472 research outputs found
Estudio retrospectivo de la eficacia y seguridad del natalizumab en el tratamiento de la esclerosis múltiple en Portugal
INTRODUCTION. Studies have shown that natalizumab is an effective treatment for relapsing-remitting multiple sclerosis (RRMS). To date, no data are available in Portuguese patients.
AIM. To determine the efficacy and safety of natalizumab in patients with RRMS in routine clinical practice in Portugal.
PATIENTS AND METHODS. Clinical data for adult patients with RRMS treated with natalizumab at specialist neurology centres in Portugal were entered retrospectively into a database for analysis between October 2010 and February 2012. Changes in annualized relapse rates (ARR), Expanded Disability Status Scale (EDSS) scores and disability status were analysed.
RESULTS. A total of 383 patients from 20 centres were included. Prior to starting natalizumab, the baseline median EDSS score was 4 and the mean ARR was 1.64. Most patients had previously received multiple sclerosis treatment (93.0%). Median natalizumab treatment duration was 12 months. Natalizumab treatment was associated with significant (p = 12 months (n = 288) and for >= 24 months (n = 160). Natalizumab was more effective in patients with less disability (EDSS < 3) and in those who had not previously received disease-modifying treatments. Two cases of progressive multifocal leukoencephalopathy were reported. No new unexpected adverse events occurred.
CONCLUSION. Natalizumab is well tolerated, and is effective in reducing relapse rate and stabilising disease in patients with RRMS in the clinical practice setting in Portugal. Its efficacy persists with continued treatment, and it may be particularly effective in patients with less disability and without prior disease modifying therapy.Introduccion. Los estudios han demostrado que el natalizumab constituye un tratamiento eficaz contra la esclerosis multiple remitente recurrente (EMRR). Hasta la fecha, no habia datos de pacientes portugueses.
Objetivo. Determinar la eficacia y la seguridad del natalizumab en pacientes con EMRR atendidos en la practica clinica ordinaria en Portugal.
Pacientes y metodos. Los datos clinicos de adultos con EMRR tratados con natalizumab en centros especializados de neurologia en Portugal se introdujeron de forma retrospectiva en una base de datos para llevar a cabo un analisis entre octubre de 2010 y febrero de 2012. Se analizo el cambio en la tasa anualizada de brotes (TAB), en las puntuaciones de la escala ampliada de discapacidad (EDSS) y en el estado de discapacidad.
Resultados. Se admitio un total de 383 pacientes atendidos en 20 centros. Antes de iniciar el tratamiento con natalizumab, la mediana inicial de la EDSS era de 4,0 y la TAB media, de 1,64. La mayor parte de los pacientes ya habia recibido tratamiento contra la esclerosis multiple (93,0%). La duracion media del tratamiento con natalizumab era de 12 meses. El tratamiento propicio reducciones significativas (p = 12 meses (n = 288) y durante >= 24 meses (n = 160). El natalizumab resulto mas eficaz en los pacientes que presentaban un menor grado de discapacidad (EDSS < 3,0) y en los que no habian recibido ningun tratamiento modificador de la enfermedad. Se notificaron dos casos de leucoencefalopatia multifocal progresiva. No hubo efectos adversos inesperados.
Conclusion. El natalizumab presenta una tolerabilidad satisfactoria y se muestra eficaz en la reduccion de las recidivas y la estabilizacion de la EMRR en el marco de la practica clinica ordinaria en Portugal. Conserva su eficacia con el tratamiento continuado y podria ser eficaz especialmente en los pacientes con menos discapacidad y en aquellos que no han recibido ningun tratamiento modificador de la enfermedad hasta el momento
Validação da BRBN-T: adaptação do Selective Reminding Teste do Word List Generation
Objective: This study aims to present the Selective Reminding Test (SRI) and Word List Generation (WLG) adaptation to the Portuguese population, within the validation of the Brief Repeatable Battery of Neuropsychological Tests (BRBN-T) for multiple sclerosis .(MS) patients. Method: 66 healthy participants (54.5% female) recruited from the community volunteered to participate in this study. Results: A combination of procedures from Classical Test Theory (OTT) and Item Response Theory (ITR) were applied to item analysis and selection. For each SRT list, 12 words were selected and 3 letters were chosen for WLG to constitute the final versions of these tests for the Portuguese population. Conclusion: The combination of CTT and ITR maximized the decision making process in the adaptation of the SRI and WLG to a different culture and language (Portuguese). The relevance of this study lies on the production of reliable standardized neuropsychological tests, so that they can be used to facilitate a more rigorous monitoring of the evolution of MS, as well as any therapeutic effects and cognitive rehabilitation.info:eu-repo/semantics/publishedVersio
Distribution-Based Categorization of Classifier Transfer Learning
Transfer Learning (TL) aims to transfer knowledge acquired in one problem,
the source problem, onto another problem, the target problem, dispensing with
the bottom-up construction of the target model. Due to its relevance, TL has
gained significant interest in the Machine Learning community since it paves
the way to devise intelligent learning models that can easily be tailored to
many different applications. As it is natural in a fast evolving area, a wide
variety of TL methods, settings and nomenclature have been proposed so far.
However, a wide range of works have been reporting different names for the same
concepts. This concept and terminology mixture contribute however to obscure
the TL field, hindering its proper consideration. In this paper we present a
review of the literature on the majority of classification TL methods, and also
a distribution-based categorization of TL with a common nomenclature suitable
to classification problems. Under this perspective three main TL categories are
presented, discussed and illustrated with examples
Protective role of N-acetylcysteine (NAC) on human sperm exposed to etoposide
Background: Although recent progress in cancer treatment has increased patient survival and improved quality of life, reproductive side effects are still for concern. One way to decrease gonadal impairment is to use cytoprotectors. In testicular cancer, etoposide is generally used in combination with other agents, but there are no in-vitro studies of sperm exposure to etoposide and cytoprotectors, namely N-acetylcysteine (NAC). Methods: Twenty semen samples were individually divided into five groups: control, incubation with NAC alone, incubation with etoposide alone, sequential exposure of NAC followed by etoposide (pre-treatment) and sequential exposure of etoposide followed by NAC (post-treatment). Sperm characteristics, chromatin condensation (aniline blue), DNA fragmentation (TUNEL), oxidative stress (OxyDNA labelling) and glutathione quantification were used to evaluate the capabilities of NAC as a prophylactic (pre-treatment) or ameliorator (post-treatment) agent over the effects caused in sperm during in-vitro exposure to etoposide. Results: No deleterious effects were observed on sperm motility or sperm membrane integrity. Results revealed that prophylactic use of NAC (pre-treatment) increased rates of immature sperm chromatin as compared to ameliorator use of NAC (post-treatment), and increased rates of sperm DNA fragmentation in relation to controls. Pre and post-treatment with NAC increased oxidative levels in comparison to controls, but also increased levels of cellular antioxidant glutathione. Conclusions: The results indicate that NAC has the ability to counteract etoposide-induced toxicity rather than preventing the etoposide cytotoxic effects over sperm DNA, suggesting that the administration of NAC to cells formerly exposed to etoposide is preferable to its prophylactic use. As the results evidenced that NAC seems to be more efficient in attenuating sperm etoposide cytotoxic effects instead of being used as a chemoprophylactic agent, this reinforces the idea that there might be a new NAC mechanism over DNA.UMIB (Pest-OE/SAU/UI0215/2014) is funded by National Funds through FCT-Foundation for Science and Technology
Prescribing patterns of medication for respiratory diseases - cluster analysis of the Portuguese electronic prescription database
We aimed to describe, for the first time, the prescribing patterns among patients on persistent respiratory treatment, from the Portuguese electronic prescription and dispensing database. This was a one-year retrospective population-based analysis of prescriptions (n = 39810) for medication for respiratory disease and exacerbations. Cluster analysis was applied based on medication and prescribers' specialty. Prescribing patterns were grouped and labelled as: possible medication for asthma and allergic rhinitis (General Practitioners-GPs and allergists to younger patients); COPD (GPs and pulmonologists to older patients); asthma or Asthma-COPD Overlap (GPs and pulmonologists); exacerbation, infection and relievers. This analysis was an important first step to understand the Portuguese reality on the treatment of respiratory diseases.info:eu-repo/semantics/publishedVersio
Pharyngolaryngeal Foreign Body as Cause of Disphonia
A ingestão acidental e a impactação de corpos estranhos na via aerodigestiva é uma urgência otorrinolaringológica comum. Nos adultos, as espinhas são os corpos estranhos mais frequentemente
impactados.
Uma anamnese e uma observação cuidadosas são de extrema importância. Os sintomas incluem odinofagia, disfagia, tosse persistente, alteração da voz, sialorreia e menos frequentemente uma complicação respiratória.
As espinhas impactam mais frequentemente numa localização supra-hioideia. Locais menos frequentes de impactação são a hipotaringe, a região cricofaríngea e o esófago, sendo o diagnóstico mais difícil a estes níveis.
A migração extra-luminal ocorre raramente, sendo mais frequente na presença de uma espinha. Atendendo a sua forma, este é o corpo estranho que mais facilmente migra e como tal, é o que apresenta maior taxa de complicações. Nesta situação, é necessário um elevado lndice de suspeição, sendo a realização de TC fundamental. Os autores apresentam um caso de migração de uma espinha ao nível da banda ventricular laringea e um algoritmo para o diagnóstico e tratamento de corpos estranhos perfurantes e migrantes.info:eu-repo/semantics/publishedVersio
Management of Intra-Abdominal Desmoid Tumours associated with Familial Adenomatous Polyposis (FAP)
AGREGADOS TUBULARES DE RETÍCULO ENDOPLASMÁTICO LISO EM OVÓCITOS HUMANOS E SUA INFLUÊNCIA NAS TAXAS DE FERTILIZAÇÃO E GRAVIDEZ
O impacto da presença de anomalias morfológicas ovocitárias na fertilização e taxas de gravidez é um tema controverso na literatura. A presença de agregados tubulares de retículo endoplasmático liso (AT-REL) foi associada a taxas de gravidez mais baixas e a maior incidência de complicações obstétricas. A estrutura
ultramiscroscópica destes AT-REL não está descrita.
Este trabalho teve como objectivos: a) determinar a influência da presença de AT-REL nas taxas de fertilização e gravidez; b) descrever a ultrastrutura dos AT-REL de ovócitos humanos maduro
Data-driven prescription patterns in patients under maintenance treatment for respiratory diseases from the Portuguese prescription database
We aimed to identify prescription patterns in respiratory patients using an unsupervised (data-driven) method, in a random sample of patients aged >14 years (n=8799), retrieved from the Portuguese Electronic Medical Prescription database. Respiratory patients were defined if >2 packs of maintenance treatment for respiratory diseases were prescribed in 2016. We analysed all the prescriptions (n=39810) for respiratory diseases and exacerbations by medication type. Two-step clustering was based on the presence of ICS, LABA, LTRA, LAMA, LABA, SABA, SAMA and on the speciality of prescriber.info:eu-repo/semantics/publishedVersio
Assessment of cognitive functions in patients with multiple sclerosis applying the normative values of the Rao’s brief repeatable battery in the Portuguese population
Background: The Brief Repeatable Battery of Neuropsychological Tests (BRBN-T) is one of the most sensitive and
used measures for detecting cognitive impairment in Multiple Sclerosis (MS).
Objective: The aim of this study was to adapt and validate this battery to the Portuguese population of MS
patients.
Methods: The Portuguese version of the BRBN-T was applied to a stratified control national sample of 326
individuals considering sex, age, educational level and geographic location and also a clinical sample of 115 MS
patients from several national hospitals. Through the exploration of its psychometrics properties, the Portuguese
BRBN-T norms were produced.
Results: The normative data is presented as a regression-based formula to adjust test scores for gender, education
and age, and the results reveal the BRBN-T has the ability to differentiate between MS patients and healthy
participant’s cognitive performance.
Conclusion: This study demonstrated in our clinical population a good ability to detect cognitive impairment. Its
clearly contributed to reinforcing the neuropsychological assessment in Portugal in patients with MS, by providing
a new set of instruments, which can be used in the clinical practice, and in future studies. Moreover, it will allow a
rigorous and precise support in relation to neuropsychological assessment for future longitudinal studies and
clinical trials.info:eu-repo/semantics/publishedVersio
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