The effectiveness of intervention by speech therapy in vocal fold paralysis: Objective assessment

Objectivos: Analisar os resultados atingidos por um grupo de pacientes com paralisia da corda vocal, usando medidas de avaliação objectivas, antes e após intervenção de Terapia da Fala. Materiais e Métodos: Análise retrospectiva dos resultados obtidos por um grupo de 38 pacientes com paralisia da corda vocal submetidos à intervenção da área de Terapia da Fala, num Hospital Central. Resultados: O tipo de paralisias foi variável, sendo que a maioria dos sujeitos apresentava paralisia unilateral, em posição paramediana. As diferenças de resultados dos parâmetros jitter, shimmer e NNE revelaram-se significativas (p < 0,05). O número médio de consultas de Terapia da Fala necessárias foi de 13,29±7,95. Conclusões: A intervenção de Terapia da Fala em casos de paralisia da corda vocal iniciada precocemente é eficaz, evitando-se assim que os pacientes fossem submetidos a procedimentos cirúrgicos, já que apresentam melhoras significativas da qualidade da voz com a intervenção terapêutica.info:eu-repo/semantics/publishedVersio

Early versus late conversion from immediate to prolonged-release tacrolimus after renal transplantation: Clinical effects and treatment costs

Introduction. Prolonged-release tacrolimus (PR-TAC) was associated with improved renal function after transplantation when compared to immediate-release tacrolimus (IR-TAC) although evidence is still scarce. This study aimed to compare clinical outcomes and treatment costs in patients who converted from IR-TAC to PR-TAC during the first year after renal transplantation (RT) (early converters [EC]) or after that period (late converters [LC]). Methods. We performed a retrospective study including 79 patients (EC, 39; LC, 41) which were followed up over 60 months. A mixed-effects approach was used to investigate the differences between both groups regarding renal and metabolic outcomes as well as treatment costs. Results. The median time from RT to conversion was 3 months for EC and 25 months for LC. For both EC and LC, a significant increase in estimated glomerular filtration rate was observed after conversion (5.2 and 4.9 mL/min per 1.73 m 2 , respectively). During the first year after RT, EC presented a higher estimated glomerular filtration rate and inferior tacrolimus trough levels when compared to LC, with higher mean treatment costs associated. However, thereafter, these outcomes were similar between groups over the remaining time. At the end of follow-up, no significant differences were found regarding allograft acute rejection (2.6% and 2.4%), new-onset diabetes (15.7% vs 12.2%) or cardiovascular events (5.2% vs 7.3%). Conclusions. There was a significant benefit on renal function after conversion from IR-TAC to PR-TAC. During the first year after RT, EC presented improved renal function, but higher treatment costs. None of these differences persisted at the end of follow-up.This work was financed by Fundo Europeu de Desenvolvimento Regional (FEDER) funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia/ Ministério da Ciência, Tecnologia e Ensino Superior in the framework of the project "Institute for Research and Innovation in Health Sciences" (POCI-01-0145-FEDER-007274)

Mental illness of the oldest, nutritional status and arterial hypertension

Changes in nutritional status and high blood pressure are very common in elderly with mental disorders. Currently, the interest in knowing associated factors to those variables is to prevent morbidity and mortality risk. The study aim was to evaluate the relationship between mental disorders, nutritional status and blood pressure. It´s a cross-sectional study in a sample of 99 elderly living in community that had a psychiatric emergency episode. Data were collected from the initial evaluation form (IE). Results show multiple pathologies, cognitive deficits, high blood pressure and change in body mass index (BMI). Conclusion: In most of the sample BMI is associated with several co morbidities and co-exists with a temporal disorientation and arterial hypertension. Prevention is the key to maintaining health and well-being.info:eu-repo/semantics/publishedVersio

Mental illness and comorbidities, aspects of initial evaluation

Mental Illness is a public problem in western societies. Recent reports say that the most frequent conditions of psychiatric hospitalization are related to elderly, over 65 years old, diagnosed with dementia, other organic disorders and depression. And we are seeing increasingly in episodes of urgency, consumption of psychoactive drugs, which can foster the emergence of other comorbidities. The aim of this study was to characterize from a socio-demographic, clinical and functional point of view, older people who staged an emergency episode in a psychiatric hospital. This is a cross-sectional, descriptive and correlational study. The sample consisted of 99 elderly people involved in a psychiatric emergency episode in the biennium 2013/2014 and data were collected from the initial evaluation form (IE). Results: People with dementia have more associated diseases than others with other mental Illnesses. Some are at higher risk for potential episodes of falls and loss of functionality and associated factors. Conclusion. More cognitive and functional impairment, evidenced in the functional dependency cycle. The quality of care in later age, requires a multidimensional and interdisciplinary approach. Initial assessment must be complete and holistic in order to give the best care.info:eu-repo/semantics/publishedVersio

Sustained-Release Bupropion Overdose: A Case Report

Bupropion is an atypical antidepressant with a unique aminoketone structure similar to amphetamines. A narrow therapeutic margin is evident from observational studies that show seizure activity with doses of 400-600 mg or higher. A 38-year old woman took an overdose of 6 grams of bupropion with 110 grams of alcohol. She presented to the Emergency Department with agitation, visual hallucinations and myoclonus of the upper limbs; eyes spontaneously open with isochoric and light reactive pupils with horizontal nystagmus; afebrile, normotensive (121/63 mm Hg) and tachycardic (120 beats/minute). The electrocardiogram revealed a sinus tachycardia with prolonged QT interval (QT/QTc: 0.46/ 0.537) and a QRS complex length in the upper limit of normal. Arterial blood gases revealed metabolic acidosis (pH = 7.16) with increased anion-gap (value=18). She developed mal epilepticus needing thiopental induced coma and Intensive Care Unit (ICU) admission. She suffered prolonged symptoms including seizures before fully recovering. The narrow therapeutic range and the increasing use in the treatment of smoking cessation boosted the number of intentional and unintentional poisoning by this drug. Previous reports of bupropion overdose almost all involve the immediate release formulation. There are some reports of overdose with sustained-release formulation, but there is limited information on its spectrum of toxicity

Pkd2 Affects Cilia Length and Impacts LR Flow Dynamics and Dand5

Funding: This work was supported by the Fundação para a Ciência e a Tecnologia (FCT-ANR/BEX-BID/0153/2012 research grant). SL is funded by an FCT CEEC contract for Principal Investigator. The work was also supported by Sociedade Portuguesa de Nefrologia (research grant 2015), iNOVA4Health – UID/Multi/04462/2013 (a program financially supported by Fundação para a Ciência e Tecnologia/ Ministério da Educação e Ciência, through national funds and co-funded by FEDER under the PT2020 Partnership Agreement) and Fundação para a Ciência e Tecnologia (research grant – PTDC/BEXBID/1411/2014). MR-R was supported by national funds through Fundação para a Ciência e Tecnologia, in the context of the celebration of the program contract foreseen in the numbers 4, 5, and 6 of article 23 of D.L. no. 57/2016 of 29 August, as amended by Law no. 57/2017 of 19 July. Zebrafish used as animal model were reared and maintained in the CEDOC Fish Facility, with the support from the research consortia Congento, co-financed by Lisboa Regional Operational Program (Lisboa2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and Fundação para a Ciência e TecnologiaThe left-right (LR) field recognizes the importance of the mechanism involving the calcium permeable channel Polycystin-2. However, whether the early LR symmetry breaking mechanism is exclusively via Polycystin-2 has not been tested. For that purpose, we need to be able to isolate the effects of decreasing the levels of Pkd2 protein from any eventual effects on flow dynamics. Here we demonstrate that curly-up (cup) homozygous mutants have abnormal flow dynamics. In addition, we performed one cell stage Pkd2 knockdowns and LR organizer specific Pkd2 knockdowns and observed that both techniques resulted in shorter cilia length and abnormal flow dynamics. We conclude that Pkd2 reduction leads to LR defects that cannot be assigned exclusively to its putative role in mediating mechanosensation because indirectly, by modifying cell shape or decreasing cilia length, Pkd2 deficit affects LR flow dynamics.publishersversionpublishe

Hospitalizations due to primary care sensitive conditions after family health strategy implementation on Petrópolis/RJ

Objective: To quantify and to compare the hospitalizations sensible to primary care (HSPC) with the brute rate of hospitalizations analyzing its frequency with the family health program (FHP) in Petrópolis/RJ. Methods: After analyzing the national health system data, we extracted the rate of HSPC between 1999-2013. Then we have established the ratio of the hospitalizations and city residents multiplied by a thousand. The Pearson correlation coefficient was applied to obtain the the variables correlation. Results: The data presented a reduction of 54.4% in the number of HSPC for the investigated period. Total hospitalizations related to primary care conditions went from 19.9% to 16.5%. The rate of HSPC decreased as the coverage of the FHP increased its coverage. Conclusion: The changes observed are significant and stimulate further investigations regarding the FHP strategy and its potential as an effective way of reducing the HSPC in other regions

Caracterização molecular de mutantes de bananeira da cv. terra por meio de marcadores ISSR.

A técnica de indução de mutação por irradiação tem sido muito empregada em programas de melhoramento de plantas visando a seleção de mutantes com características agronômicas desejáveis. Os marcadores moleculares são importantes ferramentas para a detecção dos efeitos da radiação gama com precisão, uma vez que, com o advento das técnicas modernas de biologia molecular, surgiram diversos métodos de detecção de polimorfismo genético direto; ou seja, em nível de DNA. O maior interesse na aplicação dos marcadores genéticos no melhoramento vegetal é a perspectiva de estabelecer ligações entre os marcadores e os genes que controlam determinada característica (OLIVEIRA et al., 1996).pdf 159

High-fat diet-induced obesity rat model: a comparison between wistar and sprague-dawley rat

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Circulating renalase as predictor of renal and cardiovascular outcomes in pre-dialysis ckd patients: A 5-year prospective cohort study

Chronic kidney disease (CKD) is an independent risk factor for adverse cardiovascular and cerebrovascular events (MACCEs), and mortality since the earlier stages. Therefore, it is critical to identify the link between CKD and cardiovascular risk (CVR) through early and reliable biomarkers. Acknowledging that CKD and CKD progression are associated with increased sympathetic tone, which is implicated in CVR, and that renalase metabolizes catecholamines, we aimed to evaluate the relationship between renalase serum levels (RNLS) and cardiovascular and renal outcomes. The study included 40 pre-dialysis CKD patients (19F:21M) with median age of 61 (IQ 45–66) years. At baseline, we measured RNLS as well as routine biomarkers of renal and cardiovascular risk. A prospective analysis was performed to determine whether RNLS are associated with CKD progression, MACCEs, hospitalizations and all-cause mortality. At baseline, the median level of RNLS and median estimated glomerular filtration rate (eGFR) were 63.5 (IQ 48.4–82.7) µg/mL and 47 (IQ 13–119) mL/min/1.73 m2, respectively. In univariate analysis, RNLS were strongly associated with eGFR, age and Charlson Index. Over the course of a mean follow-up of 65 (47 to 70) months, 3 (7.5%) deaths, 2 (5%) fatal MACCEs, 17 (42.5%) hospital admissions occurred, and 16 (40%) patients experienced CKD progression. In univariate analysis, RNLS were associated with CKD progression (p = 0.001), hospitalizations (p = 0.001) and all-cause mortality (p = 0.022) but not with MACCEs (p = 0.094). In adjusted analysis, RNLS predicted CKD progression and hospitalizations regardless of age, Charlson comorbidity index, cardiovascular disease, hypertension, diabetes and dyslipidemia. Our results suggest that RNLS, closely related with renal function, might have a potential role as predictor of renal outcomes, hospitalizations, and mortality in pre-dialysis CKD patients.This work was financed by FEDER-Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020-Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT-Fundação para a Ciência e a Tecnolo-gia/Ministério da Ciência, Tecnologia e Ensino Superior in the framework of the project “Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER-007274), and a grant from Portuguese Society of Nephrology