2224 research outputs found
Sort by
Cinema, aesthetics and narrative: Cinema as therapy in substance use disorders
No full textThe use of cinema as a mediator in therapeutic settings has been considered advantageous; however, few works have been published regarding this subject (Dermer & Hutchings, 2000; Egeci & Gencoz, 2017; Hesley & Hesley, 1998; Poltrum, 2009; Schulenberg, 2003; Wolz, 2005). The aim of this work was to explore the therapeutic potential of cinema, especially when applied to the treatment of substance use disorders, and to study the hypothesis that the narrative and aesthetic dimensions of cinema are primordial to its therapeutic properties. The authors first describe their clinical experience with a therapeutic activity specifically conceived to use cinema and its narrative and aesthetic dimensions in a therapeutic way, and then explore the proposed hypothesis by analysing and discussing its results. The authors found that cinema appears as a language of possibilities in the psychotherapeutic setting: not only the movies appeal to the patients' inner world and to the reflection on their previous life experiences, but also provide a safe and creative space for change. Also, movies take the patients to talk and elaborate on their thoughts, feelings and life stories, allowing a different look at the future, acting as inductors of hope. This work may be seen as an innovative contribution to further discussion about the clinical benefits of cinematographic art as a therapeutic mediator.info:eu-repo/semantics/publishedVersio
The Portuguese Registry of Hypertrophic Cardiomyopathy: Overall results
Get PDFINTRODUCTION:
We report the results of the Portuguese Registry of Hypertrophic Cardiomyopathy, an initiative that reflects the current spectrum of cardiology centers throughout the territory of Portugal.
METHODS:
A direct invitation to participate was sent to cardiology departments. Baseline and outcome data were collected.
RESULTS:
A total of 29 centers participated and 1042 patients were recruited. Four centers recruited 49% of the patients, of whom 59% were male, and mean age at diagnosis was 53±16 years. Hypertrophic cardiomyopathy (HCM) was identified as familial in 33%. The major reason for diagnosis was symptoms (53%). HCM was obstructive in 35% of cases and genetic testing was performed in 51%. Invasive septal reduction therapy was offered to 8% (23% of obstructive patients). Most patients (84%) had an estimated five-year risk of sudden death of <6%. Thirteen percent received an implantable cardioverter-defibrillator. After a median follow-up of 3.3 years (interquartile range [P25-P75] 1.3-6.5 years), 31% were asymptomatic. All-cause mortality was 1.19%/year and cardiovascular mortality 0.65%/year. The incidence of heart failure-related death was 0.25%/year, of sudden cardiac death 0.22%/year and of stroke-related death 0.04%/year. Heart failure-related death plus heart transplantation occurred in 0.27%/year and sudden cardiac death plus equivalents occurred in 0.53%/year.
CONCLUSIONS:
Contemporary HCM in Portugal is characterized by relatively advanced age at diagnosis, and a high proportion of invasive treatment of obstructive forms. Long-term mortality is low; heart failure is the most common cause of death followed by sudden cardiac death. However, the burden of morbidity remains considerable, emphasizing the need for disease-specific treatments that impact the natural history of the disease.info:eu-repo/semantics/publishedVersio
Abordagem clínica da cirrose hepática: protocolos de atuação
Get PDFCoordenação de: Alexandra Martins, Joana Carvalho e Branco, Jorge ReisN/
Thrombus aspiration in patients with ST-elevation myocardial infarction: results of a national registry of interventional cardiology.
Get PDFBACKGROUND:
We aimed to evaluate the impact of thrombus aspiration (TA) during primary percutaneous coronary intervention (P-PCI) in 'real-world' settings.
METHODS:
We performed a retrospective study, using data from the National Registry of Interventional Cardiology (RNCI 2006-2012, Portugal) with ST-elevation myocardial infarction (STEMI) patients treated with P-PCI. The primary outcome, in-hospital mortality, was analysed through adjusted odds ratio (aOR) and 95% confidence intervals (95%CI).
RESULTS:
We assessed data for 9458 STEMI patients that undergone P-PCI (35% treated with TA). The risk of in-hospital mortality with TA (aOR 0.93, 95%CI:0.54-1.60) was not significantly decreased. After matching patients through the propensity score, TA reduced significantly the risk of in-hospital mortality (OR 0.58, 95%CI:0.35-0.98; 3500 patients).
CONCLUSIONS:
The whole cohort data does not support the routine use of TA in P-PCI, but the results of the propensity-score matched cohort suggests that the use of selective TA may improve the short-term risks of STEMI.info:eu-repo/semantics/publishedVersio
Mutational mechanism for DAB1 (ATTTC)n insertion in SCA37: ATTTT repeat lengthening and nucleotide substitution.
No full textDynamic mutations by microsatellite instability are the molecular basis of a growing number of neuromuscular and neurodegenerative diseases. Repetitive stretches in the human genome may drive pathogenicity, either by expansion above a given threshold, or by insertion of abnormal tracts in nonpathogenic polymorphic repetitive regions, as is the case in spinocerebellar ataxia type 37 (SCA37). We have recently established that this neurodegenerative disease is caused by an (ATTTC)n insertion within an (ATTTT)n in a noncoding region of DAB1. We now investigated the mutational mechanism that originated the (ATTTC)n insertion within an ancestral (ATTTT)n . Approximately 3% of nonpathogenic (ATTTT)n alleles are interspersed by AT-rich motifs, contrarily to mutant alleles that are composed of pure (ATTTT)n and (ATTTC)n stretches. Haplotype studies in unaffected chromosomes suggested that the primary mutational mechanism, leading to the (ATTTC)n insertion, was likely one or more T>C substitutions in an (ATTTT)n pure allele of approximately 200 repeats. Then, the (ATTTC)n expanded in size, originating a deleterious allele in DAB1 that leads to SCA37. This is likely the mutational mechanism in three similar (TTTCA)n insertions responsible for familial myoclonic epilepsy. Because (ATTTT)n tracts are frequent in the human genome, many loci could be at risk for this mutational process.info:eu-repo/semantics/publishedVersio
Impact of organ sparing therapy in penile carcinoma on sexual and erectile function
Get PDFINTRODUCTION:
Penile carcinoma is one of the less frequent tumors of the genitourinary system, however its effect on the patients' sex life and quality of life is of great impact. Studies about the influence on patients' sex life are scarce.
OBJECTIVES:
To characterize sexual activity with penetration of patients with penile carcinoma who underwent different conservative therapeutic approaches and to evaluate pre and post treatment erectile function. Secondarily, to compare the results between the patients who underwent partial penectomy to those subjected to other conservative therapies.
MATERIAL AND METHODS:
Review of patients' records diagnosed with penile carcinoma and observed at the Portuguese Institute of Oncology of Oporto between 2005 and 2015, to obtain demographic, clinical and histopathological data. Telephone interviews for the completion of the International Index of Erectile Function-5 (IIEF-5) questionnaire to patients undergoing treatment in that period.
RESULTS:
16 out of the 107 patients met the inclusion criteria (n=16), with an average IIEF-5 score of 23.44 (10-25), lowering this value to 16.56 (5-25) after therapy, p<0,05. Fifteen out of the 16 patients kept sexual activity (93.8%) and one (6.25%) suspended due to erectile dysfunction. IIEF-5 score after treatment in the subgroup that underwent partial penectomy was lower when compared to the other subgroup of patients subjected to others conservative therapies, without statistical significance.
CONCLUSION:
Although penile carcinoma treatment has an impact in erectile function with statistical significance, the majority of patients keeps an active sexual life with penetration after treatment. It's not possible to conclude that less invasive therapies are associated with better erectile function.info:eu-repo/semantics/publishedVersio
Risk-benefit profile of intensive blood pressure treatment
No full textinfo:eu-repo/semantics/publishedVersio