Risco de suicídio em condutores adolescentes

O presente estudo insere-se no âmbito da Psicologia do Tráfego e teve como objectivo comparar o risco de suicídio de adolescentes de 14 e 15 anos, candidatos à licença especial de condução de ciclomotores (N=40), com o risco de suicídio de adolescentes mais velhos, com idades entre os 16 e 19 anos, candidatos à carta de condução de motociclos (N=40). Procura verificar ainda a influência de algumas variáveis psicosociais sobre o nível de risco, utilizando a Escala do Risco Suicidário de Jochen Stork. Os resultados obtidos indicaram que, apenas 8.9% (N=7) da amostra total apresentava risco de suicídio explícito, todos eles pertencentes ao grupo de adolescentes com idades entre os 16 e 19 anos, candidatos à carta de condução de motociclos. No que concerne às características da amostra, podemos verificar que algumas variáveis da amostra se relacionaram com significado estatístico com o somatório de pontos obtidos na Escala de Risco Suicidário, concretamente, verificou-se que o grupo de adolescentes mais velhos apresenta um valor de risco suicidário significativo mais elevado, realçando também a percepção da qualidade da relação materna (p≤0.042) e da situação económica (p≤0.043), o consumir álcool habitualmente(p≤0.047), o nível de integração familiar sentido (p≤0.001) e a auto-imagem a nível físico, em termos de atractividade (p≤0.02). Foi efectuada a discussão das implicações dos resultados da presente investigação de acordo com a literatura e modelos abordados

Physical and chemical properties of orthodontic brackets after 12 and 24 months: in situ study

Objective: The aim of this article was to assess how intraoral biodegradation influenced the surface characteristics and friction levels of metallic brackets used during 12 and 24 months of orthodontic treatment and also to compare the static friction generated in these brackets with four different methods of the ligation of orthodontic wires. Material and Methods: Seventy premolar brackets as received from the manufacturer and 224 brackets that were used in previous orthodontic treatments were evaluated in this experiment. The surface morphology and the composition of the deposits found in the brackets were evaluated with rugosimetry, scanning electron microscopy, and energy dispersive X-ray spectroscopy. Friction was analyzed by applying tensile tests simulating sliding mechanics with a 0.019x0.025" steel wire. The static friction levels produced by the following ligation methods were evaluated: loosely attached steel ligature around all four bracket wings, steel ligature attached to only two wings, conventional elastomeric ligation around all 4 bracket wings, and non-conventional Slide® elastomeric ligature. Results: The results demonstrated the presence of biodegradation effects such as corrosion pits, plastic deformation, cracks, and material deposits. The main chemical elements found on these deposits were Carbon and Oxygen. The maximum friction produced by each ligation method changed according to the time of intraoral use. The steel ligature loosely attached to all four bracket wings produced the lowest friction levels in the new brackets. The conventional elastic ligatures generated the highest friction levels. The metallic brackets underwent significant degradation during orthodontic treatment, showing an increase in surface roughness and the deposit of chemical elements on the surface. Conclusion: The levels of static friction decreased with use. The non-conventional elastic ligatures were the best alternative to reduce friction

Horton's Disease. 40 Clinical Cases

Apresentamos uma casuística de 40 casos de Doença de Horton observados no Serviço de Medicina 2 e na Consulta de Doenças Autoimunes do Hospital de Santo António dos Capuchos, entre 1984 e 2002. Pretendemos comentar e destacar os aspectos práticos, clínicos, de diagnóstico e de terapêutica, relacionados com o adequado controle da doença, através da análise comparativa da literatura com os nossos dados

Valor prognóstico da proteína-c reativa às 24 horas após a admissão hospitalar na pancreatite aguda: um estudo coorte retrospetivo

Introduction: C-reactive protein (CRP) and Bedside Index for Severity in Acute Pancreatitis (BISAP) have been used in early risk assessment of patients with AP. Objectives: We evaluated prognostic accuracy of CRP at 24 hours after hospital admission (CRP24) for in-hospital mortality (IM) in AP individually and with BISAP. Materials and Methods: This retrospective cohort study included 134 patients with AP from a Portuguese hospital in 2009---2010. Prognostic accuracy assessment used area under receiver---operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: Thirteen percent of patients had severe AP, 26% developed pancreatic necrosis, and 7% died during index hospital stay. AUCs for CRP24 and BISAP individually were 0.80 (95% confidence interval (CI) 0.65---0.95) and 0.77 (95% CI 0.59---0.95), respectively. No patients with CRP24 <60 mg/l died (P = 0.027; negative predictive value 100% (95% CI 92.3---100%)). AUC for BISAP plus CRP24 was 0.81 (95% CI 0.65---0.97). Change in NRI nonevents (42.4%; 95% CI, 24.9---59.9%) resulted in positive overall NRI (31.3%; 95% CI, − 36.4% to 98.9%), but IDI nonevents was negligible (0.004; 95% CI, − 0.007 to 0.014). Conclusions: CRP24 revealed good prognostic accuracy for IM in AP; its main role may be the selection of lowest risk patients.Introdução: A proteína-C reativa (CRP) e o Bedside Index for Severity in Acute Pancreatitis (BISAP) têm sido usados na avaliação de risco precoce de doentes com pancreatite aguda (AP). Objectivos: Nós avaliámos o valor prognóstico da CRP às 24 horas após a admissão hospitalar (CRP24) na mortalidade intrahospitalar (IM) na AP, individualmente e com o BISAP. Materiais e Métodos: Este estudo coorte retrospetivo incluiu 134 doentes com AP de um hos- pital português em 2009---2010. A acuidade prognóstica foi avaliada usando a área debaixo da receiver-operating characteristic curve (AUC), o continuous net reclassification improvement (NRI), e o integrated discrimination improvement (IDI). Resultados: Treze por cento dos doentes tiveram AP grave, 26% desenvolveram necrose pan- creática, e 7% morreram durante a hospitalização índice. As AUCs da CRP24 e do BISAP individualmente foram 0,80 (intervalo de confiança (IC) 95%, 0,65---0,95) e 0,77 (IC 95%, 0,59---0,95), respectivamente. Nenhum doente com CRP24 <60 mg/l morreu (P = 0,027; valor predictivo negativo 100% (IC 95%, 92,3---100%)). A AUC para o BISAP mais a CRP24 foi 0,81 (IC 95%, 0,65---0,97). A mudança no NRI-não-eventos (42,4%; IC 95%, 24,9---59,9%) resultou num NRI- total positivo (31,3%; IC 95%, − 36,4 a 98,9%), mas num IDI-não-eventos negligenciável (0,004; IC 95%, − 0,007 a 0,014). Conclusões: A CRP24 revelou um valor prognóstico bom para a mortalidade intrahospitalar na AP; o seu papel principal poderá ser a selecção dos doentes de menor risco

Growth factor-free vascularization of marine-origin collagen sponges using cryopreserved stromal vascular fractions from human adipose tissue

The successful integration of transplanted three-dimensional tissue engineering (TE) constructs depends greatly on their rapid vascularization. Therefore, it is essential to address this vascularization issue in the initial design of constructs for perfused tissues. Two of the most important variables in this regard are scaffold composition and cell sourcing. Collagens with marine origins overcome some issues associated with mammal-derived collagen while maintaining their advantages in terms of biocompatibility. Concurrently, the freshly isolated stromal vascular fraction (SVF) of adipose tissue has been proposed as an advantageous cell fraction for vascularization purposes due to its highly angiogenic properties, allowing extrinsic angiogenic growth factor-free vascularization strategies for TE applications. In this study, we aimed at understanding whether marine collagen 3D matrices could support cryopreserved human SVF in maintaining intrinsic angiogenic properties observed for fresh SVF. For this, cryopreserved human SVF was seeded on blue shark collagen sponges and cultured up to 7 days in a basal medium. The secretome profile of several angiogenesis-related factors was studied throughout culture times and correlated with the expression pattern of CD31 and CD146, which showed the formation of a prevascular network. Upon in ovo implantation, increased vessel recruitment was observed in prevascularized sponges when compared with sponges without SVF cells. Immunohistochemistry for CD31 demonstrated the improved integration of prevascularized sponges within chick chorioalantoic membrane (CAM) tissues, while in situ hybridization showed human cells lining blood vessels. These results demonstrate the potential of using cryopreserved SVF combined with marine collagen as a streamlined approach to improve the vascularization of TE constructs.This research has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant agreement No. 805411); Portuguese Foundation for Science and Technology under doctoral fellowship PD/BD/135252/2017 and individual grant IF/00347/2015; European Regional Development Fund, through INTERREG España-Portugal 2014-2020 under BLUEBIOLAB (0474_BLUEBIOLAB_1_E) project, through Atlantic Area Programme under BLUEHUMAN (EAPA_151/2016) project and through NORTE2020/PT2020 Programme under ATLANTIDA (Norte-01-0145-FEDER-000040) project

Gerenciamento em Supply-chain: Adoção de Ferramentas de Data Mining na indústria de Transformação / Supply-chain Management: The use of Data mining tools in the manufacturing industry

Esta pesquisa visa a comprovação prática da influência que as tecnologias de informações geram nas tomadas de decisões e gestões das empresas, bem como em toda a sua cadeia de suprimentos para que estas sobrevivam em um mercado cada vez mais competitivo, justificando assim, os investimentos neste tipo de tecnologia. Para isto, estudou-se detalhadamente conceitos acerca dos temas: Logística – Gerenciamento em Supply Chain, Tecnologia da Informação e Data Mining. Posteriormente, foi elaborado um questionário e enviado as mais diversas empresas do estado de São Paulo para a coleta de dados. Consequentemente, criou-se um banco de dados e utilizou-se técnicas de associações em mineração de dados, através do algoritmo Apriori e o software Weka. Assim, obteve-se resultados que comprovaram, de maneira prática, as vantagens competitivas obtidas por empresas que optam por investimentos nestas tecnologias (TI). Proporcionando, uma gestão da cadeia produtiva muito mais eficiente e responsiva

Juvenile polyposis of infancy in a child with deletion of BMPR1A and PTEN genes: Surgical approach

Abstract Juvenile polyposis of infancy is the most severe and life-threatening form of juvenile polyposis. This disease typically presents in the first two years of life with gastrointestinal bleeding, diarrhea, inanition, and exudative enteropathy. In very few reports concerning this entity, a large deletion in the long arm of chromosome 10 (10q23), encompassing the PTEN and BMPR1A genes, was found. The authors report a case of delayed diagnosis of juvenile polyposis of infancy at 6 years of age. A 3.34 Mb long de novo deletion was identified at 10q23.1q23.31, encompassing the PTEN and BMPR1A genes. The disease course was severe with diarrhea, abdominal pain, inanition, refractory anemia, rectal bleeding, hypoalbuminemia, and exudative enteropathy. A sub-total colectomy, combined with intraoperative endoscopic removal of ileal and rectal stump polyps, was required for palliative disease control

Análise do risco da síndrome da apnéia obstrutiva do sono em policiais militares no norte do Brasil

Introduction: The work of the military police can increase sleep deprivation and trigger chances of car accidents, injuries caused by chases in environments without lighting, wrong approaches and fatalities in confrontations with firearms or decay in the performance of work. Objective: The objective of this study is to report the prevalence of risk for obstructive sleep apnea syndrome (OSAS) and daytime sleepiness among MPs in the metropolitan region of Belém, in the state of Pará. Methods: This was a pilot cross-sectional study, which used 80 PMs working in the state of Pará, northern Brazil to answer 3 digitized questionnaires. The questionnaires were applied by the google forms platform and the first questionnaire was about epidemiological questions, the second was the STOP-Bang questionnaire (QSB), the third was the Epworth Sleepiness Scale (ESS) and the static analysis was performed by relative frequency and absolute.Results: 6 individuals who had both intermediate risk and risk of daytime sleepiness, with the most prevalent patents for this event to occur were in decreasing order: cable; sergeant, captain and major. Another 5 individuals presented more alarming cases of high risk for OSAS regarding the risk of daytime sleepiness and, as mentioned above, the most prevalent patents for this occurrence were Corporal; sergeant and captain. Conclusion: We conclude that despite the small sample size, a high prevalence of obstructive sleep apnea was identified in military police officers working on a night shift or scale when compared to the general population of the study.Introducción: El trabajo de la policía militar puede aumentar la privación del sueño y desencadenar posibilidades de accidentes automovilísticos, lesiones causadas por persecuciones en ambientes poco iluminados, acercamientos erróneos y muertes en enfrentamientos con armas de fuego o deterioro en el desempeño laboral. Objetivo: El objetivo de este estudio es relatar la prevalencia de riesgo para síndrome de apnea obstructiva del sueño (SAOS) y somnolencia diurna entre PM de la región metropolitana de Belém, en el estado de Pará. Metodología: Este fue un estudio piloto transversal, que utilizó 80 PM que trabajan en el estado de Pará, norte de Brasil para responder a 3 cuestionarios digitales. Los cuestionarios se aplicaron a través de la plataforma de formularios de google y el primer cuestionario fue sobre cuestiones epidemiológicas, el segundo fue el cuestionario STOP-Bang (QSB), el tercero fue la Escala de Somnolencia de Epworth (ESS) y el análisis estático se realizó por frecuencia relativa y absoluto. Resultados: 6 individuos que se encontraban tanto en riesgo intermedio como en riesgo de somnolencia diurna, siendo las patentes más prevalentes para que ocurra este evento en orden descendente: cable; sargento, capitán y mayor. Otros 5 individuos presentaron situaciones más alarmantes de alto riesgo para SAOS en cuanto al riesgo de somnolencia diurna y, como se mencionó anteriormente, las patentes más prevalentes para esta ocurrencia fueron cable; sargento y capitán. Conclusión: Concluimos que, a pesar del pequeño tamaño de la muestra, se identificó una alta prevalencia de apnea obstructiva del sueño en los policías militares que trabajan en turnos o turnos nocturnos en comparación con la población general del estudio.Introdução: O trabalho do policial militar pode aumentar a privação de sono e desencadear chances de acidentes automobilísticos, lesões provocadas por perseguições em ambientes sem iluminação, abordagens errôneas e fatalidades em confrontos com armas de fogo ou decaimento no desempenho do trabalho. Objetivo: O objetivo deste trabalho é relatar a prevalência do risco para síndrome da apneia obstrutiva do sono (SAOS) e sonolência diurna entre PMs na região metropolitana de Belém, no estado do Pará. Metodologia: Este foi um estudo piloto transversal, a qual utilizou-se de 80 PMs que trabalham no estado do Pará, norte do Brasil para responder 3 questionários digitalizados. Os questionários foram aplicados pela plataforma google forms e o primeiro questionário foi sobre perguntas epidemiológicas, o segundo foi o questionário STOP-Bang (QSB),o terceiro foi a Escala de Sonolência de Epworth (ESS) e a análise estática foi realizada por frequência relativa e absoluta. Resultados: 6 indivíduos os quais tinham tanto risco intermediário quanto risco a sonolência diurna, com as patentes mais prevalentes de ocorrer esse evento foram em ordem decrescente: cabo; sargento, capitão e major. Já outros 5 indivíduos apresentaram quadros mais alarmantes derisco alto para SAOS quanto risco a sonolência diurna e assim como supracitado novamente as patentes mais prevalentes desta ocorrência foram cabo; sargento e capitão. Conclusão:Concluímos que apesar do número reduzido da amostra identificou-se alta prevalência da apneia obstrutiva do sono em policiais militares trabalhando em turno ou escala noturna quando comparada à população em geral do estudo

Euthyroid Sick Syndrome and Changes in Thyroid Hormones in Dogs with Hemoparasitosis

Background: Hemoparasitoses are extremely important in the clinical routine because they affect a large number of dogs. In spite of the abundance of studies on this topic, hormonal alterations caused by infection with these agents are still poorly known. Therefore, the goal of this work was to assess the serum levels of thyroid hormones of dogs infected with Ehrlichia canis (E. canis) alone, and dogs infected with E. canis and Babesia canis vogeli (B. vogeli) and/or Anaplasma platys (A. platys) before and after treatment with doxycycline chlorohydrate. This study also aimed at checking for presence of euthyroid sick syndrome (ESS) in these animals.Materials, Methods & Results: The concentrations of the thyroid hormones total triiodothyronine (TT3), total tetraiodothyronine (TT4), free tetraiodothyronine (FT4), and canine thyroid-stimulating hormone (cTSH) were assessed by chemiluminescence in 12 dogs. Nested polymerase chain reaction (nPCR) was used to confirm diagnoses. The dogs were divided into 2 groups: G1, which comprised animals infected by E. canis alone, and G2, which included animals simultaneously infected by E. canis and B. vogeli and/or A. platys. The serum concentrations of the thyroid hormones were measured at two time points: before (D1) and after (D2) the 28-day treatment with generic doxycycline chlorohydrate (DC) at a dose of 10 mg/kg SID. On D2, another nPCR was carried out to check the efficacy of the treatment. On D2, in both groups, all dogs became negative for E. canis; however, 8 animals remained infected or were reinfected by other hemoparasites. On D1, 4 dogs in G1 exhibited low TT3 in conjunction with low TT4; one of the dogs had increased TT3 alone, and another dog had an increased TT3 accompanied by decreased TT4. In G2, on D1, one dog exhibited high TT3 accompanied by a decreased concentration of TT4; 2 dogs had decreased TT4; 2 dogs had increased TT3; and one dog had both TT3 and TT4 decreased. On D2, with only one exception, the animals in G1 that became negative for all hemoparasites under study exhibited normal serum levels of TT3 and TT4. Three dogs in G1, which were reinfected on D2, sustained decreased TT4 serum concentrations. Whereas, in G1 on D2, only one dog remained with a reduced serum TT4 concentration.Discussion: DC was effective at eliminating infection by E. canis in all dogs on D2. Even though this drug was unable to prevent reinfection of the animals by other hemoparasites, and in spite of divergent results on its efficacy at eliminating babesiosis and anaplasmosis, a clinical improvement was observed in all patients. A decrease in the serum concentrations of thyroid hormones (ESS) may occur in dogs with severe non-thyroid related diseases. Different authors have demonstrated the presence of ESS in dogs with hemoparasitoses; however, this is the first study to provide evidence on the existence of this syndrome in dogs with hemoparasitoses in Brazil, including dogs simultaneously infected by E. canis and B. vogeli and/or A. platys.We observed a reduction in TT3 and/or TT4 in dogs infected by E. canis, B. vogeli, and A. platys. We believe these results may help assessment of prognosis and patient follow-up, as TT4 concentrations returned to normal levels in all dogs that became negative for all hemoparasites after treatment; and only one dog in G1 sustained increased TT3, albeit lower than observed on D1. In animals of G1 that were reinfected after treatment started, TT3 returned to normal, even though TT4 levels remained decreased. In sum, all dogs in G1 and G2 exhibited TT3 and/or TT4 concentrations outside of the reference value ranges on D1, which indicates that alterations in the levels of thyroid hormones were due to infection by the hemoparasites. The animals infected by E. canis alone or simultaneously infected by B. vogeli and/or A. platys exhibited ESS