Hipertensão arterial :|brelação com a progressão da doença renal crónica

Dissertação de mestrado em Medicina (Nefrologia), apresentado à Faculdade de Medicina da Universidade de CoimbraA insuficiência renal crónica é um problema de saúde pública com implicações económicas e sociais significativas. A prevalência desta afecção tem vindo a crescer nos últimos anos como consequência do aumento da esperança média de vida, aliada ao sedentarismo e à maior prevalência de outras doenças como a diabetes mellitus ou hipertensão arterial. A hipertensão e a insuficiência renal crónica têm uma relação muito particular, não só pela partilha de factores de risco mas também, por uma poder ser causa ou consequência da outra. A hipertensão e a proteinúria são as duas variáveis independentes mais importantes na progressão da doença renal crónica. A estratégia terapêutica nestes doentes passa, obrigatoriamente, pela redução da excreção urinária de proteínas e vigilância e controlo da pressão arterial, que apesar da sua reconhecida importância, é fracamente controlada em inúmeros casos. Nesse sentido, o recurso a fármacos com potencial nefroprotector, como os IECA e os ARA, tem-se revelado fundamental. Nesta revisão serão abordados a fisiopatologia da doença renal crónica, o papel da pressão arterial na sua evolução e o seu tratamento.Chronic kidney disease is a serious public health problem with substantial economic and social implications. Its prevalence has been rising throughout the years due to: increased lifetime expectation, sedentary lifestyle of modern societies and higher prevalence of other chronic conditions such as diabetes mellitus or arterial hypertension. Chronic kidney disease and hypertension have a curious relationship, not only they share common risk factors, they also seem to promote and maintain each other. Hypertension and proteinuria are the two most important variables in the progression of chronic kidney disease. The present therapeutic strategies aim to reduce the urinary protein loss and to tightly control the blood pressure, which, despite its known importance is barely achieved. In this revision it will be discussed the chronic renal failure’s physiopathology and the role of the blood pressure on its progression. The use of antihypertensive medicine, whose actions extend beyond the reduction of blood pressure, such as ECA inhibitors or AARs, is one of the measures which actually is responsible for the declined progression of the chronic kidney disease

Ninfoplastia: Uma Análise Completa das Técnicas Cirúrgicas e seus Desdobramentos Emocionais

Introduction: Nymphoplasty, also known as labiaplasty, is a surgical procedure that has gained increasing prominence in the area of ​​female genital plastic surgery. In this context, a complete analysis of the surgical techniques involved in nymphoplasty and their emotional impacts is essential, in order to better understand the benefits and potential psychological repercussions of this surgical intervention. Objective: Explore and understand the surgical techniques involved in nymphoplasty, analyzing the pre- and post-operative emotional impacts on patients. Methodology: The Google Scholar, Scielo and Medline databases were used, searching for articles published between 2015 and 2023, in Portuguese or English. Final Considerations: Based on the analysis of the surgical techniques involved in nymphoplasty and its emotional consequences, it is possible to conclude that this surgery represents an effective option for women seeking to improve their genital self-image and reduce symptoms of discomfort or dissatisfaction. Therefore, a holistic approach, which takes into account not only the technical aspects of the surgery, but also the psychological well-being of patients, is crucial to guarantee satisfactory and lasting results.Introdução: A ninfoplastia, também conhecida como labioplastia, é um procedimento cirúrgico que tem ganhado cada vez mais destaque na área da cirurgia plástica genital feminina. Neste contexto, é fundamental uma análise completa das técnicas cirúrgicas envolvidas na ninfoplastia e de seus impactos emocionais, a fim de compreender melhor os benefícios e as potenciais repercussões psicológicas dessa intervenção cirúrgica. Objetivo: Explorar e compreender as técnicas cirúrgicas envolvidas na ninfoplastia, analisando os impactos emocionais pré e pós-operatórios nas pacientes. Metodologia:  Foram utilizadas as bases de dados Google Scholar, Scielo e Medline, buscando artigos publicados entre os anos de 2015 e 2023, nos idiomas Português ou Inglês. Considerações Finais: Com base na análise das técnicas cirúrgicas envolvidas na ninfoplastia e em seus desdobramentos emocionais, é possível concluir que essa cirurgia representa uma opção eficaz para mulheres que buscam melhorar sua autoimagem genital e reduzir sintomas de desconforto ou insatisfação. Portanto, uma abordagem holística, que leve em consideração não apenas os aspectos técnicos da cirurgia, mas também o bem-estar psicológico das pacientes, é crucial para garantir resultados satisfatórios e duradouros

Analise do impacto do ICQ e cc sobre o risco cardíaco em pessoas com baixos níveis de atividade física

Objetivo: Analisar o impacto do índice cintura/quadril (ICQ) e circunferência da cintura (CC) sobre o risco cardíaco (RC). Material e Métodos: Estudo descritivo, transversal e quantitative, composto por uma amostra selecionada voluntariamente, na adesão as academias de ginástica de 75 mulheres (M) e 47 homens (H), media de 30,03+11,33 anos, medidos na antropometria em instrumentos calibrados. Utilizou-se SPSS 13,0 para descritiva e "t"de Student. Significancia 5% . Resultados: 42,6% e 23,4% dos H apresentam-se na faixa de RC alto e muito alto para ICQ e 40,9% e 18,2%, risco aumentado e muito aumentado para o CC, respectivamente; 28,0% e 61,3% das M apresentam-se na faixa de risco alto e muito alto para ICQ e 59,1% e 30,6%, risco aumentado e muito aumentado para o CC, respectivamente; p=0,000, diferentes entre gêneros e ICQ e CC sao de independentes (r=0,460). Conclusao: O ICQ e CC representam impacto no risco cardíaco e ambos os gêneros estão propensos a desenvolver distúrbios cardiovasculares

Estratégias de prevenção e controle de infecções em unidades de terapia intensiva pediátrica

  Introdução: As infecções hospitalares são um desafio global de saúde pública e geram um aumento nos custos de tratamento. Muitas dessas infecções são causadas por bactérias multirresistentes. Particularmente, as bactérias gram-negativas são notórias por sua capacidade de resistir a diversos antibióticos devido à complexidade de seu envelope celular. A emergência desses organismos resistentes destaca a necessidade crítica de desenvolver métodos de prevenção e tratamentos mais eficazes.  Objetivo: Discutir as estratégias de prevenção e controle de infecções disponíveis para unidades de terapia intensiva pediátrica. Metodologia: Revisão integrativa nas bases de dados nas bases científicas: LILACS, SCIELO e PUBMED. Resultados e Discussões: 11 artigos foram selecionados. As intervenções chave incluíram: 1) meticulosa higiene das mãos, 2) emprego de técnicas assépticas durante a inserção do catéter, 3) escolha criteriosa do local de inserção, e 4) revisão periódica. Conclusão: As abordagens implementadas em Unidades de Terapia Intensiva Pediátrica para a prevenção de infecções destacam a eficácia da combinação de treinamento intensivo, técnicas de assepsia estritas e o emprego de medidas de isolamento. A adesão às diretrizes globais de saúde sublinha como práticas rigorosas de higiene e a constante vigilância são essenciais para salvaguardar pacientes em estados críticos. Estratégias como a melhoria dos sistemas de ventilação e o isolamento de pacientes com infecções ajudam a minimizar a disseminação de agentes infecciosos em ambientes intensivos

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

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

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