Adesão à terapêutica em idosos polimedicados

Polypharmacy, consists of the simultaneous and chronic use of different drugs, is frequent in elderly people (age≥ 65 years) and commits the patient's adherence to therapy, necessary to a successfully treatment. Objectives: Review the scientific evidences of adherence to therapy and polypharmacy in elderly, since this age group is more vulnerable to the use of different drugs. Materials and Methods: A review of published studies between 2005 and July 2015 was carried out using the Pubmed, B-on and SciELO databases, to search the following terms: elderly, polypharmacy, multidrug, polymedicated elderly and therapy adherence. Were used as exclusion criteria: age under 65, seniors not polymedicated, studies in other languages than Portuguese or English, studies published before 2005. Of the 31 studies initially selected, 8 were excluded as meeting any of the exclusion criteria and 23 articles were included in the review. Results and Discussion: The aging process is associated to various diseases, contributing to polypharmacy. In fact, more than half of elderly taking four or more drugs daily and this number increase with the age. Other important problem related to polypharmacy in elderly is the therapy adherence. Besides the variations between studies, the authors indicate values of non-adherence between 20 and 60%, which results in a range of health problems arising out of the increasing of adverse effects, drug-drug interactions, being this risk associated to the number of drugs consumed. Conclusion: More than half of elderly are polymedicated, with a considerable proportion of elderly non-adherent to therapy, which is associated with consequent health risks

Computerized Tomography Findings In Fahr's Syndrome.

We analyzed computerized tomography (CT) findings in six patients with Fahr's syndrome. They presented calcifications in basal ganglia, dentate nucleus, subcortical region and semioval center, due to alteration in calcium metabolism or due to senile relative hypoxemic state. The image pattern was not strictly related with etiology, although some differences in dystrophic senile calcifications (the only one present in semioval center and absent in subcortical region). CT is an easy exam, has maximum sensitivity and allows diagnosis, contributing to early treatment of many etiologies of Fahr's syndrome.62789-9

Enhancing Cultural Communication Competency in the Undergraduate Physiotherapy Course

Trabalho apresentado em 5th European Congress of the European Region WCPT on Physiotherapy Education, 2020, onlineN/

Development and Assessment of an E-Learning Course on Breast Imaging for Radiographers: A Stratified Randomized Controlled Trial

Background: Mammography is considered the best imaging technique for breast cancer screening, and the radiographer plays an important role in its performance. Therefore, continuing education is critical to improving the performance of these professionals and thus providing better health care services. Objective: Our goal was to develop an e-learning course on breast imaging for radiographers, assessing its efficacy , effectiveness, and user satisfaction. Methods: A stratified randomized controlled trial was performed with radiographers and radiology students who already had mammography training, using pre- and post-knowledge tests, and satisfaction questionnaires. The primary outcome was the improvement in test results (percentage of correct answers), using intention-to-treat and per-protocol analysis. Results: A total of 54 participants were assigned to the intervention (20 students plus 34 radiographers) with 53 controls (19+34). The intervention was completed by 40 participants (11+29), with 4 (2+2) discontinued interventions, and 10 (7+3) lost to follow-up. Differences in the primary outcome were found between intervention and control: 21 versus 4 percentage points (pp), P<.001. Stratified analysis showed effect in radiographers (23 pp vs 4 pp; P=.004) but was unclear in students (18 pp vs 5 pp; P=.098). Nonetheless, differences in students’ posttest results were found (88% vs 63%; P=.003), which were absent in pretest (63% vs 63%; P=.106). The per-protocol analysis showed a higher effect (26 pp vs 2 pp; P<.001), both in students (25 pp vs 3 pp; P=.004) and radiographers (27 pp vs 2 pp; P<.001). Overall, 85% were satisfied with the course, and 88% considered it successful. Conclusions: This e-learning course is effective, especially for radiographers, which highlights the need for continuing education

The multidimensionality of female mandrill sociality-A dynamic multiplex network approach

Funding: ASP received funding from the School of Biological Sciences, University of Aberdeen, https://www.abdn.ac.uk/sbs/, and was awarded the Watt Fund via the University of Aberdeen https://www.abdn.ac.uk. These funders do not provide grant numbers. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Data Availability: All relevant data are within the manuscript and its Supporting Information files.Peer reviewedPublisher PD

Integration of a Hydrogenase in a Lead Halide Perovskite Photoelectrode for Tandem Solar Water Splitting.

Lead halide perovskite solar cells are notoriously moisture-sensitive, but recent encapsulation strategies have demonstrated their potential application as photoelectrodes in aqueous solution. However, perovskite photoelectrodes rely on precious metal co-catalysts, and their combination with biological materials remains elusive in integrated devices. Here, we interface [NiFeSe] hydrogenase from Desulfovibrio vulgaris Hildenborough, a highly active enzyme for H2 generation, with a triple cation mixed halide perovskite. The perovskite-hydrogenase photoelectrode produces a photocurrent of -5 mA cm-2 at 0 V vs RHE during AM1.5G irradiation, is stable for 12 h and the hydrogenase exhibits a turnover number of 1.9 × 106. The positive onset potential of +0.8 V vs RHE allows its combination with a BiVO4 water oxidation photoanode to give a self-sustaining, bias-free photoelectrochemical tandem system for overall water splitting (solar-to-hydrogen efficiency of 1.1%). This work demonstrates the compatibility of immersed perovskite elements with biological catalysts to produce hybrid photoelectrodes with benchmark performance, which establishes their utility in semiartificial photosynthesis

The dynamics of grooming interactions: maintenance of partner choice and the consequences of demographic variation for female mandrills

A large body of evidence suggests that female Old World monkeys maintain selective long-term grooming interactions with fitness benefits. The last two decades have produced evidence that the regulation of social interactions among primates can be, in part, explained by the Biological Markets theory, with grooming behaviour as the focus of these studies. Grooming facilitates bonding between individuals, constituting an essential part of the regulation of social relationships among female cercopithecids. In contrast to the well-studied baboons (Papio spp), knowledge about the nature of grooming interactions and their regulation is generally lacking for the large, terrestrial species of mandrills (Mandrillus sphinx). We used a combination of social network analysis tools and well-established methods for assessing partner diversity and reciprocity to characterise grooming networks, partner choice and patterns of trade (be groomed, give grooming) among females in a captive group of mandrills, both within and across two separate observation periods. Our results suggest that, even though the relatively stable conditions of captivity allowed the studied females to maintain selective grooming interactions across time, small scale demographic changes affected the grooming dynamics of the group in accordance with the expectations of the Biological Markets theory. In particular, the maturation and consequent integration of a high ranking female into the group’s grooming network from one period to the next resulted in a more pronounced effect of rank on the regulation of grooming interactions. In addition, the influence of the maturation of a dependent infant on the grooming interactions of his mother were evident between periods. Our results also demonstrate that grooming networks are dynamic and that high ranking individuals are not necessarily the most central in grooming networks. Finally, we discuss the potential of social network analysis to identify cases of social exclusion and its consequences for captive management

Chitosan and polyethylene glycol based membranes with antibacterial properties for tissue regeneration

The prevention of microbial infections associated with implantable medical devices and superficial wounds represents one of the main research strategies in the field of biomaterials. The present study reports on the development of composite membranes of Chitosan (CS)-Polyethylene glycol (PEG) matrix, incorporating particles of biphasic calcium phosphate (BCP), zinc oxide (ZnO) and copper oxide (CuO). The properties that are relevant for intended applications in tissue regeneration and antibacterial coatings of implants were assessed. It was found that the addition of 1% (w/w - relative to the mass of CS) of each metal oxide promoted satisfactory bacteriostatic activity and exhibited no cytotoxic effects towards the Vero cell line. The formation of bonds between the CS/PEG matrix and ionic species from the powders enhanced the cross-linking degree and mechanical properties of composite membranes in comparison to the non-doped membrane with the same polymer matrix (CS/PEG = 70/30%). A gradual degradation of the composite membranes over the immersion time in simulated body fluid (SBF) was accompanied by a continuous surface deposition of uniform apatite layer.publishe

Identification of clinical predictors of flare in systemic lupus erythematosus patients: a 24-month prospective cohort study

Objective. SLE has a relapsing-remitting course with disease activity flares over time. This study aims to identify clinical predictors of SLE flares.Methods. This prospective cohort study over 24 months included all SLE patients on follow-up at one academic lupus clinic. Flare was defined as an increase in SLEDAI-2K score ≥4 points. Baseline clinical and demographic parameters were compared using survival analysis for time-to-flare outcome with univariate log-rank tests. Variables with significant differences were further evaluated as predictors with multivariate Cox regression models adjusting for potential confounding or contributing factors and hazard ratio (HR) calculation.Results. A total of 202 SLE patients were included. Over the follow-up period, 1083 visits were documented and 16.8% of patients presented with flares. In multivariate analysis, the following parameters emerged as flare predictors: SLE diagnosis up to 25 years of age (HR = 2.14, P = 0.03), lupus nephritis previous to baseline visit (HR = 4.78, P < 0.0001) and immunosuppressor treatment for severe SLE (HR = 3.22, P < 0.001). Baseline disease activity, disease duration and treatment with prednisone or HCQ were not predictive factors.Conclusion. Patients with an SLE diagnosis before age 25 years, lupus nephritis or immunosuppressor treatment for severe SLE present greater HRs for flares, suggesting the need for tighter clinical monitoring. Current immunosuppressive strategies seem to be inefficient in providing flare prevention

Zeolite stimulates the activity of microbial enrichments converting butyrate to methane

Conductive materials have been tested as a strategy to improve methane production (MP) in anaerobic digestion (AD) processes1,2. The effect of zeolite (0.5 g/L) towards microbial enrichments converting butyrate (10 mmol/L) to methane was investigated and compared with a microbial enrichment in the absence of the material. The enrichments were initiated with granular anaerobic sludge from a brewery WWTP as inoculum. Incubations were carried out under strict anaerobic conditions (at 37 °C) and periodically transferred to fresh medium. The results showed that, after an initial adaptation period (3 transfers), the presence of zeolite significantly accelerated the total conversion of butyrate to methane, since it took approximately 30d with zeolite and around 45d without zeolite. However, both enrichment cultures after extended adaptation (more than 8 transfers) behaved similarly, degrading butyrate in approximately 15d. Nevertheless, zeolite addition to active butyrate enrichment cultures without previous contact with zeolite, slightly accelerated MP, while the highly adapted zeolite-enrichment decreased activity when incubated without zeolite. Thus, the presence of zeolite showed to stimulate the microbial activity enhancing MP from butyrate degradation. This material possess natural ion-exchange properties, absorptive capacity and could function as a support for biomass which makes its application very attractive to AD processes.info:eu-repo/semantics/publishedVersio