Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side ...effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients' satisfaction.
Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn's scales, Katz index and patients' global satisfaction were analysed.
In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 - 89) and the total follow-up time was 96 (9 - 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn's scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.
The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.
Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life.
Este relatório retrata todo o trabalho que desenvolvi como Produtora na curta-metragem de ficção “Dentro” no âmbito do Projeto Final de Mestrado em Som e Imagem, especialização em Cinema e ...Audiovisual.Irei relatar os métodos, estratégias e soluções desenvolvidos por mim nas diferentes fases envolvidas: pré-produção, produção e pós-produçãoda curta-metragem. Desde organização de castings, elaboração e controlo de orçamentos, coordenação da equipas e elementos para a concretização do projeto são alguns dos pontos chave que irei falar sobre o meu desempenho como produtora do projeto.
ORAL BULLOUS LICHEN PLANUS: A CASE REPORT MEDEIROS, CATARINA BRITO DA ROCHA; NUNES, BEATRIZ VIEIRA; PEIXOTO, FERNANDA BRAGA ...
Oral surgery, oral medicine, oral pathology and oral radiology,
September 2020, 2020-09-00, Letnik:
130, Številka:
3
Journal Article
Recenzirano
Oral bullous lichen planus (OBLP) is a dermatologic disease that rarely affects the oral mucosa. It is characterized by blisters that increase and rupture, leaving an ulcerated and painful surface. ...The objective is to report an OBLP case, exposing clinical and histopathologic characteristics. An 86-year-old female patient attended the service complaining about a "protrusion" on the hard palate. On the intraoral examination, a smooth, irregular, and symptomatic red plaque was detected. The hypothesis diagnosed was erythroplakia. An incisional and microscopically observed mucosal fragments were coated with stratified atypical keratinized squamous epithelium with areas of epidermis, hyperkeratosis, exocytosis, and hydropic degeneration of the basal layer, and the conjunctive epithelial junction presented with subepithelial bubble and focal area of projection in teeth. After diagnosis, the patient was submitted to drug therapy and is being followed up. The knowledge of this pathology is of fundamental importance for early diagnosis and appropriate treatment.
SQUAMOUS CELL CARCINOMA OF THE PALATE: CASE REPORT FEITOSA, TAWANNE FRANCINNE SOARES; SANTOS, WANDERLEY BARROS DOS; SARMENTO, PAULINNE BRAGA REZENDE ...
Oral surgery, oral medicine, oral pathology and oral radiology,
September 2020, 2020-09-00, Letnik:
130, Številka:
3
Journal Article
Recenzirano
Squamous cell carcinoma (SCC) accounts for about 90% to 95% of cases of oral cancer, mainly affecting males. A female patient, 68 years of age and has the main etiologic factor smoking. The patient ...was submitted to anamnesis and physical examination. Patient reported being smoker for approximately 54 years. She also reported that while eating she felt a burning sensation on the palate. In the oral evaluation, the presence of an ulcer in the palate was observed, measuring approximately 3 x 2 x 0.2 cm, with clear limits, firm/fibrous consistency levels, ulcerated and infiltrative surface. After an anamnesis and physical examination, CEC, adenocarcinoma, and tuberculosis were suspected as death hypotheses. An incisional type biopsy was performed and the tissue fragment was sent to the oral pathology laboratory. The histopathological report confirmed the clinical diagnosis of CPB.
Background Chagas Disease (CD) affects 6-7 million people worldwide and is related to poverty-promoting conditions. Chronic asymptomatic cases are mostly invisible to health systems. Aiming (1) to ...translate CD discoveries into education/information practices to raise alertness and empowerment of affected people; and (2) to perform an active search of CD cases, articulating intersectoral actions to improve the access of infected people to the local health service for the treatment of CD; our research group developed and tested under field conditions as innovative social technology: an itinerant education interdisciplinary setting named "Chagas Express XXI" (CE21). Methodology CE21 was created as an "imaginary train" with ~40 ArtScience workshops, games, laboratory activities and conversation circles. An entry/exit plus six activity modules combined associations of affected people, microscopic observations, One Health education, and wellness activities. CE21 was conceived as a social technology, since all the processes were co-created with CD patients and inter-sector local partners. Descriptive statistics showed quantitative data collected throughout the expeditions (CD knowledge, serological results). Qualitative data accessed the public perceptions about the education activities. Principal findings CE21 was exhibited in local educational institutions (schools, universities) in four cities, engaging 2,117 people that evaluated the 41 activities carried out. Citizens and health professionals enjoyed acquisition of information related to blood, parasites, vectors, reservoirs, environmental changes, and social determinants of CD. Further, local legacies of 600 participants volunteer for health promotion groups and CD associations, local empowerment groups to fight for better health conditions, and 05 mural paintings. We observed that 81% of the participants ignored the possibility of treating CD while 52% of the participants requested a blood test for CD showing seropositivity in 20% of them. Conclusions CE21 is a social technology potentially useful for health and science education and active search of asymptomatic CD chronic cases. Moreover, this technology may be adapted to understand and to cooperate in other potentially epidemic situations, especially NTDs related.
Research on the emerging COVID-19 pandemic is demonstrating that wastewater infrastructures can be used as public health observatories of virus circulation in human communities. Important efforts are ...being organized worldwide to implement sewage-based surveillance of SARS-CoV-2 that can be used for preventive or early warning purposes, informing preparedness and response measures. However, its successful implementation requires important and iterative methodological improvements, as well as the establishment of standardized methods. The aim of this study was to develop a continuous monitoring protocol for SARS-CoV-2 in wastewater, that could be used to model virus circulation within the communities, complementing the current clinical surveillance. Specific objectives included (1) optimization and validation of a method for virus quantification; (2) monitoring the time-evolution of SARS-CoV-2 in wastewater from two wastewater treatment plants (WWTPs) in the city of Porto, Portugal. Untreated wastewater samples were collected weekly from the two WWTPs between May 2020 and March 2021, encompassing two COVID-19 incidence peaks in the region (mid-November 2020 and mid-January 2021). In the first stage of this study, we compared, optimized and selected a sampling and analysis protocol that included virus concentration through centrifugation, RNA extraction from both liquid and solid fractions and quantification by reverse transcription quantitative PCR (RT-qPCR). In the second stage, we used the selected methodology to track SARS-CoV-2 in the collected wastewater over time. SARS-CoV-2 RNA was detected in 39 and 37 out of 48 liquid and solid fraction samples of untreated wastewater, respectively. The copy numbers varied throughout the study between 0 and 0.15 copies/ng RNA and a good fit was observed between the SARS-CoV-2 RNA concentration in the untreated wastewater and the COVID-19 temporal trends in the study region. We also analyzed eight samples from the treated effluent and found no SARS-CoV-2 RNA detection after tertiary treatment and UV disinfection. In agreement with the recent literature, the results from this study support the use of wastewater-based surveillance to complement clinical testing and evaluate temporal and spatial trends of the current pandemic.
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•A method of virus concentration through precipitation and centrifugation was used.•Positive samples were detected with 3.2 COVID-19 cases per day per 100,000 people.•SARS-CoV-2 RNA was detected in liquid and solid wastewater fractions.•A good fit was observed between SARS-CoV-2 RNA in raw wastewater and COVID-19 cases.•Virus not detected in treated effluent after tertiary treatment/UV disinfection.
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•Geographic and genetic factors were used to evaluate the terroir of C. canephora.•The terroir influences the chemical composition of C. canephora.•Lipids and caffeine were the ...markers that separated the terroirs by PCA.•DD-SIMCA provided the genetic predominance of distinct groups of C. canephora.•PLS-DA model obtained an accuracy of 94.3% for the prediction set.
FTIR spectroscopy and multivariate analysis were used in the chemical study of the terroirs of Coffea canephora. Conilon coffees from Espírito Santo and Amazon robusta from Matas of Rondônia, were separated by PCA, with lipids and caffeine being the markers responsible for the separation. Coffees from Bahia, Minas Gerais, and São Paulo did not exhibit separation, indicating that the botanical variety had a greater effect on the terroir than geographic origin. Thus, the genetic factor was investigated considering the conilon and robusta botanical varieties. This last group was composed of hybrid robusta and apoatã. The DD-SIMCA favored the identification of the genetic predominance of the samples. PLS-DA had a high classification performance regarding the conilon, hybrid robusta, and apoatã genetic nature. Lipids, caffeine, chlorogenic acids, quinic acid, trigonelline, proteins, amino acids, and carbohydrates were identified as chemical markers that discriminated the genetic groups.
Health professionals should work with the notion of risk involved in the health care process. Dental practice risk is of particular interest because it encompasses both aesthetic and functional ...components. Focusing on guidelines suggested by the World Health Organization and objectives on patient safety, this study has 2 objectives: to present Portuguese medicolegal data on corporal damage evaluation related to iatrogenic sequelae during dental practice and to present updated evidence on patient safety.
A retrospective study was performed by analysing data from the database of the Laboratory of Forensic Dentistry of the Faculty of Medicine, University of Coimbra, Portugal, from 2013 to 2018.
One hundred seven medicolegal files were selected according to the inclusion and exclusion criteria. Iatrogenic sequelae (73.8%, 79 out of 107) were categorised as risks (60 out of 79) and malpractice (19 out of 79). The risk was associated mostly with mandibular dysfunction and orthodontic treatment (62.2%). Malpractice was mostly associated with neurological deficit and implant rehabilitation (47.4%).
Greater attention to these data by professionals was emphasised, especially when considering patient safety and health care quality. This article presents the Portuguese data on professional liability in the field of dental practice, categorising iatrogenic sequelae into risks and malpractice, as well as the oral rehabilitation procedure and timeline.
To evaluate the relationship between asthma control, family income and family costs of asthma in a population of children-adolescents; to detail the family costs of asthma in this age range; and to ...compare asthma costs for the families of children-adolescents and adults.
The authors invited asthmatic subjects who attended a scheduled spirometry test at the Jundiaí School of Medicine (FMJ). The FMJ performs all spirometry tests requested by staff physicians who serve at the public healthcare system in the municipality. Volunteers responded to the ACQ, the Asthma Family Costs Questionnaire and underwent a spirometry test.
The authors included 342 children-adolescents. Families of children-adolescents taking maintenance therapy and families of those reporting uncontrolled asthma symptoms were more likely to report any expenditure with asthma during the preceding month. In this age range, the smallest expenditures were on diagnostic tests and medical consultations, while home expenditures to avoid asthma triggers were the highest ones. As compared to adults’ families, the children and adolescents families reported a greater proportion of income committed with asthma. Expenditures with transportation to healthcare facilities for asthma care were greater in the families of children-adolescents as compared to the values reported by the adults’ families; in contrast, loss of income due to asthma was smaller in the families of children-adolescents.
Children-adolescents’ asthma affects the household economy. The authors believe researchers should assess this outcome when designing studies about asthma. Finally, the study's data support the necessity of public policies in low-resource communities to minimize the economic impact of children and adolescents’ asthma.
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