Análise Objetiva ao Desempenho do Monofilamento de Semmes-Weinstein de 10 gf para Avaliação da Sensibilidade Cutânea Protetora no Pé Diabético

9º Congresso Nacional de BiomecânicaA perda de sensibilidade protetora no pé diabético obriga a um diagnóstico precoce devido à eminente possibilidade de ulceração e amputação do membro afetado. Na avaliação da perda de sensibilidade protetora, o monofilamento de Semmes-Weinstein (MSW) de 10 gf é o instrumento de primeira linha mais utilizado. Este estudo foi conduzido com o objetivo de realizar uma análise objetiva e metrológica ao desempenho do MSW de 10 gf, recorrendo a um equipamento de medição previamente desenvolvido para o efeito. Procedeu-se a uma verificação metrológica de três MSW de 10 gf através de um método automatizado sob condições controladas. A força de compressão dos MSW revelou-se altamente dependente do número de utilizações, da temperatura ambiente e da velocidade de deslocamento e contacto com a região cutânea a avaliar. Efetivamente todos os MSW testados manifestaram dependência de fatores externos na sua força de compressão e registaram erros relativos superiores a 10 %, valor considerado crítico para discriminar uma possível evolução da patologia.info:eu-repo/semantics/publishedVersio

Kinetics of C-Reactive Protein and Procalcitonin in the Early Identification of ICU-Acquired Infections in Critically Ill COVID-19 Patients

UNLABELLED: The SARS-CoV-2 infection is a cause of hypoxemic acute respiratory failure, leading to frequent intensive care unit (ICU) admission. Due to invasive organ support and immunosuppressive therapies, these patients are prone to nosocomial infections. Our aim was to assess the value of daily measurements of C-reactive protein (CRP) and Procalcitonin (PCT) in the early identification of ICU-acquired infections in COVID-19 patients. METHODS: We undertook a prospective observational cohort study (12 months). All adult mechanically ventilated patients admitted for ≥72 h to ICU with COVID-19 pneumonia were divided into an infected group (n = 35) and a non-infected group (n = 83). Day 0 was considered as the day of the diagnosis of infection (infected group) and Day 10 was that of ICU stay (non-infected group). The kinetics of CRP and PCT were assessed from Day -10 to Day 10 and evaluated using a general linear model, univariate, repeated-measures analysis. RESULTS: 118 patients (mean age 63 years, 74% males) were eligible for the analysis. The groups did not differ in patient age, gender, CRP and PCT serum levels at ICU admission. However, the infected group encompassed patients with a higher severity (SOFA score at ICU admission, p = 0.009) and a higher 28-day mortality (p < 0.001). Before D0, CRP kinetics showed a significant increase in infected patients, whereas in noninfected it remained almost unchanged (p < 0.001), while PCT kinetics did not appear to retain diagnostic value to predict superinfection in COVID-19 patients (p = 0.593). CONCLUSION: COVID-19 patients who developed ICU-acquired infections exhibited different biomarker kinetics before the diagnosis of those infections. Daily CRP monitoring and the recognition of the CRP kinetics could be useful in the prediction of ICU-acquired infections.publishersversionpublishe

Estimação em Pequenos Domínios com modelos que combinam Informação Seccional e Cronológica

O objectivo principal deste artigo consiste na proposta de um novo estimador para parâmetros de interesse em pequenos domínios com dados de nível área

Estimação jackknife ponderada do erro quadrático médio de predição do EBLUP temporal

A metodologia baseada na melhor predição linear empírica não enviesada (Empirical Best Linear Unbiased Prediction), consagrada com o acrónimo EBLUP, é muito utilizada na estimação de parâmetros para pequenos domínios. Apesar da relativa facilidade de dedução dos EBLUPs, mesmo num contexto de um modelo longitudinal, a medição da sua qualidade é um problema complexo devido à di culdade de estimação do erro quadrático médio de predição (EQMP) de tais preditores. Neste trabalho utiliza-se um estimador de parâmetros de interesse em pequenos domínios assistido pelo modelo temporal de Rao-Yu (Rao e Yu, 1994). O EBLUP temporal é apresentado e é revisitada a aproximação analítica assimptótica do EQMP do EBLUP temporal proposta por Rao e Yu (1994). Sob o modelo de Rao-Yu, é proposta uma metodologia jackknife ponderada para estimar o EQMP do EBLUP, desenvolvida a partir dos trabalhos de Chen e Lahiri (2008). Foi realizado um estudo por simulação com o objectivo de comparar o desempenho do estimador proposto com o obtido por via da aproximação analítica do EQMP

Review of a New Biomarker in Sepsis

Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Sepsis is a life-threatening syndrome characterized by a dysregulated host response to an infection that may evolve rapidly into septic shock and multiple organ failure. Management of sepsis relies on the early recognition and diagnosis of infection and the providing of adequate and prompt antibiotic therapy and organ support. A novel protein biomarker, the pancreatic stone protein (PSP), has recently been studied as a biomarker of sepsis and the available evidence suggests that it has a higher diagnostic performance for the identification of infection than the most used available biomarkers and adds prognostic value. This review summarizes the clinical evidence available for PSP in the diagnosis and prognosis of sepsis.publishersversionpublishe

Estimation of unemployment rates in small areas of Portugal: a best linear unbiased prediction approach versus a hierarchical Bayes approach

The high level of unemployment is one of the major problems in most European countries nowadays. Hence, the demand for small area labor market statistics has rapidly increased over the past few years. The Labour Force Survey (LFS) conducted by the Portuguese Statistical Office is the main source of official statistics on the labour market at the macro level (e.g. NUTS2 and national level). However, the LFS was not designed to produce reliable statistics at the micro level (e.g. NUTS3, municipalities or further disaggregate level) due to small sample sizes. Consequently, traditional design-based estimators are not appropriate. A solution to this problem is to consider model-based estimators that "borrow information" from related areas or past samples by using auxiliary information. This paper reviews, under the model-based approach, Best Linear Unbiased Predictors and an estimator based on the posterior predictive distribution of a Hierarchical Bayesian model. The goal of this paper is to analyze the possibility to produce accurate unemployment rate statistics at micro level from the Portuguese LFS using these kinds of stimators. This paper discusses the advantages of using each approach and the viability of its implementation

Evaluación neuropsicológica de calidad de vida (ENCV) en pacientes con enfermedad vascular cerebral (EVC)

[Resumen] En este artículo procuramos hacer una reflexión profundizada relativa a las temáticas de la Calidad de Vida (CV) en Pacientes con Enfermedad Vascular Cerebral (EVC). La EVC se refiere a cualquier disfunción cerebral, producto de un proceso patológico que envuelva los vasos sanguíneos, e es presentada como una de las principales causas de muerte o incapacidad pos-accidente. La necesidad de una adecuada evaluación de aspectos como la Calidad de Vida es fundamental para un plano de rehabilitación adaptado a cada enfermo. En este artículo presentamos algunas de las propuestas más utilizadas en nuestros tiempos para la evaluación de la Calidad de Vida en Pacientes con Enfermedad Vascular Cerebral (EVC).[Abstract] In this article we tried to make a deepened reflection relative to the thematic of Life Quality Activities in Patients who suffered a stroke. A stroke is related with any cerebral dysfunction, product of a pathological process that surrounds the blood vessels, and is presented / displayed like one of the main causes of death or post-accident incapacity. The necessity of a suitable evaluation of Quality of Life is fundamental for an adapted rehabilitation plane to each patient. In this article we presented some of the most used proposals in our times for the evaluation of Quality of Life in Patients who suffered a strok

Airway and Respiratory Devices in the Prevention of Ventilator-Associated Pneumonia

Ventilator-associated pneumonia (VAP) is the most common ICU-acquired infection among patients under mechanical ventilation (MV). It may occur in up to 50% of mechanically ventilated patients and is associated with an increased duration of MV, antibiotic consumption, increased morbidity, and mortality. VAP prevention is a multifaceted priority of the intensive care team. The use of specialized artificial airways and other devices can have an impact on the prevention of VAP. However, these devices can also have adverse effects, and aspects of their efficacy in the prevention of VAP are still a matter of debate. This article provides a narrative review of how different airway and respiratory devices may help to reduce the incidence of VAP.publishersversionpublishe

JC virus in the pathogenesis of colorectal cancer, an etiological agent or another component in a multistep process?

JCV infection occurs early in childhood and last throughout life. JCV has been associated to colorectal cancer and might contribute to the cancer phenotype by several mechanisms. Among JCV proteins, particularly two of them, large T-antigen and agnoprotein, can interfere with cell cycle control and genomic instability mechanisms, but other viral proteins might also contribute to the process. Part of viral DNA sequences are detected in carcinoma lesions, but less frequently in adenomas, and not in the normal surrounding tissue, suggesting they are integrated in the host cell genome and these integrations have been selected; in addition viral integration can cause a gene, or chromosomal damage. The inflammatory infiltration caused by a local chronic viral infection in the intestine can contribute to the selection and expansion of a tumor prone cell in a cytokine rich microenvironment. JCV may not be the cause of colorectal cancer, but it can be a relevant risk factor and able to facilitate progression at one or several stages in tumor progression. JCV transient effects might lead to selective expansion of tumor cells. Since there is not a direct cause and effect relationship, JCV infection may be an alternative to low frequency cancer predisposition genes

Contributions for Conceptual Geohydraulic Model of the Underground Hydric Resources of Meda Municipality

This paper presents contributions on underground hydric and geothermal resources of the Meda Municipality land. After a brief introduction about the importance of the theme, the Meda municipality’s administrative, geographic, geomorphological and geological frameworks are presented in a synthetic way. The main hydrogeological units of the municipality are presented below and, based on the water surpluses resulting from precipitation, the order of magnitude of the water reserves of those hydrogeological units is advanced. From a vast field survey of groundwater points on the various hydrogeological units, the results obtained from the expeditious physicalchemical parameters are presented, and based on them some waters were selected to carry out complete physical-chemical and some isotopes analyses. Based on all the results, the municipality was organised in three different major hydrogeological domains (Longroiva, Areola, and Graben), for which the conceptual geohydraulic model was developed. From the several results, it is emphasized in particular that in the various domains there are potential to explore special groundwater with characteristics not only for medical spa and aqua-ludic spaces, but also for the production of energy and even not only heat energy, with cascading uses, but also for the production of electricity from groundwater from 70 to 113∘C