Browsing by Issue Date, starting with "2024-02-29"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
- The Function of the Ovaries after MenopausePublication . Nunes, Elsa Filipa Henriques Roque; Moutinho, José Alberto FonsecaIntroduction Removal of ovaries and fallopian tubes at the same surgical time as hysterectomy (prophylactic bilateral salpingo-oophorectomy) is a frequent practice performed with the main objective of preventing ovarian cancer. Although there is consensus that prophylactic bilateral oophorectomy in premenopausal women should not be performed in populations at low risk of ovarian cancer, as it has harmful effects on women's health and increases long-term mortality rates, evidence on the effects of postmenopausal prophylactic bilateral oophorectomy are controversial and this procedure remains a regular practice. Some studies have shown that postmenopausal ovaries continue to produce androgens, which may play an important role in cardiovascular health, bone remodeling, sexual function and cognitive function. The association between estrogen deficiency and osteoporosis is well known. New evidence has also revealed a possible impact of androgens on bone mineral density (BMD). In postmenopausal women, combined treatment with testosterone and estrogen was more effective in increasing BMD than estrogen alone. However, although most studies have revealed an association between endogenous androgens and BMD, particularly testosterone, others have not reported such an association. Estrogen deficit is responsible for vulvovaginal atrophy and higher incidence of postmenopausal dyspareunia. Few studies have evaluated the relationship between androgens and sexual function in postmenopausal women. Androgens appear to play a role in maintaining sexual health, and clinical trials have consistently shown that testosterone therapy improves sexual function in women with hypoactive sexual desire. Estrogen plays an essential role in the brain and postmenopausal women with higher levels of estradiol have better global cognitive function, but some studies have revealed contradictory results. Likewise, the influence of androgens on postmenopausal cognitive function is not well understood. A positive association between verbal learning and memory and physiological concentrations of exogenously administered testosterone has been reported. However, other studies have shown that lower levels of endogenous testosterone are associated with improved cognitive function or have shown no association. Taking into account that, with the increase in average life expectancy, the postmenopausal period is getting longer, it is essential to know the impact that the removal of the ovaries can have on the longevity and quality of life of these women. The present study aims to clarify the effect of postmenopausal bilateral oophorectomy on serum levels of steroid hormones and the impact they have on bone mineral density, sexual function and cognitive function in older women. Materials and methods In the period from January 1, 2017 to June 30, 2019, 203 postmenopausal women consented to participate in the study. All had intact ovaries at the time of menopause and none had been on hormone replacement therapy. Other general exclusion criteria were the presence of ovarian pathology, current or previous treatment with corticosteroids, alcoholism, narcotic dependence and chronic liver or kidney disease. Each participant underwent a blood collection and serum measurements of 17bestradiol (E2), dehydroepiandrosterone (DHEA), testosterone and androstenedione were performed using gas chromatography associated with mass spectrometry (GCMS/ MS). Four cross-sectional studies were performed. In the first study, postmenopausal women undergoing hysterectomy for benign conditions were divided into two groups: 18 women undergoing hysterectomy alone and 11 women undergoing hysterectomy with prophylactic bilateral salpingo-oophorectomy. Differences in hormone levels in both groups were determined. In the second study, 68 women aged over 65 years underwent bone osteodensitometry using the dual-energy X-ray absorptiometry (DXA) technique, and associations between hormone levels and T-score values of the lumbar spine and femoral neck were evaluated, controlling for confounding variables. In the third study, which included 84 sexually active women, associations between hormone levels and scores in the domains of female sexual response assessed by the Female Sexual Function Index (FSFI) questionnaire were evaluated, with adjustment for confounding variables. The fourth study included 147 women who completed the Montreal Cognitive Assessment (MoCA) test to assess cognitive function and determined associations between hormone levels and cognitive function parameters (global cognitive function, executive function, visuospatial ability, short-term memory , attention, concentration and working memory, language, orientation in time and space), controlling for confounding variables.
- How to control Polycystic Ovary Syndrome’s symptoms through pharmacological and non-pharmacological approachesPublication . Marques, Ana Sofia da Silva; Martins, Renato Alessandre Silva; Morgado, Marlene MarquesPolycystic Ovary Syndrome (PCOS) is a multisystemic disease highly prevalent in reproductive age women, with a prevalence of 20% (1), with many long-term health consequences. Even though these data are not very cheering, its pathophysiology remains poorly stablished. It seems that hyperandrogenism, hyperinsulinemia, ovarian disfunction, and obesity are involved in its development. The treatment of Polycystic Ovary Syndrome is not fully stablished yet and it depends on a variety of factors, including the patient’s phenotype, concerns, and main goals, approaching the most important symptoms for each patient and its will for pregnancy. Taking this into a count, the treatment includes lifestyle interventions, exercise, supplementation, and pharmacological treatment. Infertility is one of the consequences with the most impact on these women’s lives and their partners. Because of that, more often, these couples feel the need to seek help from Artificial Reproductive Techniques (ART). Even though they can achieve conception, the obstetric risks associated with PCOS remain high, such as early pregnancy loss and preeclampsia (73). There is a vast base of information on PCOS’s treatment which shows evidence for the usage of both pharmacological and non-pharmacological approaches. The reviewed studies lead us to believe that the adoption of an individualized and multidisciplinary treatment based on prevailing signs and symptoms is a pressing issue, including a holistic approach of each case, without discarding any kind of approach. Beside this, it is also necessary to bet on prevention and society’s literacy for the adoption of healthier lifestyles.
- Halstead Category Test (HCT): Impacto da atualização dos estímulos na sua validaçãoPublication . Viegas, Joana Lúcia Choças; Simões, Maria de Fátima de Jesus; Rodrigues, Paulo Joaquim Fonseca da Silva Farinha; Nascimento, Carla Sofia Lucas doO Halstead Category Test é um dos testes que compõe a Bateria de TestesNeuropsicológicos Halstead-Reitan, desenvolvido por Halstead e Reitan nos anos 40doséculo passado (Reitan & Wolfson, 1986). Este teste é amplamente utilizadonaavaliação clínica pois avalia diversas funções executivas, funções essas que estãointimamente ligadas à execução de tarefas da vida diária (Wolsfon e Reitan, 1993). Sendo um teste amplamente estudado, onde existem várias versões do mesmo(desde versões para crianças, versão booklet e computorizada) (Strauss et al., 2006) ecom uma conceção gráfica muito antiquada, este estudo pretende perceber se, comumaatualização dos estímulos para torná-lo mais atraente e subsequentemente suscitaruma maior motivação nos indivíduos que realizaram a prova, se existemdiferenças navalidade do HCT-Versão Computorizada da nova versão, com estímulos modernizados. Após a análise dos dados foi possível comprovar que, sim, existe impacto na validadedo teste, tendo um a de Cronbach (.561) na versão atualizada.
- Leiomiolipoma: Uma variante rara do leiomiomaPublication . Gaspar, Mariana Lino; Martins, Renato Alessandre SilvaO leiomiolipoma uterino é um tumor ginecológico raro, com uma incidência de 0,03% a 0,2%, reconhecido como uma variante do leiomioma. Frequentemente, identificado em mulheres no período pós-menopausa, sem quaisquer queixas, isto dito, doentes assintomáticos. Este tumor é formado por adipócitos maduros e por células musculares lisas, visto que o útero é um órgão, que não é reconhecido como tendo um componente adiposo, torna-se interessante a origem do mesmo. Para além disso, este tumor está frequentemente associado a outras lesões ginecológicas assim como distúrbios metabólicos. O diagnóstico pré-operatório exato é considerado difícil e só é confirmado com a histopatologia. Os principais objetivos da presente dissertação são a reunião das informações atuais sobre o leiomiolipoma uterino, desde a epidemiologia, patogénese, como é feito o diagnóstico, tratamento e o prognóstico, no sentido de uma melhor compreensão deste tumor raro, para em último caso providenciar uma orientação clínica apropriada e assim evitar procedimentos desnecessários, assegurando os melhores resultados para o doente. Neste estudo irá ser referido um caso de um leiomiolipoma uterino diagnosticado no Centro Hospitalar Universitário Cova da Beira (CHUCB), numa mulher idosa, que recorreu ao SU por hemorragia vaginal.
- Rio Acima: Entre o Sonho e o CinemaPublication . Monteiro, Jorge Janai Reis; Nogueira, Luis Carlos da CostaEste relatório descreve, analisa e reflete sobre o processo de conceção e concretização do projeto cinematográfico Rio Acima, curta-metragem realizada no âmbito do mestrado em Cinema da Universidade da Beira Interior. Este filme aborda o mundo dos sonhos e o processo criativo do mesmo foi conduzido por uma atitude inspirada na liberdade do surrealismo. Na primeira parte do documento pode ser encontrada a revisão de literatura, que estabelece a ligação entre o surrealismo, os sonhos e o cinema. Na segunda parte, é descrito o processo criativo do filme, desde a primeira página do guião, passando pela atmosfera visual e sonora adotada, até à criação dos personagens e as decisões de realização. Por último, o lado mais pessoal do relatório está patente na última parte, a qual contém reflexões sobre o filme concluído, não só sobre o processo criativo do cineasta perante a obra, mas também sobre o efeito do processo de criação para o cineasta. Em conclusão, esperamos poder demonstrar a importância da liberdade criativa, enaltecida pelo surrealismo e caraterística dos sonhos, para o processo artístico no estado de vigília.
- The impact of dietary supplements on blood pressure in older adults: A network meta-analysis of randomized controlled trialsPublication . Kujawska, Agnieszka; Bromage, Sabri; Simões, José Augusto Rodrigues; Zupkauskiene, Jurate; McMahon, Nicholas; Zalewski, Pawel; Kujawski, SławomirPurpose The prevalence of hypertension (HTN) increases with age and there is a need for effective, evidence-based treatments for HTN among older adults. The objective of this study was to perform a network meta-analysis to evaluate the effectiveness of different forms of nutritional supplementation on reducing blood pressure in older adults. Methods A systematic review using PubMed and Clinical Key was performed to identify randomized controlled trials (RCTs) evaluating the effects of dietary supplements on blood pressure in adults older than 65 years of age. Network meta-analysis (NMA) was used to compare and rank the effects of different supplements on systolic (sBP), diastolic (dBP), and mean (mBP) blood pressure. Supplements were ranked according to P score. Meta-regressions were conducted to examine whether treatment effects were moderated by baseline BP and supplementation duration. Findings We identified 144 relevant studies in the literature, twelve of which met criteria for inclusion in NMA. The included studies were published between 2003 and 2022. In reducing sBP, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), inorganic nitrates, tart cherry juice, and vitamin D supplementation were more effective than placebo, and the effect of tart cherry juice outranked that of vitamin D, vitamin E, and vitamin K2. In reducing dBP, inorganic nitrates, DHA and EPA, protein, resveratrol, and vitamin D supplementation were more effective than placebo, and the effect of resveratrol outranked that of tart cherry juice, vitamin D, vitamin E, and vitamin K2. However, the effects of tart cherry juice on sBP and resveratrol on dPB were smaller than the pooled effect of placebo, and none of the pairwise differences between the effects of examined supplements were statistically significant. Caution is needed when interpreting these results given concerns about the risk of bias assessed in seven of the twelve studies included in this analysis.