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Pereira C.S.,University of Porto | Azevedo O.,Centro Hospitalar Do Alto Ave | Maia M.L.,University of Porto | Dias A.F.,University of Porto | And 3 more authors.
Molecular Genetics and Metabolism | Year: 2013

Fabry disease is a lysosomal storage disease belonging to the group of sphingolipidoses.In Fabry disease there is accumulation of mainly globotriaosylceramide due to deficiency of the lysosomal enzyme α-galactosidase A. The lysosome is an important compartment for the activity of invariant natural killer T (iNKT) cells. iNKT cells are lipid-specific T cells that were shown to be important in infection, autoimmunity and tumor surveillance. In several mouse models of lysosomal storage disorders there is a decrease in iNKT cell numbers. Furthermore, alterations on iNKT cell subsets have been recently described in the Fabry disease mouse model. Herein, we analyzed iNKT cells and their subsets in Fabry disease patients. Although there were no differences in the percentage of iNKT cells between Fabry disease patients and control subjects, Fabry disease patients presented a reduction in the iNKT CD4+ cells accompanied by an increase in the iNKT DN cells. Since iNKT cell subsets produce different quantities of pro-inflammatory and anti-inflammatory cytokines, we analyzed IFN-γ and IL-4 production by iNKT cells of Fabry disease patients and mice.We found a significant reduction in the production of IL-4 by mice splenic iNKT cells and human iNKT cell subsets, but no significant alterations in the production of IFN-γ. Altogether, our results suggest a bias towards a pro-inflammatory phenotype in Fabry disease iNKT cells. © 2013 Elsevier Inc. Source


Ferreira M.,Centro Hospitalar Do Alto Ave | Santos P.,Escola Superior de Saude e Tecnologia do Porto
Acta Medica Portuguesa | Year: 2011

Background: Stress urinary incontinence (SUI) is involuntary leakage from effort or exertion or from sneezing or coughing and it is usually related to increased urethral mobility and/or poor intrinsic sphincter function. Pelvic floor muscle training (PFMT) has principally been recommended in the management of SUI. The aims of PFMT are to improve pelvic organ support (bladder, bladder neck, and urethra) and increase intraurethral pressure during exertion. The PFMT programmes are prescribed to increase strength, endurance and coordination muscle. Objectives: To determine the effects of pelvic floor muscle training in the management of female stress urinary incontinence. The following hypothesis was tested: • What is the evidence for PFMT, either alone or in combination with adjunctive therapies? • What is the evidence for different types of PFMT? • What is the length of treatment and number of PFMT? Material e Methods: Types of studies: randomised controlled trials and quasirandomised studies were included. Searches of MEDLINE, PUBMED, COCHRANE, PEDro e SCOPUS review articles published between 1999-2009. Types of participants: all women with stress urinary incontinence and diagnosed on the basis of symptoms, signs, or urodinamic evaluation. Other forms of controlled clinical trial were excluded, for example whose symptoms might be due to significant factors outside the urinary tract (neurological disorders, cognitive impairments, lack of independent mobility). Types of interventions: PFMT was defined as a programme of repeated voluntary pelvic floor muscle contraction and with or without supervised by health care professional. All studies were eligible for inclusion if there was at least one arm with a PFMT protocol, alone or together with other adjunctive therapies (biofeedback, electrical stimulation or vaginal weights) compared with or without control group. Types of outcome measures: The outcomes of interest were symptomatic cure and cure/improvement; symptom and condition specific quality of life assessment, quantification of leakage episodes; measures of pelvic floor muscle contraction. Results: Nineteen studies met the inclusion criteria. The review found consistent evidence from of high quality randomised controlled trials, that PFMT alone and in combination with adjunctive therapies (biofeedback and electrical stimulation) was effective treatment for women with SUI with of «cure» and «cure/improvement» up to 70% and 97% respectively. Conclusions: Based on the few data available there is strong evidence for the efficacy of physical therapy for the treatment for SUI in women but further studies are needed to evaluate the optimal training protocol and length of treatment. © 2011 CELOM. Source


Pereira V.H.,University of Minho | Pereira V.H.,PT Government Associate Laboratory | Pereira V.H.,Centro Hospitalar Do Alto Ave | Cerqueira J.J.,University of Minho | And 5 more authors.
International Journal of Cardiology | Year: 2013

Cardiovascular diseases are traditionally related to well known risk factors like dyslipidemia, smoking, diabetes and hypertension. More recently, stress, anxiety and depression have been proposed as risk factors for cardiovascular diseases including heart failure, ischemic disease, hypertension and arrhythmias. Interestingly, this association has been established largely on the basis of epidemiological data, due to insufficient knowledge on the underlying pathophysiologic mechanisms. This review will revisit evidence on the interaction between the cardiovascular and nervous systems, highlighting the perspective on how the central nervous system is involved in the pathogenesis of cardiovascular diseases. Such knowledge is likely to be of relevance for the development of better strategies to treat patients in a holistic perspective. © 2012 Elsevier Ireland Ltd. Source


Lopes E.,Centro Hospitalar Do Alto Ave
The Spanish journal of psychology | Year: 2014

Although several brief sensitive screening tools are available to detect executive dysfunction, few have been developed to quickly assess executive functioning. The INECO Frontal Screening (IFS) is a brief tool which has proved be useful for the assessment of the executive functions in patients with dementia. The aim of this study was to explore whether the IFS is as sensitive and specific as the BADS, a battery designed to assess the dysexecutive syndrome, in schizophrenia. Our sample comprised a group of 34 schizophrenic patients (Mean age = 39.59, DP = 10.697) and 31 healthy controls (Mean age = 35.52, DP = 10.211). To all groups were administered the BADS, Wisconsin Card Sorting Test and IFS. The results suggest that schizophrenic patients performed significantly worse than the control group in all tests (p < .05). The IFS total score was 13.29 for the experimental group and 26.21 for the control group (p < .001). Considering a cut-off of 14 points, the IFS sensitivity was 100% and specificity 56% in detection of executive dysfunction in schizophrenia, compared with the BADS, that if we consider a cut-off of 11 points, was a sensitivity of 100% and a specificity of 50%. Thus, IFS is a brief, sensitive and specific tool for the detection of executive dysfunction in schizophrenia. Source


Pereira C.,University of Minho | Goncalves L.,Centro Hospitalar Do Alto Ave | Ferreira M.,University of Minho
Medical and Biological Engineering and Computing | Year: 2013

Diabetic retinopathy has been revealed as the most common cause of blindness among people of working age in developed countries. However, loss of vision could be prevented by an early detection of the disease and, therefore, by a regular screening program to detect retinopathy. Due to its characteristics, the digital color fundus photographs have been the easiest way to analyze the eye fundus. An important prerequisite for automation is the segmentation of the main anatomical features in the image, particularly the optic disc. Currently, there are many works reported in the literature with the purpose of detecting and segmenting this anatomical structure. Though, none of them performs as needed, especially when dealing with images presenting pathologies and a great variability. Ant colony optimization (ACO) is an optimization algorithm inspired by the foraging behavior of some ant species that has been applied in image processing with different purposes. In this paper, this algorithm preceded by anisotropic diffusion is used for optic disc detection in color fundus images. Experimental results demonstrate the good performance of the proposed approach as the optic disc was detected in most of all the images used, even in the images with great variability. © 2012 International Federation for Medical and Biological Engineering. Source

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