Obstructive sleep apnea syndrome in heavy truck drivers: a Portuguese prospective cohort study

Introduction: Heavy truck drivers with untreated obstructive sleep apnea (OSA) are at higher risk of driving accidents. This study aims to estimate the prevalence of OSA and to identify the most frequent symptoms and comorbidities in heavy truck drivers. Methods: This cohort study included the employees of a Portuguese transport company between 2019 and 2022. A home sleep apnea test (HSAT) was performed on all patients. SPSS® was used for statistical analysis, and a p-value lower than 0.05 was considered statistically significant. Results: A total of 86 truck drivers were included, with a mean age of 48.02 years (min. 24, max 66) and a mean body mass index (BMI) of 30.14±4.4 kg/m². After performing an HSAT, it was found that 77.9% of drivers (n=67) had OSA, with a mean apnea-hypopnea index (AHI) of 16.72±14.69 events/hour. Concerning diagnosed patients, 44.78% (n=30) had mild, 31.32% (n=23) moderate, and 20.89% (n=14) severe OSA. Obesity, hypertension, and dyslipidemia had a statistically significant association. There were no statistically significant differences between patients with and without type II diabetes mellitus. The presence of nighttime and daytime symptoms had a statistically significant correlation with OSA diagnosis. Despite only eight patients reporting a high score on the Epworth Sleepiness Scale (ESS), 14 patients reported previous episodes of falling asleep while driving, which might be associated with the non-valorization of daytime sleepiness in these patients. The patients who reported previous episodes of falling asleep while driving were older and had higher BMI, higher ESS, and higher AHI. Conclusions: In the evaluated truck drivers, the prevalence of OSA was very high (77.9%), which reinforces the importance of screening for this pathology since, when left untreated, it is a major risk factor for exercising their profession safely.info:eu-repo/semantics/publishedVersio

Diana Amorim1*, Carolina Miguel Gonçalves2*, Margarida Cabral2, Sónia Silva1,3, Fátima Saraiva2, João Morais2,3, Salvato Feijó1

Background: Small cell lung cancer is an aggressive tumor with a poor prognosis that requires prompt treatment. While radiotherapy may enhance survival when superior vena cava syndrome is present, radiation therapy–induced pericardial disease can be a potential complication. Case Report: A 55-year-old man, who recently underwent radiotherapy for stage IV small-cell lung cancer complicated by superior vena cava syndrome, presented with chest pain and dyspnea. In the emergency room, he was dyspneic, hypotensive, and tachycardic. Pulmonary auscultation revealed the absence of lung sounds on the right. The initial electrocardiogram showed ST-segment elevation in lateral leads and in lead DII, with reciprocal changes in lead DIII. A bedside transthoracic echocardiogram revealed cardiac tamponade and emergent pericardiocentesis was performed, removing 500 ml of purulent fluid, resulting in an immediate clinical improvement. Thoracentesis was also performed, showing no empyema. Large spectrum empirical antibiotic therapy was started. Cultures from the pericardial fluid and peripheral blood grew multi-sensitive Streptococcus pneumoniae. Cytological analysis of the pericardial fluid was consistent with infection. The patient improved after 2 weeks of targeted antibiotic therapy and underwent the first cycle of chemotherapy. He was discharged with an early scheduled pulmonology appointment. Conclusions: Although the most common causes of pericardial effusion in lung cancer are malignant, non-malignant etiologies should also be considered. This patient had an infectious pericardial effusion most probably due to a pericardial-mediastinal mass fistula caused by radiotherapy. This was a diagnostic challenge, both in the emergency room as well in the inpatient setting.info:eu-repo/semantics/publishedVersio

Projeto SARDINHA2020

O objetivo principal do trabalho é desenvolver um plano de gestão para a pesca do cerco alinhado com as diretrizes da Política Comum da Pesca e da Diretiva Quadro da Estratégia Marinha, assente nos princípios de sustentabilidade dos recursos pesqueiros, de revitalização da biodiversidade do habitat pelágico e de exploração otimizada considerando a rentabilidade económica do setor.A pesca do cerco é de particular importância para Portugal. A sardinha (Sardina pilchardus, Walbaum 1792) (Figura 1) tem sido durante muitos anos uma das principais espécies capturadas e o recurso mais importante nas águas portuguesas (Stratoudakis & Silva, 2001). Como tal, muitas comunidades costeiras contam com a pesca da sardinha como um dos principais meios de subsistência. Além disso, a indústria de processamento de peixes e muitos fornecedores do mercado de produtos da pesca são tradicionalmente dependente da pesca do cerco. Consequentemente, a importância do cerco não pode ser analisada apenas do ponto de vista económico, sendo também importante analisar a sua importância social e cultural.info:eu-repo/semantics/publishedVersio

Second Workshop on Atlantic chub mackerel (Scomber colias) (WKCOLIAS2)

The Atlantic chub mackerel Scomber colias has become an increasingly important commercial species in the European Atlantic waters in the last 10–15 years, probably through an expansion process from NW African waters and due to market needs. However, at present there are no assessment or advice requirements. In the WK framework, available information of the species in the West Atlantic waters has been compiled in order to evaluate possible geographical differences and trends, and the feasibility to describe its population structure. Though the Atlantic chub mackerel is not routinely included among the target species in the acoustic surveys performed in the Atlantic Iberian waters and the Mediterranean Sea, a synoptic overview of the species is possible over all its West Atlantic distribution. Moreover, the data available have indicated latitudinal trends, mainly in the landings’ length composition, L50 and the spawning periods. Nevertheless, even if some degree of connectivity likely exists and migrations are occurring between adjacent areas, some subunits could be considered for management purposes. From the assessment models’ trials carried out, the results or reference points obtained for the European fisheries cannot be retained at present. Therefore, continuing collating information from fisheries and biological sampling of the species, obtaining reliable biomass estimations from scientific surveys and identifying management units seem the main priorities to address in future research work and in case of assessment requirements

Long-term progression of clinician-reported and gait performance outcomes in hereditary spastic paraplegias

IntroductionHereditary spastic paraplegias (HSPs) are a heterogeneous group of neurodegenerative diseases in which little is known about the most appropriate clinical outcome assessments (COAs) to capture disease progression. The objective of this study was to prospectively determine disease progression after 4.5 years of follow-up with different clinician-reported (ClinRO) and gait performance outcomes (PerFOs).MethodsTwenty-six HSP patients (15 SPG4, 5 SPG7, 4 SPG5, 2 SPG3A) participated in this single-center cohort study in which the ClinRO: Spastic Paraplegia Rating Scale; and the PerFOs: 10-meters walking test and timed-up and go (TUG), at self-selected and maximal walking speeds; Locomotor Rehabilitation Index; and 6-min walking test were performed at baseline and after 1.5 (18 patients) and 4.5 (13 patients) years.ResultsIn the 3-year interval between the second and third assessments, significant progressions were only found in PerFOs, while in the overall 4.5 years of follow-up, both PerFOs and ClinROs presented significant progressions. The progression slopes of COAs modeled according to the disease duration allowed the estimation of the annual progression of the outcomes and sample size estimations for future clinical trials of interventions with different effect sizes. TUG at maximal walking speed was the only COA capable of differentiating subjects with a worse compared to a stable/better impression of change and would require the smallest sample size if chosen as the primary endpoint of a clinical trial.DiscussionThese findings indicate that both performance and clinician-reported outcomes can capture long-term progression of HSPs, with some PerFOs presenting greater sensitivity to change. The presented data are paramount for planning future disease-modifying and symptomatic therapy trials for this currently untreatable group of diseases