A aplicação de fundamentos da Técnica de Alexander na iniciação do oboé

Relatório de Estágio apresentado à Escola Superior de Artes Aplicadas do Instituto Politécnico de Castelo Branco para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Ensino de Música.O presente trabalho foi elaborado como parte integrante da Prática de Ensino Supervisionada, que ocorreu no Conservatório do Vale do Sousa ao longo do ano letivo 2013/2014. Inclui o relatório da Prática de Ensino Supervisionada e um projeto de investigação com o tema “A aplicação de fundamentos da Técnica Alexander na iniciação ao oboé”. A utilização desta técnica vai ao encontro de uma maior consciencialização corporal do aluno por forma a exercer menos tensão na execução. Nesse sentido, foram implementadas estratégias, tendo por base a Técnica Alexander, com o propósito de proporcionar novas sensações que beneficiem os alunos na execução do instrumento. São ainda demonstrados os procedimentos utilizados no decurso da investigação, bem como uma reflexão dos resultados obtidos.Abstract: This work was developed as a part of Supervised Teaching Practice in Conservatório do Vale do Sousa during the school year of 2013/2014. It includes the report of Supervised Teaching Practice and the research project “The application of Alexander Technique fundamentals to oboe initiation”. The application of this technique enables the development of a greater bodily awareness in the student in order to reduce tension in the execution. In this sense I implemented strategies based on the Alexander Technique with the purpose of providing new sensations to help the students in the execution of the instrument. I also demonstrate the procedures used during the research, as well as a reflection on the results

The Portuguese Society of Rheumatology position paper on the use of biosimilars

Biotechnological drugs have become a fundamental resource for the treatment of rheumatic patients. Patent expiry of some of these drugs created the opportunity for biopharmaceutical manufacturers to develop biosimilar drugs intended to be as efficacious as the originator product but with a lower cost to healthcare systems. Due to the complex manufacturing process and highly intricate structure of biologicals, a biosimilar can never be an exact copy of its reference product. Consequently, regulatory authorities issued strict preclinical and clinical guidelines to ensure safety and efficacy equivalence and, in September 2013, the biosimilar of infliximab was the first biosimilar monoclonal antibody to be authorized for use in the European Union. The current document is a position statement of the "Sociedade Portuguesa de Reumatologia" (Portuguese Society of Rheumatology) on the use of biosimilar drugs in rheumatic diseases. Two systematic literature reviews were performed, one concerning clinical trials and the other one concerning international position papers on biosimilars. The results were presented and discussed in a national meeting and a final position document was discussed, written and approved by Portuguese rheumatologists. Briefly, this position statement is contrary to automatic substitution of the originator by the biosimilar, defends either a different INN or the prescription by brand name, supports that switching between biosimilars and the originator molecule should be done after at least 6 months of treatment and based on the attending physician decision and after adequate patient information, recommends the registration of all biosimilar treated patients in Reuma.pt for efficacy, safety and immunogenicity surveillance, following the strategy already ongoing for originators, and opposes to extrapolation of indications approved to the originator to completely different diseases and/or age groups without adequate pre-clinical, safety or efficacy data.info:eu-repo/semantics/publishedVersio

ANÁLISE COMPARATIVA DO USO DE INIBIDORES DA ALFA-GLUCOSIDASE E DE INIBIDORES DA DPP-4 NO TRATAMENTO DA DIABETES TIPO 2

Considering the growing impact of type 2 diabetes on global public health, there is a justified need to explore effective therapeutic approaches. This study aimed to conduct a comparative analysis between alpha-glucosidase inhibitors and DPP-4 inhibitors, both used in the management of type 2 diabetes. To this end, a qualitative bibliographic review was conducted, covering multiple languages, using databases such as Scielo, Google Scholar, scientific journals, repositories, and virtual libraries. Inclusion and exclusion criteria were applied to select relevant studies that addressed the efficacy, side effects, mechanisms of action, and impact on glycemic control of these inhibitors. It was observed that DPP-4 inhibitors, such as Sitagliptin and Saxagliptin, are effective in reducing fasting glucose and glycated hemoglobin (HbA1C), in addition to presenting a favorable safety profile. On the other hand, alpha-glucosidase inhibitors, such as Acarbose, stand out in reducing postprandial glucose but are frequently associated with adverse gastrointestinal effects such as flatulence and diarrhea. It is concluded that both classes of drugs have their specific advantages, with DPP-4 inhibitors being more effective in reducing HbA1C and better tolerated, while alpha-glucosidase inhibitors are particularly useful for controlling postprandial glucose. The choice of treatment should be individualized, considering the efficacy, tolerability, and specific needs of patients. Future studies may explore therapeutic combinations to maximize benefits and minimize adverse effects, as well as investigate treatments based on genetic characteristics and specific biomarkers for a more personalized management of type 2 diabetes.Considerando o crescente impacto da diabetes tipo 2 na saúde pública global, justifica-se a necessidade de explorar abordagens terapêuticas eficazes. Este estudo objetivou realizar uma análise comparativa entre inibidores da alfa-glucosidase e inibidores da DPP-4, ambos utilizados no manejo da diabetes tipo 2. Para tanto, procedeu-se a uma revisão bibliográfica qualitativa, abrangendo múltiplos idiomas, utilizando bases de dados como Scielo, Google Acadêmico, revistas científicas, repositórios e bibliotecas virtuais. Critérios de inclusão e exclusão foram aplicados para selecionar estudos relevantes que abordassem a eficácia, efeitos colaterais, mecanismos de ação e impacto no controle glicêmico desses inibidores. Observou-se que os inibidores da DPP-4, como Sitagliptina e Saxagliptina, são eficazes na redução da glicemia de jejum e na hemoglobina glicada (HbA1C), além de apresentarem um perfil de segurança favorável. Por outro lado, os inibidores da alfa-glucosidase, como a Acarbose, destacam-se na redução da glicemia pós-prandial, mas são frequentemente associados a efeitos gastrointestinais adversos, como flatulência e diarreia. Conclui-se que ambas as classes de medicamentos têm suas vantagens específicas, sendo os inibidores da DPP-4 mais eficazes na redução da HbA1C e melhor tolerados, enquanto os inibidores da alfa-glucosidase são particularmente úteis para controlar a glicemia pós-prandial. A escolha do tratamento deve ser individualizada, considerando a eficácia, a tolerabilidade e as necessidades específicas dos pacientes. Estudos futuros podem explorar combinações terapêuticas para maximizar os benefícios e minimizar os efeitos adversos, bem como investigar tratamentos baseados em características genéticas e biomarcadores específicos para um manejo mais personalizado da diabetes tipo 2. &nbsp

Portuguese recommendations for the use of methotrexate in rheumatic diseases - 2016 update

BACKGROUND: Methotrexate (MTX) is the first-line drug in the treatment of rheumatoid arthritis (RA) and the most commonly prescribed disease modifying anti-rheumatic drug. Moreover, it is also used as an adjuvant drug in patients under biologic therapies, enhancing the efficacy of biologic agents. OBJECTIVES: To review the literature and update the Portuguese recommendations for the use of MTX in rheumatic diseases first published in 2009. METHODS: The first Portuguese guidelines for the use of MTX in rheumatic diseases were published in 2009 and were integrated in the multinational 3E Initiative (Evidence Expertise Exchange) project. The Portuguese rheumatologists based on literature evidence and consensus opinion formulated 13 recommendations. At a national meeting, the recommendations included in this document were further discussed and updated. The document resulting from this meeting circulated to all Portuguese rheumatologists, who anonymously voted online on the level of agreement with the updated recommendations. RESULTS: Results presented in this article are mainly in accordance with previous guidelines, with some new information regarding hepatitis B infection during MTX treatment, pulmonary toxicity monitoring, hepatotoxicity management, association with hematologic neoplasms, combination therapy and tuberculosis screening during treatment. CONCLUSION: The present recommendations combine scientific evidence with expert opinion and attained desirable agreement among Portuguese rheumatologists. The regular update of these recommendations is essential in order to keep them a valid and useful tool in daily practice.publishersversionpublishe

Portuguese guide lines for the use of biological agents in rheumatoid arthritis - october 2011 update

The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of Rheumatoid Arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment (with a tumour necrosis factor antagonist, abatacept or tocilizumab) should be considered in RA patients with a disease activity score 28 (DAS 28) equal to or greater than 3.2 des pite treatment with at least 20mg-weekly-dose of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 3 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regi -mens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, defined by a DAS28 lower than 3.2,without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of at least 0.6 in the DAS28 score. After 6 months of treatment res ponse criteria is defined as a decrease greater than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist's clinical opi -nion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituxi mab or tocilizumab).publishersversionpublishe

Portuguese guidelines for the use of biological agents in rheumatoid arthritis - March 2010 update.

The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of rheumatoid arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment should be considered in RA patients with a disease activity score 28 (DAS 28) superior to 3.2 despite treatment with 20mg/week of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 6 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, characterized by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of 0.6 in the DAS28 score. After 6 months of treatment response criteria is defined as a decrease of more than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist's clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).publishersversionpublishe

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data