Avanços terapêuticos na surdez súbita

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017A surdez súbita neurossensorial, conhecida como surdez súbita, é geralmente definida como uma perda auditiva de pelo menos 30 dB, em 3 frequências audiométricas contíguas, num período de 3 dias. Devido ao seu aparecimento abrupto, é um sintoma assustador que exige diagnóstico e tratamento prementes. Em aproximadamente 90% dos casos, uma causa subjacente não pode ser identificada, apesar de investigação adequada. Deste modo, é definida com surdez súbita neurossensorial idiopática. A sua fisiopatologia pouco clara, aparente baixa incidência e possibilidade de recuperação espontânea contribuem para manter o tratamento controverso. Ao longo dos anos, foram propostas mais de 60 modalidades terapêuticas para a surdez súbita neurossensorial idiopática, mas poucas demonstraram eficácia suportada por evidência científica na recuperação auditiva. Os corticoides sistémicos são habitualmente a terapia inicial utilizada, pois parecem promover a melhoria dos limiares auditivos no audiograma tonal simples. Há estudos que mostram que os corticosteroides intratimpânicos são não-inferiores aos corticosteroides orais como terapêutica inicial da surdez súbita e podem ser usados eficazmente como terapia de resgate, após a falha da terapia sistêmica. A eficácia da combinação da corticoterapia sistémica e intratimpânica está a ser estudada. A oxigenoterapia hiperbárica (HBOT) apresenta resultados promissores quer como terapia primária, adjuvante ou de resgate, mas está a ser avaliada em eficácia, frequência e duração. São necessários mais estudos com amostras de doentes maiores e medidas de resultados padronizadas. Ainda nenhum outro agente provou ser eficaz no tratamento da surdez súbita. A surdez súbita tem um elevado impacto na vida diária dos doentes. No geral, há demasiado foco no sucesso audiológico e não o suficiente na qualidade de vida do doente. Uma visão holística do doente é necessária para o sucesso terapêutico.Sudden sensorineural hearing loss (SSNHL), commonly known as sudden deafness, is mostly defined as a hearing loss of at least 30 dB loss in 3 contiguous audiometric frequencies over a 3-day period. Because of its sudden appearance, it is a frightening symptom that requires pressing diagnosis and treatment. In approximately 90% of cases, an underlying cause cannot be identified, despite adequate investigation. Therefore, it is defined as idiopathic sudden sensorineural hearing loss (ISSNHL). Its unclear physiopathology, apparent low incidence and chance of spontaneous recovery contribute to keep the treatment controversial. Over the years, there have been proposed more than 60 treatment modalities for ISSNHL, but only a few have shown efficacy supported by scientific evidence in hearing recovery. Systemic corticosteroids are usually the initial therapy prescribed, for they seem to promote pure tone average (PTA) improvement. There is data showing that intratympanic corticosteroids are non-inferior to oral corticosteroids in the initial management of ISSHL and can be used effectively as a salvage therapy, after the failure of systemic therapy. The combination therapy of systemic and intratympanic steroids is still being studied in terms of efficacy. Hyperbaric oxygen therapy (HBOT) shows promising results either as a primary, adjunct or salvage therapy, but is still being assessed in efficacy, frequency and duration. Further studies with larger patient samples and standardized outcomes measures are needed. No other agent has proven to be effective in ISSNHL yet. ISSNHL has a high impact on a patient’s daily life. In general, there is too much focus in audiological success and not enough on patient quality of life. A holistic view of the patient is required for therapeutic success

Análise do perfil de ácidos gordos de camarinha, Palaemonetes varians

Mestrado em Engenharia Zootécnica - Produção Animal - Instituto Superior de Agronomia / Faculdade de Medicina VeterináriaOne of the benefits associated with the consumption of fishery products is their fatty acid composition. In this dissertation we analyze the fatty acids profile of Atlantic ditch shrimp Palaemonetes varians, determined by gas chromatography. For this, 16 samples were collected in the Sado estuary area and examined. This study identified the majority of the P. varians fatty acids. In terms of highest quantity, we had the palmitic acid in SFA group, the oleic acid in MUFA and finally EPA in PUFA. Higher n-3/n-6 and PUFA/SFA ratios were also noticed. Related outcomes were found in studies associated to several other species of crustaceans. In July, the P. varians exhibited lower levels of MUFA, higher SFA values and higher n-3/n-6 ratio in comparison with the values registered in November (p<0,001). Comparing adult and juvenile P. varians, and despite not having significant variations in PUFA, it is noted the higher concentration of MUFA and lower SFA in adults (p<0,05). Few significant differences were observed between wild and not wild P. varians. A higher concentration of palmitic acid was found in not wild P. varians.These differences may be explained mainly by the food ingested by P. varians

New Challenges in the Higher education area: university networks for internationalization and globalization.

The "A NAME for Health" project, funded by the EDULINK program, is a project that establishes A Network Approach in Medical Education (NAME) for the Pursuit of Quality in Higher Education Institutions (HEIs) and Health Systems. It aims to improve Health Care through an ongoing intervention quality program on Medical Education, at 4 HEIs in Portugal, Angola and Mozambique: Faculty of Medicine of University of Porto (project coordinator), Portugal; Faculty of Medicine of Agostinho Neto University, Luanda, Angola; Faculty of Medicine of Eduardo Mondlane University, Maputo, Mozambique; and Faculty of Health Sciences of Lúrio University, Nampula, Mozambique. São João Hospital, E.P.E. and Calouste Gulbenkian Foundation are associated with this Project.Specifically, this Higher Education project aims at reinforcing the Partner Institutions' ability to improve academic skills and clinical specializations in three priority areas (Paediatrics, Gynaecology & Obstetrics and Infectious Diseases) related with the Millennium Development Goals. The presence of a qualified network for Medical Education helps to elevate the overall level of medical care available to the people of Angola and Mozambique, through academic stimulation. The network's priority is to reinforce the capabilities and the existing strengths of the Higher Education sector, through the creation of a more qualified staff and supporting an efficient development of these HEIs.With these objectives in mind, three types of activities are being developed: structuring, academic and clinical activities. Structuring activities include the establishment of Centers for Medical Education, creation of a Network Technological Platform to the different HEI (e-learning and long-distance learning), and the establishment of Students Support Office; academic activities consist of an analysis of the medical curriculum, its reform, implementation and monitoring, and IT Seminar/Conference; clinical activities comprise the establishment of a mobility program for clinical teachers and physicians.The project's strength and sustainability come from the belief that improvements in the whole Health System will be attained through the improvement of clinical and academic practice.Increasing the Institutions' scientific, pedagogical and clinical levels will enhance the network of Portuguese speaking countries, strengthening the link between Medical Education Healthcare in the African Higher Education Institutions.Sustainability will also be reinforced through the Technological Platform (which will be maintained among the Institutions) since it will enhance the investments that are being done in the partner Universities' information and communication technologies.Curricular reforms and their adaptation to international standards, together with the expected multiplier effects obtained through the clinical mobility program, will also be a way of supporting academic and clinical sustainability after the conclusion of the project.The competence acquisitions in the three priority clinical areas will also have a multiplier effect at the level of knowledge transfer to the other health agents such as nurses and health community agents. Focusing on Medical Education by structuring its organization, will generate involvement of young medical students, which will be the future physicians and clinical teachers (The Project A NAME for Health is supported by EDULINK Program, Contract nr. 9 ACP RPR 118 # 29

Asthma prevalence in adolescent students from a Portuguese primary and secondary school

Asthma is one of the most prevalent chronic diseases worldwide, with a considerable increase, especially in children. It is considered the main cause of childhood morbidity, school absenteeism, and limitations in sports practice. The causes are multifactorial, and their prevalence varies from region to region, thus verifying a great disparity in the estimates of the prevalence of asthma. In this sense, the objective of this study is to investigate the prevalence of asthma, its control, as well as the frequency of associated symptoms, in adolescents who attended the 3rd cycle of basic education and secondary education in schools in the municipalities of Paços de Ferreira, Paredes, and Penafiel. The sample consisted of 1222 (587 males and 635 females) (p = 0.17) aged between 12 and 17 years. The instruments used to diagnose asthma-associated symptoms were the standard questionnaire of the “International Study of Asthma and Allergies in Childhood—ISAAC” and to check whether asthma was controlled, the “Test for Asthma Control” questionnaire was used. The results reveal a high prevalence of adolescents with asthma (8.9%) with a significant percentage that did not have the disease under control (38%). There was also a considerable percentage of adolescents who, despite not having asthma, have many symptoms associated with the disease. These results may be associated with environmental factors.This research is supported by the Higher Institute of Educational Sciences of the Douro and by national funding through the Portuguese Foundation for Science and Technology, I.P., under the project UID04045/2020info:eu-repo/semantics/publishedVersio

The influence of abdominal adiposity and physical fitness on obesity status of portuguese adolescents

The aim of this study was to verify the relationship between abdominal adiposity and physical fitness in the obesity status of Portuguese adolescents. BMI, abdominal adiposity, and physical fitness tests from the FITescola® were evaluated in a total of 654 Portuguese adolescents, aged 10-19 years old—male: n = 334 (51%), female: n = 320 (49%). For the final model, BMI was positively related with age (β = 0.25), abdominal adiposity (β = 0.313), horizontal jump (β = −0.100), 40 m maximal velocity (β = 0.274), and aerobic fitness (β = −0.250, R2 = 0.75, F = 382.2, and p = 0.0001). We conclude that higher age and abdominal adiposity are positively related with a higher adolescent BMI. Furthermore, lower horizontal jump distances and worse times on the 40 m maximal velocity were inversely related with a higher adolescent BMI, and lower aerobic fitness was inversely related with a higher adolescent BMI.This research was funded by the National Funds through FCT—Portuguese Foundation for Science and Technology (UIDB/DTP/04045/2020) and the Higher Institute of Educational Sciences of the Douro (grant number NIDEF.21-22).info:eu-repo/semantics/publishedVersio

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Marco romano epigrafado da Rua das Canastras (Santa Maria Maior – Lisboa)

Inscrição nº 831.O fragmento epigrafado achado em Lisboa no decurso de trabalhos arqueológicos pertence a um miliário atribuível ao imperador romano Constâncio (cerca do ano 291) ou a Crispo (depois de 316). É possível que tenha sido pensado para figurar à saída da cidade romana

As presenças de vivos e mortos na área de Belas e Carenque: sincronia e diacronia nos 4.º e 3.º milénios a.n.e.

A recente revisão dos dados acerca dos sepulcros de Belas e Carenque, assim como de núcleos habitacionais da área, como Espargueira e Baútas, permite efectuar uma avaliação da sua ocupação humana. Este trabalho procurou estabelecer possíveis sincronias e diacronias entre os vários sítios conhecidos.The revision of data from the tombs of Belas and Carenque, as well as from settlements known in the area, such as Espargueira and Baútas allowed a reassessment of the human occupation of area. Thus this work aims to establish possible synchronies and diachronies between these sites.info:eu-repo/semantics/publishedVersio

IN PERPETVAM REI MEMORIAM: A epígrafe latina em honra de D. Luís de Menezes, Senhor de Ansião

A propósito da inscrição latina inserida no monumento levantado, em 1686, na vila de Ansião, por iniciativa do Senado local, em honra do Conde da Ericeira, traça-se uma panorâmica do que era na época esse lugar; conta-se da intervenção de D. Luís de Menezes para que o lugar fosse elevado à categoria de concelho: e faz-se o estudo epigráfico da inscrição. Essa análise permitiu também trazer mais alguma luz sobre a brilhante actividade do Conde da Ericeira. À propos du texte latin qui figure sur un monument érigé, en 1686, à Ansião (localité du Centre de Portugal, district de Leiria), en honneur de Luís de Menezes, Comte d’Ericeira et Conseiller d’État, on essaie de dresser un portrait sur l’activité de cette localité à l’époque et d’évoquer les raisons par lesquelles lui a été atribué le statut de municipe. On fait l’étude épigraphique du texte, ce qui a permis, d’autre part, de mieux connaître l’œuvre de ce notable homme d’État