bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling of propellant settling processes in upper stages propulsion systems tanks under low overload
Authors:   BMSTU (Mytishchi branch), Korol’kov A.V. , Sapozhnikov V.B. ,   BMSTU
Published: July 2022

The problems arising when liquid fuel is supplied to the propulsion system of upper stages in zero gravity are formulated. The key processes are the deposition of fuel and separation of gas inclusions under the action of pre-start overload. The analysis of existing works on determining the parameters of these processes is carried out. The method of experimental studies and a new approach to the estimated time of fuel deposition under the action of pre-start overload are presented.
Common oak and scots pine subpopulations genetic changes under prolonged exposure to low doses of radiation
Authors:   FBU «Roslesozaschita» — «CFP of Voronezh region», Sivolapov V.A. , Loginova L.A. ,   FBU «Roslesozaschita» — «CFP of Voronezh region», Vorob’eva E.A. ,   FBU «Roslesozaschita» — «CFP of Voronezh region», Veprintsev V.N. ,   FBU «Roslesozaschita» — «CFP of Voronezh region», Shchetinkin S.V. ,   FBU «Roslesozaschita» — «CFP of Voronezh region»
Published: July 2022

The probability of population significant changes as a result of prolonged exposure to increased radiation in the habitat of the main forest-forming species is considered. The amount of contamination at stationary sites is correlated with the level of heterozygosity of pine and oak samples.
Determination of the maximum volume of a long-term electronic archive built on optical disks
Authors:   BMSTU (Mytishchi branch), Chernyshov A.V.
Published: July 2022

The problem of determining the maximum possible (technically achievable) volume of a long-term electronic archive built on optical disks that are not combined into RAID arrays is considered. To achieve the necessary reliability of storing information on the same disks, several backup copies of information are made. The parameters that most significantly affect the target indicator are: the number of backup copies; the time spent on writing, reading, restoring an optical disk; the total time during the year allocated for disk maintenance in the archive. The article shows the mathematical model underlying the solution of the problem, and provides an example of calculating the target parameter for the budget archive of a small organization. Possible options for increasing the target indicator are considered when some initial parameters change, meaning a decrease in the reliability of information storage, or an increase in the cost of archive maintenance hardware.
Economic Analysis of Production of a Little Gourd (Coccinia grandis) in Central Gujarat
Authors: Chotaliya Janki , Pundir R.S. , Nayak Archit Kumar
Published: July 2022

Background: Little gourd is important vegetable crop that provide a considerable amount of income to farm families in Central Gujarat. The present investigation was undertaken with the goal to study the cost and return in cultivation of little gourd in central Gujarat. Methods: For this purpose, primary data was collected from 100 little guard farmers from three districts namely Anand, Kheda and Vadodara and categorized according to size of holding as marginal, small, medium and large farms. To arrive at conclusion the data was analyzed with cost concepts and relevant income measures. Result: The study found that the average per hectare cost of cultivation, gross income and net income of little gourd followed an increasing pattern from marginal to large farm sizes. The input output ratio was found decreasing as the farm size increased. The study suggested that there is enough scope of enhancing net returns through increasing the scale of operations at farm level that may be achieved by organizing small and medium farmers into producer organizations. Over and above this, the farmers should be encouraged for production of export-oriented quality to further increase the farm income.
Growth and Yield of Blackgram [Vigna mungo (L.) Hepper] Crop as Influenced by Humic Acid Application
Authors: Duary Swarnali , Biswas Tufleuddin , Sengupta Kajal
Published: July 2022

Background: Among the different grain legumes, blackgram [Vigna mungo (L.) Hepper)] is a well-known leguminous crop popular because of its nutritional quality and suitability for multiple cropping systems. Methods: A field experiment was conducted during Autumn season of 2018 and 2019 at Kalyani, Nadia to evaluate the effect of humic acid (HA) application on growth and yield of blackgram crop. The treatments were: Control (sowing of dry seed) (T1); Seed priming (soaking) in water (T2); Seed priming in 0.5% humic acid solution (T3); Seed priming in 1% humic acid solution (T4); Seed priming in 2% Humic acid solution (T5); Soil application of humic acid @1 kg/ha (T6); Soil application of humic acid @ 2 kg/ha (T7); Soil application of humic acid @1 kg/ha + 10 t compost/ha (T8); Soil application of humic acid @ 2 kg/ha + 10 t compost/ha (T9); Foliar application of 0.01% humic acid solution 25 days after sowing (DAS) (T10); Foliar application of 0.05% humic acid solution (25 DAS) (T11); Foliar application of 0.1% humic acid solution (25 DAS) (T12). Result: Soil application of humic acid along with compost had significant effect on number of pods m-2, though; other yield components such as seeds pod-1, seed index was statistically at par in most occasions. The maximum seed yield (1295.53 kg ha-1 and 1298.47 kg ha-1 in 2018 and 2019, respectively) was obtained from the treatment T9 and the second-best treatment was T8.
Análisis descriptivo y tendencias de las tesis de pregrado en Facultades de Odontología peruanas
Authors: Moromi Nakata Hilda , Villavicencio Gastelú Jorge Eleodoro , Martínez Cadillo Elba , Ortiz  Fernández Lita , Orihuela Gutiérrez Josué , Arce Rivera Franz , Rojas Cairampoma Marcelo
Published: July 2022

Introducción: El análisis de tesis de odontología en el Perú proporciona información valiosa para optimizar esfuerzos relacionados a solucionar problemas de salud bucal. Objetivo: analizar tesis de pregrado de odontología, de universidades peruanas durante 2015–2019. Método: estudio descriptivo, asociativo y cuantitativo. Se analizaron 1,389 tesis de 14 universidades públicas y privadas. Las variables: nombre de la universidad, tipo de universidad, número de autores, acceso a texto completo o resumen, área académico-profesional, tipo de investigación, orientación a enfermedades prevalentes de la cavidad bucal, año y región de procedencia. Resultados: del total de tesis se tuvo acceso al texto completo en 66.5%, tesis con un autor 87.7% e investigaciones descriptivas 66.7%. Las áreas académicos-profesionales más frecuentes del estudio son: Estomatología Pediátrica y Social 27% y Estomatología Médico Quirúrgico 20.4%. Adicionalmente, el 19.2% están orientadas a la solución de caries dental, 11.4% a maloclusión y 8.1% a enfermedad periodontal. Discusión: los resultados alcanzados fueron similares a otros autores; no obstante, se presentaron escasos estudios con orientación a enfermedades prevalentes. Se sugiere que facultades de Odontología reorienten la investigación prioritariamente a las necesidades y políticas de la salud bucal, a fin de lograr una mejor contribución de la academia a la sociedad.
Inclusión educativa en el contexto de la formación de profesores en Chile
Authors: Cornejo Espejo Juan
Published: July 2022

Introducción: El artículo tiene como objetivo develar cómo las universidades del Consejo de Rectores de las Universidades Chilenas (CRUCH) están formando a sus futuros profesores en materia de inclusión educativa, para lo cual se analizaron los itinerarios formativos y perfiles de egreso de las distintas pedagogías que imparten dichas casas de estudio presentes en sus páginas webs institucionales. Desde el punto de vista metodológico la investigación se adscribe a un enfoque cualitativo con un diseño de casos múltiples, atendiendo a la multiplicidad de unidades de análisis conformadas por las distintas casas de estudio. Para la producción de información se recurrió al análisis de documentos provenientes de internet, los cuales a su vez fueron analizados a través del análisis de contenidos. Entre los principales hallazgos destaca que, si bien la mayoría de las universidades en estudio incorporó asignaturas referidas a inclusión, ellas están focalizadas fundamentalmente en la atención de las Necesidades Educativas Especiales (NEE), restringiendo con ello las posibilidades de comprensión de los procesos de inclusión e invisibilizando a otros posibles beneficiarios; sin contar con la perpetuación del paradigma medicalizador que aún subyace en los procesos formativos que se ve reforzado por la legislación nacional vigente.
Satisfacción de necesidades psicológicas básicas en la relación de pareja de mujeres transexuales de Lima
Authors:   , Quesquen Pachamoro Juan Gonzaga
Published: July 2022

La presente investigación tiene como objetivo explorar y describir cómo contribuye la relación de pareja en la satisfacción de necesidades psicológicas básicas (NPB) en un grupo de mujeres transexuales de Lima. Se abordó las NPB mediante un estudio cualitativo con diseño fenomenológico en seis casos de estudio. Se realizó una entrevista a semi estructurada por cada una de las seis mujeres transexuales residentes en Lima Metropolitana de nivel socioeconómico B y C que oscilaban entre los 26 y 61 años de edad. Los resultados indicaron que la relación de pareja logra tanto satisfacer como frustrar las NBP de las practicantes. Se concluyó que los procesos de satisfacción o frustración de las NBP de estas mujeres transexuales además de ser el resultado de una conducta de sus parejas, también pueden darse de forma combinada, creándose redes complejas donde la satisfacción de una necesidad puede llevar o esconde la frustración de otra u ocurrir de manera inversa.
Satisfacción con la vida y Espiritualidad en universitarios de una Universidad Privada de Lima
Authors:   , Bobadilla Castro Yahir Alexander
Published: July 2022

El presente trabajo es cuantitativo, transversal, con diseño correlacional, su objetivo es relacionar la satisfacción con la vida y la espiritualidad en universitarios peruanos. Se empleó la Escala de Satisfacción con la vida (Diener, 1985) y el Cuestionario de Espiritualidad (Parsian & Dunning, 2009). Participaron 169 universitarios (60 hombres y 109 mujeres) de una universidad privada de Lima. Se encontró que existe una correlación positiva, es decir, a mayor satisfacción con la vida, mayor espiritualidad. Entre los principales resultados, los hombres obtuvieron un mayor puntaje en satisfacción con la vida, así como en las dimensiones de conocimiento de vida interior y sentido de vida. Mientras que, las mujeres puntuaron más en importancia de la espiritualidad y necesidades espirituales. En relación con quienes viven con otros familiares puntuaron más en satisfacción con la vida. En cuanto a los participantes que solo trabajan, presentaron mayor satisfacción con la vida, así como el menor puntaje en necesidades espirituales. Por otro las, las personas que se consideraban ateas obtuvieron un mayor puntaje en satisfacción con la vida. Por último, quienes son convivientes tuvieron mayor puntaje en satisfacción con la vida, conocimiento de vida interior, importancia de espiritualidad, sentido de vida y necesidades espirituales.
THE GOOD FAITH PRINCIPLE IN TRUST AND CONFIDENTIALITY ON THE ARBITRATION PROCESS
Authors: Roosdiono Anangga W. , Subiyanto Maria Jasmine Putri , Taqwa Muhamad Dzadit
Published: July 2022

This article is to demonstrate that the principle of good faith (iktikad baik) manifests in the principles of trust and confidentiality. Not only is good faith one of the key causes of the emergence of a dispute, it also indeed has a great influence on the success of resolving that dispute. Despite its importance, we have found that many disputing parties do not apply this principle to resolve their disputes. Even though, this principle plays a huge part on maintaining trust and confidentiality at the same time. The purpose of this paper is to increase awareness on the application of the good faith principle, noting that there are still realities where this principle is not applied. In this paper, we first elaborate on the descriptive comprehension of all these three principles. Afterwards, we observe how good faith connects with the other two principles. Through the manifestations of good faith, we have concluded that the a quo principle acts as a key basis for the application of the other two principles. In trust, applying good faith means making the arbitration trustworthy, whereas in confidentiality, maintaining good faith keeps the information confidential to irrelevant parties. In the conclusion, we have pointed a few concrete resolutions on maintaining the principle of good faith, trust, and confidentiality. This is found by observing the two factors that cause the realities when the principle of good faith is not applied, which consists of the normative and human factor.
BLOCKCHAIN APPLICATION: INDONESIAN COMPETITION LAW’S PERSPECTIVES
Authors: Milenia Stevi , Tresnawati Tresnawati
Published: July 2022

Having advantages of consensus mechanism in decentralizing data transaction which potentially eliminates the need for third-party intermediaries, blockchain has the potential to revolutionize markets industry to decrease the showcase control of today’s centralized stages by utilizing the internet. Blockchain has been rising innovation in Indonesia, demonstrated by establishment of Indonesia Blockchain Association. Though its application in Indonesia is still restricted to cryptocurrency sector, no question that blockchains will be connected broadly in near future, and unquestionably will influence business competition. Law and technology ought to be thought of as allies-not enemies-as they feature complementary strengths, yet it might also have their curses. Some intriguing articles has even questioned how blockchain would cause the death of anti-trust, the so-called competition law. Meanwhile this article would focus on elaborating consequences of blockchain technology both positive and negative sides in Indonesia Competition Law Perspective, both in substantial and procedural law, using library research, statute, comparative, and conceptual approach.
Менопауза и ревматоидный артрит как факторы, ассоциированные с развитием остеопороза
Authors:   Zborovsky Research Institute of Clinical and Experimental Rheumatology, Papichev E.V. , Polyakova J.V. ,   Zborovsky Research Institute of Clinical and Experimental Rheumatology, Akhverdyan Yu.R. ,   Zborovsky Research Institute of Clinical and Experimental Rheumatology, Sivordova L.E. ,   Zborovsky Research Institute of Clinical and Experimental Rheumatology, Zavodovsky B.V. ,   Zborovsky Research Institute of Clinical and Experimental Rheumatology
Published: July 2022

The aim of the research. To study the role of menopause, glucocorticoids (GCs) intake and characteristics of rheumatoid arthritis (RA) in development of osteoporosis (OP) and osteoporotic fractures. Material and methods. A total of 73 female RA patients in menopause were examined. The control group included 29 female RA patients in premenopause. In addition to standard clinical and laboratory examinations, P1NP, 25(OH)D, CTX-1 were measured, dual-energy x-ray absorptiometry and x-ray of the thoracic and lumbar spine were performed. Statistical analysis was performed using the “Statistica 12.0” software package. Results. Premenopausal patients had lower BMI. Patients in postmenopause had higher rate of OP (42 patients) than the controls (8 patients) (57.5% vs 27.6%, respectively). Among patients in postmenopause, OP was associated with lower BMI (27.6 vs 30.5 kg/m2), higher cumulative dose of GCs (6.9 vs 1.65 g), higher duration of GCs intake (32 vs 18 months), lower RA activity (3.37 vs 3.9 according to DAS28-CRP) and lower CTX-1 level (0.52 vs 0.7 ng/ml). In the same group, osteoporotic fractures were only associated with longer GCs intake (32 vs 24 months). In premenopause patients, OP was associated with longer RA duration (21 vs 6 months), cumulative dose of GCs (13.9 vs 0.45 g), duration of GCs intake (48 vs 3 months), higher level of hs-CRP (46 vs 8 mg/l) and lower P1NP level (51.8 vs 43.8 ng/ml). Osteoporotic fractures in premenopause were associated with RA duration (28 vs 6 months), cumulative dose of GCs (12.5 vs 1.2 g) and lower BMD in all examined areas. Conclusion. The OP rate was higher in postmenopause patients. In both groups, the duration of GCs intake and accumulated dose of GCs were associated with OP. In postmenopause, OP was also associated with lower BMI. In premenopause, OP and osteoporotic fractures were associated with longer RA duration, cumulative dose of GCs and lower BMD in all studied areas.
The role of HNP1-3 in development of chronic gastritis in children
Authors:   Rostov State Medical University, Besedina D.Yu. , Badyan A.S. ,   Rostov State Medical University, Dudnikova E.V. ,   Rostov State Medical University, Besedina E.A. ,   Rostov State Medical University, Sapronova N.G ,   Rostov State Medical University, Skorobogaty A.I. ,   Rostov State Medical University
Published: July 2022

The aim of the research. To assess the role of a-1-3-defensins (HNP1-3) and H. pylori in development of chronic gastroduodenitis (CGD) in children; to study the level of a-1-3-defensin (HNP 1-3) dynamics in children with H. pylori after standard eradication therapy. Material and methods. We examined 102 children aged 8 to 14, including 70 patients with chronic gastroduodenitis in the exacerbation phase. A total of 32 children belonged to health groups I-IIa. All patients underwent FEGD with targeted gastric mucosal biopsy and subsequent morphological assessment of gastro-biopsy specimens. Diagnosis of H. pylori was carried out using bacterioscopy and PCR of gastro-biopsy specimens. The level of a-1-3-defensins in blood serum was measured via ELISA. Results. A significant increase in the level of α-defensins in patients with helicobacter pylori-associated gastritis in comparison with both healthy children (p <0.005) and patients with chronic gastritis not associated with the microorganism (p = 0.004) has been shown. Therewith, it should be noted that among patients with helicobacteriosis, the concentration of α1-3-defensins was of higher statistical significance in patients with severe gastric mucosal inflammation (p = 0.0004). Conclusion. The significant role of α-1-3-defensin in development of CHD in children, including the H. pylori-associated variant, has been determined. In addition, HNP1-3 can be used as a predictor of the severity of gastric mucosal lesions in H. pylori infection, which is necessary for identification of the risk groups of children with severe forms of chronic gastritis.
Evaluation of the influence of patch material for aortic arch repair in newborn patients with aortic coarctation
Authors:   Federal Center for Cardiovascular Surgery, Teplov P.V. , Titov A.M. ,   Federal Center for Cardiovascular Surgery, Miller A.Yu. ,   Federal Center for Cardiovascular Surgery, Spichak Yu.Yu. ,   Federal Center for Cardiovascular Surgery, Polyakova Yu.N. ,   Federal Center for Cardiovascular Surgery, Sakovich V.A. ,   Federal Center for Cardiovascular Surgery
Published: July 2022

The aim of the research. To reveal the influence of the patch material for aortic arch reconstruction in treatment of aortic coarctation in newborn patients. Material and methods. Within the framework of this retrospective study, a total of 89 medical records of newborn patients with coarctation of the aorta were analysed. The patients were divided into six groups in accordance with the surgical correction method chosen and the patch material. The following control points of the study were chosen: intraoperatively-measured gradient at aortic isthmus and the gradient measured when transferring the patient to the intensive care unit; the need for reoperation as well as death in the late postoperative period. Intergroup comparison of baseline characteristics was made using the Kolmogorov-Smirnov, Kruskal-Wallis and Kaplan-Meier tests. Results. The patients were evenly distributed into the study groups by baseline characteristics (p>0.05). The results of the Kruskal-Wallis test showed no statistically significant differences between the groups by the aortic isthmus gradient at each time period (p>0.05). There were also no intergroup differences in Kaplan-Meier survival analysis (p>0.05). Conclusion. When performing the aortic arch reconstruction in newborn patients with coarctation of the aorta, the surgeon may choose the patch material that they are most experienced with or of their preference, since the patch material does not have significant influence on the surgical outcome.
Abordagem da orbitopatia associada à tiróide.
Authors: Alves Marta , Neves Celestino , Carvalho Davide , Medina José Luís
Published: July 2022

Thyroid associated orbitopathy is a clinical entity with pathogenic mechanisms not fully understood, and appears in about 90% of cases in association with hyperthyroidism of Graves' disease. Its approach involves the recognition of typical features and the exclusion of other diseases in the less common presentations. The treatment is conditioned by the determination of the activity and severity of the disease. The restoration of the euthyroid state and avoiding of hypothyroidism are essential in mitigating the progression of orbitopathy. Glucocorticoid intravenous therapy is the treatment of choice in the active phase and surgical treatment in the inactive phase. Radiotherapy and cyclosporine in combination with corticosteroids are alternatives when monotherapy is insufficient in the active phase. Treatment should be instituted in specialized centers, with ophthalmologists and endocrinologists acting in synergy to avoid consequences of delays in intervention and in optimizing therapy.
Tratamento antibiótico da cistite não complicada em mulheres não grávidas até à menopausa.
Authors: Martins Diana Lima , Carvalho Ana Margarida , Fernandes José Luís
Published: July 2022

To review treatment recommendations for UC in non-pregnant women up to menopause, using the scale Strength of Recommendation Taxonomy (SORT).Medline, UpToDate, Cochrane, Bandolier, Database of Abstracts of Reviews of Effects, National Guideline Clearinghouse, Guidelines Finder and the website of the Portuguese Urology Association.Research of systematic reviews (SR), meta-analyses (MA), randomized controlled trials (RCT) and guidelines, published in english and portuguese, between 2000 and 2008.Two MA, two SR, four RCT and six Guidelines were included. Three-day treatments are preferable to those of seven to ten days, mainly because of higher compliance and lower cost and incidence of adverse effects (A). Longer regimens are acceptable for bacterial eradication. Trimethoprim/sulfamethoxazole (TMP/SMX) is the option where resistance levels are lower than 10-20% (A). As a clinical and microbiological alternative, evidence seems to point out the Fluoroquinolones (FQ) (C) which are equally efficient among themselves, although showing different safety profiles.In case of allergy or high resistance to TMP/SMX, FQ are the most efficacious alternative, both prescriptions recommended for three days. However, due to the risk of worsening resistance to FQ, the options consist on nitrofurantoin and fosfomicine.
Estágio de investigação em nutrição: relevância para a prática clínica em medicina.
Authors: Coronha Ana Lúcia , Lourenço Cláudia , Ferreira Marlene , Reis Nélia , Almeida Raquel , Boléo-Tomé Carolina , Monteiro-Grillo Isabel , Camilo Maria Ermelinda , Ravasco Paula
Published: July 2022

In oncology, early and individualized nutritional intervention for each patient is essential to improve nutritional intake and status, to reduce morbidity during treatment, enhance tolerance to treatment and improve Quality of Life.For medical students to evaluate nutritional risk and status, analyse the prevalence of undernutrition in a population of patients with diverse types of tumours. We aimed to identify difficulties regarding the use of the MUST tool (Malnutrition Universal Screening Tool) for nutritional risk by the students.This study included 35 cancer patients consecutively referenced for Radiotherapy (RT) in the Radiotherapy Department of the University Hospital of Santa Maria. Nutritional risk was evaluated by MUST; nutritional status by Patient Generated-Subjective Global Assessment (PG-SGA) validated and specific for oncology.Students identified 13 patients (36%) at moderate/high risk of undernutrition. According to PG-SGA, 31,5% (11/35) of patients presented moderate or severe undernutrition, of which 77% of patients needed individualized nutritional counselling. Students successfully detected undernourished patients using these specific methods.Risk of undernutrition and undernutrition are common in oncology, therefore indicating the critical need to educate all health professionals for risk screening and for the relevance of nutritional intervention in the multidisciplinary context. MUST is a simple and quick tool, that demonstrated to be adequate when applied by medical students, well accepted by these health professionals and effectively used. Nutritional risk evaluation can and must be performed by health professionals such as the medical team, as long as they are involved in patient's treatment. Our methodology may be used as a model allowing for early guidance to individualized intervention, human resources' optimization and education for the importance of nutrition care.
Estudo EXPO 2010: Excesso de Peso e Obesidade Infantil.
Authors: Martins Diana L , Branco Ana Isabel , Fernandes J Luís , Chaves Mónica
Published: July 2022

During the last decades, overweight and obesity in childwood have been suffering a significant rise. National data point towards a total prevalence up to 30% between 7 and 9 years of age. The tendency is worsening, especially in the lower socioeconomic status. The mentioned weight changes expose children to a higher risk of severe co-morbidities, justifying this way the need for early detection and orientation of the problem, particularly in the ages focused in Global Health Exams.Ensure technical and scientific quality of the following records: overweight and obesity records in problems list, minimum diagnosis tests request and therapeutic counseling.Dimension: technical and scientific quality of the records. Unit of study: children watched in health unit of authors, born from 01/01 to 31/12 2002 (inc) and 01/01 to 31/12 1995 (inc), with at least one medical surveillance carried out, respectively, to 5 or 6 years and at 11, 12 or 13 years, with BMI = 85th percentile; Evaluated Professionals: all family doctors; Time period evaluated: 2006-2009, inc. Data Type: clinical data. Data Sources: SINUS ® and SAM ® version 9.2. Evaluation: internal. Criteria for groups with overweight and Obesity, respectively: I and II) Registration in problems list, III and IV) Registration of minimum diagnosis tests request, V and VI) Registration of therapeutic counseling. Data collection: May 2010. Evaluation: Retrospective. Sample: institutional basis, not random. Type of Intervention: Educational and structural.There were included 118 children with weight changes (prevalence of 15.2% for overweight and 10,1% for obesity). In 5-6 years-old children, all the criteria were "Unsatisfactory" (the best result was the record of therapeutic plan on overweight but still only 26,2%). Regarding to teenagers, the results were "Good" for Criterion III, "Satisfactory" for the IV and VI and "Unsatisfactory" for all the others.Devaluation of overweight and obesity as a health risk to child, diagnostic errors, Child and Youth Health Program limitations, lack of national clinical guidelines, eviction of traumatic procedures, registration failure and follow-up in Pediatrician or Nutritionist are factors that may justify the results. The re-evaluation will be realized after the application of the planned corrective measures.
Doença de Pompe Juvenil: Estudo Retrospetivo de Casuística Clínica
Authors: Loureiro Neves Filipa , Garcia Paula Cristina , Madureira Núria , Araújo Henriqueta , Rodrigues Fidjy , Estêvão Maria Helena , Lacerda Lúcia , Diogo Matos Luísa Maria
Published: July 2022

Introdução: A doença de Pompe ou glicogenose tipo II é uma doença autossómica recessiva por deficiência de maltase ácida. É uma entidade rara, com prevalência de 1/40.000 nas populações holandesa e afro-americana e 1/46000 na população australiana. Embora se distingam três formas de apresentação (infantil, juvenil e do adulto), observa-se um amplo espectro clínico. Em Portugal está disponível terapêutica enzimática de substituição desde 2006.Material e Métodos: Fez-se o estudo retrospetivo de quatro doentes (duas das quais irmãs), baseado na revisão dos processos clínicos.Resultados: Em todas, a doença manifestou-se no segundo ano de vida. O tempo até ao diagnóstico variou entre dois e onze anos. Aquando do diagnóstico, todas apresentavam miopatia com atraso de aquisições motoras e em duas havia hipertrofia miocárdica. A suspeita clínica surgiu por insuficiência respiratória em contexto infeccioso em duas doentes. Em todas havia elevação da creatina quinase e das aminotransferases. Todas evoluíram com insuficiência respiratória crónica por síndrome restritiva. O diagnóstico foi baseado na diminuição da atividade da maltase ácida em fibroblastos (0 a 1,5% do limite inferior do normal). Na biópsia muscular, realizada em três doentes, demonstrou-se acumulação lisossómica de glicogénio. Todas apresentavam a mutação c.1064T > C no exão 6 do gene GAA (glucosidase-alpha-acid), em homozigotia numa delas, associada às mutações c.1666A > G no exão 12 e c.2065G > A no exão 15 nas duas irmãs e à mutação c.380G > T no exão 2 na doente mais nova. Todas iniciaram terapia enzimática de substituiçãologo que disponível, com boa tolerância. A doente mais jovem faleceu pouco depois. As outras mantêm medidas de suporteventilatório e fisioterapia, deslocando-se a mais velha, em cadeira de rodas, mantendo a irmã marcha independente e necessitando a mais nova de andarilho.Conclusão: Os nossos casos incluem-se clinicamente na forma juvenil da doença de Pompe. A hipótese de doença de Pompe deve ser considerada em lactentes com miocardiopatia e nas miopatias progressivas, especialmente as das cinturas e dos músculos respiratórios em qualquer idade. A elevação da creatina quinase é um dado sensível, embora inespecífico. Dada a grande variabilidade dos achados genéticos, a demonstração da redução da atividade da maltase ácida continua a ser o pilar do diagnóstico.
Burnout em Professores: A sua Relação com a Personalidade, Estratégias de Coping e Satisfação com a Vida
Authors: David Isabel Carmo , Quintão Sónia
Published: July 2022

Introduction/Objectives: Burnout Syndrome is characterized by feelings of physical and emotional exhaustion, depersonalization, and low personal fulfillment and teaching has been considered one of the contexts of work where the professionals seem to be more exposed to suffer from Burnout. The aim of this study was to relate Burnout, personality, affectivity, Coping strategies and life satisfaction. Material and Methods: It was used a sample of 404 teachers aged between 23 and 64 years (M = 41.20; SD = 9.79), ranging from the first cycle to university education. The following instruments were used: Coping Responses Inventory (CRI), Big Five Inventory (BFI), Positive and Negative Affective Schedule (PANAS), Maslach Burnout Inventory (MBI) and Satisfaction with Life Scale (SWLS). Results: The results showed that teachers with higher levels of neuroticism presented more Burnout, on the other hand teachers with a higher level of extraversion and agreeableness showed more personal accomplishment. Teachers who were high on negative affectivity where also high on Burnout, those who presented Coping strategies focused on the problem had higher results on personal accomplishment, conscientiousness, extraversion and openness to experience. Teachers who presented strategies more focused on emotions also revealed higher levels of neuroticism and Burnout. Results also showed that greater the satisfaction with life is correlated with higher personal accomplishment and extraversion and lower Burnout. Those who teach in higher levels of education revealed higher satisfaction with life and those who teach in lower levels showed higher emotional exhaustion. Conclusions: We cannot understand Burnout ignoring personality processes and selection of coping strategies that accompany it.
Avanços no conhecimento da doença de Still do adulto.
Authors: Cabanelas Nuno , Ferreira Patrícia , Esteves Maria Cristina , Roxo Fausto
Published: July 2022

Adult Still's Disease has systemic consequences, an inflammatory origin and unknown etiology. Knowledge about this disease is still limited, but some evolution has occurred in the last few years.Using a clinical case as example, the purpose of this paper is to review actual knowledge about Adult Still's Disease, giving special relevance to the most recent findings.Search in Pubmed and Cochrane database (1970-2009) for the terms Adultonset Still's Disease for all available papers. Those considered clinically and historically relevant were selected. An additional search was done in scientific journals and textbooks and other web sites. The information was analysed, using a clinical case in an atypical age as illustration.Adult Still's Disease as multiple manifestations, being fever, evanescent skin rash and arthralgia the most typical. Laboratorial parameters are inespecific, but high glycosilated ferritin is highly suggestive. Non-steroid anti-inflammatory, corticoids, immunosuppressors, and recent biological agents are used in treatment.Being uncommon, actual knowledge about this disease is based in isolated descriptions or very short series. There are no specific guidelines, but diagnostic criteria have been improved in recent years, as have the insights in pathophysiology and therapeutic resources.
Cirurgia bariátrica: do passado ao século XXI.
Authors: Tavares Amélia , Viveiros Fernando , Cidade Cassilda , Maciel Jorge
Published: July 2022

Obesity is a chronic and endemic disease in developed countries, there is an inverse relationship between the socio-economic level and the prevalence of this disease. Their costs are responsible from 2 to 7% of the total health costs. The prevalence of obesity in the world is so high that the World Health Organization considered this disease as the global epidemic of the XXI century. In Portugal it's estimated that around 16.5% of the population aged over 18 years, has obesity, and due to the morbidity and mortality associated with this pathology, this constitutes a serious public health issue. There are several ancient references to obesity and its consequences, with descriptions of different therapeutic attitudes. But only in 1965 the term bariatric was introduced and consequently the term bariatric surgery. Mason, the father of bariatric surgery, started its history in 1966. Several surgical techniques were subsequently developed, but currently the most used are the gastric bandoplastia, a restrictive surgery, and the gastric bypass, a combined surgery. Today, the bariatric surgery is not limited to the treatment of obesity, but the treatment of a syndrome associated with obesity, allowing a significant improvement in Quality of life of these patients. Thus, it's licit to think that the surgery that allows addressing the epidemic of the XXI century is the surgery of the century, with curative rates, of obesity and their comorbidities, which were never achieved by any other pharmacological treatment.
Drogas antidepressivas.
Authors: Aguiar C Clayton , Castro Thiago R , Carvalho André F , Vale Otoni C , Sousa F Cléa , Vasconcelos Silvânia M
Published: July 2022

Depression is a disorder of mood that causes strong impact on the patient and his family's quality of life. The increasing number of cases and its social consequences have made depression a great public health problem. Some depressant patients develop suicide thoughts and may try suicide later. The disease occurs in all ages and its prevalence is of 7.4%. Women aged 15 to 29 are more likely to be affected, whereas people aged 50 or older are less affected. The presence of depression worsens the prognostic of other clinical conditions when compared to not depressant patients. This paper describes the main drugs used in the treatment of depression and correlates the drug with the neurobiology of the disease. Aiming the study of the pharmacologic and therapeutic characteristics of antidepressant drugs, a literature review was performed using electronic databases (Pubmed and Lilacs), papers and books related to the theme. The main antidepressant drugs are classified according to their chemical structure or their action on neurotransmitters. An important point in the therapy is the understanding of the pharmacokinetics of the drugs. The choice of the drug must consider the symptoms, the patient's age, other drugs in use, the history of pharmacological treatments and so forth. No drug is significantly better than the other in the treatment of depression. The important thing in choosing a drug is to have the best therapeutic response, the reduction of symptoms, a good adherence to therapy, few side effects and secure drug interaction. By understanding the use of these drugs, it will be possible to give the patient and his family a better quality of life.
In vitro and in vivo chitosan membranes testing for peripheral nerve reconstruction.
Authors: Simões M J , Gärtner A , Shirosaki Y , Gil da Costa R M , Cortez P P , Gartnër F , Santos J D , Lopes M A , Geuna S , Varejão A S P , Maurício A Colette
Published: July 2022

Tissue regeneration over a large defect with a subsequent satisfactory functional recovery still stands as a major problem in areas such as nerve regeneration or bone healing. The routine technique for the reconstruction of a nerve gap is the use of autologous nerve grafting, but still with severe complications. Over the last decades several attempts have been made to overcome this problem by using biomaterials as scaffolds for guided tissue regeneration. Despite the wide range of biomaterials available, functional recovery after a serious nerve injury is still far from acceptable. Prior to the use of a new biomaterial on healing tissues, an evaluation of the host's inflammatory response is mandatory. In this study, three chitosan membranes were tested in vitro and in vivo for later use as nerve guides for the reconstruction of peripheral nerves submitted to axonotmesis or neurotmesis lesions. Chitosan membranes, with different compositions, were tested in vitro, with a nerve growth factor cellular producing system, N1E-115 cell line, cultured over each of the three membranes and differentiated for 48h in the presence of 1.5% of DMSO. The intracellular calcium concentrations of the non-differentiated and of the 48h-differentiated cells cultured on the three types of the chitosan membranes were measured to determine the cell culture viability. In vivo, the chitosan membranes were implanted subcutaneously in a rat model, and histological evaluations were performed from material retrieved on weeks 1, 2, 4 and 8 after implantation. The three types of chitosan membranes were a viable substrate for the N1E-115 cell multiplication, survival and differentiation. Furthermore, the in vivo studies suggested that these chitosan membranes are promising candidates as a supporting material for tissue engineering applications on the peripheral nerve, possibly owing to their porous structure, their chemical modifications and high affinity to cellular systems.
Trombose venosa cerebral: análise retrospectiva de 49 casos.
Authors: Santos Gonçalo Roque , André Rui , Pereira Sara Leonor , Parreira Tiago , Machado Egídio
Published: July 2022

Cerebral Venous Thrombosis (CVT) is a rare and potentially life-threatening disease, accounting for about 0.5% of stroke cases. However, it is believed to be an underdiagnosed condition. Early diagnosis requires a high degree of suspicion and appropriate use of imaging modalities.Imagiological and clinical characterization of CVT cases diagnosed at our hospital from 2004 to 2007.This study was a retrospective, cross-sectional analysis from 2004 to 2007, using our institution database. We reviewed hospital discharge data to assess the incidence of CVT. The study population consisted of 49 patients. Retrospective review of the clinical data and imaging studies of these patients was then performed.Of the 49 patients with confirmed CVT, 38 were female. Patient age varied between 16 and 75 years, with an average of 42.6 years. Thrombotic risk factors were found in 43 patients; the most frequent was dyslipidemia (n = 22) followed by oral contraceptive use (n = 18). Initial head Computerized Tomography (CT) was normal in six cases. Diagnosis was made by Magnetic Resonance (MR) in 38 cases, Cerebral CT-Venography in 10 cases and Digital Subtraction Angiography in one case. Average time from onset of symptoms to diagnosis was nine days; this was not significantly different when comparing the group diagnosed by MR with the group diagnosed by CT-Venography. Right transverse sinus was the most frequent location of thrombosis (n = 36). Only in four cases thrombosis did not involve the lateral sinuses.Lateral sinus thrombosis is a frequent variety of CVT, accounting for 91.8% of our cases. A negative Head CT scan does not exclude the presence of cerebral venous thrombosis; therefore appropriate imaging study should be performed whenever there's a high degree of clinical suspicion. Cerebral CT-Venography seems to be a good alternative to MR for the diagnosis of CVT.
Prescrição Off-Label: Análise Científica tendo como Exemplo a Utilização de Bevacizumab em Oftalmologia
Authors: Alarcão Joana , Costa João , Fareleira Filipa , Borges Margarida , Carneiro António Vaz
Published: July 2022

A prescrição off-label levanta problemas técnicos/científicos, profissionais e éticos específicos. No presente trabalho, procurámos realizar uma análise técnico-científica da prescrição off-label recorrendo a um exemplo atual, clinica e economicamente relevante: o caso paradigmático da utilização de bevacizumab em patologias do foro oftalmológico para as quais não tem indicação formal aprovada. Para tal realizámos uma revisão sistemática da literatura sobre a eficácia e segurança deste medicamento, assim como de ranibizumab– o qual tem indicações oftalmológicas aprovadas, no sentido de analisar qualitativamente a evidência científica disponível sobreas duas intervenções. Este caso é exemplar para análise técnico-científica dos problemas da prescrição off-label, já que, de acordo com os resultados da revisão sistemática realizada, o uso do bevacizumab neste contexto possui, de facto, evidência científica de dimensão apreciável, incluindo ensaios clínicos head-to-head com ranibizumab. No entanto, os problemas de segurança identificados levantam a questão da utilização deste fármaco nas patologias oftalmológicas. Os diferentes agentes que participam no processo de decisão terapêutica (médicos, doentes e decisores institucionais) devem estar adequadamente informados sobre a evidência existente que suporta a prescrição off-label, a qual, por definição, deve ser sempre de caracter excecional e devidamente justificada.
Lesão Renal Aguda e Rabdomiólise como Apresentação da Doença de Mcardle
Authors: Costa Rui , Castro Rui , Costa Alexandre , Taipa Ricardo , Vizcaíno Ramon , Morgado Teresa
Published: July 2022

A doença de McArdle apresenta-se tipicamente por mialgias, intolerância aos esforços, cãibras e mioglobinúria na infância ou jovens adultos. A deficiência hereditária da enzima miofosforílase incapacita a degradação de glicogénio, com consequente acumulação no tecido muscular e défice energético. A rabdomiólise pode ocorrer e complicar-se de lesão renal aguda mas raramente, em cerca de 11% dos casos, é manifestação inicial da doença. Apresentamos um caso de Doença de McArdle num paciente de 38 anos de idade. Tinha antecedentes de mialgias, intolerância aos esforços e episódio isolado de mioglobinúria. A doença foi diagnosticada num episódio de rabdomiólise grave complicada de lesão renal aguda oligúrica, com necessidade de hemodiálise. A biópsia renal demonstrou necrose tubular aguda. Apesar da recuperação renal, os marcadores de lise muscular permaneceram elevados. Na suspeita de miopatia metabólica realizou biópsia muscular que revelou deposição subsarcolémica de glicogénio e ausência de atividade da miofosforilase. As miopatias metabólicas devem ser consideradas na abordagem de LRA associada a rabdomiólise severa.
Traumatismo Crânio-Encefálico: Abordagem Integrada
Authors: Oliveira Edson , Lavrador José Pedro , Santos Maria Manuel , Lobo Antunes João
Published: July 2022

Traumatic brain injury is a public health problem with significant economic and social impact. Its incidence has increased worldwide at the expense of developing countries and remains as the major cause of morbidity and mortality among young adults. The authors present a general and integrated approach of this pathology contextualizing epidemiological, pathophysiological, clinical and therapeutical aspects.
Iodo e Tiróide: O que o Clínico Deve Saber
Authors: Santana Lopes Maria , Jácome de Castro João , Marcelino Mafalda , Oliveira Maria João , Carrilho Francisco , Limbert Edward
Published: July 2022

The World Health Organization considers iodine deficiency as a major worldwide cause of mental and development diseases, estimating that about 13% of the world population is affected by diseases caused by iodine deficiency. Iodine is a trace element necessary for the synthesis of thyroid hormones which, since it cannot be formed by the organism, must be taken regularly with food. Fish and shellfish are generally a good source, because the ocean contains a considerable amount of iodine. On the contrary, plants which grow in iodine-deficient soils are poor in this element, as well as meat and other animal products fed in plants low in iodine. Salt is the best way for iodine supplementation. Cooking the food with iodized salt is a desirable practice because it guarantees the presence of this element. There are also other methods to provide iodine to the general population, such as adding iodine to drinking water or taking supplements of iodine. In pregnancy is recommended iodine supplementation, except in patients with known thyroid disorders. Iodine is an essential component of thyroid hormones (T4 and T3). Inadequate iodine intake leads to inadequate thyroid hormone production. The most important consequences of iodine deficiency, in the general population are goiter and hypothyroidism, and in the severe cases, mental retardation, cretinism and increased neo-natal and infant mortality. The International Council for the Control of Iodine Deficiency Disorders (ICCIDD) formed in 1985, with the only aim of achieving optimal iodine nutrition in the world, in cooperation with UNICEF and WHO. In Portugal, recent studies show significant deficiencies in pregnancy and The Portuguese Society of Endocrinology Diabetes and Metabolism, in partnership with General Directorate of Health, proposed an iodine supplementation during pregnancy with 150-200μg/day.