A diabetologia social em Portugal. Génese, influências e concretizações (1926-1931)

Diabetes is a silent and debilitating epidemic that has received increased attention in recent decades by Medicine. This work intends to carry out an analysis of the emergence of social diabetology in Portugal, centered in the second quarter of the 20th century. Firstly, it is intended to understand the genesis of this medical area, based on the work developed by the physician Ernesto Roma in Lisbon. This is followed by an analysis focused on tracking the currents of medical thought that influenced Portuguese diabetology and, finally, it is intended to understand how the model of assistance to diabetics was organized in the early days of its existence.[pt] A diabetes é uma epidemia silenciosa e debilitadora que tem recebido uma atenção redobrada nas últimas décadas por parte da Medicina. Este trabalho pretende realizar uma análise sobre o aparecimento da diabetologia social em Portugal, centrado no segundo quartel do século XX. Primeiramente pretende-se perceber a génese desta área médica, tendo por base o trabalho desenvolvido pelo médico Ernesto Roma em Lisboa. Segue-se uma análise focada no rastreamento das correntes de pensamento médico que influenciaram a diabetologia portuguesa e por último pretende-se perceber como foi organizado o modelo de assistência aos diabéticos nos primeiros tempos da sua existência

Detection of Escherichia coli O157 by Peptide Nucleic Acid Fluorescence In Situ Hybridization (PNA-FISH) and Comparison to a Standard Culture Method

Despite the emergence of non-O157 shiga toxin-producing Escherichia coli (STEC) infections, E. coli O157 serotype is still the most commonly identified STEC in world. It causes high morbidity and mortality, and has been responsible for a number of outbreaks in many parts of the world. Various methods have been developed to detect this particular serotype, but standard bacteriological methods remain as the gold standard.In here, we propose a new peptide nucleic acid fluorescence in situ hybridization (PNA-FISH) method for the rapid detection of E. coli O157.Testing on 54 representative strains showed that the PNA probe is highly sensitive and specific to E. coli O157. Then, the method was optimized for the detection in food samples. Ground beef and unpasteurized milk samples were artificially contaminated with E. coli O157 concentrations ranging from 1×10-2 to 1×102 CFU per 25g or ml of food. Samples were then pre-enriched and analyzed by both the traditional bacteriological method (ISO 16654:2001) and PNA-FISH. The PNA-FISH method performed well in both types of food matrixes with a detection limit of 1 CFU/25 g or ml of food samples. Tests on 60 food samples have shown a specificity value of 100% (95% CI 82.83 - 100), a sensitivity of 97.22% (95% CI, 83.79 - 99.85) and an accuracy of 98,33% (CI 95%, 83.41 - 99.91). Results indicate that PNA-FISH performed as well as the traditional culture methods and can reduce the diagnosis time to 1 day.This work was supported by the Portuguese Institute Fundacao para a Ciencia e Tecnologia (FCT), project PIC/IC/82815/2007. C.A. acknowledges FCT for individual postdoctoral fellowship SFRH/BPD/74480/2010. We also acknowledge Biomode S.A. for providing some supplies for this project

Development and application of Peptide Nucleic Acid Fluorescence in situ Hybridization for the specific detection of Listeria monocytogenes

Supplementary data to this article can be found online at https:// doi.org/10.1016/j.fm.2018.12.009.Listeria monocytogenes is one of the most important foodborne pathogens due to the high hospitalization and mortality rates associated to an outbreak. Several new molecular methods that accelerate the identification of L. monocytogenes have been developed, however conventional culture-based methods still remain the gold standard. In this work we developed a novel Peptide Nucleic Acid Fluorescence in situ Hybridization (PNA-FISH) method for the specific detection of L. monocytogenes. The method was based on an already existing PNA probe, LmPNA1253, coupled with a novel blocker probe in a 1:2 ratio. The method was optimized for the detection of L. monocytogenes in food samples through an evaluation of several rich and selective enrichment broths. The best outcome was achieved using One Broth Listeria in a two-step enrichment of 24h plus 18h. For validation in food samples, ground beef, ground pork, milk, lettuce and cooked shrimp were artificially contaminated with two ranges of inoculum: a low level (0.22CFU/25g or mL) and a high level (210CFU/25g or mL). The PNA-FISH method performed well in all types of food matrices, presenting an overall accuracy of 99% and a detection limit of 0.5CFU/25g or mL of food sample.Nuno R. da Silva acknowledges the financial support byFundac¸ ão para a Ciência e Tecnologia (FCT) of the Portuguese’s Min-istry for Science, Technology and Higher Education (MCTES), in theframework of the POCH – Programa Operacional Capital Humano,co-funded by the European Social Fund (SFRH/BD/111825/2015).This work was also supported by FCT under the scope ofthe strategic funding of UID/BIO/04469 unit and COMPETE2020 (POCI-01-0145-FEDER-006684) and BioTecNorte opera-tion (NORTE-01-0145-FEDER-000004) funded by the EuropeanRegional Development Fund under the scope of Norte2020 – Pro-grama Operacional Regional do Norte.info:eu-repo/semantics/publishedVersio

Multiple Sclerosis Patient Management During the COVID-19 Pandemic: Practical Recommendations From the Portuguese Multiple Sclerosis Study Group (GEEM)

The spread of the COVID-19 pandemic has imposed significant challenges on healthcare provision, requiring changes in the conventional patient management, particularly in chronic diseases like multiple sclerosis (MS). To increase patient safety and reduce the risk of infection, while ensuring an appropriate and regular follow-up, tele-medicine gained prominence as a valid alternative to face-to-face appointments. However, the urgency of the implementation and the lack of experience in most MS centers led to "ad hoc" and extremely diverse approaches, which now merit to be standardized and refined. Indeed, while tele-consultation cannot fully replace face-to-face visits, it certainly can, and will, be incorporated as part of the routine care of MS patients in the near future. Bearing this in mind, the Portuguese Multiple Sclerosis Study Group (GEEM) has developed a set of recommendations for the usage of tele-medicine in the management of MS patients, both during the pandemic and in the future. The consensus was obtained through a two-step modified Delphi methodology, resulting in 15 recommendations, which are detailed in the manuscript.The consensus and the publication of this manuscript were supported by an educational grant from Novartis Portugal to the Grupo de Estudos de Esclerose Múltipla. These funds were used to pay the work of the consultancy MOAI, which set up the online questionnaire and helped with writing the summary of the meeting and the first draft of the consensus, and the publishing fee (article processing charge). The funding source had no role in the process and did not influence, by any means, the content of the consensus or the present manuscriptinfo:eu-repo/semantics/publishedVersio

Natalizumab for the treatment of pediatric-onset multiple sclerosis in Portugal

Background: A significant proportion of pediatric-onset multiple sclerosis (POMS) patients do not respond to first-line disease-modifying therapies. Clinical trials showed that natalizumab is effective and safe in adults, but there are limited clinical trial data for children. Natalizumab is currently prescribed off-label for POMS. We aimed to characterize the effectiveness, safety and tolerability of natalizumab in all POMS cases treated in Portugal (from 2007 to 2018). Methods: Data from clinical records were retrospectively collected for all POMS cases treated with natalizumab in Portugal. Results: Twenty-one patients were included, 14 (67%) of which were female. The median age at POMS diagnosis was 13 years old. The median duration of treatment with natalizumab was 2 years and 3 months. Median Expanded Disability Status Scale score decreased from 1.5 to 1.0 after 24 months. The Annualized Relapse Rate decreased from 1.31 events/patient/year before treatment with natalizumab to 0 after 12 months of treatment and to 0.04 after 24 months. No gadolinium-enhancing lesions or new or enlarged T2 hyperintense lesions were observed in 8/8 patients (100%) after 12 months, and 4/5 (80%) after 24 months. There was one possible serious adverse event, which did not require dose adjustment. Five patients discontinued treatment due to positive anti-JCV (JC virus) antibody JC serostatus. Conclusion: Natalizumab may be an effective and safe disease-modifying therapy for POMS. Our results are in line with data published for the adult population, as well as with similar observational studies in pediatric populations in other regions.publishersversionpublishe

Proceedings of the Conference on Entrepreneurship Education

Proceedings of the Conference on Entrepreneurship Education.publishe

Universidade empreendedora no contexto português: das políticas públicas ao projeto GAPI 3

O fenómeno da universidade empreendedora em Portugal é relativemente recente, mas vital para impulsionar a inovação, a criatividade e o crescimento económico, no âmbito de um ecossistema inovador. A partir dos anos 90 verificou-se a implementação de políticas públicas e demais iniciativas de promoção do empreendedorismo e transferência de tecnologia que foram determinantes para alterar o paradigma das instituições de ensino superior Portuguesas. Por um lado, a criação da rede GAPI e a constituição das OTIC, a par de alteração do estatuto da carreira docente e enquadramento ao nível do regime jurídico do capital de risco, são disso exemplos relevantes e que muito contribuíram para o desempenho cada vez mais positivo de Portugal em termos da taxa de crescimento da performance ao nível da inovação. Por outro, tem-se verificado o alinhamento de interesses e a partilha de boas práticas entre instituições de ensino superior, nomeadamente no que diz respeito ao desenvolvimento de estruturas de apoio e à promoção do espírito empresarial, à criação de empresas inovadoras de cariz tecnológico e ao aumento das competências empreendedoras dos alunos. Esta preocupação serviu de mote à implementação do projecto GAPI 3. Este projeto, promovido por seis universidades e institutos de investigação, decorreu entre 2013 e 2015, tendo sido apoiado pelo programa COMPETE e FEDER. As diversas atividades e iniciativas promovidas no âmbito deste projeto contribuíram de forma assinalável para a promoção de uma cultura empreendedora no seio das instituições participantes, contribuindo para o desenvolvimento de universidades empreendedoras em Portugal

Recomendações e Consensos do Grupo de Estudos de Esclerose Múltipla e da Sociedade Portuguesa de Neurorradiologia sobre Ressonância Magnética na Esclerose Múltipla na Prática Clínica: Parte 1

Magnetic resonance imaging is established as a recognizable tool in the diagnosis and monitoring of multiple sclerosis patients. In the present, among multiple sclerosis centers, there are different magnetic resonance imaging sequences and protocols used to study multiple sclerosis that may hamper the optimal use of magnetic resonance imaging in multiple sclerosis. In this context, the Group of Studies of Multiple Sclerosis and the Portuguese Society of Neuroradiology, after a joint discussion, appointed a committee of experts to create recommendations adapted to the national reality on the use of magnetic resonance imaging in multiple sclerosis. The purpose of this document is to publish the first Portuguese consensus recommendations on the use of magnetic resonance imaging in multiple sclerosis in clinical practice.This work had a investigational grant from Roche Farmaceutica Quimica LDA: EPAM129844-G.info:eu-repo/semantics/publishedVersio