386 research outputs found

    Distúrbios miccionais e anormalidades urodinâmicas em pacientes idosos

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    Lower urinary tract dysfunction is a major cause of morbidity and decreased quality of life in elderly men and women. With the progressive aging of the population, it is important to understand common micturitional disorders that may occur in this population. Most urinary problems in the elderly are multifactorial in origin, demanding a comprehensive assessment of the lower urinary tract organs, functional impairments, and concurrent medical diseases. Urodynamics is a highly valuable tool in the investigation of elderly patients with lower urinary tract symptoms. Urodynamic tests are not always necessary, being indicated after excluding potentially reversible conditions outside the urinary tract that may be causing or contributing to the symptoms. Although urodynamic tests may reveal common diagnoses such as bladder outlet obstruction and stress urinary incontinence in the elderly population, findings such as detrusor overactivity and impaired detrusor contractility are common and have important prognostic and therapeutic implications. The purpose of this article is to describe common urologic problems in the elderly and review the indications for and clinical aspects of urodynamic studies in these conditions.Disfunções do trato urinário inferior são uma causa importante de morbidade e diminuição da qualidade de vida em homens e mulheres idosos. Com o envelhecimento progressivo da população, é importante compreender os distúrbios miccionais mais comuns nesta população. A maioria dos problemas miccionais em homens idosos tem origem multifatorial, requerendo uma avaliação ampla dos órgãos do trato urinário inferior, da capacidade funcional e neurológica dos pacientes e dos problemas clínicos coexistentes. A avaliação urodinâmica é uma ferramenta importante na investigação de pacientes idosos com sintomas do trato urinário inferior. Ela não é necessária em todos os casos e só deve ser indicada após a exclusão de problemas não urológicos e potencialmente reversíveis que poderiam causar ou contribuir para os sintomas miccionais. Embora os exames urodinâmicos possam revelar diagnósticos comuns como obstrução vesical ou incontinência urinária de esforço, na população idosa é freqüente a ocorrência de achados como hiperatividade detrusora e falência da contratilidade vesical, com implicações prognósticas e terapêuticas importantes. O objetivo deste artigo é descrever os problemas urológicos mais comuns nos idosos e discutir as indicações e características dos exames urodinâmicos nestas condições

    KPI tree - a hierarchical relationship structure of key performance indicators for value streams

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    Performance Measurement Systems (PMS) have been a potential answer to problems related to production systems monitoring, allowing the management and manipulation of data collected at various levels in organizations. PMS can be defined as a group of indicators in an information system. There are several types of PMS, however, the relationship between indicators in a PMS is still an issue that needs to be explored, as the KPIs in a production system are not independent and may have an intrinsic relationship. The purpose of this paper is to present a multilevel structure and its intrinsic structural relation for managing and analysing KPIs for a value stream production system. This hierarchical structure has different KPI levels such as Improvement KPIs, Monitoring KPIs, and Results KPIs or KPR (Key Performance Results), intrinsically related from the strategic levels to the operational levels. This provides a useful tool for the management of production systems, being used to analyse, and support the organization's continuous improvement processes.This Work was supported by the FCT – Fundação para a Ciência e Tecnologia, Portugal, within the Project Scope UIDB/00319/2020. C.J. has been supported by operation NORTE-06-3559-FSE-000226, funded by Norte Portugal Regional Operational Program (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Social Fund (ESF)

    Social and cultural contexts change but intelligence persists as incisive to explain children’s academic achievement

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    The intelligence is a well established predictor of school achievement. Although school failure/success can be explained by cognitive variables, socio-familial variables can also have an impact. Since these variables haven’t been so systematically investigated together, the present study aims to consider both variables to understand their causal roles in academic achievement. With a sample of 376 Portuguese children aged 6 to 10 years, a path analysis was carried out based on a prior analysis to search for causal relationships between intelligence and socio-familial variables to explain children’s academic achievement. The results point to intelligence as a major influence on school performance, combined with socio-familial variables (directly: community, type of school, mother's education and school year; and indirectly: socioeconomic status and father’s education level). Practical implications were discussed concerning the relevance of the investigated variables in explaining academic achievement of children.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Fundação para a Ciência e Tecnologia, IP (FCT) and the POCH/FSE under Grant SFRH/BD/85110/2012 to Ana Filipa Alves

    Childhood adversity and leisure time physical and sports activity in older adults: A cross-sectional analysis from the International Mobility in Aging Study

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    Aim: The purpose is to examine the relationship between childhood adversity and leisure time physical activity (LTPA) among community-dwelling older adults from high and middle-income sites. Methods: Cross-sectional analysis of 2012 data from older adult ages 64-75 years old from King-ston, Canada; St. Hyacinthe, Canada; Tirana, Albania; Manizales, Colombia; and Natal, Brazil. Principal exposure variables were childhood social and economic adversity. Covariates included participant age, sex, income, and educational attainment. Outcome variables were LTPA and lei-sure time sports activity (LTSA). Results: High-income sites had higher LTPA prevalence than middle-income sites. Females were less likely to engage in LTPA compared to males in Tirana (OR:0.53, 95%CI:0.30-0.94), but were more likely to engage in LTPA in Manizales (OR:2.54, 95%CI:1.54-4.18). Low education was less likely than high education to engage in LTPA in Kingston (OR:0.38, 95%CI:0.19-0.73) and Natal (OR: 0.52, 95%CI:0.28-0.97). Low income was less likely than high income to engage in LTPA in St. Hyacinthe (OR: 0.42, 95%CI:0.20-0.89) and Manizales (OR:0.33, 95%CI:0.16-0.55). In Tirana, low income was more likely than high income to engage in LTPA (OR:5.27, 95%CI:2.06-13.51). Conclusions: Childhood economic and social adversity were not significantly associated with LTPA. Sex, income, and education were associated with older adult PA engagement, however the direction of the association varied by site location. This suggests that the paradigms surrounding PA behavior may vary from city to city. Understanding the site-specific risk factors to PA engage-ment may better inform clinical recommendations and public health approaches to increase PA engagement among older adults across the globe

    Effect of short-term practice of breathing exercises on the breathing capacity in school-age girls

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    Background: The breathing mechanism has existed since our birth and accompanies us throughout life. Breathing is an important function in the regulatory process of numerous body functions, its optimization can bring many health benefits. However, many children are unaware of the mechanisms of breathing, namely abdominal or diaphragmatic breathing, and in addition to this, many breathe normally through their mouths. Methods: The present study aimed to verify the influence of a short-Term breathing exercise program in school-Age girls breathing capacity. Fourteen female students aged between 8 and 10 years were selected, from this selection two groups were formed, the control group (CG) with 7 children and the experimental group (EG) with 7. Through a spirometric test, an assessment of breathing capacity (ABC) was carried out for both groups. The GE participated in a program of breathing exercises (BEP) lasting 15 to 20 minutes for 5 weeks. Then, the ABC was performed again for both groups. Discussion: The results demonstrate a significant increase in the values (p 0.01) of the forced vital capacity (FVC) of the EG, thus suggesting that the application of a BEP promotes the breathing capacity of school-Aged girls. Further studies should be performed with larger samples and with a longer protocol.info:eu-repo/semantics/publishedVersio

    Expression of tyrosine kinase receptor AXL is associated with worse outcome of metastatic renal cell carcinomas treated with sunitinib

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    Expression of tyrosine kinase receptor AXL is associated with worse outcome of metastatic renal cell carcinomas treated with sunitinibBackground: Renal cell carcinoma (RCC) represents 2%-3% of all cancers of the Western countries. Currently, sunitinib, a receptor tyrosine kinase inhibitor, particularly of PDGF and VEGF receptors, is the first-line therapy for metastatic RCC (mRCC), with significant improvement in clinical outcome. However, there is a lack of predictive biomarkers of sunitinib response. Recently, others and our group suggested that the receptor tyrosine kinase AXL may modify the response to sunitinib. Objective: To study the expression of AXL in a series patients with of mRCC treated with sunitinib and to correlate it with patient's clinic-pathological features and therapeutic response. Material and methods: Sixty-four patients with mRCC (51 clear cell carcinomas (CCCs) and 13 non-CCCs) were evaluated for AXL expression by immunohistochemistry in the primary tumor. Results: AXL positivity was observed in 47% (30/64) of cases, namely in 43% (22/51) of CCCs and 61% (8/13) of non-CCC. Considering only the clear cell subtype, the univariate analysis showed that AXL expression was statistically associated with a poor prognosis, with a median overall survival of 13 months vs. 43 months in patients with negative AXL. In this subtype, along with the AXL positivity, other prognostic factors were absence of nephrectomy, Karnofsky performance status, more than 1 site of metastasis and liver metastasis. Moreover, AXL expression was associated with shorter progression to sunitinib. Overall, the multivariate survival analysis showed that absence of nephrectomy (HR = 4.85, P = 0.001), more than 1 site of metastasis (HR = 2.99, P = 0.002), bone metastasis (HR = 2.95, P = 0.001), together with AXL expression (HR = 2.01, P = 0.048) were independent poor prognostic factor in patients with mRCC. Conclusion: AXL expression was associated with worse clinical outcome and may be an important prognostic biomarker in sunitinibtreated patients with metastatic renal cell carcinoma.this study was supported by Barretos Cancer Hospital Internal Research Funds (PAIP) of participant authors. Rui Manuel Reis is recipient of a National Council of Technological and Scientific Development (CNPq) scholarship.info:eu-repo/semantics/publishedVersio

    Extracellular electrophysiological measurements of cooperative signals in astrocytes populations

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    Astrocytes are neuroglial cells that exhibit functional electrical properties sensitive to neuronal activity and capable of modulating neurotransmission. Thus, electrophysiological recordings of astroglial activity are very attractive to study the dynamics of glial signaling. This contribution reports on the use of ultra-sensitive planar electrodes combined with low noise and low frequency amplifiers that enable the detection of extracellular signals produced by primary cultures of astrocytes isolated from mouse cerebral cortex. Recorded activity is characterized by spontaneous bursts comprised of discrete signals with pronounced changes on the signal rate and amplitude. Weak and sporadic signals become synchronized and evolve with time to higher amplitude signals with a quasi-periodic behavior, revealing a cooperative signaling process. The methodology presented herewith enables the study of ionic fluctuations of population of cells, complementing the single cells observation by calcium imaging as well as by patch-clamp techniques.Portuguese Foundation for Science and Technology (FCT) [PTDC/EEI-AUT/5442/2014]; Instituto de Telecomunicacoes [UID/Multi/04326/2013]; Associated Laboratory - Institute of Nanoscience and Nanotechnology [POCI-01-0145-FEDER-016623]; [PTDC/CTM-NAN/3146/2014]info:eu-repo/semantics/publishedVersio

    Web platform using digital image processing and geographic information system tools : a Brazilian case study on dengue

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    Background: Dengue fever is endemic in Asia, the Americas, the East of the Mediterranean and the Western Pacific. According to the World Health Organization, it is one of the diseases of greatest impact on health, affecting millions of people each year worldwide. A fast detection of increases in populations of the transmitting vector, the Aedes aegypti mosquito, is essential to avoid dengue outbreaks. Unfortunately, in several countries, such as Brazil, the current methods for detecting populations changes and disseminating this information are too slow to allow efficient allocation of resources to fight outbreaks. To reduce the delay in providing the information regarding A. aegypti population changes, we propose, develop, and evaluate a system for counting the eggs found in special traps and to provide the collected data using a web structure with geographical location resources. Methods: One of the most useful tools for the detection and surveillance of arthropods is the ovitrap, a special trap built to collect the mosquito eggs. This allows for an egg counting process, which is still usually performed manually, in countries such as Brazil. We implement and evaluate a novel system for automatically counting the eggs found in the ovitraps’ cardboards. The system we propose is based on digital image processing (DIP) techniques, as well as a Web based Semi-Automatic Counting System (SCSA-WEB). All data collected are geographically referenced in a geographic information system (GIS) and made available on a Web platform. The work was developed in Gama’s administrative region, in Brasília/Brazil, with the aid of the Environmental Surveillance Directory (DIVAL-Gama) and Brasília’s Board of Health (SSDF), in partnership with the University of Brasília (UnB). The system was built based on a field survey carried out during three months and provided by health professionals. These professionals provided 84 cardboards from 84 ovitraps, sized 15 × 5 cm. In developing the system, we conducted the following steps: i. Obtain images from the eggs on an ovitrap’s cardboards, with a microscope. ii. Apply a proposed image-processing-based semi-automatic counting system. The system we developed uses the Java programming language and the Java Server Faces technology. This is a framework suite for web applications development. This approach will allow a simple migration to any Operating System platform and future applications on mobile devices. iii. Collect and store all data into a Database (DB) and then georeference them in a GIS. The Database Management System used to develop the DB is based on PostgreSQL. The GIS will assist in the visualization and spatial analysis of digital maps, allowing the location of Dengue outbreaks in the region of study. This will also facilitate the planning, analysis, and evaluation of temporal and spatial epidemiology, as required by the Brazilian Health Care Control Center. iv. Deploy the SCSA-WEB, DB and GIS on a single Web platform. Results: The statistical results obtained by DIP were satisfactory when compared with the SCSA-WEB’s semi-automated eggs count. The results also indicate that the time spent in manual counting has being considerably reduced when using our fully automated DIP algorithm and semi-automated SCSA-WEB. The developed georeferencing Web platform proves to be of great support for future visualization with statistical and trace analysis of the disease. Conclusions: The analyses suggest the efficiency of our algorithm for automatic eggs counting, in terms of expediting the work of the laboratory technician, reducing considerably its time and error counting rates. We believe that this kind of integrated platform and tools can simplify the decision making process of the Brazilian Health Care Control Center
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