Metabolic Activity in the Visceral and Subcutaneous Adipose Tissues by FDG-PET/CT in Obese Patients

INTRODUCTION: The emerging role of the 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in the study of the metabolic activity and inflammation in adipose tissue indicates that it might be a reliable tool to complement the risk stratification in obesity. The aims of this study were the evaluation of 18F-fluorodeoxyglucose uptake by visceral adipose tissues and subcutaneous adipose tissues and to determine eventual differences in patients with and without obesity. MATERIAL AND METHODS: Retrospective study of adult patients who underwent whole body 18F-fluorodeoxyglucose-positron emission tomography/ computed tomography scanning between July and August of 2016. STATISTICAL ANALYSIS: SPSS™ software v.20. Statisticalsignificance: p < 0.05. RESULTS: We assessed fluorodeoxyglucose-positron emission tomography/computed tomography scans from 156 patients (58.3% of males) with a mean age of 61.0 ± 14.1 years. Half of the patients had a body mass index ≥ 25.0 kg/m2 and 15.4% (n = 24) were obese. In both groups, the mean 18F-fluorodeoxyglucose uptake was higher in visceral adipose tissues. There were no differences in 18F-fluorodeoxyglucose uptake in visceral adipose tissues between the groups. Obese patients had lower density of adipose tissue,both in subcutaneous adipose tissues and in visceral adipose tissues. Abdominal circumference and density of visceral adipose tissueshad a positive predictive value in the mean 18F-fluorodeoxyglucose uptake in visceral adipose tissues. Discussion: Through a non-invasive test, this study demonstrated a significant higher metabolic activity in visceral adipose tissues in both obese and non-obese patients. According to our results, abdominal circumference was an important determinant in 18F-fluorodeoxyglucose uptake in visceral adipose tissues. We also demonstrated that obese patients had differences in adipose tissue quality. CONCLUSION: Our findings reinforce the importance of the adipose tissue quality and distribution for metabolic risk stratification.info:eu-repo/semantics/publishedVersio

Adenoid cystic carcinoma of the palpebral lobe of the lacrimal gland – case report and literature review

Epithelial tumors of the lacrimal gland are rare and usually develop in the orbital lobe. We report the exceedingly rare occurrence of a primary adenoid cystic carcinoma in the palpebral lobe of the lacrimal gland. A 26-year-old female was referred for evaluation of a gradually enlarging mass in the lateral upper eyelid, previously diagnosed as a chalazion. Computed tomography revealed a heterogeneous round lesion anterior to the orbital rim. Excisional biopsy was compatible with an adenoid cystic carcinoma. After excluding distant metastasis, and as the patient refused adjuvant radiotherapy, a second surgical procedure, with wide local excision, was indicated. Follow-up showed no recurrence. This case highlights the importance of performing a thorough clinical examination when diagnosing any lateral upper eyelid mass. A high index of suspicion for malignant tumors of the lacrimal gland should always be maintained, and a complete excision with histological analysis should be preferred whenever possible.info:eu-repo/semantics/publishedVersio

Experience and Learning from the COVID-19 Pandemic in Portugal: Perceptions of Community Pharmacy Professionals

Background: During the COVID-19 pandemic, community pharmacy (CP) professionals were among those who experienced the greatest risk of contracting SARS-CoV-2, which forced major adaptations. Objectives: The objectives of the study were to describe the changes implemented in CP professionals during the pandemic, understand the perception of professionals about their experience, and explore changes to remain. Methods: An observational and cross-sectional study was conducted via an online questionnaire (June-September 2020). The target population was CP professionals working in Portugal for >2 years and serving the public during the pandemic. Results: Of a total of 353 participants, 84% were female (mean age of 37.6 years), and 81% were pharmacists (mean professional experience of 12.9 years). In the management and organizational dimensions, the most mentioned changes were adaptation to legislative changes (90%), fluctuations in the treasury (82%), and reduction of working hours (46%). Only 2% resorted to simplified layoff. In the back office, there was a need to adapt stock management (93%) and purchase personal protective equipment (99%). In the front office, there was a change in service policies - wicket or conditional opening (92%), routes of the arrival of user requests (91%), and home delivery (82%). Physical changes occurred in 100% of pharmacies. The most frequently implemented procedures were the use of protection systems and PPE, articulation with hospital pharmacies for dispensing in proximity (75%), and training in this area (55%). Regarding interpersonal climate, improvements in the connection between team members are evident: increase in mutual help (57%), solidarity (54%), and group cohesion (50%); in the relationship with clients, the majority indicated the replacement of the usual user by third parties (71%), and changes in communication channels (increase in use of technological means 68%). Conclusions: Results illustrate the profound impact of the pandemic on CP professionals, both professionally and personally. It also highlights the importance of their roles in proximity and community support. © 2023 S. Karger AG. All rights reserved.This work was funded by 4IE project (0499_4IE_PLUS_4_E) funded by the Interreg V-A España-Portugal (POCTEP) 2017/2022 ( https://4ie.eu/ )

Políticas de movilidad y gestión de la pandemia en ciudades latinoamericanas

Hoy las ciudades de América Latina tal vez están enfrentando el reto de salud y gobernanza más crítico de este siglo, la pandemia de COVID-19. En cinco meses el mundo urbano ha pasado de una dinámica de incesante movimiento a una de movimiento regulado. Para controlar la pandemia, los agentes públicos han pedido a la población estar en casa, evadir espacios públicos o privados de gran aglomeración de personas y, limitar los sistemas de transporte masivo y colectivo. Todas estas respuestas están reconfigurando drásticamente la movilidad urbana y exigiendo la construcción de nuevas herramientas de gobernanza. El objetivo de este trabajo es proponer una investigación orientada a determinar cuál es el papel que las políticas publicas de movilidad, implementadas durante la pandemia, tienen en la reducción de la mortalidad y expansión del contagio en diversas ciudades latinoamericanas. Para esto, planteamos dos tipos de análisis: 1) del contenido de políticas públicas y 2) de la correlación entre estas medidas y los resultados del contagio. Al final se logra evidenciar que, si bien la expansión de la pandemia está asociada a redes globales, las respuestas de gobernanza urbana adoptadas localmente tienen alta variabilidad tanto de estrategias como de resultados en la gestión de la pandemia

Manipulating task constraints shapes emergence of herding tendencies in team games performance

The herding phenomenon is observed in nature and has been perceived to be less desirable use of space in impacting overall team play performance. The effective manipulating of rules and task constraints might be able to alter herding tendencies in sport performance. The aim of this study was to determine the impact of altering task constraints on herding tendencies, measured with the use of cluster phase analysis, which has also been used to analyse the synchrony exhibited by performers in invasion games such as professional association football matches. In this study, tracking positional data of individual players in a simulated pass and catch game was undertaken, with no specific verbal instructions provided to participants on how and where to move so that emergent behavioural tendencies could be observed. Data revealed how task constraint manipulations impacted on herding tendencies. Manipulation of task constraints revealed higher levels of clustering tendencies in the herding condition compared to, the non-herding condition. Within the herding condition, between-team synchrony was also strong, especially in the longitudinal direction. Ball possession also seemed to have some impact on within-team synchrony. Findings provided preliminary evidence on how manipulating task constraints can be effective in altering herding tendencies in team games

Comparing the cost-effectiveness of two screening strategies for latent tuberculosis infection in Portugal

Introduction and objectives: Screening for latent tuberculosis infection (LTBI) in close contacts of infectious TB cases might include Tuberculin Skin Test (TST) and Interferon-Gamma Release Assays (IGRA), in combination or as single-tests. In Portugal, the screening strategy changed from TST followed by IGRA to IGRA-only testing in 2016. Our objective was to compare the cost-effectiveness of two-step TST/IGRA with the current IGRA-only screening strategy in immunocompetent individuals exposed to individuals with respiratory TB. Materials and methods: We reviewed clinical records of individuals exposed to infectious TB cases diagnosed in 2015 and 2016, in two TB outpatient centers in the district of Porto. We estimated medical, non-medical and indirect costs for each screening strategy, taking into account costs of tests and health care personnel, travel distance from place of residence to screening site and employment status. We calculated the incremental cost-effectiveness ratio (ICER) as the cost difference between the two screening strategies with the difference number of LTBI diagnosis as a measure of cost-effectiveness, assuming that treating LTBI is a cost-effective intervention. We also calculated adjusted odds-ratios to test the association between diagnosis of LTBI and screening strategy and estimated the total cost for averting a potential TB case. Results: We compared 499 contacts TST/IGRA screened with 547 IGRA-only. IGRA-only strategy yielded a higher screening effectiveness for diagnosing latent tuberculosis infection (aOR 2.12, 95%CI: 1.53 - 2.94). ICER was €106 per LTBI diagnosis, representing increased effectiveness with a slightly increased cost of IGRA-only screening strategy. Conclusions: Our data suggests that in Portugal LTBI screening with IGRA-only is more cost-effective than the two-step TST/IGRA testing strategy, preventing a higher number of cases of TB cases

Stir Casting Routes for Processing Metal Matrix Syntactic Foams: A Scoping Review

Metal matrix syntactic foams (MMSFs) are advanced lightweight materials constituted by a metallic matrix and a dispersion of hollow/porous fillers. Physical and mechanical properties can be fitted regarding matrix and filler properties and processing parameters. Their properties make them potential materials for sectors where density is a limiting parameter, such as transport, marine, defense, aerospace, and engineering applications. MMSFs are mainly manufactured by powder metallurgy, infiltration, and stir casting techniques. This study focuses on the current stir casting approaches and on the advances and deficiencies, providing processing parameters and comparative analyses on porosity and mechanical properties. PRISMA approaches were followed to favor traceability and reproducibility of the study. Stir casting techniques are low-cost, industrially scalable approaches, but they exhibit critical limitations: buoyancy of fillers, corrosion of processing equipment, premature solidification of molten metal during mixing, cracking of fillers, heterogeneous distribution, and limited incorporation of fillers. Six different approaches were identified; four focus on limiting buoyancy, cracking, heterogeneous distribution of fillers, and excessive oxidation of sensitive matrix alloys to oxygen. These improvements favor reaching the maximum porosity of 54%, increasing the fillers size from a few microns to 45 mm, reducing residual porosity by ±4%, synthesizing bimodal MMSFs, and reaching maximum incorporation of 74 vol%.</jats:p

Glycomimetics; A Novel Class of Drugs to Protect Against Free Fatty Acid-Induced Endothelial Dysfunction

Background Endothelial dysfunction is a key player in cardiovascular disease (CVD) complications and novel drugs are required to treat this pathological process. Glycosaminoglycans (GAGs) are key molecules that regulate signalling in many biological processes and drugs that mimic their structure could be a novel source of therapeutics to target specific CVD pathways. Purpose We have synthesised a set of four glycomimetic compounds and our objective was to determine whether they could activate protective pathways in endothelial cells subjected to fatty acid-induced endothelial dysfunction. Methods Glycomimetics, C1-C4, were synthesised by the stepwise transformation of 2,5-dihydroxybenzoic acid to a range of 2,5-substituted benzoic acid derivatives, incorporating the key sulphate groups to mimic heparan sulphate. Human Umbilical Vein Endothelial Cells (HUVECs) were treated with glycomimetics (1µM) in the presence or absence of the free fatty acid, palmitate. DAF-2 and H2DCF-DA assays were used to determine NO and reactive oxygen species (ROS) production, respectively. Lipid peroxidation colorimetric and antioxidant enzyme activity ssays were also carried out. RT-PCR and western blotting were utilised to measure Akt, eNOS, Nrf-2, NQO-1 and HO-1 expression. Endothelial function was determined ex vivo using acetylcholine-induced endothelium-dependent relaxation in mouse thoracic aortic rings by wire myography. Results All four glycomimetics protected against palmitate-induced oxidative stress and enhanced NO production in vitro via upregulation of Akt/eNOS signalling, activation of the Nrf2/ARE pathway and down-regulation of ROS-induced lipid peroxidation. Under palmitate-induced oxidative stress, ex vivo endothelium-dependent relaxation was significantly enhanced by all four glycomimetics. Furthermore, the glycomimetics did not induce HUVEC activation, as determined by lack of ICAM-1 protein. Conclusion We have developed a new set of small molecule glycomimetics that do not activate ECs and protect against free fatty acid-induced endothelial dysfunction both in vitro and ex vivo. Future work will focus on developing the glycomimetics into drug-like therapies that target endothelial damage

COVID-19 vaccines effectiveness against symptomatic disease and severe outcomes, 2021-2022: a test-negative case-control study

Objectives: This study evaluated the effectiveness of COVID-19 vaccines in preventing symptomatic and severe disease.Study design: This was an observational test-negative case-control study.Methods: Study participants were adults with at least one symptom included in the World Health Or-ganization COVID-19 definition who sought health care in a public emergency department between 1 November 2021 and 2 March 2022 (corresponding with the fifth pandemic wave in Portugal dominated by the Omicron variant). This study used multivariable logistic regression models to estimate and compare the odds ratio of vaccination between test-positive cases and test-negative controls to calculate the absolute and relative vaccine effectiveness.Results: The study included 1059 individuals (522 cases and 537 controls) with a median age of 56 years and 58% were women. Compared with the effectiveness of the primary vaccination scheme that had been completed >= 180 days earlier, the relative effectiveness against symptomatic infection of a booster administered between 14 and 132 days earlier was 71% (95% confidence interval [CI]: 57%, 81%; P = 180 days.Conclusions: Despite the known immunological evasion characteristics of the Omicron variant, results from this study show that vaccine effectiveness increases after booster administration. COVID-19 vaccine effectiveness decreases to less than 50% between 3 and 6 months after completion of the primary cycle; therefore, this would be an appropriate time to administer a booster to restore immunity.(c) 2023 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Ana Aguiar holds a PhD grant (Reference: 2020.09390.BD) , co-funded by the Fundacao para a Ciencia e a Tecnologia (FCT) and the Fundo Social Europeu (FSE) Program