metodologia e aplicabilidade

A score methodology to assess concept maps in medical education in the context of pathophysiology teaching

The main objective of pathophysiology teaching is to facilitate the learning of mechanisms of diseases and the understanding of their expressions in patients (symptoms, signs and tests). This objective requires the application of basic biomedical science to explain the abnormalities expressed by the patients. The capacity to integrate this new organization of knowledge is essential to the understanding of pathophysiological mechanisms, which explain expressions of specific diseases. Our group has a longstanding experience in the teaching of pathophysiology to medical students using problem-based learning (PBL) and concept mapping (CM). This semestral discipline has a yearly intake of 190 students, divided into 18 tutorial groups and supported by 14 tutors. The students’ learning progress is evaluated by their performance during the tutorial sessions and the CM methodology has been introduced as an additional tool to visualize the integration of knowledge and how it is displayed in the different pathophysiological mechanisms. Until now, the evaluation of CM has been qualitative and used as an additional assessment tool by the tutors. This study reports how we are changing this approach by training the tutors and developing a scoring methodology, which will be described in detail, together with a preliminary application in selected mapsFonseca, M.; Oliveira, B.; Carreiro-Martins, P.; Neuparth, N.; Rendas, A. (2020). A score methodology to assess concept maps in medical education in the context of pathophysiology teaching. En 6th International Conference on Higher Education Advances (HEAd'20). Editorial Universitat Politècnica de València. (30-05-2020):867-874. https://doi.org/10.4995/HEAd20.2020.11163OCS86787430-05-202

Modelo de Gamification aplicado ao sector da saúde

As empresas procuram cada vez mais ferramentas que envolvam e motivem os trabalhadores no seu trabalho. A comunicação interna de uma organização é, portanto, fundamental para esta função. Esta permite não só criar vantagens competitivas, possibilitando a permanência das organizações num mercado altamente competitivo, como também aumenta a eficiência e a eficácia no trabalho. A literatura descreve a Gamification como uma importante técnica de comunicação interna para as novas gerações Millenials e iGeneration. Tais gerações requerem a criação de trabalhos mais dinâmicos para que o colaborador se sinta motivado e queira envolver-se na função que desempenha. Este projecto tem como principal objectivo o aprofundamento da temática Gamification aplicada aos clientes internos. E nesse seguimento que esta pode, então, ser ajustada aos hospitais portugueses, tornando as actividades dos profissionais de saúde mais próximas entre departamentos. Com a governação hospitalar surgiu um desfazamento a este nível e a sua restruturação é imprescindível.Companies are constantly in pursuit of organizational tools to engage and motivate their employees with their work environment. Therefore, internal communication is crucial for this roll. It not only boosts competitive advantages, allowing companies to thrive on competitive markets, but also increases efficiency and productivity. The literature review describes Gamification as an important internal communication technique to new generations such as Millennials and iGenerations. Those generations require a more dynamic work environment that involves and makes them feel motivated with their roll within the company. The main goal of this project is to deepen the Gamification topic applied to internal customers. Following that, Gamification can be adjusted to Portuguese hospitals shortening the distance among the health professional activities and their respective departments. The hospital governance led to such disruption and it is crucial to restructure it

Toxicity ranking of estuarine sediments on the basis of Sparus aurata biomarkers

Sparus aurata biomarkers were used to rank sediments from the Sado River estuary (Portugal) according to their toxicity. Initially, the activities of liver ethoxyresorufin-O-deethylase, liver and gill glutathione S-transferases, muscle lactate dehydrogenase, and brain acetylcholinesterase were tested in a laboratory bioassay with the reference compound benzo[a]pyrene. Enzymatic activities were determined in different tissues of fish exposed for 48, 96, or 240 h to three concentrations of benzo[a]pyrene (25, 50, and 100 g/L). Induction of liver ethoxyresorufin-O-deethylase was observed at all the exposure periods and concentrations, suggesting a continuous response of this system to toxicant exposure. Induction of liver glutathione S-transferases activity was only observed after 240 h of exposure, whereas gill glutathione S-transferases activity was significantly inhibited at all the exposure periods, suggesting a direct or indirect effect of the toxicant on these enzymes. Inhibition of lactate dehydrogenases activity was only observed after 96 h of exposure to 25 g/L of benzo[a]pyrene. No significant effects were observed on acetylcholinesterase activity, suggesting that cholinergic function of S. aurata is not affected by benzo[a]pyrene. In a second phase, fish were exposed for 240 h to sediments collected at five sites of the Sado River estuary, and the same biomarkers were analyzed. For all the enzymes assayed, significant differences among sites were found. In this study, the battery of biomarkers used allowed to discrimination among sites with different types of contamination, levels of contamination, or both, after multivariate data analysis. Discrimination of sites was similar to the ranking provided by a more complex and parallel study (including chemical analysis of sediments, macrobenthic community analysis, amphipod mortality toxicity tests, and sea urchin abnormality embryo assays), suggesting its suitability to evaluate the toxicity of estuarine sediments.info:eu-repo/semantics/publishedVersio