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- Pavimentos aeronáuticos em betão pré-esforçado: reforço estrutural em Stone Mastic Asphalt aplicado à pista da Base Aérea N.º 11 em BejaPublication . Madrinha, MiguelA evolução que, nos dias de hoje, se verifica no transporte de passageiros por meio aéreo obriga ao desenvolvimento de soluções que permitam o transporte de elevada quantidade passageiros e de forma expedita. Estas soluções podem incidir sobre um incremento no número de movimentações de aeronaves ou de um aumento da capacidade de transporte de passageiros por aeronave. Esta dissertação incide no estudo de uma possibilidade de reforço do pavimento da pista da Base Aérea N.º 11, partilhada com o aeroporto de Beja, recorrendo a um material relativamente recente, o Stone Mastic Asphalt (SMA) de forma a suportar, pelo menos, as exigências estruturais da aeronave Airbus A380. Esta dissertação faz uma caracterização geral dos pavimentos com principal incidência nos pavimentos com destino a estruturas aeroportuárias, assim como das metodologias de ensaio mais correntes para avaliação estrutural e funcional. Segue-se uma caracterização do pavimento da Base Aérea N.º 11, com o fim de se compreender o estado atual em que se encontra, fundamental para a justificação de uma proposta de dimensionamento de reforço. Para o dimensionamento, foi necessário realizar um estudo do tráfego aéreo atual, civil e militar. Com este estudo elaborou-se uma previsão e proposta das alterações a que o tráfego civil poderá estar sujeito e que influenciam o dimensionamento do reforço estrutural. Recorrendo a ferramentas computacionais de dimensionamento, desenvolveu-se uma proposta para reforço estrutural levando em linha de conta o tráfego proposto e a possibilidade de operação do A380. Pode dizer-se que se chegaram a valores com significado para a espessura de SMA, o que indica a necessidade de avaliar mais especificamente as soluções e eventualmente estudar alternativas que permitam uma maior relação custo-benefício.
- Os inventários à luz do SNC e do SNC-APPublication . Godinho, Teresa; Silva, Susana; Aleixo, Maria do ConceiçãoO objetivo deste trabalho é a comparação entre a Norma de Contabilidade Pública 10 (NCP10) e a Norma de Contabilidade e de Relato Financeiro 18 (NCRF18), ambas dedicadas ao tratamento contabilístico dos Inventários. As especificidades do Setor Público estão patentes na NCP 10, que apresenta diferenças relativamente à NCRF 18, nomeadamente ao nível do entendimento concetual e, consequentemente, do reconhecimento. O conceito de inventários da NCP 10 é mais lato e o reconhecimento tem, naturalmente, outras especificidades além das exigidas pela NCRF 18. O resultado desta análise comparativa contribui para o desenvolvimento de competências, tanto na vertente do processo de ensino aprendizagem, como na ótica profissional.
- Identification of potentially inappropriate medications with risk of major adverse cardiac and cerebrovascular events among elderly patients in ambulatory setting and long-term care facilitiesPublication . Aguiar, João Pedro; Costa, Luís Heitor; Costa, Filipa Alves da; Leufkens, Hubert G. M.; Martins, Ana PaulaPURPOSE: Cardiovascular diseases (CVDs) are extremely common among the elderly, but information on the use of potentially inappropriate medications (PIMs) with cardiovascular risk is scarce. We aimed to determine the prevalence of PIMs with risk of cardiac and cerebrovascular adverse events (CCVAEs), including major adverse cardiac and cerebrovascular events (MACCE). PATIENTS AND METHODS: A cross-sectional study was performed using a convenience sample from four long-term care facilities and one community pharmacy in Portugal. Patients were included if they were aged 65 or older and presented at least one type of medication in their medical and pharmacotherapeutic records from 2015 until December 2017. The main outcome was defined as the presence of PIMs with risk of MACCE and was assessed by applying a PIM-MACCE list that was developed from a previous study. All medications included in this list were assessed for their availability in Portugal. RESULTS: A total of 680 patients were included. Of those, 428 (63%) were female with a mean age of 78.4±8.1 years. Four-hundred and four (59.4%) patients were taking medications associated with CCVAEs risk (mean =1.7±1.0 drugs/patient), including 264 patients (38.8%) who used drugs with MACCE risk (mean =1.4±0.8 drugs/patient). Fifty percent of patients with a previous history of CVD (n=521) were taking PIMs with risk of CCVAEs, including 30.0% with risk of MACCE. CONCLUSION: Our findings show that 50% of patients with previous history of CVD were taking drugs with risk of CCAVEs and 30% with risk of MACCE. More tailored tools for the management of drug therapy in elderly patients with CVD are of major importance in clinical practice.
- Hyperpigmentation associated with hormonal contraceptive usePublication . Peixoto, R.; Fonseca, A.P.Introduction: Melanocytes are cells which are present in the human skin and they are responsible for the melanin production. They can be found in the basal stratum of the epidermis and they have some prolongations extending until the stratum corneum. Melanin synthesis may increase in the presence of some factors and some irregular brownish spots – hyperpigmentations – may appear. Factors which can trigger melanogenesis are excessive sun exposure, hormonal contraception, hormonal reposition therapy, pregnancy, medicines, cosmetics, stress or genetics. Aim: Understanding of the relationship between hormonal contraceptives and hyperpigmentation. Material and Methods: A bibliographic review through a research in diverse databases (PubMed, Google Scholar, ScienceDirect and Wiley Online Library). Results/Discussion: According to some authors, estrogenic components found in hormonal contraceptives are associated with hyperpigmentation situations. In the case of progestagenic components, opinions diverge: some studies substantiate that progesterone has the ability to increase melanogenesis and others that it may have the opposite effect of estrogen. In a general way, most researchers say that hormonal contraceptives affect melanin synthesis; however others reject that fact. Conclusion: It is verified the relationship between hormonal contraceptives and hyperpigmentation. However, this topic is not sufficiently well approached, so future investigations are needed to allow its best understanding.
- Influence of stuttering on the P300Publication . Prata, Cláudia; Silva, Carla Matos, 1975-Background, Stuttering is a disturbance of language that affects 1% of the adult population and about one hundred thousand Portuguese people. This speech disturbance may show changes in the processing of information received through the sense of hearing. After several theories, the need to evaluate neurophysiological processes in individuals with stuttering arises and in this sense, electrophysiological tests can be used. Material and methods, The sample consisted of 10 individuals with stuttering (study group), and 10 fluent individuals (control group), with an age range between 19 to 57. All subjects have undergone an otoscopy, tympanogram and a research of the Stapedial Reflex in 1000 Hz and 2000 Hz frequency, pure tone audiogram screening (pass-fail) at the frequencies of 1000 Hz, 2000 Hz and 4000 Hz. To collect the electrophysiological responses (P300), we used some inclusion criteria, such as being aged between 18 to 60, speaking the European Portuguese, without diagnosis of psychiatric and/or neurological alterations, otoscopy without alterations, the Tympanogram being of type A or C1 and getting response up to 40 dB in the frequencies 1000 Hz, 2000 Hz and 4000 Hz in the pure tone audiogram screening. Then, every subject did the evoked auditory potential of long latency (P300). Results, There were statistically significant differences (p = 0.005) between the right ear latency values in subjects with stuttering (347.10 ms ± 18.24) compared to fluent individuals (315.80 ms ± 22.51). In the left ear there were also statistically significant differences (p = 0.023) in mean values of latencies that were higher in stutterers (344 ms ± 32.50) compared to fluent individuals (311 ms ± 20.75). Conclusion, In this study it was verified a change in the electrophysiological response of the P300 in individuals with stuttering. Although the values of latency are within the normal range, in both groups (300-400ms) the individuals with stuttering need more time to process and discriminate auditory stimuli.
- Vestibular dysfunctions:comparison between patients with head and neck tumors and a control groupPublication . Nobre, Ana Rita; Silva, Carla Matos, 1975-; Guiomar, Júlia; Martins, TâniaBackground, the use of ototoxic drugs is common in patients with head and neck tumors. Consequently, there may be vestibular dysfunctions that are not always detected, affecting the quality of life. Thus, it is important to evaluate the factors that may lead to vestibular system dysfunction. The objective of this study is to determine if vestibular dysfunction in individuals with head and neck tumors who underwent chemotherapy and/or radiotherapy also occurred in a control group. Material and Methods, the sample consists of 54 individuals of both genders, aged between 20 and 91 years old and is divided into two groups: a group of 30 individuals without any kind of tumor and no medical history of chemotherapy and/or radiotherapy (control group) and a group of 24 individuals with head and neck tumors. The instruments used to collect the data were an Anamnesis, the modified Clinical Test of Sensory Interaction and Balance (mCTSIB), Limits of Stability test (LOS) and the Dizziness Handicap Inventory (DHI) scale. Results, there are statistically significant differences between the two groups on the Physical, Functional and Emotional sub-scales of the DHI scale, on the DHI Total (p DHI Physical < 0,0001; p DHI Functional < 0,0001; p DHI Emotional < 0,0001; p DHI Total < 0,0001) and on the Reaction Time (RT) in LOS test in every position (p RT Front = 0,020, p RT Back = 0,011, p RT Right = 0,036, p RT Left = 0,036). There are marginally significant differences between the two groups in the postural oscillation velocity in Condition 4 of the mCTSIB (p Condition 4 = 0,065). Conclusion, the group of individuals with head and neck tumors had worse results on the DHI scale, in the RT in LOS test and in the Condition 4 of the mCTSIB, suggesting the existence of greater vestibular alterations in this group compared to the control group.
- Alterações no crescimento craniofacial : perspetiva de um caso clínicoPublication . Jamba, Abisag Palmira Panguela de Jorge; Costa, Hélder Nunes; Oliveira, Pedro AntunesOs bebés humanos, ao nascer, geralmente apresentam uma relação esquelética de classe II. Posteriomente, à medida que o crescimento vai ocorrendo, a mandíbula vai gradualmente tomando um posicionamento mais anterior. A relação esquelética de classe I é alcançada, por norma, entre os quatro e os seis anos de idade. Contudo, existem excepções. Uma dessas excepções é o caso clínico de uma paciente de um ano e cinco meses de idade, gémea heterozigótica, prematura, de baixo peso à nascença, que apresenta um hemangioma da parótida esquerda, sem sintomatologia dolorosa, que regrediu sem tratamento antes de completar um ano de idade. Após a regressão desenvolveu uma má oclusão de classe III. Por não ser comum, achámos o caso interessante para o nosso estudo e, com isso, pretendemos realizar uma pesquisa no sentido de tentarmos perceber o porquê deste desvio do padrão de crescimento e sua eventual relação com a patologia da parótida. Os hemangiomas são tumores vasculares benignos que afetam predominantemente lactentes do sexo feminino, caucasianos, de baixo peso à nascença e prematuros. Apresentam predileção pela zona cervicofacial e na sua maioria são esporádicos, assintomáticos e não necessitam de qualquer intervenção. A menos que estejam localizados em zonas de alto risco e possam comprometer estruturas nobres. Raramente causam complicações e, quando acontece, a ulceração é a mais frequente. Quanto ao seu envolvimento com as estruturas ósseas, tentaremos perceber ao longo deste trabalho qual é o papel destas lesões e se realmente podem ou não envolver o esqueleto craniofacial, modificando o seu padrão de crescimento.
- Reabilitação de dentes endodonciados com ou sem meios de tratamento intra-canalarPublication . Cabaço, Ana Sofia Calado; Maurício, PauloA restauração dos dentes com tratamento endodôntico é dos temas mais desafiantes e controversos na Medicina dentária, existindo várias opções em termos de materiais e de procedimentos clínicos de tratamento a adotar, o que leva a diferentes opiniões no momento da sua escolha. O médico dentista deve possuir um conhecimento aprofundado das alterações destes dentes, de forma a ser capaz de definir um planeamento de reabilitação, baseado numa abordagem caso a caso. O tratamento dos dentes endodonciados tem como objetivo devolver ao dente a sua funcionalidade e a viabilidade de manter o mais tempo possível o dente na boca. A decisão quanto ao tipo de restauração e/ou de retenção intra-radicular é complexa e difícil, pois envolve muitos fatores que variam de acordo com cada caso clínico. Assim, o planeamento de cada caso clínico deve envolver uma avaliação e diagnóstico de acordo com o paciente em causa.
- Earlier initiation of antiretroviral treatment coincides with an initial control of the HIV-1 sub-subtype F1 outbreak among men-having-sex-with-men in Flanders, BelgiumPublication . Vinken, Lore; Fransen, Katrien; Cuypers, Lize; Alexiev, Ivailo; Balotta, Claudia; Debaisieux, Laurent; Seguin-Devaux, Carole; Ribas, Sergio García; Gomes, Perpétua; Incardona, Francesca; Kaiser, Rolf; Ruelle, Jean; Sayan, Murat; Paraschiv, Simona; Paredes, Roger; Peeters, Martine; Sönnerborg, Anders; Vancutsem, Ellen; Vandamme, Anne-Mieke; Van den Wijngaert, Sigi; Van Ranst, Marc; Verhofstede, Chris; Stadler, Tanja; Lemey, Philippe; Van Laethem, KristelHuman immunodeficiency virus type 1 (HIV-1) non-B subtype infections occurred in Belgium since the 1980s, mainly amongst migrants and heterosexuals, whereas subtype B predominated in men-having-sex-with-men (MSM). In the last decade, the diagnosis of F1 sub-subtype in particular has increased substantially, which prompted us to perform a detailed reconstruction of its epidemiological history. To this purpose, the Belgian AIDS Reference Laboratories collected HIV-1 pol sequences from all sub-subtype F1-infected patients for whom genotypic drug resistance testing was requested as part of routine clinical follow-up. This data was complemented with HIV-1 pol sequences from countries with a high burden of F1 infections or a potential role in the global origin of sub-subtype F1. The molecular epidemiology of the Belgian subtype F1 epidemic was investigated using Bayesian phylogenetic inference and transmission dynamics were characterized based on birth-death models. F1 sequences were retained from 297 patients diagnosed and linked to care in Belgium between 1988 and 2015. Phylogenetic inference indicated that among the 297 Belgian F1 sequences, 191 belonged to a monophyletic group that mainly contained sequences from people likely infected in Belgium (OR 26.67, 95% CI 9.59–74.15), diagnosed in Flanders (OR 7.28, 95% CI 4.23–12.53), diagnosed at a recent stage of infection (OR 7.19, 95% CI 2.88-17.95) or declared to be MSM (OR 34.8, 95% CI 16.0–75.6). Together with a Spanish clade, this Belgian clade was embedded in the genetic diversity of Brazilian subtype F1 strains and most probably emerged after one or only a few migration events from Brazil to the European continent before 2002. The origin of the Belgian outbreak was dated back to 2002 (95% higher posterior density 2000–2004) and birth-death models suggested that its extensive growth had been controlled (Re < 1) by 2012, coinciding with a time period where delay in antiretroviral treatment initiation substantially declined. In conclusion, phylogenetic reconstruction of the Belgian HIV-1 sub-subtype F1 epidemic illustrates the introduction and substantial dissemination of viral strains in a geographically restricted risk group that was most likely controlled by effective treatment as prevention.
- Ordinary differential equations with point interactions: An inverse problemaPublication . Dias, N.C.; C., Jorge; Prata, J.N.We study a class of linear ordinary differential equations (ODEs) with distributional coefficients. These equations are defined using an intrinsic multiplicative product of Schwartz distributions which is an extension of the Hörmander product of distributions with nonintersecting singular supports (Hörmander in The analysis of linear partial differential operators I, Springer, Berlin, 1983). We provide a regularization procedure for these ODEs and prove an existence and uniqueness theorem for their solutions. We also determine the conditions for which the solutions are regular and distributional. These results are used to study the Euler–Bernoulli beam equation with discontinuous and singular coefficients. This problem was addressed in the past using intrinsic products (under some restrictive conditions) and the Colombeau formalism (in the general case). Here we present a new intrinsic formulation that is simpler and more general. As an application, the case of a non-uniform static beam displaying structural cracks is discussed in some detail.