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- Speech and voice response to a Levodopa challenge in late-stage Parkinson’s DiseasePublication . Fabbri, Margherita; Guimarães, Isabel; Cardoso, Rita; Coelho, Miguel; Guedes, Leonor Correia; Rosa, Maria M.; Godinho, Catarina; Abreu, Daisy; Gonçalves, Nilza; Antonini, Angelo; Ferreira, Joaquim J."Background: Parkinson’s disease (PD) patients are affected by hypokinetic dysarthria, characterized by hypophonia and dysprosody, which worsens with disease progression. Levodopa’s (l-dopa) effect on quality of speech is inconclusive; no data are currently available for late-stage PD (LSPD). Objective: To assess the modifications of speech and voice in LSPD following an acute l-dopa challenge. Method: LSPD patients [Schwab and England score <50/Hoehn and Yahr stage >3 (MED ON)] performed several vocal tasks before and after an acute l-dopa challenge. The following was assessed: respiratory support for speech, voice quality, stability and variability, speech rate, and motor performance (MDS-UPDRS-III). All voice samples were recorded and analyzed by a speech and language therapist blinded to patients’ therapeutic condition using Praat 5.1 software. Results: 24/27 (14 men) LSPD patients succeeded in performing voice tasks. Median age and disease duration of patients were 79 [IQR: 71.5–81.7] and 14.5 [IQR: 11–15.7] years, respectively. In MED OFF, respiratory breath support and pitch break time of LSPD patients were worse than the normative values of non-parkinsonian. A correlation was found between disease duration and voice quality (R = 0.51; p = 0.013) and speech rate (R = −0.55; p = 0.008). l-Dopa significantly improved MDS-UPDRS-III score (20%), with no effect on speech as assessed by clinical rating scales and automated analysis. Conclusion: Speech is severely affected in LSPD. Although l-dopa had some effect on motor performance, including axial signs, speech and voice did not improve. The applicability and efficacy of non-pharmacological treatment for speech impairment should be considered for speech disorder management in PD."
- Provision of pharmaceutical care by community pharmacists across Europe: Is it developing and spreading?Publication . Costa, Filipa A.; Scullin, Claire; Al-Taani, Ghaith; Hawwa, Ahmed F.; Anderson, Claire; Bezverhni, Zinaida; Binakaj, Zahida; Cordina, Maria; Foulon, Veerle; Garcia de Bikuña, Borja; Gier, Han de; Granås, Anne Gerd; Grinstova, Olga; Griese-Mammen, Nina; Grincevicius, Jonas; Grinceviciene, Svitrigaile; Kaae, Susanne; Kubiliene, Loreta; Mariño, Eduardo L.; Martins, Silvia; Modamio, Pilar; Nadin, Giancarlo; Nørgaard, Lotte Stig; Obarcanin, Emina; Tadic, Ivana; Tasic, Ljiljana; McElnay, James C.; Hersberger, Kurt E.; Westerlund, TommyRationale, Aims, and Objectives Pharmaceutical care involves patient-centred pharmacist activity to improve medicines management by patients. The implementation of this service in a comprehensive manner, however, requires considerable organisation and effort, and indeed, it is often not fully implemented in care settings. The main objective was to assess how pharmaceutical care provision within community pharmacy has evolved over time in Europe.
- Substantia nigra neuromelanin as an imaging biomarker of disease progression in Parkinson’s DiseasePublication . Fabbri, Margherita; Reimão, Sofia; Carvalho, Miguel; Nunes, Rita G.; Abreu, Daisy; Guedes, Leonor Correia; Bouça, Raquel; Lobo, Patrícia P.; Godinho, Catarina; Coelho, Miguel; Gonçalves, Nilza C.; Rosa, Mario Miguel; Antonini, Angelo; Ferreira, Joaquim J."BACKGROUND: A specific T1-weighted magnetic resonance imaging (MRI) sequence has been shown to detect substantia nigra (SN) neuromelanin (NM) signal changes that accurately discriminate Parkinson's disease (PD) patients from controls, even in early disease stages. However, it is unclear what happens to these SN changes in later disease stages and if they can be a marker of disease progression. OBJECTIVE: to investigate the pattern of SN-NM area loss and contrast ratio (CR) intensity changes in late-stage PD (LSPD) compared to earlier disease stages. METHODS: A comparative cross-sectional study was performed, analyzing SN-NM MRI signal in LSPD (Schwab and England Activities of Daily Living Scale score <50 or Hoehn Yahr Stage [HY] >3), comparing this group with de novo, 2-5 year PD and controls. SN-NM signal area and CR values for the internal and lateral SN regions were obtained with semi-automated methods. RESULTS: 13 LSPD, 12 de novo patients with PD, 10 PD patients with a 2-5 year disease duration, and 10 controls were included. NM signal area was significantly decreased in LSPD compared to de novo PD (P-value = 0.005; sensitivity: 75%; specificity 92% and AUC: 0.86). In the lateral SN region, a decrease in the CR was detected in all PD groups compared to controls; despite not reaching statistical significance, a slight increment was observed comparing LSPD to 2-5 year PD. NM signal area significantly correlated with HY (R = -0.37; P < 0.05) and Movement disorder Society Unified Parkinson's Disease Rating Scale part II (MDS-UPDRS) (R = -0.4; P < 0.05) while a weak correlation was found with MDS-UPDRS part III (R = -0.26; P: 0.1). CONCLUSION: SN area evaluated by NM-sensitive MRI may be a promising biomarker of nigral degeneration and disease progression in PD patients."
- Assessment of the Cavidi ExaVir load assay for monitoring plasma viral load in HIV-2-infected patientsPublication . Borrego, Pedro; Gonçalves, Maria Fátima; Gomes, Perpétua; Araújo, Lavínia; Moranguinho, Inês; Figueiredo, Inês Brito; Barahona, Isabel; Rocha, José; Mendonça, Claudino; Cruz, Maria Cesarina; Barreto, Jorge; Taveira, NunoHIV plasma viral load is an established marker of disease progression and of response to antiretroviral therapy, but currently there is no commercial assay validated for the quantification of viral load in HIV-2-infected individuals. We sought to make the first clinical evaluation of Cavidi ExaVir Load (version 3) in HIV-2- infected patients. Samples were collected from a total of 102 individuals living in Cape Verde, and the HIV-2 viral load was quantified by both ExaVir Load and a reference in-house real-time quantitative PCR (qPCR) used in Portugal in 91 samples. The associations between viral load and clinical prognostic variables (CD4 T cell counts and antiretroviral therapy status) were similar for measurements obtained using ExaVir Load and qPCR. There was no difference between the two methods in the capacity to discriminate between nonquantifiable and quantifiable HIV-2 in the plasma. In samples with an HIV-2 viral load quantifiable by both methods (n 27), the measurements were highly correlated (Pearson r 0.908), but the ExaVir Load values were systematically higher relative to those determined by qPCR (median difference, 0.942 log10 copies/ml). A regression model was derived that enables the conversion of ExaVir Load results to those that would have been obtained by the reference qPCR. In conclusion, ExaVir Load version 3 is a reliable commercial assay to measure viral load in HIV-2-infected patients and therefore a valuable alternative to the inhouse assays in current use.
- Evaluation of this temporomandibular joint space when using different occlusal splints by cone beam computerized tomography : a case reportPublication . Januzzi, Eduardo; Ferreira, Luciano Ambrosio; Duarte, Juliana da Silva; Ribondi, Carla Rodrigues; Corrêa, Cira Valéria Almeida; Alvarenga, Mariana Guimarães Jorge de; Gonçalves, Rafael Tardin Rosa Ferraz; Almeida, André Mariz de; Maurício, Paulo João Bela Teiga de DurãoIntroduction: An occlusal splint is a removable, reversible, non-invasive device made of acrylic, used to promote a harmonious occlusal contact. It is part of an arsenal of therapeutic modalities used in the treatment of Temporomandibular Joint (TMJ) Disorders. However, its mechanisms of action remain controversial. Several hypotheses have been proposed to explain its efficiency, such as: repositioning of the condyle or disk; reduction of the masticatory electromyographic activity; change of harmful oral habits; increase of the intra-articular space reducing the overload on the TMJ. Case presentation: This case report aims to demonstrate the changes in TMJ spaces, assessed by Cone Beam Computed Tomography (CBTC) scans, in a patient with indication to use occlusal splints. She was submitted to occlusal splints of 1 and 3 mm which were used during CBTC acquisition. The measures of the joint spaces with and without splints were compared by image software that shows an alteration of the upper, anterior, posterior, medial and lateral joint spaces. The 3 mm plate promoted an initial translation of condyle. Conclusion: The thicknesses of 3 and 1 mm promoted different joint space variations. The use of different thicknesses enables the individualization of the treatment for different pathologies affecting the TMJ.
- Pitfalls in imaging of female pelvic massesPublication . Horta, Mariana; Cunha, Teresa MargaridaPurpose of Review The purpose of this review is to highlight potential magnetic resonance (MR) imaging pitfalls that may mask and simulate ovarian cancer. Recent Findings MR imaging is the standard method for evaluating female pelvic masses of indeterminate origin, especially sonographically indeterminate adnexal masses. To define the correct origin and nature of a pelvic mass has an enormous clinical impact, namely in females of child-bearing age. This is particularly true in adnexal lesions. Ovarian cancer usually requires a cytoreductive surgery in a specialized oncological centre. In contrast, a benign ovarian lesion may be treated by simple resection in a general hospital. To help preventing diagnostic errors and in order to guide appropriate therapeutic management, radiologists should be aware of potential MR pitfalls that may mask and simulate ovarian cancer. Summary The first section of this article will describe the MR imaging protocol that authors perform in their oncological centre, highlighting how imaging techniques can be optimized in order to reduce pitfalls in the characterization of an indeterminate pelvic mass. In the next section, authors will revise the main anatomic and organ-specific signs that may allow the radiologist to determine the ovarian origin of a pelvic mass. Finally, benign gynaecological masses that may simulate ovarian cancer in a non-emergency setting will be discussed, with emphasis on features that may provide important clues to their diagnosis.
- Modelling of Statistical Fading Parameters in Maritime Container Terminal EnvironmentsPublication . Ferreira, Manuel; Ambroziak, Slawomir; Cardoso, Filipe; Sadowski, Jaroslaw; Correia, Luís
- Metascience in pre-service primary teacher education: enhancing teachers’ science conceptionsPublication . Saraiva, Maria Leonor da Graça; Neves, Isabel Pestana
- A cooperative multicriteria group decision aiding tool: a guide tour of the desktop applicationPublication . Fernandes, Sérgio; Clímaco, João; Captivo, Maria EugéniaThe main features of the adaptation to a face-to-face cooperative group approach of an interactive decision support tool previously developed with the aim of supporting decisions concerning multicriteria location problems are described. In the application implemented there is no inter-criterion aggregation, so there is no need to reduce the various evaluation dimensions into the same scale. It allows for the individual intervention of several elements of the group, includes some logical tools as well as the possibility of introducing constraints. Furthermore, it propitiates an extensive use of interactive graphics. A guided tour of the desktop application emphasizing its potentialities and limitations is presented.
- Similarity laws in low speed switched reluctance machines designPublication . Lobato, Pedro; Dente, J. A.; Martins, J. F.; Pires, A. J.This paper presents a set of similarity laws appropriate for low speed switched reluctance machines design. Design methodologies of switched reluctance machines for low speed applications are generally oriented towards the choice of suitable combinations of stator and rotor poles in regular topologies. The proposed similarity laws provide an easy-to-use and robust methodology to compare different magnetic topologies, regular or non-regular, and have the capability to incorporate thermal and magnetic saturation phenomena by introducing constraints. With the assistance of finite-element analysis the issues surrounding the design of low speed SR multimachines topologies are discussed, leading into consideration of modular non-regular topologies. Using similarity laws, the modular topology is compared with a regular switched reluctance machine. The comparison results point out the reduction of copper losses of the modular topology over the regular topology. This paper extends previous discussions of switched machine design into a more general context.