Sarcoidosis or Tuberculosis? Difficulties in Diagnosis

A sarcoidose é uma doença multissistémica rara, caracterizada por granulomas não caseosos. A clínica e os testes diagnósticos são pouco sensíveis e específicos, dificultando o diagnóstico diferencial, particularmente com a tuberculose. Relata-se o caso clínico de um rapaz de 17 anos com nódulos cutâneos dolorosos, astenia, hipersudorese e uveíte recorrente com dois anos de evolução. Apresentava prova tuberculínica e interferon gamma release assay positivos, anemia e velocidade de sedimentação elevada, hipergamaglobulinemia, lisozima e enzima de conversão de angiotensina elevadas. A tomografia computorizada torácica mostrava opacidades micronodulares centrilobulares, gânglios mediastinicos e hilares calcificados; a broncofibroscopia e o teste de difusão de monóxido de carbono foram normais. A biópsia de nódulo cutâneo revelou paniculite septolobular. A cintigrafia das glândulas lacrimal e salivar sugeriu sarcoidose. Não se podendo excluir tuberculose concomitante, iniciou antibacilares. Dois meses depois, foram associados prednisolona e metotrexato. Seis meses depois verificou-se remissão dos sintomas e normalização dos exames laboratoriais. Este caso mostra as dificuldades no diagnóstico de sarcoidose e tuberculose na ausência dos achados microbiológicos e histológicos típicos e a possibilidade da coexistência destas entidades.info:eu-repo/semantics/publishedVersio

Influence of P53 on the radiotherapy response of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and it has a poor prognosis and few therapeutic options. Radiotherapy is one of the most effective forms of cancer treatment, and P53 protein is one of the key molecules determining how a cell responds to radiotherapy. The aim of this study was to determine the therapeutic efficacy of iodine-131 in three human HCC cell lines

What attributes do patients prefer in a family physician? A cross-sectional study in a northern region of Portugal

Objectives: To determine which modifiable and non-modifiable attributes patients prefer in a family physician, as well as to analyse participants’ characteristics associated with their choices. Design: Cross-sectional study. Setting: Family healthcare units (FHU) in the city of Braga and Barcelos (Northern Portugal). Participants: Adults aged 18 years or more, enrolled in the selected FHU. Main outcome measures: The preferred attributes were assessed with a questionnaire delivered in the FHU. These attributes included gender, age and nationality and the importance of being Portuguese, of greeting with a handshake, of welcoming in the waiting area, of using an identification badge and of wearing a white coat. Results: A total of 556 questionnaires were included in the analysis; 66% and 58% of the participants had no preference for the gender or age of the family physician, respectively. Using a multinomial logistic regression, male participants were 3.8 times more likely to have a preference for a male physician than having no preference, in comparison to female participants (OR 3.864, 95% CI 1.96 to 7.61). More than 69% of the participants considered greeting with a handshake, using an identification badge and wearing a white coat important or very important. There was a statistically significant association between being Portuguese and the major importance given to the use of an identification badge (β=0.68, 95% CI 0.23 to 1.12). Conclusions: Our data show that modifiable attributes of the family physician (greeting, presence of an identification badge and wearing a white coat) are important for patients. Potential changes in family physician attitude in consultation could ultimately affect patient–physician relationship.The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors

Deriving phytoplankton size classes from satellite data: Validation along a trophic gradient in the eastern Atlantic Ocean

In recent years, the global distribution of phytoplankton functional types (PFT) and phytoplankton size classes (PSC) has been determined by remote sensing. Many of these methods rely on interpretation of phytoplankton size or type from pigment data, but independent validation has been difficult due to lack of appropriate in situ data on cell size. This work uses in situ data (photosynthetic pigments concentration and cell abundances) from the north-east Atlantic, along a trophic gradient, sampled from 2005 to 2010, as well as Atlantic Meridional Transect (AMT) data for the same region, to test a previously developed conceptual model, which calculates the fractional contributions of pico-, nano- and micro-plankton to total phytoplankton chlorophyll biomass (Brewin et al., 2010). The application of the model proved to be successful, as shown by low mean absolute error between data and model fit. However, regional values obtained for the model parameters had some effect on the relative distribution of size classes as a function of chlorophyll-a, compared with the results according to the original model. The regional parameterisation yielded a dominance of micro-plankton contribution for chlorophyll-a concentrations greater than 0.5 mg m− 3, rather than from 1.3 mg m− 3 in the original model. Intracellular chlorophyll-a (Chla) per cell, for each size class, was computed from the cell enumeration results (microscope counts and flow cytometry) and the chlorophyll-a concentration for that size class given by the model. The median intracellular chlorophyll-a values computed were 0.004, 0.224 and 26.78 pg Chla cell− 1 for pico-, nano-, and micro-plankton respectively. This is generally consistent with the literature, thereby providing an indirect validation of the method based on pigments to assign size classes. Using a satellite-derived composite image of chlorophyll-a for the study area, a map of cell abundance was generated based on the computed intracellular chlorophyll-a for each size-class, thus extending the remote-sensing method for mapping size classes of phytoplankton from chlorophyll-a concentration to mapping cell numbers in each class. The map reveals the ubiquitous presence of pico-plankton, and shows that all size classes are more abundant in more productive areas

Effects of external nutrient sources and extreme weather events on the nutrient budget of a Southern European coastal lagoon

The seasonal and annual nitrogen (N), phosphorus (P), and carbon (C) budgets of the mesotidal Ria Formosa lagoon, southern Portugal, were estimated to reveal the main inputs and outputs, the seasonal patterns, and how they may influence the ecological functioning of the system. The effects of extreme weather events such as long-lasting strong winds causing upwelling and strong rainfall were assessed. External nutrient inputs were quantified; ocean exchange was assessed in 24-h sampling campaigns, and final calculations were made using a hydrodynamic model of the lagoon. Rain and stream inputs were the main freshwater sources to the lagoon. However, wastewater treatment plant and groundwater discharges dominated nutrient input, together accounting for 98, 96, and 88 % of total C, N, and P input, respectively. Organic matter and nutrients were continuously exported to the ocean. This pattern was reversed following extreme events, such as strong winds in early summer that caused upwelling and after a period of heavy rainfall in late autumn. A principal component analysis (PCA) revealed that ammonium and organic N and C exchange were positively associated with temperature as opposed to pH and nitrate. These variables reflected mostly the benthic lagoon metabolism, whereas particulate P exchange was correlated to Chl a, indicating that this was more related to phytoplankton dynamics. The increase of stochastic events, as expected in climate change scenarios, may have strong effects on the ecological functioning of coastal lagoons, altering the C and nutrient budgets.Portuguese Science and Technology Foundation (FCT) [POCI/MAR/58427/2004, PPCDT/MAR/58427/2004]; Portuguese Science and Technology Foundation (FCT

Listeria monocytogenes induces host DNA damage and delays the host cell cycle to promote infection

Listeria monocytogenes (Lm) is a human intracellular pathogen widely used to uncover the mechanisms evolved by pathogens to establish infection. However, its capacity to perturb the host cell cycle was never reported. We show that Lm infection affects the host cell cycle progression, increasing its overall duration but allowing consecutive rounds of division. A complete Lm infectious cycle induces a S-phase delay accompanied by a slower rate of DNA synthesis and increased levels of host DNA strand breaks. Additionally, DNA damage/replication checkpoint responses are triggered in an Lm dose-dependent manner through the phosphorylation of DNA-PK, H2A.X, and CDC25A and independently from ATM/ATR. While host DNA damage induced exogenously favors Lm dissemination, the override of checkpoint pathways limits infection. We propose that host DNA replication disturbed by Lm infection culminates in DNA strand breaks, triggering DNA damage/replication responses, and ensuring a cell cycle delay that favors Lm propagation.We thank AFCU and ALM facilities (IBMC), T Duarte (IBMC), G Almeida, and R Guimarães (ESB) for technical support, M Moroso for the LmΔinlB strain and members of Maiato’s and Sunkel’s lab (IBMC) for fruitful discussions. This work was funded by the Fundo Europeu de Desenvolvimento Regional (FEDER) through the Operational Competitiveness Programme (COMPETE) and by National funds through FCT (Fundação para a Ciência e Tecnologia) under the projects (PTDC/BIA-BCM/111215/2009FCOMP-01-0124- FEDER-014178, ERANet-Pathogenomics LISTRESS ERAPTG/0003/2010); Project “NORTE-07-0124-FEDER-000002- Host-Pathogen Interactions” co-funded by Programa Operacional Regional do Norte (ON.2, O Novo Norte), under the Quadro de Referência Estratégico Nacional (QREN), through the FEDER and by FCT. E.L., A.C.C., and R.P. were supported by FCT grants (SFRH/BPD/62926/2009, SFRH/BPD/88769/2012 and SFRH/BD/89542/2012, respectively), L.C. by ERASMUS program and S.S. by Ciência 2008 program (COMPETE, POPH, and FCT)

Incident risk factors as predictors of HIV seroconversion in the Lisbon cohort of men who have sex with men: first results, 2011-2014

HIV incidence in men who have sex with men (MSM) is increasing in western countries, including Portugal. We aimed to estimate HIV incidence and to assess how individual short-term changes in exposures over time predict seroconversion. We evaluated participants of an open cohort of HIV-negative MSM enrolled after testing at a community-based voluntary HIV counselling and testing centre in Lisbon. At each evaluation a structured questionnaire was completed and HIV status was ascertained using rapid followed by confirmatory testing. Between April 2011 and February 2014, 804 MSM were followed for a total of 893 person-years. Predictors of HIV seroconversion were identified using Poisson generalised linear regression. The overall seroincidence was 2.80/100 person-years (95% confidence interval: 1.89–4.14). Men who seroconverted had a higher mean number of tests per year. Seroconversions were significantly associated with partner disclosure of HIV status during follow-up, newly-adopted unprotected anal intercourse (UAI) with a steady partner and being newly-diagnosed with syphilis during follow-up. Likewise, sexual intercourse with HIV-positive men, having an HIV-positive steady partner at least once during follow-up and persistent UAI with occasional partners were predictors of seroconversion. High HIV incidence in this cohort is likely driven by short-term contextual and behavioural changes during follow-up

The Lisbon Cohort of men who have sex with men

Purpose Newly diagnosed HIV infections among men who have sex with men (MSM) are rising in many European countries. Surveillance tools must be tailored to the current state of the epidemic, and include decentralised prospective monitoring of HIV incidence and behavioural changes in key populations. In this scenario, an open prospective cohort study was assembled—The Lisbon Cohort of MSM—aiming to dynamically monitor the frequency of disease and its predictors. Participants The Lisbon Cohort of MSM is an ongoing observational prospective study conducted at a community-based voluntary HIV counselling and testing centre in Lisbon, Portugal (CheckpointLX). Men testing negative for HIV, aged 18 or over and reporting having had sex with men are invited to follow-up visits every 6 months. At each evaluation, a face-to-face interview using a structured questionnaire is conducted, and HIV and syphilis rapid tests are performed by trained peer counsellors. From April 2011 to February 2014, 3106 MSM were eligible to the cohort of whom 923 (29.7%) did not participate. The remaining 2183 (70.3%) MSM were enrolled and 804 had at least one follow-up evaluation, for a total of 893 person-years of observation. Future plans The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences. The follow-up of this cohort of HIV-negative MSM will be a valuable tool for monitoring HIV incidence in a setting where limited prospective information existed. Moreover, it will allow for a deeper analytical approach to the study of population time trends and individual changes in risk factors that currently shape the HIV epidemic among MSM

A fluidic device for the controlled formation and real-time monitoring of soft membranes self-assembled at liquid interfaces

The work was supported by the European Research Council Starting Grant (STROFUNSCAFF) and the Marie Curie Career Integration Grant (BIOMORPH). L.B. acknowledges fnancial support from the European Community through grant no. 618335 ‘FlowMat: Flow and Capillarity in Materials Science’ and ERC Starting Grant FLEXNANOFLOW no. 715475. Te authors thank Karla E. Inostroza-Brito for the constructive support in this work