The impact of self-stigma in people with diagnosis of severe mental illness: a cross-sectional pilot study from a community psychiatry unit in Porto, Portugal

"Introduction Self-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal. Objectives In Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels. Methods Fifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values<0.05 were considered significant. Results From the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P<0.001), as well as self-stigma and quality of life (rho=-0.585; P<0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P<0.001) was found. Conclusions This study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.

Seroprevalence of Bordetella pertussis in healthcare workers in a Portuguese tertiary referral hospital

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Astenopia Digital: Estudo do Grupo Português de Ergoftalmologia

INTRODUCTION: Given the increasing use of electronic devices, and the increasing number of complaints with its use, we intend to evaluate the prevalence of manifestations of dry eye and ocular fatigue in a population of individuals, who use the computer daily to perform all their professional tasks, as well as to correlate these complaints with the number of hours of digital use as well as their possible improvement with behavioural measures and use of tear drops. MATERIAL AND METHODS: A total of 77 individuals (154 eyes) were evaluated on two separate days with a 1-month interval. They completed two questionnaires: OSDI and PEG Eye Fatigue. An objective ocular surface assessment was performed: Schirmer test without anesthetic, DR-1a Dry Eye Monitor™, hyperemia evaluation, lacrimal break up, presence of keratitis and lesions in the conjunctiva, as well as near accommodation point and near convergence point. After the first evaluation, the subjects were divided into two groups: group A ( 2 hours of computer working). Some environmental measures to reduce complaints and recommendation of use of artificial tears were explained to the latter. RESULTS: There was a statistically significant difference in the majority of the parameters evaluated in the group B, in relation to the morning period (group A) - tear film (p = 0.032), hyperemia (p < 0.001), BUT (p < 0.001), keratitis (p < 0.001), conjunctival lesion (p = 0.002) and accommodation point (p < 0.001). In the evaluation - one month later - there were no statistically significant differences in any of the parameters analysed in the group A, and in group B there was a decrease in most parameters at the end of that period - Schirmer test (p = 0.005), lacrimal film (p = 0.022), keratitis (p < 0.001), conjunctival lesion (p = 0.005) and fatigue score (p < 0.001). DISCUSSION: It was thus possible to show the appearance of ocular fatigue and ocular surface changes with prolonged use of computers (> 2 hours) as well as a significant improvement in symptomatology (subjective assessment) as well as of ocular surface changes (objective evaluation) with the implementation of postural measures, regular breaks and use of lubricants. This is the first study, to the best of our knowledge, of digital asthenopia in which, in addition to the subjective evaluation, the presence of ocular surface modifications (objective assessment) were evaluated and the respective improvement with the aforementioned ergophthalmological measures were evaluated. CONCLUSION: This survey highlights the increased overall level of awareness that we need to have to face the rapid and wide-scale changes driven by the emergence of digital technology and, more particularly, its impact on user's vision and posture. We concluded that the longer we use the electronic devices (more than two hours) the more severe the complaints and rates of ocular surface changes are. Environmental and ocular strategies can attenuate or even eliminate the discomfort caused by this syndrome, and increase professional performance and quality of life.info:eu-repo/semantics/publishedVersio

Hyperbaric Oxygen Therapy in Retinal Arterial Occlusion: Epidemiology, Clinical Approach, and Visual Outcomes

PURPOSE: To evaluate the efficacy and safety of hyperbaric oxygen therapy (HBOT) in patients with acute retinal artery occlusion (RAO). Secondarily, to analyse the epidemiology and the clinical approach. METHODS: Retrospective study of 13 patients submitted to HBOT between 2013 and 2018. The analysed parameters consisted of: systemic history, time between symptoms onset and treatment, initial approach, number of HBOT sessions, complications of HBOT and best corrected visual acuity-BCVA (of the total sample, central RAO-CRAO-group, and branch RAO-BRAO group). RESULTS: Arterial hypertension was the most prevalent systemic risk factor (53.8%). Initial therapies were 100% normobaric oxygen administration, topical and oral hypotensive medication, eye massage and aspirin. CRAO was observed in 69.2% and BRAO in 30.8% of the cases, with clinically significant visual improvement (a decrease in logMAR of 0.3) in 55.5% and 75%, respectively. Time between symptoms onset and treatment had a median of 9 hours. The median number of HBOT sessions was 7, without complications. CONCLUSIONS: HBOT provide BCVA improvement in patients with RAO, when it is performed in an early time after the symptom onset. It seems to be an effective and safe therapeutic option for a pathology that still remains without approved treatment.info:eu-repo/semantics/publishedVersio

Microbial community dynamics in diesel waste biodegradation using sequencing batch bioreactor operation mode (SBR)

The dynamic of molecular microbial community during diesel waste biodegradation was investigated. The waste was treated in bioreactors operated in sequencing batch operation mode (SBR) in four cycles of 72 h, using optimized setpoints (pH, initial waste load, C:N ratio, aeration). Optimal conditions allowed the system to reach biodegradation of 53.3, 96.0, 76.2 and 75.0% at the end of cycles one, two three and four, respectively. Oxygen uptake rate (OUR) indicated increases in microbial activity from cycle one to cycle two (124.9 to 252.9 mgO2/L/h) and decreases in cycles three and four (120.4 to 108.8 mgO2/L/h, respectively). Investigations of microbial diversity showed changes in the microbial community members at the end of the cycle one. Significant reductions in the relative ecotoxicity were observed beginning with cycle two, and the reductions extended until the end of process. The SBR operation mode proved to be an efficient method for treating the diesel waste, and the process allowed for relevant reductions in the hydrocarbon content of the waste along with an increase in its environmental quality. Changes in the microbial members are evidence of the synergistic action of the microbiota in the process.Key words: Microbial diversity, denaturing gradient gel electrophoresis, sequencing batch, biodegradation

mTOR pathway overactivation in BRAF mutated papillary thyroid carcinoma

CONTEXT: There are several genetic and molecular evidences suggesting dysregulation of the mammalian target of rapamycin (mTOR) pathway in thyroid neoplasia. Activation of the phosphatidylinositol-3-kinase/AKT pathway by RET/PTC and mutant RAS has already been demonstrated, but no data have been reported for the BRAF(V600E) mutation. OBJECTIVE: The aim of this study was to evaluate the activation pattern of the mTOR pathway in malignant thyroid lesions and whether it may be correlated with known genetic alterations, as well as to explore the mechanisms underlying mTOR pathway activation in these neoplasias. RESULTS: We observed, by immunohistochemical evaluation, an up-regulation/activation of the mTOR pathway proteins in thyroid cancer, particularly in conventional papillary thyroid carcinoma (cPTC). Overactivation of the mTOR signaling was particularly evident in cPTC samples harboring the BRAF(V600E) mutation. Transfection assays with BRAF expression vectors as well as BRAF knockdown by small interfering RNA revealed a positive association between BRAF expression and mTOR pathway activation, which appears to be mediated by pLKB1 Ser428, and emerged as a possible mechanism contributing to the association between BRAF mutation and mTOR pathway up-regulation. When we evaluated the rapamycin in the growth of thyroid cancer cell lines, we detected that cell lines with activating mutations in the MAPK pathway show a higher sensitivity to this drug. CONCLUSIONS: We determined that the AKT/mTOR pathway is particularly overactivated in human cPTC harboring the BRAF(V600E) mutation. Moreover, our results suggest that the mTOR pathway could be a good target to enhance therapy effects in certain types of thyroid carcinoma, namely in those harboring the BRAF(V600E) mutation

Hordéolo ou algo mais?

Criança do sexo feminino, caucasiana, 15 anos, com história de hordéolo da pálpebra inferior do olho esquerdo, medicada com antibiótico e corticóide tópico associado a limpeza palpebral, desde há cerca de 4 semanas. Por ausência de melhoria e com crescimento progressivo da lesão, recorreu ao serviço de urgência. Negava outras queixas oftalmológicas ou sistémicas associadas. Ao exame objectivo observou-se tumefação da pálpebra inferior do olho esquerdo, com eritema mas sem dor ou calor à palpação, sem blefarite. Acuidade visual de 10/10 em ambos os olhos, com movimentos oculares mantidos e sem proptose. Reflexo pupilar mantido. Segmento anterior e fundoscopia sem alterações de relevo. As 2 principais hipóteses de diagnósticas foram celulite pré-septal ou rabdomiossarcoma. A TC de órbita revelou lesão infero-medial da órbita esquerda, com componente pré-septal envolvendo a pálpebra inferior e pós-septal, de densidade identifica à dos músculos extra-oculares, sem aparente envolvimento do recto medial e inferior. Foi realizada biópsia excisional e estabeleceu-se o diagnóstico de rabdomiossarcoma do tipo embrionário (T1N0M0). Iniciou tratamento com quimioterapia (ifosfamida, vincristina, doxorubicina) e radioterapia local (40Gy). Após 1 ano, apresenta –se clinicamente estável, sem recidiva local nem complicações oculares, mantendo uma AV de 10/10. Conclusão: O diagnóstico de rabdomiossarcoma deve ser lembrado, pois apesar de raro, é o tumor maligno primário da órbita mais frequente na criança. Na presença de uma massa palpebral de rápido crescimento geralmente indolor e/ou proptose, a hipótese de rabdomiossarcoma orbitário deve ser equacionada. Para se obterem bons resultados terapêuticos do ponto de vista de sobrevida e funcional é essencial um diagnóstico e tratamento precoce

Using zeta-potential measurements to quantify peptide partition to lipid membranes

© The Author(s) 2011. This article is published with open access at Springerlink.com.Open Access: This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.Many cellular phenomena occur on the biomembranes. There are plenty of molecules (natural or xenobiotics) that interact directly or partially with the cell membrane. Biomolecules, such as several peptides (e.g., antimicrobial peptides) and proteins, exert their effects at the cell membrane level. This feature makes necessary investigating their interactions with lipids to clarify their mechanisms of action and side effects necessary. The determination of molecular lipid/water partition constants (Kp) is frequently used to quantify the extension of the interaction. The determination of this parameter has been achieved by using different methodologies, such as UV-Vis absorption spectrophotometry, fluorescence spectroscopy and ζ-potential measurements. In this work, we derived and tested a mathematical model to determine the Kp from ζ-potential data. The values obtained with this method were compared with those obtained by fluorescence spectroscopy, which is a regular technique used to quantify the interaction of intrinsically fluorescent peptides with selected biomembrane model systems. Two antimicrobial peptides (BP100 and pepR) were evaluated by this new method. The results obtained by this new methodology show that ζ-potential is a powerful technique to quantify peptide/lipid interactions of a wide variety of charged molecules, overcoming some of the limitations inherent to other techniques, such as the need for fluorescent labeling.This work was partially supported by project PTDC/QUI/ 69937/2006 from Fundação para a Ciência e Tecnologia-Ministério da Ciência, Tecnologia e Ensino Superior (FCT-MCTES, Portugal), and by Fundação Calouste Gulbenkian (Portugal). JMF and MMD also thank FCT-MCTES for grants IMM/BT/37-2010 and SFRH/BD/41750/2007, respectively

Avaliação e tratamento do doente com acne - Parte II: tratamento tópico, sistémico e cirúrgico, tratamento da acne na grávida, algoritmo terapêutico

O Portuguese Acne Advisory Board (PAAB), grupo de dermatologistas portugueses que, à semelhança de grupos congéneres internacionais, tem dedicado particular atenção à definição de linhas de orientação para o tratamento da acne, pretende que o presente documento constitua uma ferramenta útil na abordagem dos doentes com esta patologia. Elaborou-se um dossier, para educação médica contínua, subdividido em 2 partes: Parte I – etiopatogenia e clínica; Parte II – abordagem terapêutica. Nesta Parte II discute-se a abordagem terapêutica – tópica e sistémica – em cada forma clínica de acne, dando particular ênfase aos retinóides e aos antimicrobianos, e salientam-se as estratégias a adoptar para limitar a crescente resistência bacteriana aos antibióticos. Referem-se as indicações específicas para terapêutica hormonal e analisam-se as particularidades do tratamento da acne na grávida e lactante. Descrevem-se algumas técnicas para correcção das cicatrizes da acne. Por último, publica-se um algoritmo que pretende ilustrar a classificação da acne e definir, para cada tipo clínico, a abordagem terapêutica consensualmente recomendada