Data-driven prescription patterns in patients under maintenance treatment for respiratory diseases from the Portuguese prescription database

We aimed to identify prescription patterns in respiratory patients using an unsupervised (data-driven) method, in a random sample of patients aged >14 years (n=8799), retrieved from the Portuguese Electronic Medical Prescription database. Respiratory patients were defined if >2 packs of maintenance treatment for respiratory diseases were prescribed in 2016. We analysed all the prescriptions (n=39810) for respiratory diseases and exacerbations by medication type. Two-step clustering was based on the presence of ICS, LABA, LTRA, LAMA, LABA, SABA, SAMA and on the speciality of prescriber.info:eu-repo/semantics/publishedVersio

Distribution of polymorphisms IL4 -590 C/T and IL4 RP2 in the human populations of Madeira, Azores, Portugal, Cape

Abstract: The IL4 gene is located on chromosome 5q23.3-31.2. Polymorphisms within this cytokine gene, like the derivative allele T of IL4-590, have been reported as being associated to elevated IgE serum levels and asthma. In the present work, the allelic and genotypic frequency of the IL4-590 and IL4 RP2 polymorphisms was carried out in 599 individuals from Madeira, Azores, Portugal mainland, Cape Verde and Guinea-Bissau and in a sample of 101 asthmatics from Madeira population. In all populations the polymorphisms were in LD and presented a significant dissimilar allelic and genotypic distribution (p<0.05) except between mainland Portugal and Madeira when compared to Azores. Significant differences regarding both loci were found between Madeira population and the group of asthmatics. Genotype 183183TT frequency is higher for African populations while 253253CC prevails in Caucasian populations. The existence of a Hardy-Weinberg Disequilibrium in Guinea-Bissau population not observed in neutral markers leads to the hypothesis of natural selection occurring in these loci probably associated to a rapid population growth an hypothesis strengthened by neutral STRs D5S818 and CSF1PO gene diversity.info:eu-repo/semantics/publishedVersio

Interferência do esmalte de unha na saturação periférica de oxigênio em pacientes pneumopatas no exercício

AIM: To assess the interference of nail polish on the reading of peripheral oxygen saturation in patients with chronic obstructive pulmonary disease on the step exercise. METHODS: In this study, there was the inclusion of patients with chronic obstructive pulmonary disease, current non-smokers, of both sexes. Four different colours of nail polish were used in the present study (base, light pink, red and brown), randomly distributed among the fingers of the right hand, with the corresponding fingers on the opposite hand being controls. Saturation was measured at rest, with and without the polish, and also during the 4th, 5th and 6th minutes of the exercise programme. RESULTS: The experimental universe included 42 patients with ages of 62.9±8.7 years. In the exercise considered, the red colour reduced it in the fourth minute of the exercise (p=0.047). In contrast, the brown colour reduced saturation at rest and also during the course of exercise (p=0.01). CONCLUSION: In patients with chronic obstructive pulmonary disease, the red and brown colours interfered with the reading of the peripheral oxygen saturation during exercise. This study is registered at the Brazilian Register of Clinical Trials (Registro Brasileiro de Ensaios Clínicos) under No. RBR-9vc722.OBJETIVO: Evaluar la interferencia del esmalte de uñas en la lectura de la saturación periférica de oxígeno en pacientes con enfermedad pulmonar obstructiva crónica en el ejercicio de la etapa. MÉTODOS: Fueron incluidos pacientes con enfermedad pulmonar obstructiva crónica estable, no fumadores actuales, de ambos los sexos. Fueron utilizadas cuatro colores de esmalte (base, rosa claro, rojo y marrón) distribuidas aleatoriamente entre los dedos de la mano derecha teniendo los dedos contralaterales como control. La saturación fue medida en reposo con y sin esmalte y durante el 4º, 5º y 6º minutos del ejercicio. RESULTADOS: Fueron incluidos 42 pacientes con edad de 62,9±8,7 años. En el ejercicio el color rojo apocó la misma en el cuarto minuto de ejercicio (p=0,047). El color marrón redujo la saturación en el reposo y durante el ejercicio (p=0,01). CONCLUSIÓN: En pacientes con enfermedad pulmonar obstructiva crónica los colores marrón y rojo interfieren en la lectura de la saturación periférica de oxígeno en el ejercicio. Este estudio está registrado en el Registro Brasileño de Ensayos Clínicos bajo el número de registro: RBR-9vc722.OBJETIVO: avaliar a interferência do esmalte de unha na leitura da saturação periférica de oxigênio em pacientes com doença pulmonar obstrutiva crônica, no exercício do degrau. MÉTODOS: foram incluídos pacientes com doença pulmonar obstrutiva crônica estável, não fumantes atuais, de ambos os sexos. Utilizaram-se quatro cores de esmalte (base, rosa claro, vermelho e marrom), distribuídas aleatoriamente entre os dedos da mão direita, tendo os dedos contralaterais como controle. A saturação foi medida em repouso com e sem esmalte e durante o 4º, 5º e 6º minutos do exercício. RESULTADOS: foram incluídos 42 pacientes com idade de 62,9±8,7 anos. No exercício, a cor vermelha diminuiu a mesma no quarto minuto de exercício (p=0,047). A cor marrom reduziu a saturação no repouso e durante o exercício (p=0,01). CONCLUSÃO: em pacientes com doença pulmonar obstrutiva crônica, as cores marrom e vermelha interferem na leitura da saturação periférica de oxigênio no exercício. Este estudo está registrado no Registro Brasileiro de Ensaios Clínicos, sob número de registro: RBR-9vc722.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP, EPESciEL

Interferência do esmalte de unha na saturação periférica de oxigênio em pacientes pneumopatas no exercício

AIM: To assess the interference of nail polish on the reading of peripheral oxygen saturation in patients with chronic obstructive pulmonary disease on the step exercise. METHODS: In this study, there was the inclusion of patients with chronic obstructive pulmonary disease, current non-smokers, of both sexes. Four different colours of nail polish were used in the present study (base, light pink, red and brown), randomly distributed among the fingers of the right hand, with the corresponding fingers on the opposite hand being controls. Saturation was measured at rest, with and without the polish, and also during the 4th, 5th and 6th minutes of the exercise programme. RESULTS: The experimental universe included 42 patients with ages of 62.9±8.7 years. In the exercise considered, the red colour reduced it in the fourth minute of the exercise (p=0.047). In contrast, the brown colour reduced saturation at rest and also during the course of exercise (p=0.01). CONCLUSION: In patients with chronic obstructive pulmonary disease, the red and brown colours interfered with the reading of the peripheral oxygen saturation during exercise. This study is registered at the Brazilian Register of Clinical Trials (Registro Brasileiro de Ensaios Clínicos) under No. RBR-9vc722.OBJETIVO: Evaluar la interferencia del esmalte de uñas en la lectura de la saturación periférica de oxígeno en pacientes con enfermedad pulmonar obstructiva crónica en el ejercicio de la etapa. MÉTODOS: Fueron incluidos pacientes con enfermedad pulmonar obstructiva crónica estable, no fumadores actuales, de ambos los sexos. Fueron utilizadas cuatro colores de esmalte (base, rosa claro, rojo y marrón) distribuidas aleatoriamente entre los dedos de la mano derecha teniendo los dedos contralaterales como control. La saturación fue medida en reposo con y sin esmalte y durante el 4º, 5º y 6º minutos del ejercicio. RESULTADOS: Fueron incluidos 42 pacientes con edad de 62,9±8,7 años. En el ejercicio el color rojo apocó la misma en el cuarto minuto de ejercicio (p=0,047). El color marrón redujo la saturación en el reposo y durante el ejercicio (p=0,01). CONCLUSIÓN: En pacientes con enfermedad pulmonar obstructiva crónica los colores marrón y rojo interfieren en la lectura de la saturación periférica de oxígeno en el ejercicio. Este estudio está registrado en el Registro Brasileño de Ensayos Clínicos bajo el número de registro: RBR-9vc722.OBJETIVO: avaliar a interferência do esmalte de unha na leitura da saturação periférica de oxigênio em pacientes com doença pulmonar obstrutiva crônica, no exercício do degrau. MÉTODOS: foram incluídos pacientes com doença pulmonar obstrutiva crônica estável, não fumantes atuais, de ambos os sexos. Utilizaram-se quatro cores de esmalte (base, rosa claro, vermelho e marrom), distribuídas aleatoriamente entre os dedos da mão direita, tendo os dedos contralaterais como controle. A saturação foi medida em repouso com e sem esmalte e durante o 4º, 5º e 6º minutos do exercício. RESULTADOS: foram incluídos 42 pacientes com idade de 62,9±8,7 anos. No exercício, a cor vermelha diminuiu a mesma no quarto minuto de exercício (p=0,047). A cor marrom reduziu a saturação no repouso e durante o exercício (p=0,01). CONCLUSÃO: em pacientes com doença pulmonar obstrutiva crônica, as cores marrom e vermelha interferem na leitura da saturação periférica de oxigênio no exercício. Este estudo está registrado no Registro Brasileiro de Ensaios Clínicos, sob número de registro: RBR-9vc722

Exercise training in the spectrum of breast cancer

Exercise training and regular physical activity have been mentioned as one of the non-pharmacological approaches to enhance breast cancer outcomes. Such evidence encourages health professionals to recommend it as an adjuvant in treatment conditions to improve cardiorespiratory fitness that, can increase the rate of completion of pharmacologic therapies, reduce cancer-related fatigue, and improve muscle strength and quality of life. Research results have highlighted a positive relationship between exercise and breast tumor outcomes, that seem to be dose dependent (the more activity the more protection) and can be mediated through several biological mechanisms. In this chapter, we intend to summarize the current knowledge about the effects of exercise in the regulation of metabolic and steroid hormones, tumor-related inflammation, and the attenuation of cancer-induced muscle wasting, highlighting the exercise designs that can prompt the best results.info:eu-repo/semantics/publishedVersio

Comparação da qualidade de vida de portadores de câncer de pulmão antes e após o tratamento quimioterápico

OBJECTIVE: this prospective study aimed to assess the quality of life related to health (QLRH) of patients with lung cancer after chemotherapy treatment. METHOD: The QLRH was assessed using the questionnaires Quality-of-Life Questionnaire-Core 30 (QLQ-C30) and Lung Cancer Module (LC13), version 3.0. RESULTS: the sample was made up of 11 women and 19 men, with an average age of 68 years (51-87 years). After the chemotherapy treatment, the authors observed a clinically-relevant improvement in general quality of life, as well as in the symptoms of dyspnea, insomnia, hemoptysis, cough, thoracic pain, pain in the arm/shoulder, and financial difficulty. There was a worsening on the functional scale which assesses role performance and symptoms of fatigue, nausea and vomiting, sensory neuropathy, pain in other parts, constipation, loss of appetite and alopecia. CONCLUSION: although the patients have an improvement of their QLRH and symptoms related to the lung cancer after the chemotherapy treatment, there was a worsening of the symptoms which resulted from the toxicity of the chemotherapy medications.OBJETIVO: estudio prospectivo con objetivo de evaluar la calidad de vida relacionada a la salud (CVRS) de pacientes con cáncer de pulmón después de tratamiento de quimioterapia. MÉTODO: la CVRS fue evaluada por los cuestionarios Quality-of-Life Questionnaire-Core 30 (QLQ-C30) y Lung Cancer Module (LC13), versión 3.0. RESULTADOS: la muestra estuvo compuesta por 11 mujeres y 19 hombres, con promedio de edad de 68 años (51-87 años). Después del tratamiento de quimioterapia, observamos una mejoría clínicamente relevante de la calidad de vida general, así como en los síntomas de disnea, insomnio, hemoptisis, tos, dolor torácico, dolor en el brazo/hombro y dificultad financiera. Hubo empeoramiento en la escala funcional que evalúa el desempeño de papel y de los síntomas de fatiga, náusea y vómito, neuropatía sensorial, dolor extra-torácico, constipación, pérdida de apetito y alopecia. CONCLUSÍON: los pacientes presentaron mejoría de la CVRS y de los síntomas relacionados al cáncer de pulmón después del tratamiento de quimioterapia, entretanto hubo un empeoramiento de los síntomas provenientes de la toxicidad de los medicamentos de la quimioterapia.OBJETIVO: estudo prospectivo, com o objetivo de avaliar a Qualidade de Vida Relacionada à Saúde de pacientes com câncer de pulmão, após tratamento quimioterápico. MÉTODO: a Qualidade de Vida Relacionada à Saúde foi avaliada pelos questionários Quality-of-Life Questionnaire-Core 30 e Lung Cancer Module, versão 3.0. RESULTADOS: a amostra foi composta por 11 mulheres e 19 homens, com média de idade de 68 anos (51-87 anos). Após o tratamento quimioterápico, observou-se melhora clinicamente relevante da qualidade de vida geral, assim como dos sintomas de dispneia, insônia, hemoptise, tosse, dor torácica, dor no braço/ombro e dificuldade financeira. Houve piora na escala funcional que avalia o desempenho de papel e dos sintomas de fadiga, náusea e vômito, neuropatia sensorial, dor extratorácica, constipação, perda de apetite e alopecia. CONCLUSÃO: os pacientes apresentaram melhora da Qualidade de Vida Relacionada à Saúde e sintomas relacionados ao câncer de pulmão, após o tratamento quimioterápico; entretanto, houve piora dos sintomas decorrentes da toxicidade dos medicamentos quimioterápicos.Hospital Servidor Público EstadualUniversidade Federal de São Paulo (UNIFESP) Departamento de PneumologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP, Depto. de PneumologiaUNIFESP, EPESciEL

Exercise Training in the Spectrum of Breast Cancer

Exercise training and regular physical activity have been mentioned as one of the non-pharmacological approaches to enhance breast cancer outcomes. Such evidence encourages health professionals to recommend it as an adjuvant in treatment conditions to improve cardiorespiratory fitness that, can increase the rate of completion of pharmacologic therapies, reduce cancer-related fatigue, and improve muscle strength and quality of life. Research results have highlighted a positive relationship between exercise and breast tumor outcomes, that seem to be dose dependent (the more activity the more protection) and can be mediated through several biological mechanisms. In this chapter, we intend to summarize the current knowledge about the effects of exercise in the regulation of metabolic and steroid hormones, tumor-related inflammation, and the attenuation of cancer-induced muscle wasting, highlighting the exercise designs that can prompt the best results

Biopsia do cório fetal em cães

With the great development of the gestational studies in all of the species, we noticed the necessity of adaptations of these techniques for prenatal diagnosis in dogs. Based on this, we studied the feasibility of chorion biopsy guided by ultrasound. Our results demonstrated accuracy on the sex determination being 2 males and 12 females, as well as it would be possible to identify chromosome alteration due to the quality of samplings. Sex determination was accomplished with the identification of Y gene chromosomes in PCR technique. After the collection, fragments were prepared for light microscopy studies and revealed fetal chorion tissue, blood colloid and erythrocyte. In the whole material we found hemosiderin impregnations due to the hemolysis and to the residue of blood of the placental marginal hematomes. The submitted female dogs to this technique demonstrated normal puppy births without death.Com o grande desenvolvimento dos estudos gestacionais em todas as espécies, percebemos a necessidade de adaptarmos técnicas para diagnóstico pré-natal para cães. Assim, buscamos bases nas técnicas já existentes empregadas em humanos, e através destas, conseguimos estabelecer um método para coleta em cães, utilizando PCR para garantirmos a integridade das amostras. O procedimento foi realizado através de punção da cinta placentária com agulha de biopsia guiada por ultra-som. De todas as 14 amostras coletadas, duas apresentaram-se positivas para o cromossomo Y, presente apenas em machos, confirmando assim a viabilidade das amostras demonstrando com isso que através desta técnica podemos coletar material fetal para diagnóstico de alterações gênicas ou cromossômicas presentes nos cães antes mesmo destes virem a termo. A microscopia de material revelou fragmentos de cório fetal, colóide sangüíneo e eritrócitos. Em todo o material encontramos impregnações de hemosiderina devido à hemólise e ao resíduo de sangue dos hematomas marginais placentários. As cadelas submetidas a esta técnica tiveram partos normais sem óbito de nenhum filhote.FAPES

Aspectos Morfológicos do cordão umbilical de búfalos (Bubalus bubalis)

Buffalo is an important livestock resource, with a great participation in agricultural systems, providing milk, meat, and work power. Umbilical cord is responsible for maternal-fetal nutrients exchange during pregnancy, and its alterations can compromise the fetal development. We investigated ten pregnant uteruses collected from cross-bread buffaloes in different stages of gestation. Pregnancy and fetal age was determined by measuring the apex sacral length and development period was calculated by previously published formula. Umbilical cords were measured for length determination. Umbilical cord vascular net and anastomosis were observed by injection of Neoprene latex. Histological sections of the umbilical cord were studied after stain with HE, picrossirius, toluidine blue, orceine, and PAS reaction. Buffaloes' umbilical cord was formed by two central arteries, an allantois duct and two peripheral veins. The artery wall was composed by large quantity of collagen, elastic fibers, fibroblasts and large number of vasa vasorum. The allantois duct was located between the arteries and presented a great number of small nourishing vessels. Small nourishing vessels should be carefully considered to avoid to be mistaken to the arterials and veins vasa vasorum. Medium length of umbilical cord from buffalos was 11.8cm (minimum of 6.8cm and maximum of 17.4cm).Búfalo é uma importante fonte de recurso nos rebanhos animais, apresentando uma grande participação na agropecuária, provendo leite, carne e força de trabalho. O Cordão umbilical é responsável pela troca de nutrientes materno-fetais durante a gestação, e suas alterações podem comprometer o desenvolvimento fetal. Nós investigamos dez úteros gravídicos de búfalos de raças cruzadas em fases diferentes de gestação. O período de gestação e a idade fetal foram determinados pelo comprimento ápice sacral, aplicando fórmulas previamente estabelecidas. Posteriormente mediu-se o comprimento do cordão umbilical. A rede vascular do cordão umbilical e anastomoses foram observadas por injeção ou látex de neoprene. O cordão umbilical foi estudado a partir de cortes histológicos, corados por HE, picrossirius, azul de Toluidina, orceína e reação histoquímica de PAS. O cordão umbilical de búfalos é formado por duas artérias centrais, ducto alantóide e duas veias periféricas e apresentam forma de ampulheta. A parede da artéria umbilical é composta por grande quantidade de fibras colágenas e elásticas, fibroblastos e um grande número de vasa vasorum. O ducto alantóide fica alocado entre as artérias e apresenta um grande número de pequenos vasos nutritivos. Os vasos nutritivos devem ser cuidadosamente identificados para evitar-se confundi-los com vasa vasorum. O comprimento médio do cabo de cordão umbilical dos búfalos era 11.8cm (mínimo de 6.8cm e máximo de 17.4cm)