Stomach cancer incidence in Southern Portugal 1998-2006:a spatio-temporal analysis

Understanding geographical differences in health, particularly in small areas, became a major concern of epidemiologists. Geographical association studies and, more recently, several spatial disease mapping studies have emerged due to the development of new spatial statistical tools. Among other diseases, these methods are being applied to analyze cancer data. However, in this kind of studies, it is of utmost importance to also investigate the influence of temporal variability and that is why spatio-temporal studies became so popular. The aim of this study is to investigate spatial and temporal trends for the incidence of this type of cancer. This retrospective population-based study is based on data on all stomach cancers registered by the Southern Portuguese Cancer Registry (ROR Sul) between 1998 and 2006. Because several studies have underlined the important role of socioeconomic status in cancer risk, information on this variable has also been taken into account. Bayesian hierarchical models were applied to model stomach incidence at a county level and resulting relative risks were used to build risk maps for cancer incidence. Age-Period-Cohort models were also applied.N/

The Lockdown Impact on the Relations between Portuguese Parents and Their 1- to 3-Year-Old Children during the COVID-19 Pandemic

Funding Information: In Portugal, during the first lockdown, with few exceptions, families with children under 12 years old were given a choice. One parent could suspend his/her professional activity temporarily and receive financial support from the National Social Security System []. Most families, especially those with little children, chose this option. Publisher Copyright: © 2022 by the authors.Many countries have applied mandatory confinement measures in response to the COVID-19 pandemic, such as school and kindergarten closures, which confined families to their homes. The study concerns the impacts of the first COVID-19 lockdown on the relationships between Portuguese parents and their children, in a non-clinical population composed of fathers and mothers of children between the ages of 12 months and 3 years and 364 days. An online questionnaire (set by the research team) and the Parenting Daily Hassles Scale (PDHS) concerning the confinement period were applied between 17 June and 29 July 2020. To assess the impacts of the lockdown, outcomes regarding the impacts perceived by the parents, the potential regression in the development of children, and the willingness to promote changes in family routines in the future, were considered. Of the total sample (n = 1885), 95.4% of the parents (n = 1798) said that, after confinement, the relationship with their children had improved or remained similar to the pre-confinement period; 97.3% (n = 1835) noticed positive changes in the development of their children, and 63.7% (n = 1200) noted that the relationships with their children during the confinement period would lead to some changes in family routines in the future. Multivariate regression analyses showed that most of the sociodemographic variables chosen were not associated with the outcomes. However, significant levels of pressure over parenting and parental overload (reported by high scores in the PDHS intensity and frequency scales), challenging behaviors of the children, and the impacts they had on parental tasks had negative influences on the studied outcomes. On the contrary, the number of adults living with their children, the perceptions regarding the development of their children, and sharing new experiences with them were significant factors for positively-perceived impacts on the relationships between them or in the desire to bring about changes in family routines in the future. The impacts of the lockdown on the relationships between parents and children aged between 1 and 3 years old were more dependent on relational aspects and on the parents’ sense of competence in exercising parental functions. We conclude that, despite the increased demands imposed by the lockdown, nearly all of the parents evaluated the quality of the relationship with their children as positive after this period.publishersversionpublishe

The Impact of Ischemia Assessed by Magnetic Resonance on Functional, Arrhythmic, and Imaging Features of Hypertrophic Cardiomyopathy

Funding: LL is supported by an MRC UK clinical academic partnership award (CARP) MR/T005181/1.publishersversionpublishe

Sobrevivência relativa do cancro colo-rectal e do estômago no sul de Portugal

A análise de sobrevivência é de importância ímpar na área das Ciências Biomédicas, em particular na oncologia onde constitui um instrumento de monitorização das atividades de controlo do cancro. Dado que a morte de um doente poderá ficar a dever-se a outras causas que não o cancro e que a causa específica de morte pode ser desconhecida, foi proposta uma medida objetiva da sobrevivência designada por sobrevivência relativa, no sentido de identificar qual a contribuição da neoplasia em si para a sobrevivência. Não dependendo da causa específica de morte, esta é uma medida útil na monitorização da sobrevivência, permitindo comparações entre grupos étnicos, regiões e registos de cancro de base populacional. Com base nos casos diagnosticados entre 1998 e 2006, registados pelo Registo Oncologico Regional Sul (ROR-Sul), o presente estudo tem como objetivo estimar a sobrevivência relativa considerando 11859 e 21575 doentes diagnosticados com cancro do estômago e colo-rectal, respetivamente. Foi considerado um período de follow-up de cinco anos. Procurar-se- ́a identificar a existência de diferenças significa- tivas na sobrevivência relativa quanto ao tipo de neoplasia, idade, género e região geográfica.info:eu-repo/semantics/publishedVersio

Therapeutic profile of orphan medicines

Purpose To characterise the therapeutic profile of orphan medicines. Materials and Methods A cross-sectional study was performed during 2 months in a convenience sample of seven hospital pharmacy services, in the region of Lisbon. Data were collected, from pharmaceutical service's records. Results A total of 18 orphan medicines, were dispensed to 355 patients with rare diseases. Most patients were adults (76.4%). Premature and neonates accounted with 50.0% of the paediatric patients. Differences were not found between the proportion of male and female patients across age groups (p = 0.762). Only 18.3% were inpatients. A high proportion of paediatric inpatients (58.3%) were seen in relation to adult inpatients (5.9%) (P = 0.001). In general, anti-neoplastic and immunomodulating agents for rare cancers were the most frequent dispensed medicines (51.3%). In relation to paediatrics, Caffeine Citrate for primary apnoea of premature newborns had the higher frequency distribution (57.1%). Five (71.4%) medicines dispensed for paediatrics, do not have market authorisation and the remaining (28.6%) were used off-label. For pulmonary arterial hypertension 19 of 27 patients (70.3%) were treated with Bosentan. According to evidence-based clinical practice guidelines, Bosentan has a good level of evidence and substantial benefit: grade of recommendation A. Conclusions Most orphan medicines dispensed to paediatrics and adults were not licensed. A special pharmacovigilance program and a risk management plan through the entire life cycle should be implemented, towards effectiveness and safety of orphan medicines. Copyright (c) 2006 John Wiley & Sons, Ltd

HLA Allele and Haplotype Frequencies of the Portuguese Bone Marrow Donors Registry

Genes in human leucocyte antigens (HLA) System are important in the study of autoimmune diseases and responsible for the rejection of transplants of organs and tissues. HLA genes are part of the human major histocompatibility complex (MHC) which is characterized by the presence of several multigene families, extensive polymorphism at many loci and significant linkage disequilibrium between alleles at particular loci. We analysed HLA-A,-B,-DRB1 locus phenotypes through a sample of 1,021 subjects that were randomly selected among the volunteers recruited by the Portuguese Bone Marrow Donors Registry (Cedace) in order to evaluate allele, gene, haplotype and phenotype frequencies. Allelic frequencies in each of the studied locus were obtained by direct counting. Maximum-likelihood haplotype frequencies were estimated using an expectation-maximization (EM) algorithm [2]. Locus phenotype and gene relative frequencies were estimated according to Baur and Danilov [1]. Hardy–Weinberg equilibrium were tested. The data presented is a definition of HLA genetic repertoire of Cedace with relevance on the strategic management for the increase of a more diverse register with clinical utility.info:eu-repo/semantics/publishedVersio

Colorectal cancer incidence: a spatio-temporal analysis in Southern Portugal 1998-2006

Investigate the influence of geographical environment in colorectal cancer (CRC) incidence in Southern Portugal. Due to the important role of socioeconomic status in the risk of CRC, this variable has also been taken into account.info:eu-repo/semantics/publishedVersio

Evolution of resting energy expenditure, respiratory quotient, and adiposity in infants recovering from corrective surgery of major congenital gastrointestinal tract anomalies: a cohort study

This cohort study describes the evolution of resting energy expenditure (REE), respiratory quotient (RQ), and adiposity in infants recovering from corrective surgery of major congenital gastrointestinal tract anomalies. Energy and macronutrient intakes were assessed. The REE and RQ were assessed by indirect calorimetry, and fat mass index (FMI) was assessed by air displacement plethysmography. Longitudinal variations over time are described. Explanatory models for REE, RQ, and adiposity were obtained by multiple linear regression analysis. Twenty-nine infants were included, 15 born preterm and 14 at term, with median gestational age of 35.3 and 38.1 weeks and birth weight of 2304 g and 2935 g, respectively. In preterm infants, median REE varied between 55.7 and 67.4 Kcal/kg/d and median RQ increased from 0.70 to 0.86-0.92. In term infants, median REE varied between 57.3 and 67.9 Kcal/kg/d and median RQ increased from 0.63 to 0.84-0.88. Weight gain velocity was slower in term than preterm infants. FMI, assessed in a subset of 15 infants, varied between a median of 1.7 and 1.8 kg/m2 at term age. This low adiposity may be related to poor energy balance, low fat intakes, and low RQ¸ that were frequently recorded in several follow-up periods.info:eu-repo/semantics/publishedVersio

Cystatin C as a Marker of Acute Kidney Injury in the Emergency Department

Background and objectives: The diagnosis of acute kidney injury (AKI) is usually based on changes in serum creatinine, which is a poor marker of early renal dysfunction. The discriminative and predictive abilities of serum and urinary cystatin C were examined for the prediction of AKI

Higher mineralized bone volume is associated with a lower plain X-Ray vascular calcification score in hemodialysis patients.

In dialysis patients, there is an increasing evidence that altered bone metabolism is associated with cardiovascular calcifications. The main objective of this study was to analyse, in hemodialysis patients, the relationships between bone turnover, mineralization and volume, evaluated in bone biopsies, with a plain X-ray vascular calcification score.In a cross-sectional study, bone biopsies and evaluation of vascular calcifications were performed in fifty hemodialysis patients. Cancellous bone volume, mineralized bone volume, osteoid volume, activation frequency, bone formation rate/bone surface, osteoid thickness and mineralization lag time were determined by histomorphometry. Vascular calcifications were assessed by the simple vascular calcification score (SVCS) in plain X-Ray of pelvis and hands and, for comparison, by the Agatston score in Multi-Slice Computed Tomography (MSCT).SVCS≥3 was present in 20 patients (40%). Low and high bone turnover were present in 54% and 38% of patients, respectively. Low bone volume was present in 20% of patients. In multivariable analysis, higher age (p = 0.015) and longer hemodialysis duration (p = 0.017) were associated with SVCS≥3. Contrary to cancellous bone volume, the addition to this model of mineralized bone volume (OR = 0.863; 95%CI: 0.766, 0.971; p = 0.015), improved the performance of the model. For each increase of 1% in mineralized bone volume there was a 13.7% decrease in the odds of having SVCS≥3 (p = 0.015). An Agatston score>400 was observed in 80% of the patients with a SVCS≥3 versus 4% of patients with a SVCS<3, (p<0.001).Higher mineralized bone volume was associated with a lower plain X-ray vascular calcification. This study corroborates the hypothesis of the existence of a link between bone and vessel and reinforces the clinical utility of this simple and inexpensive vascular calcification score in dialysis patients