A Pain to the Patient and to the Doctor

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Chronic Pruritus

O Prurido crónico é um sintoma que tem um impacto significativo na qualidade de vida dos doentes. Pode estar associado a um vasto conjunto de doenças e na maioria dos casos, é difícil conseguir um alívio completo da sintomatologia. A investigação da sua etiologia implica a colheita de uma história clínica meticulosa, bem com a realização do exame objectivo e de exames complementares de diagnóstico. O tratamento do prurido é frequentemente um desafio para o dermatologista e pode incluir a implementação de diferentes terapêuticas. Esta revisão pretende dar ênfase à abordagem clínica e às opções terapêuticas do doente com prurido crónico

Garch models for drug effects on patient heart rate, during general anaesthesia

A model that can describe the effect of anaesthetic drugs on patient’s heart rate (HR) is of great importance when considering haemodynamic stability under surgery. A Generalized Autoregressive Conditional Heteroscedasticity (GARCH) model was used to model HR considering the effect concentrations of the anaesthetic propofol and the analgesic remifentanil, using the clinical data of 16 patients. The model was able to capture the HR trend in all 16 patients with very small errors throughout the surgical time. A correlation was found between the GARCH parameters and patient baseline characteristics, leading to the possibility a patient adjusted adaptive model.info:eu-repo/semantics/publishedVersio

Focus group as a tool in the development of procedures in radiation therapy

Morgan defines a focus group as “a research technique that collects data through group interaction on a topic determined by the researcher.” This definition provides the 3 major components of the focus group research: (1) A method devoted to data collection, (2) interaction as a source of data, and (3) the active role of the researcher in creating group discussion for data collection. This technique emerged as a qualitative data collection approach and a bridging strategy for scientific research and local knowledge. In this setting, the researcher facilitates or moderates a group discussion between participants and not between the researcher and the participants. The fact that the group process helps people to identify and clarify their views is an important advantage of focus groups compared with individual interviews. Is typically used in health care research to (1) develop or improve research instruments (eg, interview guides, questionnaires); (2) explore issues and generate data; and (3) evaluate and validate findings from other research methods (or triangulation). Focus group discussion is a technique in which a researcher gathers a group of individuals to discuss a specific topic. In this case, the participants will examine a prototype tool in radiation therapy, aiming to purposefully generate meaningful opinions, suggestions, and feedback. This study aims to present the focus group as a tool for use and multidisciplinary collaboration within a healthcare team, to outline the implementation steps in the specific case of developing a procedure/resource for subsequent application, and to assess the acceptance and feasibility of their implementation.info:eu-repo/semantics/publishedVersio

Revisiting the genetics of APOE

Apolipoprotein E (APOE) is a lipid-transport protein expressed in almost all tissues, including the brain. In addition to lipid delivery, brain APOE also regulates amyloid beta clearance and aggregation. In humans, there are three main isoforms, APOE2, APOE3 and APOE4, with structural differences that influence protein function. APOE4 is the most important genetic risk factor for Alzheimer’s disease and Dementia with Lewy bodies. In this review, we will focus on the genetic variability of APOE and its association with different diseases (mainly neurodegenerative, psychiatric and lipid-related). Despite the increasing number of studies, the association of APOE genetic variants with other neurological conditions beyond Alzheimer’s disease and Dementia with Lewy bodies is still far from clear. We will also discuss the association of different structural and functional aspects of APOE with different diseases, particularly the amyloid beta-dependent and-independent mechanisms, such as tau-mediated neurodegeneration, associated with Alzheimer’s disease pathogenesis. As the most significant genetic risk factor for Alzheimer’s disease, APOE has a central role in the risk assessment of this disease. Consequently, a better understanding of the impact of common and rare APOE variants will not only contribute to a more accurate risk management of these patients, but it will also clarify the potential of APOE as a therapeutic target

Alternative regimens for prostate cancer treatment using radiation therapy

Purpose/Objective: The purpose of this work was to determine biologically equivalent alternative regimens for the treatment of prostate cancer using External Beam Radiotherapy (EBRT) and Low Dose-Rate Brachytherapy (LDRBT) with 125I implants and to evaluate the sensitivity of these regimens to different sets of radiobiological parameters of the Linear-Quadratic (LQ) model

Treatment of Lupus Erythematosus of the Eyelids with Pulsed Dye Laser

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A dermatosis of pregnancy

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Drug Allergy with Cutaneous Manifestations. Diagnostic Approach

As reacções adversas a fármacos (RAF) representam um problema frequente na prática clínica. A alergia a fármacos resulta de mecanismos de hipersensibilidade imunológica e representa 6-10% do total de RAF. Clinicamente, as reacções alérgicas a fármacos podem ser classificadas como imediatas (tipo I) ou não-imediatas (com manifestações clínicas diversas e associadas sobretudo a reacções de tipo IV). Neste artigo são abordados aspectos gerais, nomeadamente os mecanismos imunopatogénicos implicados na alergia a fármacos e reactividade cruzada mas também as manifestações cutâneas mais relevantes, nomeadamente exantemas máculo-papulares, eritema fixo a fármacos (EFF), pustulose exantemática aguda generalizada (PEAG), síndrome de hipersensibilidade a fármacos (DRESS – drug rash with eosinophilia and systemic symptoms), síndrome de Stevens-Johnson/necrólise epidérmica tóxica (SSJ/NET). O papel dos testes cutâneos (epicutâneos ou intradérmicos de leitura tardia) na abordagem de reacções não-imediatas é também revisto. Os beta-lactâmicos (BL) são o grupo farmacológico mais frequentemente envolvido em reacções de hipersensibilidade imunológica e que mais dificuldades coloca na prática clínica diária, nomeadamente devido aos riscos de reactividade cruzada, pelo que é analisado em maior detalhe ao longo da revisão. A indução de tolerância a fármacos poderá ser considerada em casos selecionados, sobretudo quando na ausência de alternativas terapêuticas igualmente eficazes ou seguras

Popeye Deformity: a Red Flag for Wild-Type Transthyretin Amyloidosis

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