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Stidworthy, Jennifer Jane. "The implementation of a portfolio assessment system for a rural clinical school in South Africa : what can be learned from the implementation of portfolios as an assessment system in a rural clinical school." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80389.
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Thesis (MPhil)--Stellenbosch University, 2013.ENGLISH ABSTRACT: A portfolio assessment system was designed to meet the needs of a Rural Clinical School education platform, hosting final year MB ChB students for the duration of their final year. A study entitled “What can be learned from the implementation of a portfolio assessment system, to be used in the assessment of clinical reasoning of final MB ChB students placed in a Rural Clinical School in South Africa? “ was conducted. The experience of educators and students during this process was explored. The findings are in keeping with the literature. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 claim that portfolios drive deep student learning and develop clinical reasoning. Burch & Seggie (2008) offer an assessment tool which has proved feasible within the South African setting on which this portfolio assessment system was modelled. The assessment tool design faced a number of challenges within the RCS setting which were addressed during a review process. The portfolio assessment system is viewed as a work in progress requiring further development. Despite the constraints and challenges, both staff and students unanimously supported the development of patient case studies within the design as a valuable learning tool.
AFRIKAANSE OPSOMMING: ‘n Portefeulje assesserings sisteem is ontwerp om die behoeftes van ‘n UKWANDA Landelike Kliniese Skool opvoedings program wat die gasheer van die MB ChB student tydens hul finale jaar is, na te kom. ‘n Studie genaamd “ Wat kan geleer word uit die implementering van ‘n portefeulje assesserings sisteem, wat gebruik gaan word om die kliniese redenering te bepaal van finale jaar MB ChB student wat geplaas is in ‘n Landelike Klinieke Skool in Suid Afrika? ” is uitgeoefen. Die ervaring van die dosent, so wel as die studente, is ondersoek. Die bevinding is in lyn met die literatuur. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 beweer dat portfeuljes dryf student tot diep studie en ontwikkel kliniese redenasie. Burch & Seggie (2008) bied ‘n assesserings (hulp)middel aan wat toepaslik en uitvoerbaar is in die SA konteks , waarop die portfeulje assessering sisteem gebaseer is. Die ontwerp van die assesserings (hulp)middel het vele uitdagings binne die RCS opset in die oog gestaar. Dit is aangespreek tydens ‘n proses van hersiening. (Lather, 2006).Die portefeulje assesserings sisteem word gesien as ‘n werk onder hande en vereis verdere ontwikkeling. Ten spyte van die beperkinge en uitdagings het beide die staf en die student onomwonde die ontwikkeling van pasiente gevalle studies, binne die ontwerp, as ‘n waardevolle leermiddel gesien.
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Paguay, Ruiz R. Patricio. "Relation between Internal Parasites with Basic Services and the Nutritional Status of Children Five Years of Age in the Indigenous, Black and Mestizo Communities of the Rural Area, Imbabura Province." BYU ScholarsArchive, 2000. https://scholarsarchive.byu.edu/etd/5415.
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Various studies have been done to determine the prevalence of anemia in our country, but these studies don't reflect the true magnitude of this sickness, considered in Ecuador a problem of public health since these investigations correspond to urban sectors and margins and not to rural places where the care is very deficient and in certain cases useless, mainly because of the difficult access and the lack of economic resources of the government institutions. The current work was realized in coordination with the school of Nutrition and Dietetics and with the help of the Benson Agriculture and Food Institute was applied in rural communities of the Indigenous, "Mixed-Race" and African-American of Imbabura taking into account kids under the age of 5 as being a population group in constant risk of suffering specific deficiencies, such as Iron deficiency and its subsequent evolution towards Anemia. In this investigation we are going to find information about the prevalence of Anemia in the before mentioned groups of kids, their relationship with the deficiency of the consumption of Iron, influence of one of the most common sicknesses in these sectors as are Intestinal Parasitism. I am sure that the content will be of enormous interest to those that desire to know and better the critical situation of health and nutrition which unwinds this people, because of the provision of updated and truthful information will permit a better orientation of the different programs and projects that are implemented in these areas.
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Varma, Rajesh. "An investigation of basic science and clinical research methodologies to benefit clinical practice." Thesis, University of Birmingham, 2009. http://etheses.bham.ac.uk//id/eprint/306/.
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The aim of this PhD thesis was to produce research that could inform and benefit clinical practice by exploring the application of basic science and clinical research methodologies to disorders in obstetrics and gynaecology. Chapter 1’s investigation of endometriosis is the first to 1) report detailed genetic mapping of endometriosis-associated ovarian cancer, 2) report the existence of micro-LOH (loss of heterozygosity) in ovarian endometriosis through a SNP 100K DNA array. Chapter 2 explores the efficacy of interventions to treat menstrual abnormalities using clinical cohort studies. Furthermore, Chapter 2 highlights how negligence in female sterilization failure may be mathematically (Bayesian) modelled. Chapter 3 explores the value of systematic reviews for preventing preterm delivery and use of LNG-IUS (Mirena coil). The clinical guidelines published in Chapter 4 include: vaginal birth after previous caesarean, ectopic pregnancy, safe laparoscopic entry and minimising risk of sterilisation failure. The thesis concludes (Chapter 5) by suggesting strategies to augment the research methodological approaches evaluated in this thesis in order fulfill the aim of benefitting clinical practice. Work included in this PhD thesis has been orally presented at international conferences, published in peer-reviewed journals, and published as a national clinical guideline by the Royal College of Obstetricians and Gynaecologists, UK (RCOG).
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Bass, Christopher. "Positron Emission Tomography for Pre-Clinical Sub-Volume Dose Escalation." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/3202.
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Purpose: This dissertation focuses on establishment of pre-clinical methods facilitating the use of PET imaging for selective sub-volume dose escalation. Specifically the problems addressed are 1.) The difficulties associated with comparing multiple PET images, 2.) The need for further validation of novel PET tracers before their implementation in dose escalation schema and 3.) The lack of concrete pre-clinical data supporting the use of PET images for guidance of selective sub-volume dose escalations. Methods and materials: In order to compare multiple PET images the confounding effects of mispositioning and anatomical change between imaging sessions needed to be alleviated. To mitigate the effects of these sources of error, deformable image registration was employed. A deformable registration algorithm was selected and the registration error was evaluated via the introduction of external fiducials to the tumor. Once a method for image registration was established, a procedure for validating the use of novel PET tracers with FDG was developed. Nude mice were used to perform in-vivo comparisons of the spatial distributions of two PET tracers, FDG and FLT. The spatial distributions were also compared across two separate tumor lines to determine the effects of tumor morphology on spatial distribution. Finally, the research establishes a method for acquiring pre-clinical data supporting the use of PET for image-guidance in selective dose escalation. Nude mice were imaged using only FDG PET/CT and the resulting images were used to plan PET-guided dose escalations to a 5 mm sub-volume within the tumor that contained the highest PET tracer uptake. These plans were then delivered using the Small Animal Radiation Research Platform (SARRP) and the efficacy of the PET-guided plans was observed. Results and Conclusions: The analysis of deformable registration algorithms revealed that the BRAINSFit B-spline deformable registration algorithm available in SLICER3D was capable of registering small animal PET/CT data sets in less than 5 minutes with an average registration error of .3 mm. The methods used in chapter 3 allowed for the comparison of the spatial distributions of multiple PET tracers imaged at different times. A comparison of FDG and FLT showed that both are positively correlated but that tumor morphology does significantly affect the correlation between the two tracers. An overlap analysis of the high intensity PET regions of FDG and FLT showed that FLT offers additional spatial information to that seen with FDG. In chapter 4 the SARRP allowed for the delivery of planned PET-guided selective dose escalations to a pre-clinical tumor model. This will facilitate future research validating the use of PET for clinical selective dose escalation.
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Ferretti, Maria Teresa. "Neuroinflammation in early, pre-clinical stages of Alzheimer's disease: evidence from a new transgenic model of Alzheimer's disease-like amyloid pathology." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=106441.
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Despite much advancement in our understanding of its pathobiology, there is no cure for Alzheimer's disease (AD), a devastating neurodegenerative disorder affecting more than 35 million people world-wide. At diagnosis, the brains of AD patients are already severely damaged and display massive accumulation of intraneuronal neurofibrillary tangles and extracellular amyloid plaques. Amyloid plaques are composed of aggregated, insoluble amyloid beta peptide (Abeta), which is known to be highly neurotoxic. At this stage, AD drugs can only delay, but not arrest, the progression of the disease, likely because the neuronal damage is already beyond rescue.It is currently accepted that, for any pharmacological agent to achieve efficacy, the treatment should be initiated prior to extensive central nervous system (CNS) damage, possibly in pre-clinical stages. A better understanding of the earliest events occurring in the pre-clinical phase of the disease is therefore a priority. Unfortunately, the study of pre-clinical stages in AD is complicated by the lack of biomarkers signalling the conversion from non cognitive impairment to AD. On the other hand, transgenic (Tg) models of the AD-like amyloid pathology represent a very suitable model to investigate the progression of the disease.In these studies, we took advantage of our newly generated Tg model of AD-like amyloid pathology, coded McGill-Thy1-APP mice to identify early pathological events preceding plaque deposition. We first examined the cognitive status of the animals and demonstrated that cognitive impairments occur prior to plaque deposition. Such deficits were associated with a paradoxical up-regulation of cholinergic pre-synaptic boutons. Prior to plaque deposition we also described the occurrence of intraneuronal Abeta-immunoreactive material. Furthermore, using oligomeric specific antibodies, we found that the intraneuronal Abeta material was in large part composed of Abeta-oligomers. To further elucidate the mechanisms involved in the early neuronal dysfunction, we characterized the occurrence of inflammation in young, pre-plaque mice. We started by confirming the occurrence of the well known, plaque-associated microglial activation in old, 13-14 months old Tg mice. In young, pre-plaque mice we observed a moderate, but significant up-regulation of inflammatory enzymes (iNOS, inducible nitric oxide synthase) and membrane bound receptors (CD40 and MHC-II); the neuronal marker COX-2 was also found to be up-regulated. Furthermore, we observed that microglial cells at this age display an activated morphology and are specifically associated with Abeta-oligomers burdened neurons. Finally, the anti-inflammatory drug minocycline was administered to 2-month old mice for one month, till the age of 3 months, thus in the absence of any amyloid plaque deposition. This protocol allowed us to investigate the role of inflammation in the early, pre-plaque stage of the disease. We found that, besides correcting neuroinflammation, minocycline significantly reduced the levels of amyloid precursor protein and APP-immunoreactive fragments, including C-terminus fragments (CTF). Furthermore, we observed that minocycline reduced the levels and activity of BACE, which were up-regulated in Tg animals compared to Non Tg.Taken together, our results showed that intracellular accumulation of Abeta-oligomers per se, prior to plaque deposition, is sufficient to trigger a number of CNS alterations. Amongst these, microglial activation appears to be, at least in its earliest manifestation, a key player in APP processing. We suggest that neuroinflammation in pre-clinical stages of AD might represent a suitable target for the discovery of novel preventive agents and/or early diagnostic markers.Il n'existe aucun remède pour la maladie de Alzheimer (MA), une condition neurodégénérative dévastatrice, qui attaque plus de 35 millions de personnes dans le monde entier. Lorsque cette maladie est diagnostiquée, le cerveau des patients est déjà gravement endommagé et montre l'accumulation d'enchevêtrements neurofibrillaires intracellulaires et des plaques amyloïdes extracellulaires. Les plaques amyloïdes sont composées d'agrégats insolubles de la protéine beta amyloïde (Abeta) qui est neurotoxique. Il est actuellement admis que, pour obtenir un résultat thérapeutique, il faudrait commencer le traitement pharmacologique dans les premiers stades de la maladie, lors de la période pré-clinique, avant que les dommages neuronaux deviennent irrécupérables. Une meilleure compréhension des événements survenant dans ces premiers stades de la maladie est donc une priorité. Malheureusement, l'étude de ces stades pré-cliniques est compliquée par l'absence de biomarqueurs indiquant la conversion du stade sans troubles cognitifs à MA. Ainsi, les modèles transgéniques (Tg) de la pathologie amyloïde similaires à MA représentent des modèles très appropriés pour étudier l'évolution de la maladie.Afin d'étudier les premiers événements pathologiques survenant avant l'accumulation des plaques, nous avons profité d'un modèle Tg nouvellement généré dans notre laboratoire et nommé McGill-Thy1-APP. Nous avons d'abord examiné l'état cognitif des souris Tg et nous avons démontré que les troubles cognitifs précèdent l'accumulation des plaques. Nous avons aussi démontré qu'une augmentation paradoxale de boutons cholinergiques accompagnait les troubles cognitifs chez ces animaux. Avant l'apparition des plaques, nous avons décrit la survenance de matériel intraneuronal immunoréactif pour l'Abeta. Par ailleurs, en utilisant des anticorps spécifiques pour les formes oligomériques, nous avons constaté que le matériel intraneuronal est en grande partie composé d'oligomères de l'Abeta.Pour élucider si les mécanismes impliqués dans la dysfonction neuronale précèdent l'accumulation de plaques, nous avons caractérisé l'apparition de l'inflammation chez les jeunes souris Tg, avant qu'elles montrent des plaques. Nous avons d'abord confirmé l'apparition de l'activation microgliale associée avec les plaques amyloïdes chez les vieilles souris Tg de 13-14 mois. Chez les jeunes souris pré-plaques, nous avons observé une augmentation modérée mais significative des enzymes (iNOS et COX-2) et des récepteurs de membranaires (CD40 et CMH-II) inflammatoires. Par ailleurs, nous avons observé que les cellules microglies à cet âge affichent une morphologie activée et sont spécifiquement associées à des neurones contenant des oligomères de l'Abeta.Enfin, la minocycline (un médicament anti-inflammatoire) a été administrée à des souris âgées de deux mois pour un mois (jusqu'à l'âge de 3 mois) donc en l'absence de tout dépôt de plaques amyloïde. Ce protocole nous a permis d'étudier le rôle de l'inflammation dans les premiers stades de la maladie, avant le dépôt de plaques. Nous avons constaté que, outre la correction de la neuroinflammation, la minocycline réduit considérablement les niveaux de la protéine précurseur de l'amyloïde (APP) et les fragments connexes avec l'APP, y compris les fragments du carboxy terminaux. Par ailleurs, nous avons observé que la minocycline réduit les niveaux et l'activité de BACE.Ensemble, nos résultats montrent que l'accumulation intracellulaire des oligomères de l'Abeta en soi, avant le dépôt de plaques, est suffisante pour déclencher des modifications du SNC. Parmi ces derniers, l'activation microgliale semble avoir, du moins dans sa première manifestation, un rôle fondamental dans le métabolism de l'APP. Nous suggérons que la neuroinflammation dans les stades pré-cliniques de la MA pourrait représenter une cible appropriée pour la découverte de nouveaux agents préventifs et/ou de marqueurs diagnostiques.
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Eleftheriadou, Olga. "Regulation of the PP2AC, PP4C, PP6C and alpha4 signalling axis in the myocardium : roles in calcium homeostasis and hypertrophy." Thesis, Kingston University, 2017. http://eprints.kingston.ac.uk/39280/.
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Cardiac physiology and hypertrophy are regulated by the phosphorylation status of most proteins, which is controlled by the opposing reactions of protein kinases and phosphatases (PP). The type 2A protein phosphatase family is comprised of PP2A, PP4 and PP6, due to the high amino acid homology of their catalytic subunits (PP2ACα/β, PP4C and PP6C). The activity and expression of this family are partly regulated by alpha4, a common regulatory protein that is essential in type 2A phosphatase holoenzyme biogenesis. In the heart, more than 98% of protein dephosphorylation is mediated by serine/ threonine protein phosphatases, of which type 2A protein phosphatases along with protein phosphatase 1, contr ibute approximately 90%. Currently, the role(s) of type 2A protein phosphatases and their regulation by alpha4 in the heart is poorly defined and requires detailed investigation. In this study, quantitative PCR analysi s demonstrated that PP2ACβ mRNA was most abundant in H9c2 cardiomyocytes and neonatal rat ventricular myocytes (NRVM) whilst, in adult rat ventricular myocytes (ARVM), PP2ACα mRNA was the most abundantly transcribed. Surprisingly, immunoblotting analysis, using catalytic subunit-specific antibodies, identified the expression of all type 2A protein phosphatase catalytic subunits in H9c2 cardiomyocytes and NRVM, however, ARVM only expressed PP2AC and PP6C protein. PP4C protein expression was only detectable in ARVM following proteasomal inhibition with compound MG132. Using siRNA to selectively knockdown type 2A protein phosphatase catalytic subunits, it was revealed that PP2ACα alone dephosphorylates CaV1.2-Ser1928. The data also suggested that PP2ACα, PP2ACβ and PP4C dephosphorylate phospholemman at both Ser63 and Ser68 in cardiomyocytes. siRNA-mediated knockdown of alpha4 protein expression rapidly reduced the expression of all type 2A catalytic subunits. Interestingly, expression of both PP2AC and alpha4 protein expression was elevated in pressure overload-induced left ventricular (LV) hypertrophy. Even though PP6C expression was unchanged, expression of PP6C regulatory subunits (i) SIT4-associated protein 1 (SAP1) and (ii) ankyrin repeat domain (ANKRD) 28 and 44 proteins were upregulated, whereas SAP2 expression was downregulated in hypertrophied LV tissue. Co-immunoprecipitation experiments revealed that the cellular association between alpha4 protein and PP2AC or PP6C subunits was either unchanged or reduced in hypertrophied LV tissue, respectively. Exposure of cardiomyocytes to hydrogen peroxide increased levels of H2AX phosphorylation (γH2AX), indicating hydrogen peroxide-induced DNA damage, which was unaffected by the knockdown of PP6C, however, levels of both total H2AX and γH2AX were diminished by the knockdown of alpha4 protein. The novel findings in this study collectively, demonstrate the differences in th e expression, stability, substrate specificity and altered alpha4-mediated regulation of the type 2A protein phosphatases in normal and hypertrophied myocardium and provide new insights into the molecular mechanisms involved in cardiac calcium homeostasis and DNA repair and thereby help to identify potential targets for the development of new and improved therapies against cardiac pathological hypertrophy.
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Duffin, Christopher John. "The historical roles of mineral materials in folk medicine and the development of the materia medica." Thesis, Kingston University, 2018. http://eprints.kingston.ac.uk/41903/.
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Mineral materials include rocks, minerals, fossils, earths, mineraloids, biogenic skeletal remains and synthetic stones. Each of these classes of material has enjoyed much popularity as supposedly therapeutic medicinal ingredients in the history of pharmacy; many have an unbroken record of use since ancient and classical times. The historical materia medica incorporates minerals that have been made use of in both medical folklore and academic analysis. This thesis presents a body of work which develops examples from each class of mineral material, tries to establish their identities, and explores the evolution of their therapeutic use against the backdrop of changing philosophies in the history of medicine. The most rudimentary use of mineral materials was in a magico-medicinal way as amulets wom for protection against harmful influences which might be expressed in the body as loss of health, and as prophylactics against specific diseases and poisons. Amulets were often worn as pendants, necklaces and rings, or appended to the clothing in some way. The humoral system of Greek medicine saw the health of the body as being a state of balance between the four humours. Humoral imbalance was corrected by, amongst other interventions, the application of medicinal simples or 'Galenicals', which were largely unmodified (other than by trituration) herbal, zoological and mineralogical materials. The choice of simple was determined by the Aristotelian qualities ascribed to them, and their perceived efficacy according to the Doctrine of Signatures. This approach to prescribing practice held sway from classical times until the work of Paracelsus at the beginning of the Scientific Revolution which commended the use of only the active ingredients of a particular simple, separated from the remainder by alchemical means. These iatrochemical preparations permitted dosage standardisation and encouraged a more empirical approach to prescribing practice. The mineral materials most closely examined in this thesis in the context of the evolving materia medica are pumice, gemstones, holed flints, amber, unicom horn, Jews' stones (fossil echinoid spines), Porcupine bezoars, otoliths and synthetic stones. The analyses presented here rely on the study of manuscript, archival, printed and material sources.
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Wood, Tamara Michelle. "Nutritional Assessment of Rural Mossi People in Burkina Faso: A Comparison of Pre- and Post-Harvest Status." UNF Digital Commons, 2000. http://digitalcommons.unf.edu/etd/287.
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The purpose of this study was to compare the nutritional status of a rural population of Mossi people in Burkina Faso during the pre- and post-harvest seasons. Comparisons were made between the sample population and the American population, between the pre- and post-harvest seasons, between males and females in the sample population and between the various age groups in the sample population.
This nutritional assessment consisted of collecting demographical information, anthropometrical measurements such as weight and height, a clinical assessment to evaluate physiological signs of nutritional deficiencies and a food frequency questionnaire to describe the dietary practices of the population. Due to the potential risks of handling human blood, urine and feces, biochemical analyses were not performed in this study. Special attention was given to the nutritional problems most common in Africa: protein energy malnutrition, vitamin A deficiency, iron deficiency and goiter.
Adults in this study had an average body mass index of 19.1, classifying the adult population as "underweight". The population of American adults, however, has a tendency toward a body mass index in the slightly overweight category. The BMI range of adults in the study population was 12.9 to 27.8. A total of 36.9% of the adult population presented with some level of protein energy malnutrition while only 2.7% were slightly obese.
Seventy percent of children were below the 50th percentile on the 2000 Centers for Disease Control weight-for-height growth chart. A third of all children were below the 3rd percentile of weight-for-height. The vast majority of children in this study had a weight-for-height below the median, or "average", American child. The mean percent of median body weight-for-height for the child population in the lean season was 85.2% indicating that the median child in this sample population was mildly wasted. The mean percent of median weight-for-height rose to 94.6% in the post-harvest season indicating that the median child of the sample population was "normal" concerning wasting status.
The results of this study indicate that this rural population of Mossi people was less well-nourished than their American counterpart and that their nutritional status differed based on season (F=[4,177] 4.77, p=.03 for adults and F=[4,51] 8.56, p=.005 for children) but not gender (F=[ 4,177] .04, p=.83 for adults and chi square= 4.37, p=.22, df=3 for children) or age group for adults (r=.l 0, p=.29). In children, nutritional status was based on age group (but contrary to the expected outcome) with prepubescent children having lower weight-for-height percentiles than the under-five population (chi square = 40.34, p=.02, df=24). Nutritional status improved as predicted during the postharvest, or plentiful, season. Due to the lack of biochemical analyses, the potential vitamin and mineral deficiencies indicated in the brief physical examination were not confirmed. Vitamin A deficiency was the most likely nutrient deficiency; symptoms occurred in 51% of the population, primarily in adults and older children. PEM, although indicated by the anthropometric measures to affect 37.1% of the adult population and 55.4% of the child population, did not greatly manifest itself in clinical symptoms. The incidence of iron deficiency anemia was also relatively low with only 7% of the population presenting with pale conjunctivae, a potential, but non-specific sign of iron deficiency anemia. The goiter rate was also very low with only two cases occurring during the post-harvest season.
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Santana, Sondra Michelle Phipps. "Practitioners' Use of Clinical Practice Guidelines: An Evidence-Based Approach." UNF Digital Commons, 2013. http://digitalcommons.unf.edu/etd/462.
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Pre-diabetes is a serious health problem in the United States. Distinguished by plasma glucose levels that are above the normal threshold, patients with pre-diabetes are 10 times more likely to develop type 2 diabetes. Patients with pre-diabetes suffer the same complications as patients with diabetes including diabetic retinopathy, nephropathy, and microalbuminuria.
There is considerable evidence to support the idea that early identification and aggressive treatment of pre-diabetes has the potential to delay disease progression. The American Diabetes Association’s clinical practice guideline recommends management of with lifestyle modification and metformin for patients who are at risk for developing type 2 diabetes. The purpose of this project was to evaluate the implementation of the 2012 ADA clinical practice guidelines regarding the management of patients with pre-diabetes by the health care providers at a volunteer-run clinic located in a large metropolitan area in the southeastern United States.
This study, even with a small sample size (n=26) revealed that the providers at the clinic had not implemented the 2012 ADA clinical practice guidelines. Clinical practice guidelines promote health care interventions that have proven benefits and improve the consistency of care provided to patients. The greatest benefits of implementing clinical practice guidelines for patients with pre-diabetes are early diagnosis and aggressive disease management. This would improve patient outcomes and in the long run, decrease the cost of medical care.
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Belo, Ana Catarina Freitas. "Clinical and forensic aspects of ibogaine." Master's thesis, 2020. https://hdl.handle.net/10216/128920.
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A ibogaína é um alcaloide indólico derivado da planta africana Tabernanthe iboga e usado no tratamento do abuso de substâncias psicoativas. Foi realizada uma pesquisa extensiva acerca do contexto histórico e dos aspetos clínicos e forenses. Atualmente, o consumo de ibogaína é ilegal em múltiplos países devido às suas propriedades alucinogénicas e efeitos cardiotóxicos, tendo sido demonstrada a sua atividade em diversos mecanismos no sistema nervoso central e no coração. A maioria dos mecanismos parece explicar a eficácia na diminuição de comportamentos aditivos e de sintomas de abstinência de opioides. No entanto, está descrita a associação da ibogaína a mais de 30 mortes desde 1990 e a provável relação com os efeitos em recetores cardíacos. Alguns fatores possivelmente responsáveis pelos efeitos tardios da ibogaína incluem a semivida prolongada do seu metabolito, a noribogaína; a acumulação da ibogaína no tecido adiposo; e a existência de metabolizadores lentos. Desta forma, é necessário aprofundar o estudo dos potenciais benefícios médicos da ibogaína assim como dos seus efeitos adversos.Ibogaine is a natural indole alkaloid derived from the African shrub Tabernanthe iboga used in the treatment of psychoactive substance abuse. There has been made an extensive search regarding ibogaine's historical context, clinical and forensic features. Ibogaine's consumption was made illegal in several countries due to its hallucinogenic and cardiotoxic effects. It has shown to act on a variety of sites in the central nervous system and in the heart. Most of these mechanisms seem to explain ibogaine's efficacy in decreasing drug-seeking behavior and opioid withdrawal symptoms. However, it has been related to more than 30 deaths since 1990 which seem to be caused by the effects in cardiac receptors. Many factors appear to explain ibogaine late effects including the long half-life of its active metabolite, noribogaine; accumulation of ibogaine in adipose tissue; and the existence of poor metabolizers. Therefore, it is necessary to further study the potential medical uses of ibogaine as well as its adverse effects.
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Belo, Ana Catarina Freitas. "Clinical and forensic aspects of ibogaine." Dissertação, 2020. https://hdl.handle.net/10216/128920.
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A ibogaína é um alcaloide indólico derivado da planta africana Tabernanthe iboga e usado no tratamento do abuso de substâncias psicoativas. Foi realizada uma pesquisa extensiva acerca do contexto histórico e dos aspetos clínicos e forenses. Atualmente, o consumo de ibogaína é ilegal em múltiplos países devido às suas propriedades alucinogénicas e efeitos cardiotóxicos, tendo sido demonstrada a sua atividade em diversos mecanismos no sistema nervoso central e no coração. A maioria dos mecanismos parece explicar a eficácia na diminuição de comportamentos aditivos e de sintomas de abstinência de opioides. No entanto, está descrita a associação da ibogaína a mais de 30 mortes desde 1990 e a provável relação com os efeitos em recetores cardíacos. Alguns fatores possivelmente responsáveis pelos efeitos tardios da ibogaína incluem a semivida prolongada do seu metabolito, a noribogaína; a acumulação da ibogaína no tecido adiposo; e a existência de metabolizadores lentos. Desta forma, é necessário aprofundar o estudo dos potenciais benefícios médicos da ibogaína assim como dos seus efeitos adversos.Ibogaine is a natural indole alkaloid derived from the African shrub Tabernanthe iboga used in the treatment of psychoactive substance abuse. There has been made an extensive search regarding ibogaine's historical context, clinical and forensic features. Ibogaine's consumption was made illegal in several countries due to its hallucinogenic and cardiotoxic effects. It has shown to act on a variety of sites in the central nervous system and in the heart. Most of these mechanisms seem to explain ibogaine's efficacy in decreasing drug-seeking behavior and opioid withdrawal symptoms. However, it has been related to more than 30 deaths since 1990 which seem to be caused by the effects in cardiac receptors. Many factors appear to explain ibogaine late effects including the long half-life of its active metabolite, noribogaine; accumulation of ibogaine in adipose tissue; and the existence of poor metabolizers. Therefore, it is necessary to further study the potential medical uses of ibogaine as well as its adverse effects.
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Leitão, Filipa Batista Ferreira. "Clinical findings on chromosome 1 copy number variations." Master's thesis, 2021. https://hdl.handle.net/10216/134521.
Full textAbstract:
Uma grande parte da variabilidade do nosso genoma pode ser atribuída a variações do número de cópias do ADN, nomeadamente deleções e duplicações. A presença destas variações no cromossoma 1, o maior cromossoma humano, é uma causa conhecida de morbilidade. Este estudo tem como objetivo contribuir para o mapa de doenças associadas ao cromossoma 1, através da análise de pacientes com rearranjos neste cromossoma.
Foi feita uma seleção transversal, a partir da base de dados do Departamento de Genética da Faculdade de Medicina da Universidade do Porto, dos pacientes que realizaram estudo genético por array-CGH e que obtiveram como resultado alterações do no cromossoma 1 consideradas patogénicas ou provavelmente patogénicas. Foram avaliados os dados clínicos destes pacientes. As alterações genéticas encontradas foram pesquisadas em bases de dados nacionais e internacionais de referência assim como na literatura para classificação e para permitir o estabelecimento de uma correlação entre o genótipo e o fenótipo.
De um total de 2516 pacientes incluídos na base de dados, identificámos 24 (0.95%) com variantes no cromossoma 1, 9 patogénicas e 15 provavelmente patogénicas. Estas corresponderam a 6,1% (24/392) do total de variantes patogénicas e provavelmente patogénicas incluídas na base de dados. A região 1q21.1 foi a região com mais alterações genéticas associadas, tanto deleções como duplicações, sendo que algumas destas alterações se estendiam até à região 1q21.2.
Este estudo permitiu fortalecer a associação entre alterações genéticas do número de cópias no cromossoma 1 e doenças do neurodesenvolvimento, assim como dismorfismos craniofaciais. Adicionalmente, permitiu reforçar a ideia de que nem sempre será fácil interpretar estas variantes e estabelecer uma associação entre o genótipo e o fenótipo, uma vez que existe um largo espectro entre o que é considerado benigno e o que é claramente patogénico.Copy number variants (CNVs) are a major contribution to genome variability, and the presence of CNVs on chromosome 1 is a known cause of morbidity. The main objective of this study was to contribute for chromosome 1 disease map, through the analysis of patients with chromosome 1 CNVs. A cross-sectional study was performed using the array comparative genomic hybridization (array-CGH) database of the Genetic Department of the Faculty of Medicine. Patients with pathogenic (P) or probably pathogenic (VOUS-PP) CNVs on chromosome 1 were selected for the study. Clinical information was collected for all patients. Databases and related literature were used for genotype-phenotype correlation. From a total of 2516 patients included in the database we identified 24 patients (0.95%) with P (9 patients) or VOUS-PP (15 patients) CNVs on chromosome 1. These CNVs account for 6.1% (24/392 CNVs) of the total P/VOUS-PP CNVs in the database. Most common CNVs found were on 1q21.1-1q21.2 region. This study reinforces the association between chromosome 1 CNVs and neurodevelopmental disorders and craniofacial dysmorphisms. Additionally, it also strengthened the idea that CNVs interpretation is not always a linear task due to the broad spectrum of variants that can be identified between benign and clearly pathogenic CNVs.
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Leitão, Filipa Batista Ferreira. "Clinical findings on chromosome 1 copy number variations." Dissertação, 2021. https://hdl.handle.net/10216/134521.
Full textAbstract:
Uma grande parte da variabilidade do nosso genoma pode ser atribuída a variações do número de cópias do ADN, nomeadamente deleções e duplicações. A presença destas variações no cromossoma 1, o maior cromossoma humano, é uma causa conhecida de morbilidade. Este estudo tem como objetivo contribuir para o mapa de doenças associadas ao cromossoma 1, através da análise de pacientes com rearranjos neste cromossoma.
Foi feita uma seleção transversal, a partir da base de dados do Departamento de Genética da Faculdade de Medicina da Universidade do Porto, dos pacientes que realizaram estudo genético por array-CGH e que obtiveram como resultado alterações do no cromossoma 1 consideradas patogénicas ou provavelmente patogénicas. Foram avaliados os dados clínicos destes pacientes. As alterações genéticas encontradas foram pesquisadas em bases de dados nacionais e internacionais de referência assim como na literatura para classificação e para permitir o estabelecimento de uma correlação entre o genótipo e o fenótipo.
De um total de 2516 pacientes incluídos na base de dados, identificámos 24 (0.95%) com variantes no cromossoma 1, 9 patogénicas e 15 provavelmente patogénicas. Estas corresponderam a 6,1% (24/392) do total de variantes patogénicas e provavelmente patogénicas incluídas na base de dados. A região 1q21.1 foi a região com mais alterações genéticas associadas, tanto deleções como duplicações, sendo que algumas destas alterações se estendiam até à região 1q21.2.
Este estudo permitiu fortalecer a associação entre alterações genéticas do número de cópias no cromossoma 1 e doenças do neurodesenvolvimento, assim como dismorfismos craniofaciais. Adicionalmente, permitiu reforçar a ideia de que nem sempre será fácil interpretar estas variantes e estabelecer uma associação entre o genótipo e o fenótipo, uma vez que existe um largo espectro entre o que é considerado benigno e o que é claramente patogénico.Copy number variants (CNVs) are a major contribution to genome variability, and the presence of CNVs on chromosome 1 is a known cause of morbidity. The main objective of this study was to contribute for chromosome 1 disease map, through the analysis of patients with chromosome 1 CNVs. A cross-sectional study was performed using the array comparative genomic hybridization (array-CGH) database of the Genetic Department of the Faculty of Medicine. Patients with pathogenic (P) or probably pathogenic (VOUS-PP) CNVs on chromosome 1 were selected for the study. Clinical information was collected for all patients. Databases and related literature were used for genotype-phenotype correlation. From a total of 2516 patients included in the database we identified 24 patients (0.95%) with P (9 patients) or VOUS-PP (15 patients) CNVs on chromosome 1. These CNVs account for 6.1% (24/392 CNVs) of the total P/VOUS-PP CNVs in the database. Most common CNVs found were on 1q21.1-1q21.2 region. This study reinforces the association between chromosome 1 CNVs and neurodevelopmental disorders and craniofacial dysmorphisms. Additionally, it also strengthened the idea that CNVs interpretation is not always a linear task due to the broad spectrum of variants that can be identified between benign and clearly pathogenic CNVs.
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Baptista, Pedro Miguel Almeida. "Adult Neurogenesis: Regulation and Possible Functional and Clinical Correlates." Master's thesis, 2018. https://hdl.handle.net/10216/111915.
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Pereira, João Pedro Alves Nunes. "Synthetic cannabinoids: pharmacokinetics, pharmacodynamics and clinical and forensic issues." Master's thesis, 2017. https://hdl.handle.net/10216/104546.
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Baptista, Pedro Miguel Almeida. "Adult Neurogenesis: Regulation and Possible Functional and Clinical Correlates." Dissertação, 2018. https://hdl.handle.net/10216/111915.
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Pereira, João Pedro Alves Nunes. "Synthetic cannabinoids: pharmacokinetics, pharmacodynamics and clinical and forensic issues." Dissertação, 2017. https://hdl.handle.net/10216/104546.
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Oliveira, Raphael da Costa. "Transformation of clinical data from HL7 messages to openEHR compositions." Master's thesis, 2016. https://repositorio-aberto.up.pt/handle/10216/88169.
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Oliveira, Raphael da Costa. "Transformation of clinical data from HL7 messages to openEHR compositions." Dissertação, 2016. https://repositorio-aberto.up.pt/handle/10216/88169.
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Freitas, Marta Catarina Baptista. "Prenatal diagnosis: the clinical usefulness of Array Comparative Genomic Hybridization (aCGH)." Master's thesis, 2017. https://hdl.handle.net/10216/104446.
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Freitas, Marta Catarina Baptista. "Prenatal diagnosis: the clinical usefulness of Array Comparative Genomic Hybridization (aCGH)." Dissertação, 2017. https://hdl.handle.net/10216/104446.
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Luís, Ana Sílvia Pires. "Development of new epigenetic-based biomarkers for renal cell tumors with clinical application." Doctoral thesis, 2017. https://repositorio-aberto.up.pt/handle/10216/108067.
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Luís, Ana Sílvia Pires. "Development of new epigenetic-based biomarkers for renal cell tumors with clinical application." Tese, 2017. https://repositorio-aberto.up.pt/handle/10216/108067.
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Nóbrega, Leandro José Abreu. "The Synthetic Cathinone α-Pyrrolidinovalerophenone (α-PVP): Pharmacokinetic and Pharmacodynamic Clinical and Forensic Aspects." Master's thesis, 2018. https://hdl.handle.net/10216/112227.
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Ferreira, Ana Filipa da Silva. "A systematic review on infliximab and adalimumab drug monitoring: levels, clinical outcomes and assays." Master's thesis, 2017. https://hdl.handle.net/10216/105089.
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Ferreira, Ana Filipa da Silva. "A systematic review on infliximab and adalimumab drug monitoring: levels, clinical outcomes and assays." Dissertação, 2017. https://repositorio-aberto.up.pt/handle/10216/105089.
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Nóbrega, Leandro José Abreu. "The Synthetic Cathinone α-Pyrrolidinovalerophenone (α-PVP): Pharmacokinetic and Pharmacodynamic Clinical and Forensic Aspects." Dissertação, 2018. https://repositorio-aberto.up.pt/handle/10216/112227.
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Moreira, Soraia Celeste Gomes. "Early and mid-term haemodynamic performance and clinical outcomes of aortic bioprosthesis St. Jude Medical Trifecta." Master's thesis, 2017. https://repositorio-aberto.up.pt/handle/10216/106830.
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Rocha, Vânia Patrícia Pinto. "Clinical Utility of Frailty Scales for the Prediction of Postoperative Complications. Systematic Review and Meta-Analysis." Master's thesis, 2017. https://repositorio-aberto.up.pt/handle/10216/107168.
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Moreira, Soraia Celeste Gomes. "Early and mid-term haemodynamic performance and clinical outcomes of aortic bioprosthesis St. Jude Medical Trifecta." Dissertação, 2017. https://repositorio-aberto.up.pt/handle/10216/106830.
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Rocha, Vânia Patrícia Pinto. "Clinical Utility of Frailty Scales for the Prediction of Postoperative Complications. Systematic Review and Meta-Analysis." Dissertação, 2017. https://repositorio-aberto.up.pt/handle/10216/107168.
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Silva, Marta Escobar Dantas da. "Diagnostic accuracy of basic fetal heart examination at 11-13 weeks' gestation of pregnancy." Master's thesis, 2017. https://hdl.handle.net/10216/105450.
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Silva, Marta Escobar Dantas da. "Diagnostic accuracy of basic fetal heart examination at 11-13 weeks' gestation of pregnancy." Dissertação, 2017. https://hdl.handle.net/10216/105450.
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Rocha, João Paulo Pereira da. "Pathological features of risk-reducing gastrectomy specimens from hereditary diffuse gastric cancer patients and implications for clinical management." Master's thesis, 2018. https://hdl.handle.net/10216/114283.
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Estevinho, Maria Manuela Fernandes. "A systematic review and meta-analysis on 6-thioguanine nucleotides levels and clinical remission in inflammatory bowel disease." Master's thesis, 2018. https://hdl.handle.net/10216/112120.
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Rocha, João Paulo Pereira da. "Pathological features of risk-reducing gastrectomy specimens from hereditary diffuse gastric cancer patients and implications for clinical management." Dissertação, 2018. https://hdl.handle.net/10216/114283.
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Estevinho, Maria Manuela Fernandes. "A systematic review and meta-analysis on 6-thioguanine nucleotides levels and clinical remission in inflammatory bowel disease." Dissertação, 2018. https://hdl.handle.net/10216/112120.
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Silva, José Diogo Ramalho e. "Drug-induced potentially fatal arrhythmias and sudden cardiac death: a clinical perspective of long QT, short QT and Brugada syndromes." Master's thesis, 2017. https://hdl.handle.net/10216/104358.
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Silva, José Diogo Ramalho e. "Drug-induced potentially fatal arrhythmias and sudden cardiac death: a clinical perspective of long QT, short QT and Brugada syndromes." Dissertação, 2017. https://hdl.handle.net/10216/104358.
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Ribeiro, Tiago Filipe Carneiro. "Obstructive Sleep Apnea and Cancer: from the basics to the patient." Master's thesis, 2018. https://hdl.handle.net/10216/111945.
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Ribeiro, Tiago Filipe Carneiro. "Obstructive Sleep Apnea and Cancer: from the basics to the patient." Dissertação, 2018. https://hdl.handle.net/10216/111945.
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Hsu, Michael Chih-Yuan. "A co-occurrence framework conceptualized for bridging the gap between basic science, clinical research and clinical practices." Thesis, 2016. https://hdl.handle.net/2144/16817.
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The intellectual impulsiveness of man to understand the unknown and the continual need of the society to improve healthcare have encouraged extensive investigation on numerous and diverse cause-and-effect relationships. The nature of this endeavor, however, renders the inability of investigator at all levels to escape beyond the narrow conceptual boundary described by an early French philosopher as the vicious cycle. To enjoy the theoretically plausible benefits of refined labor division, data-driven healthcare management, and real-time evidence-based practices, it must first be acknowledged that co-occurrence is better than cause-and-effect in explaining how an observation takes place at a particular time. This paper details a co-occurrence framework, and discusses its implications for the global healthcare system.
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Cardoso, Mariana Pinto. "Native Vitamin D in Pre Dialysis Chronic Kidney Disease." Master's thesis, 2018. https://hdl.handle.net/10216/112341.
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Cardoso, Mariana Pinto. "Native Vitamin D in Pre Dialysis Chronic Kidney Disease." Dissertação, 2018. https://hdl.handle.net/10216/112341.
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Simões, Sofia Isabel Santos Silva. "Psychomotor development assessment in pre-schooler children with primary congenital hypothyroidism." Master's thesis, 2021. https://hdl.handle.net/10216/134425.
Full textAbstract:
Introdução: O hipotiroidismo congénito (HC) é a doença neonatal mais comum e a principal causa prevenível e tratável de deficiência intelectual.
Objetivo: O objetivo deste estudo é avaliar o desenvolvimento psicomotor em crianças em idade pré-escolar com HC primário permanente.
Desenho do estudo: Análise retrospetiva de pacientes com HC diagnosticado no rastreio neonatal, entre setembro de 1996 e julho de 2018, e seguidos num hospital terciário do Porto, Portugal, incluídos num estudo transversal. O desenvolvimento psicomotor foi avaliado segundo a escala de desenvolvimento mental de Griffiths (GMDS) ou a escala de inteligência de Wechsler para a idade pré-escolar e primária (WPPSI), entre os 2/3 anos de idade e novamente entre os 4/5 anos de idade, pelo mesmo psicólogo treinado. Os dados relativos à idade ao diagnóstico, niveís de hormona estimulante da tiróide (TSH) ao diagnóstico, dose inicial de levotiroxina, etiologia do HC primário, número de consultas nos primeiros três anos de vida e dose de levotiroxina aquando da avaliação das escalas de desenvolvimento foram recolhidos dos registos clínicos. Défice cognitivo foi definido como quociente intelectual (QI) ≤69.
Resultados: Foram incluídos 62 pacientes no estudo. A mediana dos níveis de TSH ao diagnóstico foi 189,5 [19-727] mU/L. A idade mediana no início da toma de levotiroxina era de 11,5 [5-28] dias com uma dose mediana de 10,5 [7-19] ug/kg/dia. O QI total das crianças com HC entre os 2/3 anos de idade (28,4 ± 9,0 meses) foi de 99,743 ± 1,5 enquanto aos 4/5 anos de idade (61,2 ± 12,1 meses) foi de 103 [73-121]. Nenhum dos pacientes incluídos no estudo tinham QI ≤69.
Conclusão: Nenhum atraso no desenvolvimento psicomotor/deficiência intelectual foi encontrado em crianças em idade pré-escolar com hipotiroidismo congénito tratado.Background: Congenital hypothyroidism (CH) is the most common neonatal disease and the main treatable and preventable cause of intellectual disability. Objective: The aim of this study is to assess psychomotor development in pre-schooler children with permanent primary CH. Design: Retrospective analysis of patients with CH, diagnosed through the neonatal screening program, between September 1996 and July 2018, and followed up in a tertiary hospital in Porto, Portugal, included in a cross-sectional study. Psychomotor development was assessed using Griffiths Mental Development Scale (GMDS) or Wechsler Preschool and Primary Scale of Intelligence (WPPSI) at age 2/3 years old and again at age 4/5 years old, by the same trained psychologist. Data regarding age at diagnosis, thyroid-stimulating hormone (TSH) level at diagnosis, initial levothyroxine dose, etiology of the primary CH, number of appointments in the first three years of life and levothyroxine dose supplementation by the time of the development scale assessment were abstracted from clinical records. Intellectual disability was defined as intellectual quotient (IQ) ≤69. Results: 62 patients were included in the study. Patients' median TSH level at diagnosis was 189,5 [19-727] mU/L. Median age at levothyroxine initiation was 11,5 [5-28] days with a median dose of 10,5 [7-19] ug/kg/day. The total IQ of children with CH at ages 2/3 years old (28,4 ± 9,0 months) was 99,743 ± 1,5 whereas at ages 4/5 years old (61,2 ± 12,1 months) was 103 [73-121]. None of the patients included in the study had IQ ≤69. Conclusion: No impaired psychomotor development/intellectual disability was found in pre-schooler children with treated CH.
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Simões, Sofia Isabel Santos Silva. "Psychomotor development assessment in pre-schooler children with primary congenital hypothyroidism." Dissertação, 2021. https://hdl.handle.net/10216/134425.
Full textAbstract:
Introdução: O hipotiroidismo congénito (HC) é a doença neonatal mais comum e a principal causa prevenível e tratável de deficiência intelectual.
Objetivo: O objetivo deste estudo é avaliar o desenvolvimento psicomotor em crianças em idade pré-escolar com HC primário permanente.
Desenho do estudo: Análise retrospetiva de pacientes com HC diagnosticado no rastreio neonatal, entre setembro de 1996 e julho de 2018, e seguidos num hospital terciário do Porto, Portugal, incluídos num estudo transversal. O desenvolvimento psicomotor foi avaliado segundo a escala de desenvolvimento mental de Griffiths (GMDS) ou a escala de inteligência de Wechsler para a idade pré-escolar e primária (WPPSI), entre os 2/3 anos de idade e novamente entre os 4/5 anos de idade, pelo mesmo psicólogo treinado. Os dados relativos à idade ao diagnóstico, niveís de hormona estimulante da tiróide (TSH) ao diagnóstico, dose inicial de levotiroxina, etiologia do HC primário, número de consultas nos primeiros três anos de vida e dose de levotiroxina aquando da avaliação das escalas de desenvolvimento foram recolhidos dos registos clínicos. Défice cognitivo foi definido como quociente intelectual (QI) ≤69.
Resultados: Foram incluídos 62 pacientes no estudo. A mediana dos níveis de TSH ao diagnóstico foi 189,5 [19-727] mU/L. A idade mediana no início da toma de levotiroxina era de 11,5 [5-28] dias com uma dose mediana de 10,5 [7-19] ug/kg/dia. O QI total das crianças com HC entre os 2/3 anos de idade (28,4 ± 9,0 meses) foi de 99,743 ± 1,5 enquanto aos 4/5 anos de idade (61,2 ± 12,1 meses) foi de 103 [73-121]. Nenhum dos pacientes incluídos no estudo tinham QI ≤69.
Conclusão: Nenhum atraso no desenvolvimento psicomotor/deficiência intelectual foi encontrado em crianças em idade pré-escolar com hipotiroidismo congénito tratado.Background: Congenital hypothyroidism (CH) is the most common neonatal disease and the main treatable and preventable cause of intellectual disability. Objective: The aim of this study is to assess psychomotor development in pre-schooler children with permanent primary CH. Design: Retrospective analysis of patients with CH, diagnosed through the neonatal screening program, between September 1996 and July 2018, and followed up in a tertiary hospital in Porto, Portugal, included in a cross-sectional study. Psychomotor development was assessed using Griffiths Mental Development Scale (GMDS) or Wechsler Preschool and Primary Scale of Intelligence (WPPSI) at age 2/3 years old and again at age 4/5 years old, by the same trained psychologist. Data regarding age at diagnosis, thyroid-stimulating hormone (TSH) level at diagnosis, initial levothyroxine dose, etiology of the primary CH, number of appointments in the first three years of life and levothyroxine dose supplementation by the time of the development scale assessment were abstracted from clinical records. Intellectual disability was defined as intellectual quotient (IQ) ≤69. Results: 62 patients were included in the study. Patients' median TSH level at diagnosis was 189,5 [19-727] mU/L. Median age at levothyroxine initiation was 11,5 [5-28] days with a median dose of 10,5 [7-19] ug/kg/day. The total IQ of children with CH at ages 2/3 years old (28,4 ± 9,0 months) was 99,743 ± 1,5 whereas at ages 4/5 years old (61,2 ± 12,1 months) was 103 [73-121]. None of the patients included in the study had IQ ≤69. Conclusion: No impaired psychomotor development/intellectual disability was found in pre-schooler children with treated CH.
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Ferraz, Maria Beatriz Dias. "Pre and post-intervention modeling to predict funcional outcome three months after an ischemic stroke." Master's thesis, 2019. https://hdl.handle.net/10216/119831.
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Ferraz, Maria Beatriz Dias. "Pre and post-intervention modeling to predict funcional outcome three months after an ischemic stroke." Dissertação, 2019. https://hdl.handle.net/10216/119831.
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