What potential biomarkers should be considered in diagnosing and managing canine chronic inflammatory enteropathies?

As enteropatias inflamatórias crónicas em cães caracterizam-se pela manifestação de sinais clínicos gastrointestinais persistentes ou recorrentes com uma duração superior a três semanas. Apesar da falta de clareza na etiopatogenia, considera-se que a predisposição genética, associada a fatores ambientais, como os antigénios alimentares e a microbiota intestinal, poderá induzir uma resposta imunitária anormal no hospedeiro. O diagnóstico deste quadro clínico requer uma investigação completa, de forma a excluir todas as outras possíveis causas. Atualmente, a observação de sinais clínicos, associada à avaliação histopatológica e a ensaios terapêuticos sistemáticos, constitui o método de eleição para o diagnóstico das enteropatias crónicas. Para além disso, o diagnóstico, a monitorização da progressão da doença e a avaliação da resposta ao tratamento, podem ser exaustivos, visto que todo este processo é extenso, dispendioso e parcialmente invasivo. Assim, os biomarcadores surgem como ferramentas não invasivas, que podem ser úteis na avaliação da função gastrointestinal, na identificação da presença da doença e na avaliação da sua progressão natural, bem como na deteção de mudanças temporais na atividade clínica. Adicionalmente, os biomarcadores podem ser vantajosos na monitorização da inflamação gastrointestinal, na previsão da resposta ao tratamento e dos desfechos clínicos. Na última década, vários estudos foram realizados com o intuíto de explorar a utilidade clínica dos biomarcadores. Assim, o objetivo desta dissertação é fornecer uma visão geral dos biomarcadores considerados relevantes para o diagnóstico e gestão de cães com enteropatias inflamatórias crónicas. Os biomarcadores abordados neste estudo poderão ser serológicos, estar presentes nas fezes e urina, ou ainda derivados de tecidos. Este estudo argumenta que os biomarcadores, em particular a calprotectina e a calgranulina c, têm um grande potencial para serem utilizados na prática clínica, no diagnóstico e gestão de cães doentes. Contudo, um único biomarcador não pode, com certeza, predizer a severidade da doença, a progressão, a resposta ao tratamento e o desfecho clínico. Deste modo, com o intuito de alcançar uma maior precisão, será benéfico se estas ferramentas forem utilizadas em conjunto com as ferramentas contemporâneas. Futuras investigações são necessárias, com o objetivo de melhor determinar a utilidade destas ferramentas no diagnóstico e gestão de cães com enteropatias crónicas inflamatórias.Chronic inflammatory enteropathies in dogs are characterized by persistent or recurrent gastrointestinal signs that last for more than three weeks. Despite unclarity in the etiopathogenesis, it is considered that a genetic predisposition associated with environmental factors, such as dietary antigens and the intestinal microbiota, might induce an abnormal immune response in the host. The diagnosis of this condition requires full investigation in order to exclude all other possible causes. Currently, observation of clinical signs associated with histopathologic evaluation and systematic therapeutic trials is the gold standard for the diagnosis of chronic enteropathies. Furthermore, diagnosis, monitoring the disease progression and treatment response evaluation can be exhausting, since this whole process is time-consuming, costly and partially invasive. Therefore, biomarkers appear as non-invasive tools, which can be useful in evaluating gastrointestinal function, identifying the presence of disease, and assessing its natural progression, as well as detecting temporal changes in clinical activity. Moreover, it can be advantageous in monitoring gastrointestinal inflammation, predicting response to treatment and clinical outcomes. Over the past decade, several studies were conducted in order to explore the clinical utility of biomarkers. Thus, the aim of this dissertation is to provide an overview of the biomarkers considered relevant in the diagnosis and management of dogs with chronic inflammatory enteropathies. The biomarkers addressed in this study may be serological, present in urine and feces or even tissue-derived. This study argues that biomarkers, in particular calprotectin and calgranulin c, have great potential to be used in clinical practice in the diagnosis and management of dogs affected dogs. However, a single biomarker cannot assuredly predict disease severity, progression, response to treatment and clinical outcome. Therefore, in order to achieve greater accuracy, it would be beneficial if these tools are used in conjunction with the c ontemporary ones. Future research is needed with the aim of better determine the usefulness of these tools in diagnosing and managing chronic inflammatory enteropathies in dogs

Disseminated cutaneous histoplasmosis with laryngeal involvement in a setting of immune reconstitution inflammatory syndrome

Introduction: Histoplasmosis is a systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. We report a case of disseminated cutaneous histoplasmosis with mucocutaneous involvement in an AIDS patient paradigmatic of the multifaceted nature of the disease, which is an expression of the immune reconstitution inflammatory syndrome (IRIS).Patient presentation: A 39-year-old man presented with a three month history of asymptomatic papules and nodules with necrotic centres involving the centrofacial region. The patient was diagnosed as being HIV-positive a month earlier and was commenced on antiretroviral treatment. Two weeks after the development of skin lesions, the patient complained of a sore throat and hoarseness of his voice. A fibre-optic laryngoscopy and biopsies of the skin, larynx and liver were performed.Management and outcome: The CD4 counts increased from 2 cells/μL to 124 cells/μL, whereas the viral load decreased from one million to less than 20 copies/mL. A fibre-optic laryngoscopy revealed a supraglottitis with ulceration on the epiglottis. Histology of the liver, larynx and sections of the skin demonstrated pandermal necrotising granulomatous inflammation. Grocott-Gomori methenamine silver and Periodic acid–Schiff (PAS) stains revealed a relative paucity of intracellular, narrow-neck budding fungal organisms. Culture findings confirmed the diagnosis of histoplasmosis. The patient was treated with intravenous amphotericin B for two weeks followed by oral itraconazole 100 mg twice a day, with an excellent response to treatment.Conclusion: We present this case to remind clinicians that disseminated histoplasmosis in AIDS patients may occur as an expression of IRIS. A sudden onset of hoarseness with cutaneous lesions in a patient with disseminated disease should alert one to possible laryngeal histoplasmosis. Prompt recognition and treatment will avert the potential fatal complications of this disease

Factors associated with attempted suicide during adolescence

Thesis (M.A.)--University of the Witwatersrand, Faculty of Humanities, 1991.This study examines factors associated with attempted suicide during adolescence. The sample consists of 10 Black adolescent girls who atempted suicide in the past year, and were admitted to Baragwanath Hospital. Each subject was questioned on demographic information and completed the Separation Anxiety Test (Hansburg, 1972) and Section 1 of the Inventory of Parent and Peer Attachment (Armsden and Greenberg, 1987), which assesses attachment to a parent. Subjects were also required to answer questions on their choice of responses. Common trends were found to exist among adolescent girls who attempt suicide. Adolescent girls who attempt suicide have disruptive home environments where parents experience marital problems. They show a low degree of attachment, high degree of hostility, stress avoidance during the stage of identity crisis, and they maintain a poor attachment-individuation balance. These findings suggest that the most common treatment strategy, ie. crisis intervention is not sufficient as it does not deal with underlying problems of adolescent suicide

Sistema de apoio à decisão para melhoria da mobilidade urbana

O Balanced Scorecard (BSC) é uma metodologia de gestão estratégica desenvolvida por Robert Kaplan e David Norton, em meados da década de 90, que atualmente é vista como uma ferramenta para a comunicação e execução da estratégia. A presente investigação surgiu no âmbito do projeto FCT iLU - "Aprendizagem avançada em dados urbanos com contexto situacional para otimização da mobilidade nas cidades", que envolve uma parceria com o INESC-IST, o LNEC e a Câmara Municipal de Lisboa (CML), e no qual o objetivo é a aplicação do BSC para avaliar, de acordo com uma visão holística, a mobilidade na cidade de Lisboa. A mobilidade urbana sustentável é um grande desafio para as cidades sendo necessário investimento num sistema integrado e multimodal de transportes, definir políticas urbanísticas e de ordenamento do território de forma a melhorar o uso e ocupação do espaço, potenciar a utilização de transportes públicos e mobilidade suave, reestruturar as interfaces dos transportes públicos e introduzir soluções descarbonizadas. Devido à complexidade de elaborar um BSC que compreenda todas estas necessidades juntamente com os diversos modos de transporte para a CML, esta investigação focou-se no serviço de transporte público da CARRIS. Os dados utilizados para a realização deste trabalho foram provenientes de uma leitura extensa de documentos públicos e análise documental do que está publicado do ponto de vista estratégico. O desenvolvimento do BSC contou também com o apoio de peritos nas áreas de gestão estratégica e mobilidade e transportes, partilhando diferentes pontos de vista.The Balanced Scorecard (BSC) is a strategic management methodology developed by Robert Kaplan and David Norton, in the mid-1990s, which is currently seen as a tool for communicating and executing the strategy. The present dissertation was developed in the context of the iLU FCT project - "Advanced learning in urban data with a situational context for optimizing mobility in cities", which involves a partnership with INESC-IST, LNEC and the Lisbon City Council (CML), and in which the objective is the application of the BSC to assess, according to a holistic view, the mobility in the city of Lisbon. Sustainable urban mobility is a major challenge for cities requiring investment in an integrated and multimodal transport system, to define urban policies and spatial planning in order to improve land consumption, to enhance the use of public transport and smooth mobility, to restructure public transport interfaces and to introduce decarbonized solutions. Due to the complexity of developing a BSC that embraces all these needs together with the different modes of transport for CML, this dissertation has focused on the CARRIS public transport service. The data used for this work came from an extensive reading of public documents and document analysis of what is published from a strategic point of view. The development of the BSC was also supported by experts in the areas of strategic management and mobility and transportation, sharing different points of view

Uma incursão pelo regime legal da insolvência culposa : à luz da lei n.º 9/2022, de 11 de janeiro

A alteração levada a cabo pela mais recente Lei n.º 9/2022, de 11 de janeiro, surgiu da necessidade de estabelecer medidas de apoio e agilização no âmbito dos processos de reestruturação de empresas e dos acordos de pagamento, transpondo, para tal, a Diretiva (UE) 2019/1023, do Parlamento Europeu e do Conselho, de 20 de junho de 2019, e alterando, entres outros, o Código da Insolvência e da Recuperação de Empresas. Em consequência, o instituto do incidente da qualificação da insolvência foi uma das temáticas de entre as várias que foram objeto daquela alteração legislativa, e que nos despertou particular interesse. A presente dissertação tem o objetivo de contribuir para a compreensão do “novo regime” que foi instituído naquela matéria, e, simultaneamente, perceber que efeitos e respetivos impactos diversos poderão advir e resultar daquelas alterações. O interesse na presente temática assenta na fundamentalidade da qualificação da insolvência para o interesse público, por tutelar a segurança jurídica do comércio jurídicoeconómico através da prevenção de condutas prejudiciais às empresas, e da reprovação de comportamentos dolosos capazes de gerar insolvências, ou de, pelo menos, agravá-las. De modo a alcançar aquele objetivo, abordamos o instituto da qualificação da insolvência a três níveis: regime processual, regime substantivo, e efeitos. A conclusão que retiramos das mais recentes alterações, revela um sentimento ambíguo, de clarificação, mas também de confusão. De todo o modo, temos de ter presente que a evolução do Direito é uma consequência da própria evolução das sociedades, e até do próprio ser humano. Com efeito, acreditamos que a intenção do legislador com a aprovação da Lei n.º 9/2022, de 11 de janeiro, tenha sido motivada pelas melhores intenções de preenchimento de lacunas, e clarificação de questões que há muito vinham a ser debatidas na doutrina. No entanto, o ser humano não é perfeito, nem o próprio legislador. E, tendo em conta esse facto, apesar de algumas questões ainda terem ficado em aberto, acreditamos que o legislador, futuramente, fará melhores escolhas, pelas quais ficaremos a aguardar.The amendment made by the most recent Law 9/2022, of 11 January, arose from the need to establish support and streamlining measures in the context of company restructuring processes and payment agreements, transposing Directive (EU) 2019/1023, of the European Parliament and of the Council, of 20 June 2019, and amending, among others, the Insolvency and Corporate Recovery Code. As a result, the institute of the insolvency qualification incident was one of the topics among the several that were object of that legislative amendment, and that aroused our particular interest. The present dissertation aims to contribute to the understanding of the "new regime" which was instituted on this matter, and, simultaneously, to understand what effects and different impacts may arise from those changes. The interest in this topic is based on the fundamentality of the qualification of insolvency for the public interest, as it protects the legal security of legal-economic commerce through the prevention of conducts which are harmful to companies, and the reproving of wilful behaviour capable of generating insolvencies, or at least of aggravating them. In order to achieve that goal, we approach the institute of insolvency qualification at three levels: procedural regime, substantive regime and effects. The conclusion we draw from the most recent changes reveals an ambiguous feeling, of clarification, but also of confusion. In any case, we must bear in mind that the evolution of Law is a consequence of the evolution of societies and even of the human being itself. In fact, we believe that the legislator's intention with the approval of Law no. 9/2022, of 11 January, was motivated by the best intentions of filling gaps, and clarifying issues that had long been debated in the doctrine. However, human beings are not perfect, nor is the legislator himself. And, taking this fact into account, although some issues were still left open, we believe that in the future the legislator will make better choices, for which we will be waiting

Plantas e produtos vegetais com ação no sistema digestivo: Gengibre e os seus efeitos terapêuticos

Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2020, Universidade de Lisboa, Faculdade de Farmácia.No domínio da nutrição, desde a antiguidade que se explora as propriedades benéficas medicinais dos produtos naturais, nomeadamente as plantas. Os rizomas de Zingiber officinale Roscoe, vulgarmente conhecidos como gengibre, são extremamente utilizados na cozinha como tempero e especiaria, e também traz inúmeros benefícios para a saúde. Os rizomas são utilizados há mais de dois mil anos nos vários sistemas tradicionais da medicina para tratar artrite, reumatismo, estados hipertensivos, dores musculares, dores de garganta, entorses, cãimbras, asma, catarro, derrames, febre, doenças infeciosas, doenças nervosas, gengivite, dor de dentes, demência e diabetes. O gengibre também é utilizado como medicamento caseiro e tem um elevado valor no tratamento e prevenção de várias doenças gástricas, como indigestão, dispepsia, náusea, vómito, gastrite, desconforto epigástrico, ulcerações gástricas, arrotos e estudos científicos que vieram validar a sua utilização etnomedicinal. Foi também demonstrado que o gengibre é eficaz na prevenção de úlceras gástricas induzidas por: anti-inflamatórios não-esteróides (AINEs como a indometacina, a aspirina); a reserpina, o etanol; stresse (hipotérmico e natação); ácido acético e ulcerações gástricas induzidas pela bactéria Helicobacter pylori em animais de laboratório. Vários estudos clínicos e estudos pré-clínicos também demonstraram que o gengibre possui efeitos antieméticos contra diferentes estímulos emetogénicos. No entanto, existem relatos conflituantes relativamente à sua eficácia, especialmente na prevenção de naúseas, vômitos e enjoos que são induzidos pela quimioterapia, que impedem de chegar a uma conclusão sólida sobre a eficácia do gengibre com um amplo espectro antiemético. Demonstrou-se que o gengibre possui propriedades antioxidantes, eliminador de radicais livres, inibição da peroxidação lipídica e que essas propriedades possam ter contribuído para os efeitos gastroprotectores observados. Esta monografia resume os vários efeitos gastroprotectores do gengbre entre outras propriedades relevantes, a sua história e fitoquímica, e também denota aspectos que garantem pesquisas futuras para establecer a sua atividade e utilidade como agente gastroprotector em humanos.In the field of nutricion, the beneficial medicinal properties of natural products, including plants, have been explored since ancient times. The rhizomes of Zingiber officinale Roscoe (Zingiberaceae), commonly known as ginger is a significant kitchen spice and also possess a numerous health benefits. The rhizomes have been used for more than two thousand years in the various tradicional systems of medicine to treat arthritis, rheumatism, hypertension, muscular aches, pains, sore throats, sprains, cramps, asthma, catarrh, stroke, fever, infectious diseases, nervous diseases, gingivitis, toothache, dementia and diabetes. Ginger is also used as home remedy and is of immense value in treating various gastric ailments like indigestion, constipation, dyspepsia, nausea, vomiting, gastritis, epigastric discomfort, gastric ulcerations, belching, bloating and scientific studies have validated the ethnomedicinal uses. Ginger is also shown to be effective in preventing gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs like indomethacin, aspirin), reserpine, ethanol, stress (hypothermic and swimming), acetic acid and Helicobacter pylori-induced gastric ulcerations in laboratory animals. Various preclinical and clinical studies have also shown ginger to possess anti-emetic effects against different emetogenic stimuli. However, conflicting reports especially in the prevention of chemotherapy-induced nausea and vomiting and motion sickness prevent us from drawing any firm conclusion on its effectiveness as a antioxidant; inhibition of lipid peroxidation and that these properties might have contributed to the observed gastroprotective effects. This monography summarizes the various gastroprotective effects of ginger, its history and phytochemistry, and also emphasizes on aspects that warranty future research to establish its activity and utility as a gastroprotective agent in humans

Volatilidade e risco nas taxas de câmbio: simulações de Monte Carlo e bootstrapping

Tese de mestrado, Matemática Financeira, Universidade de Lisboa, Faculdade de Ciências, 2019Este trabalho teve como principal objetivo o estudo do risco e volatilidade das séries temporais financeiras. Como tal, a série utlizada foi a taxa de câmbio EUR/USD (Euro/Dólar Americano), uma vez que estas são as divisas mais transacionadas no mundo inteiro, o que implica que estas taxas estejam sujeitas a um maior risco e volatilidade por serem tão complexas e dependentes de tantos fatores externos, tanto políticos como económicos e sociais. Esta dissertação consiste em aplicar simulações de Monte Carlo e Bootstrapping para a estimação da volatilidade e risco, recorrendo ao conceito de Value at Risk. A série temporal analisada é a taxa de câmbio EUR/USD desde 01-01-2010 a 01-01-2019, uma vez que o ano de 2008 representa uma quebra de estrutura, pelo que a decisão tomada consistiu em repartir esta série e estudá-la apenas após o período da Crise de Subprime. Foram efetuadas análises estatísticas e testes de estacionariedade, bem como a aplicação dos dois métodos de simulação, para os três níveis de confiança usuais (95%, 97.5% e 99%), para dois períodos: o ano de 2018 e o período de 2010 a 2018. Verificou-se que o método de Bootstrapping é o que apresenta valores mais elevados para o Value at Risk. De forma a validar os modelos obtidos pelos dois métodos de simulação acima referidos, foi efetuado o método de backtesting, que concluiu que o método de Bootstrapping é o que produz melhores resultados, para dois dos três níveis de confiança considerados.The main goal of this work is to study the risk and volatility of financial time series. As such, the time series used was the EUR/USD exchange rate, since these are the most traded currencies worldwide, implying that these rates are subject to greater risk and volatility because they are so complex and dependent on several external factors, such as political, economic and social. This dissertation consists of applying Monte Carlo and Bootstrapping simulations for the estimation of volatility and risk, using the concept of Value at Risk. The time series analyzed is the EUR/USD exchange rate from 01-01-2010 to 01-01-2019, since the year 2008 represents a breakdown of structure, so the decision made consisted of dividing this series and studying it only after the period of the Subprime Crisis. Statistical analysis and stationarity tests were performed, as well as the application of the two simulation methods, for the three usual confidence levels (95%, 97.5% and 99%) for the year 2018 and for 2010 to 2018. It was concluded that the Bootstrapping method is the one with the highest values for Value at Risk. In order to validate the models obtained by the two simulation methods mentioned above, the backtesting method was performed, from which we conclude that the Bootstrapping method produces the best results for two of the three confidence levels considered

Levels and trends of demographic indices in southern rural Mozambique: evidence from demographic surveillance in Manhica district

Background: In Mozambique most of demographic data are obtained using census or sample survey including indirect estimations. A method of collecting longitudinal demographic data was introduced in southern Mozambique since 1996 (DSS -Demographic Surveillance System in Manhiça district, Maputo province), but the extent to which it yields demographic measures that are typical of southern rural Mozambique has not been evaluated yet. Methods: Data from the DSS were used to estimate the levels and trends of fertility, mortality and migration in Manhiça, between 1998 and 2005. The estimates from Manhiça were compared with estimates from Maputo province using the 1997 National census and 1997 Demographic and Health Survey (DHS). The DHS data were used to estimate levels and trends of adult mortality using the siblings' histories and the orphanhood methods. Results: The populations in Manhiça and in Maputo province are young (44% <15 years in Manhiça and 42% in Maputo); with reduced adult males when compared to females (all ages sex ratio of 78.7 in Manhiça and 89 in Maputo). Fertility in Manhiça is at a similar level as in Maputo province and has remained around 5 children per woman, during the eight years of surveillance in Manhiça. Although the infant mortality rate (IMR) in Mozambique has decreased during the last two decades (from 148 deaths per 1000 live births in 1980 to 101 in 2003), it has remained stable around 80 in Manhiça during the surveillance period. Adult mortality has increased both in Manhiça (probability of dying from ages 15 to 60 increased from 0.4 in 1998 to 0.6 in 2005 in Manhiça, from 0.3 in 1992 to 0.4 in 1997 in Maputo province and from 0.1 in 1980 to 0.6 in 2000 in Mozambique). Consequently, the life expectancy decreased from 53 to 46 in Manhiça and from 42 years in 1997 to 38 in 2004 in Mozambique. Migration is high in Manhiça but tends to stabilise after the movements of resettlement that followed the end of the civil war in 1992. Conclusion: The population under demographic surveillance in Manhiça district presents characteristics that are typical of southern rural Mozambique, with predominance of young people and reduction of adult males. Labour migration and excess adult male mortality are the major factors for the reduction of adult males. Mortality is high and only infant mortality has started to stabilise while adult mortality has increased, and as consequence, life expectancy has decreased. The Manhiça DSS is an adequate tool to report demographic measures for southern rural Mozambique

Determinants of household demand for bed nets in a rural area of southern Mozambique

<p>Abstract</p> <p>Background</p> <p>A key to making insecticide-treated nets (ITNs) a long-term, sustainable solution to the spread of malaria is understanding what drives their purchase and use. Few studies have analysed the determinants of demand for bed nets for malaria prevention at the household level, and in particular, how demand for nets compares with demand for other mosquito prevention methods.</p> <p>Methods</p> <p>This study uses a household survey to assess the determinants of demand for bed nets in an area of endemic malaria transmission in rural, southern Mozambique. The study looks at willingness to pay (WTP) for bed nets, net ownership, usage, and past purchase behaviour, alongside expenditure and frequency of use of alternate methods for malaria prevention.</p> <p>Results</p> <p>While overall net ownership in the sample is low, the evidence fails to suggest that poorer households are less likely to own bed nets, when controlling for covariates, nor does the likelihood of receiving a free net depend on socioeconomic status (SES). Formal schooling and market knowledge seem to indicate higher average willingness to pay, while use of alternate methods for malaria prevention, and receipt of Indoor Residual Spraying (IRS) are found to decrease demand for bed nets.</p> <p>Conclusion</p> <p>For long-term sustainability of ITNs to be realized, results suggest that either full or partial subsidies may be necessary in some contexts to encourage households to obtain and use nets. Given the possible substitution effects of combined malaria control interventions, and the danger of not taking into consideration household preferences for malaria prevention, successful malaria control campaigns should invest a portion of their funds towards educating recipients of IRS and users of other preventive methods on the importance of net use even in the absence of mosquitoes.</p