Ativação funcional da Default Mode Network na sintomatologia depressiva e ansiosa

Dissertação de mestrado integrado em Psicologia (área de especialização em Psicologia Clínica e da Saúde)Resumo: As redes cerebrais no estado de repouso têm sido amplamente investigadas, nomeadamente a Default Mode Network (DMN) cujas funções sustentam a cognição espontânea, bem como, os estados emocionais internos e os processos autorreferentes. Neste estudo colocou-se a hipótese de que as áreas corticais mediais da DMN poderiam apresentar maior ativação durante os estados de ansiedade e humor depressivo. A amostra foi constituída por 24 adultos saudáveis. Os participantes foram avaliados com as escalas HDRS e HARS e realizaram um exame de ressonância magnética funcional no estado de repouso com a duração de 5 minutos. Foi realizada uma análise de regressão múltipla que revelou a relação entre a ativação das áreas da DMN e a variação dos scores de ansiedade e depressão. Verificou-se uma correlação positiva entre a ativação de porções anteriores da DMN, tipicamente envolvidas em pensamento autorreferente e processamento emocional e os scores de ansiedade e depressão. Ao contrário, as áreas posteriores da DMN apresentaram uma correlação negativa com os scores de ansiedade e depressão. Este estudo demonstra que na ansiedade e depressão, os indivíduos apresentam um elevado foco introspetivo e uma regulação emocional disfuncional.Abstract: Brain networks in the resting state have been widely investigated, namely the Default Mode Network (DMN), whose functions sustain spontaneous cognition, as well as, internal emotional states and self-referential processes. In this study it was hypothesized that the cortical areas of the medial DMN might present greater activation during anxiety states and depressed mood. The sample of healthy adults consisted of 24 healthy subjects. Participants were assessed using HARS and HDRS scales and completed a 5 minutes restingstate functional magnetic resonance imaging scan. Multiple regression was performed and revealed which areas of the DMN were being recruited depending on the variation of anxiety and depression scores. It was found a positive correlation between the activation of the anterior portions of DMN involved in self-referential thought and emotional processes and the anxiety and depression scores. However posterior areas were negatively correlated with anxiety and depression scores. The present study demonstrates that anxious and depressed individuals are strongly engaged in introspection and might present dysfunctional emotion regulation

A psychomotor rehabilitation intervention to improve health and well-being indicators of institutionalized older adults.

INTRODUCTION Institutionalization tends to exacerbate the usual fragility and disability associated with the ageing process (Heppenstall, Wilkinson, Hanger, Keeling, & Pearson, 2011). In turn, poor health and well-being compromise older adults’ quality of life. OBJECTIVE The aim of this study was to analyze the impact of a psychomotor rehabilitation program on health and well-being indicators of institutionalized older adults. METHODOLOGY A total of 42 nursing home residents (84 ± 6.2 years) participated in the study: 21 were allocated to the experimental group (EG: engaged the rehabilitation program twice a week for 75 min), and 21 were allocated to the control group (CG: maintained daily institution activities). The Mini Mental State Examination was used to screen severe cognitive impairment as an exclusion criteria. Mood states, pain, disability and self-rated health were assessed through the Profile of Mood States, the P4 Pain Scale, the Barthel Index, and the EuroQol visual analogue scale, respectively. After finishing the study, the CG attended the rehabilitation program.RESULTS Comparisons showed that: in terms of mood states, both groups showed improvements in tension, whereas only the EG demonstrated improvements in depression, anger, vigor, fatigue, and confusion (treatment effect: -0.23 to -2.60); the EG experienced a decrease in pain (treatment effect: 0.21 to 0.50), while the CG showed an increase; finally, in terms of the disability level and the self-rated health the EG experienced no changes, whereas these indicators worsened in the CG (p <0.05). CONCLUSION The psychomotor program was able to revert the expected loss of health and well-being characteristic of older people, particularly the institutionalized ones. Specifically, the program was effective in improving the mood states and in decreasing pain of the nursing home residents, as well as in maintaining their disability level and health status. These findings suggest that the general adherence of nursing home residents to psychomotor rehabilitation programs may improve the quality of life of our oldest adults

The Cyclodextrins as Modelling Agents of Drug Controlled Release

The controlled release of nicardipine (NC) was achieved by hybridizing its hydrophilic and hydrophobic cyclodextrin (CDs) complexes, i.e., those with hydroxypropyl-ß-cyclodextrin (HPßCD) andtriacetyl-ß-cyclodextrin (TAßCD),respectively. 1H-nuclearmagnetic resonance (1H-NMR) was performed to examine the interaction between both CDs and NC in solution. The solid complexes of NC : HPßCD and NC : TAßCD were prepared, in a 1 : 1 molar ratio by the spray-drying method. Complexation in the solid state was demonstrated by differential scanning calorimetry (DSC) and powder X-ray diffractometry. In vitro dissolution studies were carried out in simulated gastric (pH 1.2) and intestinal (pH 6.8) fluids, according to the USP basket method. The 1H-NMR studies provided clear evidence of an interaction between the CDs and the aromatic rings of NC. The DSC thermograms of the solid complexes showed no endothermic peak due to NC melting and their diffraction pattern was completely diffuse, which suggested the formation of a novel type solid phase with an amorphous character. The low dissolution rate of NC, a weak basic drug, in alkaline medium was significantly improved by complexation with HPßCD. In contrast, the in vitro release of this drug from the NC : TAßCD complexes was markedly retarded in both dissolution media. An optimal formulation was then designed by the combination, in different molar ratios, of these two complexes. The release behavior of these preparations was investigated and it was observed that the retarding effect was dependent on the amount of the NC : TAßCD complex. In addition, the initial release rate became faster as the molar ratio of the NC : HPßCD complex increased

O fenómeno estético em Nietzsche

O estilo de Nietzsche confunde-se facilmente com a sua obra. Ao leitor atento e liberto acontece-lhe surpreender-se, num momento de alegria estética, de coerência entre o que é dito e o que é sentido. Ao mesmo tempo, Nietzsche traz-nos, com invulgar lucidez, a possibilidade de, com ele, percorrermos o caminho da investigação através de um duro exercício de despojamento e máxima honestidade, sem cedências ou garantias. Tomámos este caminho com o intuito de compreender o que fundamenta a criação de uma estética da tragicidade e por que razão considera Nietzsche a estética como única justificação para existência humana. As próprias obras de Nietzsche constituem-se como paradigmas, elementos-chave, sobre os quais se sustenta para fazer a justa crítica sobre a cultura e dessa forma também para nos dar conta das fragilidades e potencialidades humanas. Estas últimas são exaltadas, na teoria nietzscheana, até à sua máxima expressão através da criação artística

Elaboração de um guia do cliente enquanto ferramenta de comunicação na meeting industry : caso prático do Centro de Congressos de Lisboa

Mestrado em MarketingO presente trabalho de projecto tem como principal objectivo fundamentar as bases para a elaboração de um Guia de Cliente, enquanto ferramenta de comunicação na Meeting Industry, no âmbito da prestação de serviços de gestão de eventos num negócio business-to-business. O guia foi desenhado para o Centro de Congressos de Lisboa, enquanto produto de uma estratégia de marketing e comunicação assente no marketing de relacionamento, focalização no cliente e nas suas necessidades, bem como na gestão efectiva da rede de marketing, fundamental à integração dos intervenientes no processo de organização de eventos e no sucesso do produto final. Este trabalho parte de um enquadramento teórico para uma aplicação estratégica, terminando num plano táctico e respectiva operacionalização. Optou-se por efectuar uma revisão bibliográfica, bem como uma recolha de informação em estudos e relatórios de associações relacionadas com a Meeting Industry, de modo a fundamentar devidamente os antecedentes e respectiva justificação. O Guia do Cliente, enquanto documento final, exigiu uma pesquisa profunda em diversas áreas do conhecimento, num esforço de antecipação das necessidades, dúvidas e questões dos clientes e potenciais clientes do Centro de Congressos de Lisboa. Não sendo o projecto em si, assume-se como o produto do trabalho de projecto agora apresentado.This project report discusses the bases used for the development of a Customer Guide as a tool of communication in the Meeting Industry, under the services marketing and the business-to-business framework. The guide was designed for the Lisbon Congress Centre, as a product of a Marketing Strategy based on communication and relationship marketing, focused on the customers and their needs and on the effective management of the marketing network, relevant for the integration of all the parts in the process of organizing events and for the success of the final product. This report presents a theoretical framework for a strategic application that resulted in a tactical plan and its implementation. There was the need to carry out a literature review and collect information from studies and reports produced by associations related to the Meeting Industry, in order to provide the background and justification for the project. The Customer Guide, as the final document, required careful consideration of various areas of knowledge in an effort to anticipate the needs, concerns and questions from customers and potential customers of the Lisbon Congress Centre. The guide not being the project itself is assumed to be the product of the project hereby reported

Utilização de engenharia inversa aplicada a um caso de bruxismo

As goteiras oclusais são a abordagem de tratamento do bruxismo mais usada pelos médicos dentistas e, embora úteis como prevenção do desgaste dentário, ajudam na redução da atividade muscular mastigatória rítmica, característica do bruxismo. O presente trabalho consiste na criação de uma goteira personalizada low cost recorrendo a técnicas de engenharia inversa aplicada ao fabrico. O propósito é que recubra parcialmente as superfícies dentárias, alterando a oclusão do paciente, para ser utilizado no período noturno a fim de amenizar os danos causados e desta forma ser considerada uma forma estratégica para o tratamento do bruxismo. Com recurso à Biomodelação em alternativa aos métodos tradicionais atualmente utilizados, é possível através desta tecnologia, a obtenção de um biomodelo personalizado com grande detalhe. Verifica-se uma opção eficaz de tratamento para prevenção do desgaste dentário, de uma forma mais rápida e com custo mais acessível, apresentando todas as condições necessárias de forma a garantir o máximo beneficio ao doente.Occlusal gutters are the bruxism treatment approach most used by dentists and, although useful as prevention of tooth wear, they help to reduce rhythmic masticatory muscle activity, characteristic of bruxism. The present work consists of the creation of a custom low cost gutter using reverse engineering techniques applied to the manufacture. The purpose is to partially cover the dental surfaces, changing the patient's occlusion, to be used at night in order to mitigate the damage caused and thus be considered a strategic way to treat bruxism. Using Biomodeling as an alternative to the traditional methods currently used, it is possible through this technology to obtain a customized biomodel with great detail. There is an effective treatment option for preventing dental wear, in a faster and more affordable way, presenting all the necessary conditions in order to guarantee the maximum benefit to the patient

Avaliação da cardiotoxicidade da doxorrubicina em cães – estudo piloto

Orientação : Luís Lima Lobo ; co-orientação : Joaquim HenriquesA doxorrubicina, é um potente agente antineoplásico, pertencente a uma das principais classes de quimioterápicos utilizadas em oncologia, as antraciclinas. Este fármaco apresenta atividade antitumoral contra uma grande variedade de neoplasias, tais como, linfoma, sarcomas e carcinomas, no entanto, o seu uso é condicionado pela possível ocorrência de cardiotoxicidade. O mecanismo cardiotóxico da doxorrubicina ainda é controverso, no entanto, pensase que está relacionado com um aumento do stress oxidativo no miocárdio, devido, sobretudo, à formação de espécies reativas de oxigénio e indução de peroxidação lipídica nas células cardíacas. A cardiotoxicidade induzida pela doxorrubicina manifesta-se de forma semelhante à cardiomiopatia dilatada, num processo que depende da dose total cumulativa administrada. Neste estudo, pretendi avaliar a presença de cardiotoxicidade em cães com diferentes neoplasias, sujeitos a quimioterapia com doxorrubicina. Para o efeito, foram realizados controlos de parâmetros ecocardiográficos e de biomarcadores cardíacos, durante 5 estádios de administração de doxorrubicina. Os resultados do estudo não foram sugestivos de ocorrência de cardiotoxicidade, porém, um aumento da concentração de troponina I, com maior relevância no final do protocolo, pareceu sugerir alguma contribuição da doxorrubicina na lesão do miocárdio. Devido ao constrangimento associado às perdas de seguimento, frequentemente implícitas na especialidade oncológica, não foi possível obter um tamanho de amostra ideal, pelo que as conclusões retiradas deste estudo são limitativas. Pretende-se, com este estudo, alertar para a importância de uma prevenção e controlo frequentes da função cardíaca em animais tratados com este fármaco cardiotóxico. Apesar de a cardiotoxicidade não ser tão frequente em cães, devido a uma menor agressividade dos protocolos quimioterápicos e a um maior controlo das doses cumulativas utilizadas, creio que é fundamental apostar na prevenção, de forma a assegurar um diagnóstico precoce de cardiotoxicidade, ou até mesmo, de patologias cardíacas ocultas ou envolvimento cardíaco de origem neoplásica, os quais, podem contribuir para um agravamento da saúde de cada paciente.Doxorubicin is a potent antineoplastic agent, belonging to one of the major classes of chemotherapeutic drugs used in oncology, the anthracyclines. Doxorubicin exerts antitumor activity against a wide variety of neoplasms, such as lymphoma, sarcomas and carcinomas, however, its use is conditioned by the possible occurrence of cardiotoxicity. The cardiotoxic mechanism of doxorubicin is still controversial, however, it is thought to be related to an increase in oxidative stress in the myocardium, mainly due to the generation of reactive oxygen species and lipid peroxidation, in cardiac cells. The cardiotoxicity induced by doxorubicin manifests itself in a similar way to dilated cardiomyopathy, in a process that depends on the cumulative total dosage administered. In this study, I intended to evaluate the presence of cardiotoxicity in dogs with different neoplasms, undergoing doxorubicin chemotherapy protocols. For this purpose, controls of echocardiographic parameters and cardiac biomarkers were performed during 5 stages of doxorubicin administration. Results of this study were not suggestive of cardiotoxicity, however, a consistent increase in plasma cardiac troponin I, with greater relevance at the end of the protocol, suggested some contribution of doxorubicin in myocardial injury. Because of the constraint associated with loss to follow-up, often implied in medical oncology, it was not possible to obtain an ideal sample size, so the conclusions drawn from this study are limiting. With this study, I pretend to alert to the importance of frequent prevention and control of cardiac function, in animals treated with this cardiotoxic drug. Although cardiotoxicity is not so frequent in dogs, due to the lower aggressiveness of chemotherapy protocols and a greater control of the cumulative doses, I believe that it is fundamental to focus on prevention in order to ensure an early diagnosis of cardiotoxicity, or even occult cardiac pathologies or cardiac involvement of neoplastic origin, which can contribute to a worsening of the health of each patient

Coexistent molar pregnancy with a normal fetus-a rare presentation of gestational trophoblastic disease

A coexistent molar pregnancy with a normal fetus is rare, with an incidence of 1 in 22.000 to 100.000 pregnancies-only 200 cases reported in the last two decades. The ultrasound is essential for an earlier diagnosis, and the management of these cases is challenging due to the increased risk of obstetrics complications and the possibility of posterior gestational trophoblastic neoplasia. Here we describe a 33-year-old healthy woman with a first-trimester twin pregnancy, presented with a normal fetus and a heterogeneous and vacuolar structure suggestive of complete hydatidiform mole. The pregnancy was interrupted, and a histological diagnosis confirmed complete hydatidiform mole in dichorionic/diamniotic twin pregnancy at 14 weeks. Molar twin pregnancy is a rare condition, and do not exist any consensus protocol to guide the clinical approach, so the decision to continue the pregnancy depends on the couple’s desire and maternal and fetal complications

Nanoencapsulation I. Methods for preparation of drug-loaded polymeric nanoparticles

Polymeric nanoparticles have been extensively studied as particulate carriers in the pharmaceutical and medical fields, because they show promise as drug delivery systems as a result of their controlled- and sustained-release properties, subcellular size, and biocompatibility with tissue and cells. Several methods to prepare nanoparticles have been developed during the last two decades, classified according to whether the particle formation involves a polymerization reaction or arises from a macromolecule or preformed polymer. In this review the most important preparation methods are described, especially those that make use of natural polymers. Advantages and disadvantages will be presented so as to facilitate selection of an appropriate nanoencapsulation method according to a particular application.http://www.sciencedirect.com/science/article/B7MDB-4JH72D0-3/1/fd4828f502f6e3c7e40643c9b4dbfea