Estudo comparativo das complicações maculares, após facoemulsificação com implante de lente intraocular, entre doentes normais e diabéticos

Introdução: A catarata contribui para cerca de 50% da cegueira mundial e o seu desenvolvimento pode ter etiologia congénita, ou ser secundário à presença de doenças sistémicas como a diabetes mellitus. Atualmente, o tratamento curativo standard para esta patologia consiste na cirurgia de facoemulsificação com implante de lente intraocular, na qual se procede à remoção do cristalino por microfragmentação e aspiração, com consequente implante da lente. Esta abordagem cirúrgica apresenta como principal vantagem a diminuída invasão ocular que se repercute numa baixa incidência de complicações pós-operatórias. Contudo, o desenvolvimento de edema macular cistoide, após a intervenção cirurgia, é uma possível complicação que consiste na acumulação de líquido e formação de cistos no espaço extracelular, secundários às alterações agudas que ocorrem na vasculatura retiniana pelo trauma cirúrgico. Um dos fatores de risco apontados na literatura para o desenvolvimento tanto da catarata como do edema macular é a diabetes mellitus, uma doença crónica e multissistémica que pode comprometer a longo prazo a normal anatomia e fisiologia da retina, pelo desenvolvimento de alterações no endotélio vascular, que se manifestam na forma de retinopatia diabética. Objetivo: Com base nestes conhecimentos, surgiu o interesse em comparar, com recurso à tomografia de coerência ótica, a incidência do desenvolvimento de edema macular entre doentes saudáveis e doentes diabéticos, ambos com diagnóstico de cataratas, após facoemulsificação com implante de lente intraocular. Métodos: Utilizou-se uma amostra de 32 doentes (64 olhos) submetidos a facectomia e seguidos na Clínica Oftalmológica das Antas - Porto. Os indivíduos em estudo foram divididos em 2 grupos: diabéticos sem retinopatia diabética e não diabéticos, formados por, respetivamente, 14 e 18 elementos, os quais se subdividiram por sexo (M/F) e por idades (<65 anos; ≥65 anos). Através dos resultados obtidos por tomografia de coerência ótica realizada aos dois olhos antes e depois da cirurgia, procedeu-se à análise comparativa dos valores da espessura média da depressão foveal (área C) e das áreas periféricas da mácula (áreas A1 a A4 e B1 a B4). Resultados / Conclusão: Os resultados alcançados permitiram concluir que, contrariamente ao que é apresentado em grande parte da bibliografia, o desenvolvimento de edema macular pós-cirúrgico ocorre de forma semelhante nos doentes saudáveis e nos diabéticos. Apesar de o valor médio da espessura macular não ter apresentado diferenças estatisticamente significativas entre estes dois grupos, a espessura média no grupo dos não diabéticos foi ligeiramente superior.Background: Cataract accounts for approximately 50% of global blindness and its development can have congenital etiology, or be secondary to the presence of systemic diseases such as diabetes mellitus. Currently, the standard curative treatment for this condition is phacoemulsification with intraocular lens implantation, in which the lens is removed by microfragmentation and vacuum, with subsequent implantation of the intraocular lens. This surgical approach presents as major advantage its low ocular invasion, which is reflected in a decreased incidence of postoperative complications. However, the development of cystoid macular edema after surgical intervention is a possible complication, and it consists in the accumulation of fluid and cysts formation in the extracellular space, secondary to acute changes that occur in the retinal vasculature by surgical trauma. One of the risk factors mentioned in the literature for the development of both cataracts and macular edema is diabetes mellitus, a chronic and multisystemic illness that may compromise in long-term the normal anatomy and retinal physiology, with consequent development of changes in its vascular endothelium , presented in the form of diabetic retinopathy. Purpose: Based on this acquirement, it became relevant to compare, using the optical coherence tomography, the incidence of developing macular edema between healthy patients and diabetic patients, both diagnosed with cataracts, after phacoemulsification with implantation of intraocular lens. Methods: To do this, we used a sample of 32 patients (64 eyes) who were underwent to phacoemulsification surgery and were followed in Clinica Oftalmológica das Antas - Porto. The studied pacients were divided into two groups: diabetic patients without retinopathy and non-diabetic formed by, respectively, 14 and 18 elements, which are subdivided by gender (M/F) and age ( <65; =65 years). With the results obtained by tomography optical coherence performed to both eyes before and after surgery, we proceeded to the comparative analysis of the average thickness values of foveal depression (region C) and peripheral areas of the macula (areas A1 to A4 and B1 to B4). Results / Conclusions: The obtained results led to the conclusion that, in contrast to what is shown in most of the literature, the incidence of macular edema after surgery is similiar between healthy patients and diabetic ones. Although the average macular thickness have not shown significant estatistic differences between these two groups, the average thickness of the non-diabetic group was slightly higher

Vacinação Anti-Sarampo, Parotidite e Rubéola na criança com alergia ao ovo

Introduction: Egg allergy is one of the most common food allergies in childhood. Administration of the measles, mumps, and rubella (MMR) vaccine is recommended in pediatric age. Despite the presence of traces of egg protein in its composition, the literature recommends MMR vaccine administration regardless of the patient’s past egg allergy history, identifying cases in which the administration should occur in hospital setting. Purpose: To characterize the pediatric population referred to the Allergy and Clinical Immunology Department of Centro Hospitalar Universitário do Porto for MMR vaccine administration and investigate vaccination safety in children with egg allergy or sensitization. Methods: This was a retrospective observational study of clinical records of children with confirmed or suspected egg allergy referred to the Allergy and Clinical Immunology Department for administration of the MMR vaccine between January 1, 2013 and December 31, 2019. Results: Among 60 children studied, 90% presented symptoms upon egg intake, with cutaneous reactions being the most prevalent (67%) and four reported cases of anaphylaxis. Allergy to cow’s milk protein (55%), followed by allergy to other foods (45%) were the most frequent personal histories of allergic diseases. Asthma was identified in 10% of patients and was controlled in all cases. Among children referred for vaccination booster dose, one had had a reaction to the previous MMR vaccine dose. Three children developed late local skin reactions, and one had a late systemic reaction after vaccination. All children had negative oral food challenge. Conclusion: MMR vaccine administration is safe and recommended in pediatric age, regardless of egg allergy history. However, immunization should be performed in hospital setting in children with a history of anaphylaxis due to egg allergy, previous anaphylactic reaction to MMR vaccine or one of its constituents, uncontrolled asthma with documented egg allergy, and uncontrolled asthma with allergy to a previous MMR vaccine dose.info:eu-repo/semantics/publishedVersio

Challenging metastatic breast cancer with the natural defensin PvD1

© The Royal Society of Chemistry 2017Metastatic breast cancer is a very serious life threatening condition that poses many challenges for the pharmaceutical development of effective chemotherapeutics. As the therapeutics targeted to the localized masses in breast improve, metastatic lesions in the brain slowly increase in their incidence compromising successful treatment outcomes overall. The blood-brain-barrier (BBB) is one important obstacle for the management of breast cancer brain metastases. New therapeutic approaches are in demand for overcoming the BBB's breaching by breast tumor cells. In this work we demonstrate the potential dual role of a natural antimicrobial plant defensin, PvD1: it interferes with the formation of solid tumors in the breast and concomitantly controls adhesion of breast cancer cells to human brain endothelial cells. We have used a combination of techniques that probe PvD1's effect at the single cell level and reveal that this peptide can effectively damage breast tumor cells, leaving healthy breast and brain cells unaffected. Results suggest that PvD1 quickly internalizes in cancer cells but remains located in the membrane of normal cells with no significant damage to its structure and biomechanical properties. These interactions in turn modulate cell adhesiveness between tumor and BBB cells. PvD1 is a potential template for the design of innovative pharmacological approaches for metastatic breast cancer treatment: the manipulation of the biomechanical properties of tumor cells that ultimately prevent their attachment to the BBB.This work was supported by a grant from Laço (Portugal). The authors thank Fundação para a Ciência e a Tecnologia (FCT I.P., Portugal) for funding—PTDC/BBB-BQB/1693/2014 and LISBOA-01-0145-FEDER-007391, project co-financed by FEDER through POR Lisboa 2020 - Programa Operacional Regional de Lisboa, Portugal 2020, and by Fundação para a Ciência e a Tecnologia, and also acknowledge financial support from the Brazilian agencies CNPq, CAPES, and FAPERJ (E-26/203.090/2016; E-26/202.132/2015). Tiago N. Figueira, Filipa D. Oliveira and Diana Gaspar acknowledge FCT I.P. for fellowships SFRH/ BD/5283/2013, PD/BD/135046/2017 and SFRH/BPD/109010/2015. Marie Skłodowska-Curie Research and Innovation Staff Exchange (RISE) is also acknowledged for funding: call H2020-MSCA-RISE-2014, Grant agreement 644167, 2015–2019. Prof. Teresa R. Pacheco (FMUL) and Prof. Alexandra Brito (FFUL) are acknowledged for providing the human breast cell lines and HBMEC primary culture, respectively.info:eu-repo/semantics/publishedVersio

Scalable production of human mesenchymal stromal cell-derived extracellular vesicles under serum-/xeno-free conditions in a microcarrier-based bioreactor culture system

Copyright © 2020 de Almeida Fuzeta, Bernardes, Oliveira, Costa, Fernandes-Platzgummer, Farinha, Rodrigues, Jung, Tseng, Milligan, Lee, Castanho, Gaspar, Cabral and da Silva. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Mesenchymal stromal cells (MSC) hold great promise for tissue engineering and cell-based therapies due to their multilineage differentiation potential and intrinsic immunomodulatory and trophic activities. Over the past years, increasing evidence has proposed extracellular vesicles (EVs) as mediators of many of the MSC-associated therapeutic features. EVs have emerged as mediators of intercellular communication, being associated with multiple physiological processes, but also in the pathogenesis of several diseases. EVs are derived from cell membranes, allowing high biocompatibility to target cells, while their small size makes them ideal candidates to cross biological barriers. Despite the promising potential of EVs for therapeutic applications, robust manufacturing processes that would increase the consistency and scalability of EV production are still lacking. In this work, EVs were produced by MSC isolated from different human tissue sources [bone marrow (BM), adipose tissue (AT), and umbilical cord matrix (UCM)]. A serum-/xeno-free microcarrier-based culture system was implemented in a Vertical-WheelTM bioreactor (VWBR), employing a human platelet lysate culture supplement (UltraGROTM-PURE), toward the scalable production of MSC-derived EVs (MSC-EVs). The morphology and structure of the manufactured EVs were assessed by atomic force microscopy, while EV protein markers were successfully identified in EVs by Western blot, and EV surface charge was maintained relatively constant (between −15.5 ± 1.6 mV and −19.4 ± 1.4 mV), as determined by zeta potential measurements. When compared to traditional culture systems under static conditions (T-flasks), the VWBR system allowed the production of EVs at higher concentration (i.e., EV concentration in the conditioned medium) (5.7-fold increase overall) and productivity (i.e., amount of EVs generated per cell) (3-fold increase overall). BM, AT and UCM MSC cultured in the VWBR system yielded an average of 2.8 ± 0.1 × 1011, 3.1 ± 1.3 × 1011, and 4.1 ± 1.7 × 1011 EV particles (n = 3), respectively, in a 60 mL final volume. This bioreactor system also allowed to obtain a more robust MSC-EV production, regarding their purity, compared to static culture. Overall, we demonstrate that this scalable culture system can robustly manufacture EVs from MSC derived from different tissue sources, toward the development of novel therapeutic products.unding received by iBB-Institute for Bioengineering and Biosciences from the Portuguese Foundation for Science and Technology (FCT) (UID/BIO/04565/2020) and through the projects PTDC/EQU-EQU/31651/2017, PTDC/BBB-BQB/1693/2014, and PTDC/BTM-SAL/31057/2017 is acknowledged. Funding received from POR de Lisboa 2020 through the project PRECISE – Accelerating progress toward the new era of precision medicine (Project N. 16394) is also acknowledged. MAF (PD/BD/128328/2017) and FO (PD/BD/135046/2017) acknowledge FCT for the Ph.D. fellowships and DG (SFRH/BPD/109010/2015) for the Post-Doctoral fellowship.info:eu-repo/semantics/publishedVersio

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe

práticas artísticas no ensino básico e secundário

Educação Artística: integrar a inovação. A educação artística apresenta-se como um território a re-cartografar, numa atualização tão rápida quanto aquela que ocorre no campo artístico. As propostas publicadas neste número 11 da Revista Matéria-Prima trazem essa diversidade de abordagens, com novidades conceptuais que estabelecem as devidas relações entre educação e cidadania, participação, sustentabilidade, cultura visual, e também com alguma atenção sobre os debates pós-coloniais e as questões de género. Os 16 artigos reunidos neste 11º número da Revista Matéria-Prima trazem a realidade operativa quer na formação de professores e quer na formulação dos discursos pedagógicos, suas justificações e suas propostas alternativas.As propostas apresentadas devolvem o debate ao terreno, e alargam-no. Provocam as periferias, convocam abordagens diferenciadas sobre o tema da arte e da educação. Em todas elas a proposta de crescimento através da arte, que hoje implica cada vez mais cidadania, crítica, criatividade, interligação, comprometimento, participação.info:eu-repo/semantics/publishedVersio

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation