Efeitos da reabilitação cardíaca após transplante de coração: uma revisão

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaObjetivo: Compreender a efetividade da reabilitação pós-operatório em pacientes submetidos a cirurgia de transplante de coração. Metodologia: Pesquisa computorizada nas bases de dados Pubmed/Medline e PEDro para identificar estudos randomizados controlados que avaliaram os efeitos da reabilitação cardíaca com base em técnicas de fisioterapia em pacientes submetidos a cirurgia de transplante do coração. Resultados: Nesta revisão foram incluídos 8 artigos envolvendo 194 indivíduos, com classificação metodológica de 5.75 na escala de PEDro. Os artigos mencionados nesta revisão referem-se à realização de programas de reabilitação cardíaca sendo que 6 estudos foram realizados em meio hospitalar, um é a comparação entre o meio domiciliar e hospitalar e o último só em meio domiciliar. Conclusão: A reabilitação cardíaca representa um papel importante mostrando-se eficaz no aumento da força muscular, dos batimentos cardíacos, diminuição da pressão arterial sistólica e melhoria da função endotelial. Ajuda também na prevenção de doenças cardíacas futuras e principalmente ajuda na reinserção na vida diária do paciente após cirurgia.Objective: To understand the effectiveness of postoperative rehabilitation in patients undergoing heart transplant surgery. Methodology: Computerized search in the Pubmed / Medline and PEDro databases to identify randomized controlled trials that evaluated the effects of cardiac rehabilitation based on physiotherapy techniques in patients undergoing heart transplant surgery. Results: In this review were included eight articles involving 194 individuals with a methodological classification of 5.75 on the PEDro scale. The articles mentioned in this review refer to the implementation of cardiac rehabilitation programs. 6 of these studies were performed in a hospital setting, one is the comparison between the home and hospital environment and the last one only in the home setting. Conclusion: Cardiac rehabilitation plays an important role in increasing muscle strength, heart rate, decreasing systolic blood pressure and improving endothelial function. It also helps in the prevention of future heart diseases and mainly helps in reinsertion into the daily life of the patient after surgery.N/

Efeitos da reabilitação cardíaca após transplante de coração: uma revisão

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaObjetivo: Compreender a efetividade da reabilitação pós-operatório em pacientes submetidos a cirurgia de transplante de coração. Metodologia: Pesquisa computorizada nas bases de dados Pubmed/Medline e PEDro para identificar estudos randomizados controlados que avaliaram os efeitos da reabilitação cardíaca com base em técnicas de fisioterapia em pacientes submetidos a cirurgia de transplante do coração. Resultados: Nesta revisão foram incluídos 8 artigos envolvendo 194 indivíduos, com classificação metodológica de 5.75 na escala de PEDro. Os artigos mencionados nesta revisão referem-se à realização de programas de reabilitação cardíaca sendo que 6 estudos foram realizados em meio hospitalar, um é a comparação entre o meio domiciliar e hospitalar e o último só em meio domiciliar. Conclusão: A reabilitação cardíaca representa um papel importante mostrando-se eficaz no aumento da força muscular, dos batimentos cardíacos, diminuição da pressão arterial sistólica e melhoria da função endotelial. Ajuda também na prevenção de doenças cardíacas futuras e principalmente ajuda na reinserção na vida diária do paciente após cirurgia.Objective: To understand the effectiveness of postoperative rehabilitation in patients undergoing heart transplant surgery. Methodology: Computerized search in the Pubmed / Medline and PEDro databases to identify randomized controlled trials that evaluated the effects of cardiac rehabilitation based on physiotherapy techniques in patients undergoing heart transplant surgery. Results: In this review were included eight articles involving 194 individuals with a methodological classification of 5.75 on the PEDro scale. The articles mentioned in this review refer to the implementation of cardiac rehabilitation programs. 6 of these studies were performed in a hospital setting, one is the comparison between the home and hospital environment and the last one only in the home setting. Conclusion: Cardiac rehabilitation plays an important role in increasing muscle strength, heart rate, decreasing systolic blood pressure and improving endothelial function. It also helps in the prevention of future heart diseases and mainly helps in reinsertion into the daily life of the patient after surgery.N/

Responsabilidade social das empresas e cadeia de valor : o caso Sonae Sierra

Mestrado em MarketingA sustentabilidade tem sido abraçada a diversos níveis na indústria imobiliária com o objectivo de reverter o seu significativo impacto negativo no meio ambiente. Os centros comerciais assumem uma posição particular na indústria imobiliária aos quais é atribuída uma crescente responsabilização social e ambiental por se tratarem de locais de consumo e lazer em grande escala. Os lojistas dos centros comerciais representam a principal fonte geradora de resíduos, pelo que é fundamental que a actividade dos lojistas esteja alinhada com a estratégia de RSE (Responsabilidade Social das Empresas) do centro comercial, para que uma verdadeira sustentabilidade seja atingida. O estudo incide na forma como a empresa Sonae Sierra, que detém, gere e desenvolve centros comerciais, potencia a sustentabilidade da marca junto dos lojistas que integram os seus centros comerciais. Realizou-se um estudo qualitativo com base em entrevistas em profundidade aos lojistas de centros comerciais Sonae Sierra em Portugal, no qual se procurou compreender qual o grau de adopção das práticas de RSE instituídas pela Sonae Sierra. Os lojistas conseguiram identificar várias acções implementadas pela empresa ao nível de RSE mas, de um modo geral, ainda se encontram pouco informados e demonstram pouca iniciativa na condução de um negócio sustentável em todos os sentidos. Algumas das iniciativas impostas pela Sonae Sierra apresentaram elevadas taxas de notoriedade entre os lojistas, o que pode sugerir a implementação de um maior número de práticas e métricas estipuladas a nível contratual.Sustainability has been embraced in the real estate industry to varying degrees with the aim of reversing its significant negative impact on the environment. Shopping centres take on a particular role in the real estate industry, to which a growing social and environmental responsibility is assigned on account of the consumption and leisure taking place on a large scale. Shopping centre tenants represent the main source of waste generation on site, ergo it is fundamental that tenants' activities align with the shopping centre CSR (Corporate Social Responsibility) strategy so that true sustainability can be achieved. The investigation focuses on the ways under which Sonae Sierra, shopping centre owner, manager and developer, enhances the sustainability of its brand among the tenants of their shopping centres. A qualitative study based on in-depth interviews to Sonae Sierra shopping centre tenants was conducted, in which the level of adoption of CSR practices established by Sonae Sierra was the subject of investigation. Tenants were able to identify several CSR practices implemented by Sonae Sierra but, in general, they are still uninformed and show little initiative in the conduction of an all-round sustainable business. Some of the initiatives imposed by Sonae Sierra showed high rates of awareness among tenants, which might induce the implementation of more practices and metrics set forth in a contractual level

Impact of organic acids supplementation to hardwood spent sulfite liquor as substrate for the selection of polyhydroxyalkanoates-producing organisms

The effectiveness of polyhydroxyalkanoates (PHAs) production process from a waste stream is determined by the selection of a suitable mixed microbial culture (MMC). In this work, a feedstock from the paper industry, hardwood spent sulfite liquor (HSSL), supplemented with short-chain organic acids (SCOAs) to simulate a fermented effluent, was used as substrate to enrich a MMC in PHA-storing microorganisms. A stable culture was quickly established, and during the accumulation step the selected MMC reached a maximum PHA content of 34.6% (3HB:3HV-76:24). The bacterial community was analyzed through FISH analysis. Bacteria belonging to the four main classes were identified: Betaproteobacteria (44.7 ± 2.7%), Alphaproteobacteria (13.6 ± 1.3%) and Gammaproteobacteria (2.40 ± 1.1%) and Bacteroidetes (9.20 ± 3.8%). Inside the Betaproteobacteria class, Acidovorax (71%) was the dominant genus.publishe

Small Deletion of 143 Kb Encompassing Exon 2 of the AUTS2: Rise of a NewMicrodeletion Syndrome?

Abstract publicado em: Chromosome Res. 2015 Jun;23 Suppl 1:35-36. doi: 10.1007/s10577-015-9476-6.Chromosome microarray analysis is a powerful diagnostic tool and is being used as a first-line approach to detect chromosome imbalances associated with intellectual disability, dysmorphic features and congenital anomalies. This test enables the identification of new copy number variants (CNVs) and their association with new microdeletion/microduplication syndromes in patients previously without diagnosis. Here we report the case of a 17 year-old female with severe intellectual disability, absence of speech, microcephaly and congenital abnormalities with a previous normal karyotype performed at a younger age. Affymetrix CytoScan HD chromosome microarray analysis was performed detecting a 143 Kb deletion at the 7q11.22 breakpoint, encompassing exon 2 of AUTS2 gene: arr[hg19] 7q11.22(69238957- 69381975)×1. The AUTS2 gene has been recently implicated in neurodevelopment and is a candidate gene for numerous neurological disorders. Common clinical features described in patients with deletions in AUTS2 gene include intellectual disability, speech delay and microcephaly, among others. Thus, the CNV identified in our patient explains the phenotype observed. We compare our patient with other similar reported cases, adding additional value to the phenotypegenotype correlation of deletions in this region. The growing collection of new cases with similar phenotypes, and the observation of this deletion occurring frequently de novo, indicates this CNV as a possible new single gene microdeletion syndrome

Subsyndromal delirium in critically ill patients: cognitive and functional long-term outcomes

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Subsyndromal delirium (SSD) in the Intensive Care Unit (ICU) is associated with an increased morbidity with unknown post-discharge functional and cognitive outcomes. We performed a prospective multicenter study to analyze the mental status of patients during their first 72 h after ICU admission and its trajectory, with follow-ups at 3 and 6 months after hospital discharge. Amongst the 106 included patients, SSD occurred in 24.5% (n = 26) and was associated with the duration of mechanical ventilation (p = 0.003) and the length of the ICU stay (p = 0.002). After the initial 72 h, most of the SSD patients (30.8%) improved and no longer had SSD; 19.2% continued to experience SSD and one patient (3.8%) progressed to delirium. The post-hospital discharge survival rate for the SSD patients was 100% at 3 months and 87.5% at 6 months. At admission, 96.2% of the SSD patients were fully independent in daily living activities, 66.7% at 3-month follow-up, and 100% at 6-month follow-up. Most SSD patients demonstrated a cognitive decline from admission to 3-month follow-up and improved at 6 months (IQCODE-SF: admission 3.13, p < 0.001; 3 months 3.41, p = 0.019; 6 months 3.19, p = 0.194). We concluded that early SSD is associated with worse outcomes, mainly a transitory cognitive decline after hospital discharge at 3 months, with an improvement at 6 months. This highlights the need to prevent and identify this condition during ICU stays.info:eu-repo/semantics/publishedVersio

Severe Imported Malaria in Critical Care Patients

Introduction: Imported malaria is a frequent diagnosis in Portugal, and in the most severe clinical forms it may present a high mortality rate. Material and Methods: We present seven cases of severe imported malaria, admitted to an intensive care unit between 2000 and 2010, with particular focus on risk factors, clinical presentation, treatment and results. Results: All patients had a history of recent travel to African endemic areas for malaria. Plasmodium falciparum was the agent isolated in all cases. Most patients had an inadequate prophylaxis. High parasitaemia in non-immune patients and treatment delay were associated with more severe clinical presentation. All the cases were complicated by organ failure, and three patients needed organ support and in two exchange blood transfusions were performed. There was one single death that was associated with marked delay in the initiation of therapy. Conclusion: In these patients, early and aggressive treatment, with a organ support in a critical care setting, allowed a good outcome with low mortality and no significant sequelae, despite the severity of presentation.publishersversionpublishe

Bacterially assembled biopolyester nanobeads for removing cadmium from water

Cadmium (Cd)-contaminated waterbodies are a worldwide concern for the environment, impacting human health. To address the need for efficient, sustainable and cost-effective remediation measures, we developed innovative Cd bioremediation agents by engineering Escherichia coli to assemble poly(3-hydroxybutyric acid) (PHB) beads densely coated with Cd-binding peptides. This was accomplished by translational fusion of Cd-binding peptides to the N- or C-terminus of a PHB synthase that catalyzes PHB synthesis and mediates assembly of Cd2 or Cd1 coated PHB beads, respectively. Cd1 beads showed greater Cd adsorption with 441 nmol Cd mg-1 bead mass when compared to Cd2 beads (334 nmol Cd mg-1 bead-mass) and plain beads (238 nmol Cd mg-1 bead-mass). The Cd beads were not ecotoxic and did attenuate Cd-spiked solutions toxicity. Overall, the bioengineered beads provide a means to remediate Cd-contaminated sites, can be cost-effectively produced at large scale, and offer a biodegradable and safe alternative to synthetic ecotoxic treatments.publishe

EAIR 41st Annual Forum in Leiden, The Netherlands 25 till 28 August 2019

Trabalho apresentado em EAIR 41st Annual Forum, 25-28 agosto 2019, Leiden, Países Baixos.Polytechnic Institutes in Portugal: research on the impact of twelve institutes on the local economy Higher Education Institutions are recognized as important actors in regional development. The Portuguese higher education system comprises both Universities and Polytechnic Institutes, which face an increasing pressure to demonstrate that their presence has an impact on the surrounding communities contributing to their economic development. This paper presents the estimation of the economic impact of twelve Polytechnic Institutes, located in quite diverse regions, based on a shared model so that comparisons have a collective framework of analysis. The main results obtained show that the economic impact ranged from 1.8% to 10.6% of the local GDP and that these Institutes are major local employers.info:eu-repo/semantics/publishedVersio

Stream diatom community assembly processes in islands and continents: a global perspective

[EN] Understanding the roles of deterministic and stochastic processes in community assembly is essential for gaining insights into the biogeographical patterns of biodiversity. However, the way community assembly processes operate is still not fully understood, especially in oceanic islands. In this study, we examine the importance of assembly processes in shaping diatom communities in islands and continents, while also investigating the influence of climate and local water chemistry variables on species distributions. Location Global. Taxon Stream benthic diatoms. Methods We used diatom datasets from five continents and 19 islands and applied beta diversity analyses with a null model approach and hierarchical joint species distribution modelling. To facilitate comparisons with continents, we used continental area equivalents (CAEs), which represent continental subsets with comparable areas and the same number of study sites as their corresponding islands counterparts. Results We found that homogeneous selection (i.e., communities being more similar than the random expectation) was the dominant assembly process within islands whereas stochastic processes tended to be more important within continents. In addition, assembly processes were influenced by study scale and island isolation. Climatic variables showed a greater influence on species distribution than local factors. However, in islands, local environmental variables had a greater impact on the distributions of unique taxa as opposed to non-unique taxa. Main Conclusions We observed that the assembly processes of diatom communities were complex and influenced by a combination of deterministic and stochastic forces, which varied across spatial scales. In islands, there was no universal pattern of assembly processes, given that their influence depends on abiotic conditions such as area, isolation, and environmental heterogeneity. In addition, the sensitivity of species occurring uniquely in islands to local environmental variables suggests that they are perhaps less vulnerable to climatic changes but may be more influenced by changes in local physicochemistrySIFor financial support, the authors thank the Academy of Finland (grant nr. 346812 to JS); the Institut Francais de Finlande; the Embassy of France to Finland; the French Ministry of Education and Higher Education; Finnish Society of Sciences and Letters. J.J. Wang was further supported by the National Natural Science Foundation of China (91851117, 41871048), CAS Key Research Program of Frontier Sciences (QYZDB-SSW-DQC043), and The National Key Research and Development Program of China (2019YFA0607100