Molecular Mediators of Depression Pathophysiology and Treatment: Neuroscience-Based Approaches for Personalized Care

info:eu-repo/semantics/publishedVersio

Effectiveness of hypnosis for pain management and promotion of health-related quality-of-life among people with haemophilia: a randomised controlled pilot trial

Joint deterioration and associated chronic pain are common among people with haemophilia (PWH), having an impact on quality-of-life. Though non-pharmacological strategies are recommended, psychological interventions to promote pain control and quality-of-life have scarcely been tested in haemophilia. This randomised controlled pilot trial aimed to assess feasibility, acceptability and effectiveness of hypnosis for pain management and promotion of health-related quality-of-life (HRQoL) among PWH. Twenty adults were randomised either to four weekly hypnosis sessions plus treatment-as-usual (experimental group; EG) or treatment-as-usual only (control group; CG). Participants completed sociodemographic and clinical assessment, measures of pain, HRQoL and emotional distress before (T1) and after (T2) intervention. Changes were analysed by calculating the differences between T1 and T2, and the groups were compared through independent-sample t tests (or chi-squared). Retention rates (90%) and analysis of patient satisfaction showed good acceptability and feasibility of the intervention. The EG (n = 8) had a higher reduction on pain interference than the CG (n = 10) (d = -0.267). A higher improvement on HRQoL (EQ-5D index: d = 0.334; EQ-5D VAS: d = 1.437) and a tendency towards better haemophilia-related quality-of-life (A36-Hemofilia QoL) were also evident in the EG. This is the first study showing the effectiveness of hypnosis to reduce pain interference and promote HRQoL among PWH.Novo Nordisk HERO Research Grant 2015. P. R. Pinto has a post-doctoral grant (SFRH/BPD/103529/2014) from the Portuguese Foundation of Science and Technolog

The influence of adipocyte secretome on selected metabolic fingerprints of breast cancer cell lines representing the four major breast cancer subtypes

Molecular subtype (MS) is one of the most used classifications of breast cancer (BC). Four MSs are widely accepted according to receptor expression of estrogen, progesterone, and HER2. The impact of adipose tissue on BC MS metabolic impairment is still unclear. The present work aims to elucidate the metabolic alterations in breast cancer cell lines representing different MSs subjected to adipocyte associated factors. Preadipocytes isolated from human subcutaneous adipose tissue were differentiated into mature adipocytes. MS representative cell lines were exposed to mature adipocyte secretome. Extracellular medium was collected for metabolomics and RNA was extracted to evaluate enzymatic expression by RT-PCR. Adipocyte secretome exposure resulted in a decrease in the Warburg effect rate and an increase in cholesterol release. HER2+ cell lines (BT-474 and SK-BR-3) exhibited a similar metabolic pattern, in contrast to luminal A (MCF-7) and triple negative (TN) (MDA-MB-231), both presenting identical metabolisms. Anaplerosis was found in luminal A and TN representative cells, whereas cataplerotic reactions were likely to occur in HER2+ cell lines. Our results indicate that adipocyte secretome affects the central metabolism distinctly in each BC MS representative cell line.info:eu-repo/semantics/publishedVersio

Effectiveness of two psychological interventions for pain management, emotional regulation and promotion of quality of life among adult Portuguese men with haemophilia (PSY-HaEMOPEQ): study protocol for a single-centre prospective randomised controlled trial

Introduction Haemophilia is a bleeding disorder associated with significant pain, emotional distress, quality of life (QoL) impairment and considerable healthcare costs. Psychosocial health and effective pain management are considered essential end points for optimal haemophilia care, but there is a significant gap in evidence-based treatments targeting these outcomes in people with haemophilia (PWH). Psychological interventions are cost-effective in promoting emotional well-being, QoL and pain control, although these have been scarcely used in haemophilia field. This investigation aims to evaluate the effectiveness of two psychological interventions for pain management, emotional regulation and promotion of QoL in PWH. Methods and analysis This is a single-centre parallel randomised controlled trial conducted at a European Haemophilia Comprehensive Care Centre in Portugal, with five assessment points: baseline (T0), postintervention (T1), 3 (T2), 6 (T3) and 12 (T4) months follow-up. Eligible adult males, with moderate or severe haemophilia A or B will be randomised to experimental (EG) or control (CG) group. Intervention is either cognitive-behavioural therapy (EG1) or hypnosis (EG2), both consisting of four weekly sessions following standardised scripts delivered by trained psychologists. Randomisation will be computer generated, allocation concealment will be guaranteed and outcome assessors will be blind to EG/CG allocation. Main outcomes are pain and haemophilia-related QoL and secondary outcomes include clinical (clotting factor replacement consumption, joint bleeding episodes, analgesic intake) and psychological (pain coping strategies, anxiety, depression, illness perceptions) variables, functional assessment of the joints, inflammatory biomarkers (cytokines, high-sensitivity C reactive protein) and white blood cell count. Ethics and dissemination This study was approved by the competent authorities and all procedures will comply with international ethical guidelines for clinical studies involving humans. Written informed consent will be obtained from all participants. The dissemination plan includes peer-reviewed scientific publications, conference participation and web and media coverage.This work is supported by a grant from the Novo Nordisk HERO Research Grant 2015. PRP has a grant (SFRH/BPD/103529/2014) from the Portuguese Foundation of Science and Technologyinfo:eu-repo/semantics/publishedVersio

Balance assessment in HTLV-1 associated myelopathy or tropical spastic paraparesis

INTRODUCTION: A good rating of the device in people with HTLV-1 in this population is essential for accuracy in prescribing data (walking). Thus, this study aimed to analyze the counterpart assessment methods that are best suited to patients with human T-cell lymphotropic virus (HTLV)-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP). METHODS: This cross-sectional study related stabilometric and kinematic variables of postural oscillations with Berg’s balance scale (BBS) and Timed Up and Go (TUG) in subjects with HAM/TSP compared to asymptomatic subjects. To assess the posterior and lateral postural projection, baropodometry and the Footwork® system was used, and the CVMob system was applied to kinematic parameters. The means comparison tests and correlations were applied with an alpha of 5%. RESULTS: Thirty-nine subjects (predominantly female) made up the sample. There was an increase in barodopometric oscillations, in the total oscillation area (p = 0.004), in the anteroposterior oscillation in the left (p = 0.015) and right views (p = 0.036), and in the lateral oscillation (p = 0.039) in the HAM/TSP group. Moderate correlations were found between oscillation baropodometry and the angular variation of the ankle, as well as with the BBS in the three angles and the TUG for lateral oscillation (p = 0.406). CONCLUSIONS: Each method has advantages and disadvantages, including cost accuracy. The best resources available at no additional cost for outpatient to use are the kinematic evaluation using a simple smartphone camera and free analysis software, and the TUG.info:eu-repo/semantics/publishedVersio

Sociodemographic, clinical, and psychosocial characteristics of people with hemophilia in Portugal: findings from the first national survey

Hemophilia is a rare genetic bleeding disorder associated with pain, impaired functionality, and decreased quality of life (QoL). Several studies have focused on patient-reported outcomes of people with hemophilia (PWH) worldwide, but no such data are available for Portugal. This survey aimed to describe sociodemographic, clinical, and psychosocial characteristics of PWH of all ages in Portugal. Questionnaires were answered by self-report or by parents of children with hemophilia (proxy version). Variables assessed were sociodemographic and clinical, physical activity patterns, pain, functionality (HAL/PedHAL), QoL (A36 Hemofilia-QoL/CHO-KLAT), anxiety and depression (PROMIS), and illness perceptions (IPQ-R). One-hundred and forty-six PWH answered the survey: 106 adults, 21 children/teenagers between 10 and 17 years, 11 children between 6 and 9 years, and 8 children between 1 and 5 years. Most participants had severe hemophilia (60.3%) and type A was most commonly reported (86.3%). Bleeding episodes, joint deterioration, and pain were very prevalent, with the ankles and knees being the most affected joints, as illustrated by HAL/PedHAL scores. The A36 Hemofilia-QoL assessment showed moderate QoL (96.45; 0–144 scale) and significant anxiety and depression symptoms were found in 36.7 and 27.2% of adults, respectively. CHO-KLAT global score (0–100 scale) was 75.63/76.32 (self-report/proxy). Concerning hemophilia-related illness beliefs, a perception of chronicity and symptoms unpredictability was particularly prominent among adults and children/teenagers. This survey provided a comprehensive characterization of Portuguese PWH, including the first report of psychosocial characteristics. The findings allow for a deeper understanding of life with hemophilia in Portugal and the identification of relevant health care and research needsNovo Nordisk HERO Research Grant 2015. P.R.P. has a grant (SFRH/BPD/103529/2014) from the Portuguese Foundation of Science and Technologyinfo:eu-repo/semantics/publishedVersio

Longitudinal measurement invariance of memory performance and executive functioning in healthy aging

In this work, we examined the longitudinal measurement invariance of a battery composed of distinct cognitive parameters. A sample of 86 individuals (53.5% females; mean age = 65.73), representative of the Portuguese older population, with respect to sex, age and level of education was assessed twice over an average of two years. By means of a confirmatory factor analysis approach, we tested whether a two-factor solution [corresponding to measures of memory performance (MEM) and executive functioning (EXEC)] was reliable over time. Nested models of longitudinal invariance demonstrated the existence of partial strong invariance over time. In other words, this indicates that there is an equivalence of the factorial structure and factor loadings for all items; this was also observed for the item intercepts for all the items, except for one of the items from the EXEC dimension. Stability coefficients revealed high associations between the dimensions over time and that, whereas there was a significant decline of the MEM across time, this was not observed for the EXEC dimension. These findings reveal that changes in MEM and EXEC scores can be attributed to true changes on these constructs, enabling the use of this battery as a reliable method to study cognitive aging.PSM (ref: PDE/BDE/113601/2015 - PhD-iHES program), TCC (ref: SFRH/BD/90078/2012), LA (SFRH/BD/101398/2014) and CPN (ref: PD/BD/106050/2015 - PhDOC program) were supported by FCT fellowship grants. The work has been developed under the scope of the projects NORTE-01-0145-FEDER-000013 supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 (P2020) Partnership Agreement, through the European Regional Development Fund (FEDER) and POCI-01-0145-FEDER-016428 supported by the Operational Programme Competitiveness and Internationalization (COMPETE 2020) and the Regional Operational Program of Lisbon and National Funding through Portuguese Foundation for Science and Technology (FCT, Portugal); and, by the Portuguese North Regional Operational Programme (ON.2 - O Novo Norte), under the National Strategic Reference Framework (QREN), through FEDER, the Fundação Calouste Gulbenkian (Portugal) (contract grant number: P-139977; project "TEMPO - Better mental health during ageing based on temporal prediction of individual brain ageing trajectories") and SwitchBox-FP7-HEALTH-2010-grant 259772-2info:eu-repo/semantics/publishedVersio

A influência da monitoria no desempenho do discente no módulo de nutrição da concepção ao 2º ano de vida / The influence of monitoring on the performance of the disciple in the nutrition module of the concept to the 2 nd year of life

Analisar a presença do discente do curso de Nutrição nos encontros de monitoria do módulo de Nutrição da Concepção ao 2º Ano de Vida e o seu desempenho no decorrer do semestre 2017.1. Observou-se que, dos 96 estudantes matriculados, 19,79% passaram a ir ou aumentaram o número de presenças, apresentando melhora na média de NP2 em relação à média de NP1, e 23,95%, que continuaram a frequentar, alcançaram a uma nota superior à anterior ou maior ou igual a 8,0 na NP2, resultando, assim, em 43,74% de alunos com melhora em suas médias ou manutenção de suas boas notas. Apenas 2,08% deixaram de frequentar ou reduziram a presença aos encontros de monitoria, com uma diminuição na média de NP2. Houve correlação fraca, porém positiva e significativa (p = 0,009), apresentando uma correlação entre a variação das notas de NP1 e NP2 e a variação das presenças nas monitorias, sugerindo que alunos que aumentam a frequência nas monitorias obtêm um maior desempenho em suas médias

Análise de ferramenta criada para auxiliar aprendizagem dos alunos de nutrição da concepção ao 2° ano de vida / Analysis of a tool created to assist the students' learning of conception nutrition at the 2nd year of life

Objetivo: O presente estudo objetiva avaliar a eficácia de um instrumento educacional criado para reduzir as dificuldades dos alunos no Módulo de Nutrição da concepção ao segundo ano de vida da Universidade de Fortaleza. Metodologia: Trata-se de um estudo descritivo, transversal, observacional de natureza quantitativa, realizado na Universidade de Fortaleza, no período de julho a dezembro de 2017. Para a coleta de dados, foi aplicado um questionário de 6 questões para  avaliação da ferramenta, constando-se cinco perguntas de teor objetivo e uma de teor descritivo, visando avaliar a eficácia da ferramenta de passo a passo criada. A aplicação do questionário foi realizada em ambiente virtual, no programa Google Forms. Resultados: A população do estudo foi de 34 alunos matriculados no Módulo. Observou-se que 94,1% (n=32) dos alunos tiveram acesso a ferramenta; 100% (n=34) dos alunos consideraram uma ferramenta útil para aprender o conteúdo abordado; 97,1% (n=33) dos alunos consideraram que a ferramenta colaborou para a melhoria do seu aprendizado; 97,1% (n=33) considerou que a ferramenta colaborou para auxiliar em dúvidas no momento do estudo; 100% dos alunos considerou uma metodologia eficaz a ser usada em um Módulo que contenha cálculos e avaliações. Já na analise subjetiva da ferramenta, os alunos consideraram que a ferramenta poderia ser utilizada em outras disciplinas para o auxílio das dúvidas. Conclusão: Conclui-se que a ferramenta de Passo a Passo criada foi útil para os estudos e o aprendizado desses estudantes e, que foi interessante tanto para o Módulo como também para outras disciplinas, além de ser um instrumento com o objetivo de auxiliar os alunos fora da sala de aula e ser capaz de detectar suas dificuldades

A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis

Tuberculosis imposes high human and economic tolls, including in Europe. This study was conducted to develop a severity assessment tool for stratifying mortality risk in pulmonary tuberculosis (PTB) patients. A derivation cohort of 681 PTB cases was retrospectively reviewed to generate a model based on multiple logistic regression analysis of prognostic variables with 6-month mortality as the outcome measure. A clinical scoring system was developed and tested against a validation cohort of 103 patients. Five risk features were selected for the prediction model: hypoxemic respiratory failure (OR 4.7, 95% CI 2.8-7.9), age >= 50 years (OR 2.9, 95% CI 1.7-4.8), bilateral lung involvement (OR 2.5, 95% CI 1.44.4), >= 1 significant comorbidity-HIV infection, diabetes mellitus, liver failure or cirrhosis, congestive heart failure and chronic respiratory disease-(OR 2.3, 95% CI 1.3-3.8), and hemoglobin = 6) mortality risk. The mortality associated with each group was 2.9%, 22.9% and 53.9%, respectively. The model performed equally well in the validation cohort. We provide a new, easy-to-use clinical scoring system to identify PTB patients with high-mortality risk in settings with good healthcare access, helping clinicians to decide which patients are in need of closer medical care during treatment.This work was supported by Fundacao Amelia de Mello/Jose de Mello Saude and Sociedade Portuguesa de Pneumologia (SPP). This work was developed under the scope of the project NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER). NSO is a FCT (Fundacao para a Ciencia e Tecnologia) investigator. MS is an Associate FCT Investigator. The fundershad no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript