Measles outbreak after 12 years without endemic transmission, Portugal, February to May 2017

We report a measles outbreak in two Portuguese health regions (Algarve and Lisbon and the Tagus Valley) since February 2017, and which by 31 May resulted in 28 confirmed cases, of which 16 were unvaccinated. Thirteen cases were healthcare workers. One unvaccinated teenager died. Genotype B3 was identified in 14 cases from both regions. This outbreak occurs after 12 years without endemic measles transmission, and in a context of high measles vaccination coverage and immunity.info:eu-repo/semantics/publishedVersio

Enfermeiros na graduação médica: experiências e perspectivas nas duas graduações / Nurses in medical graduation: experiences and perspectives in the two graduations

Nas Faculdades de Medicina encontramos profissionais já graduados em diferentes áreas retornando para uma segunda graduação. Nesse grupo, predominam os enfermeiros. É frequente haver opiniões contrastantes sobre a atuação de enfermeiros e médicos no tocante ao envolvimento desses profissionais no atendimento prestado aos pacientes: há uma percepção dominante que enfermeiros estão mais envolvidos no cuidar enquanto médicos concentram-se principalmente na doença, tanto no seu diagnóstico quanto tratamento, deixando muitas vezes em segundo plano a atenção à pessoa que atravessa o processo de adoecimento. Através da experiência de enfermeiros que atualmente cursam a graduação em medicina procurou-se conhecer as motivações que fizeram com que esses profissionais buscassem uma segunda graduação com mais seis anos de estudos bem como os desafios por que passam. Analisar as diferenças percebidas por eles nas duas graduações poderia ajudar no entendimento das diferentes formas predominantes de atuação entre enfermeiros e médicos na prática profissional. Foram entrevistados 10 enfermeiros que atualmente encontram-se entre o 2º e o 9º período da graduação em medicina em uma universidade privada, 7 mulheres e 3 homens, variando de 28 a 39 anos. Seis desses alunos tinham auxílio financeiro através do FIES e cinco mantinham atividade profissional concomitante aos estudos. O desejo de cursar medicina já existia em três deles antes mesmo do início da graduação em enfermagem enquanto nos demais esse desejo só se manifestou após o final da graduação, principalmente em busca de uma maior valorização profissional tanto do ponto de vista de reconhecimento por parte dos pacientes quanto financeira. O médico é percebido como um profissional muito valorizado, aparecendo numa posição superior em relação aos demais profissionais de saúde tanto nos espac?os hospitalares quanto na sociedade. A percepção da enfermagem como uma profissão sem o reconhecimento esperado pela sociedade foi constante entre os entrevistados e o sentimento de que na graduação em medicina há um conteúdo muito extenso e que privilegia os aspectos técnicos do atendimento foram também frequentes. O tempo dispensado ao paciente parece ser um fator primordial para o estabelecimento de uma relação que vá além do diagnosticar e tratar, e que possa voltar um pouco mais o olhar médico para o cuidar. A extensa carga horária e de conteúdo parece diminuir essa disponibilidade de aproximação com o paciente dificultando a expressão de um cuidado que possibilite uma maior expressão das subjetividades dos sujeitos envolvidos. Um contato mais efetivo da equipe de saúde multiprofissional pode contribuir para uma ampliação da atuação médica e um maior contato entre diferentes cursos de graduação poderia contribuir no processo formativo de profissionais que se valorizem mutuamente e que colaborem efetivamente para um cuidado mais integral ao paciente. 

Photobiomodulation reduces the cytokine storm syndrome associated with Covid-19 in the zebrafish model

Although the exact mechanism of the pathogenesis of COVID-19 is not fully understood, oxidative stress and the release of pro-inflammatory cytokines have been highlighted as playing a vital role in the pathogenesis of the disease. In this sense, alternative treatments are needed to reduce the inflammation caused by COVID-19. Therefore, this study aimed to investigate the potential effect of red PBM as an attractive therapy to downregulate the cytokine storm caused by COVID-19 from a zebrafish model. RT-PCR analyses and protein-protein interaction prediction among SARS-CoV-2 and Danio rerio proteins showed that rSpike was responsible for generating systemic inflammatory processes with significantly increased pro-inflammatory (il1b, il6, tnfa, and nfkbiab), oxidative stress (romo1) and energy metabolism (slc2a1a, coa1) mRNA markers, with a pattern like those observed in COVID-19 cases in humans. On the other hand, PBM treatment decreased the mRNA levels of these pro-inflammatory and oxidative stress markers compared with rSpike in various tissues, promoting an anti-inflammatory response. Conversely, PBM promotes cellular and tissue repair of injured tissues and significantly increases the survival rate of rSpike-inoculated individuals. Additionally, metabolomics analysis showed that the most impacted metabolic pathways between PBM and the rSpike-treated groups were related to steroid metabolism, immune system, and lipids metabolism. Together, our findings suggest that the inflammatory process is an incisive feature of COVID-19, and red PBM can be used as a novel therapeutic agent for COVID-19 by regulating the inflammatory response. Nevertheless, the need for more clinical trials remains, and there is a significant gap to overcome before clinical trials.publishedVersio

Membrane Cholesterol Regulates Lysosome-Plasma Membrane Fusion Events and Modulates Trypanosoma cruzi Invasion of Host Cells

Trypanosoma cruzi, is the etiological agent of a neglected tropical malady known as Chagas' disease, which affects about 8 million people in Latin America. 30–40% of affected individuals develop a symptomatic chronic infection, with cardiomyopathy being the most prevalent condition. T. cruzi utilizes an interesting strategy for entering cells: T. cruzi enhances intracellular calcium levels, which in turn trigger the exocytosis of lysosomal contents. Lysosomes then donate their membrane for the formation of the parasitophorous vacuole. Membrane rafts, cholesterol-enriched microdomains in the host cell plasma membrane, have also been implicated in T. cruzi invasion process. Since both plasma membrane and lysosomes collaborate in parasite invasion, we decided to study the importance of these membrane domains for lysosomal recruitment and fusion during T. cruzi invasion into host cells. Our results show that drug dependent depletion of plasma membrane cholesterol changes raft organization and induces excessive lysosome exocytosis in the earlier stages of treatment, leading to a depletion of lysosomes near the cell cortex, which in turn compromises T. cruzi invasion. Based on these results, we propose that cholesterol depletion leads to unregulated exocytic events of pre-docked lysosomes, reducing lysosome availability at the cell cortex and consequently compromising T. cruzi infection

Evaluation of physical activity programmes for the elderly - exploring the lessons from other sectors and examining the general characteristics of the programmes

<p>Abstract</p> <p>Background</p> <p>In Portugal, there are several physical activity (PA) programmes for elderly people developed by the local government. The importance of these programmes has been increasing since the evidence has shown that this type of health promotion interventions may reduce the deleterious effects of the ageing process. However, no study has already identified the general characteristics of these programmes nor if they use any scheme to assess the quality of the service provided. A widely-used scheme is the EFQM Excellence Model, which will be in the core of our present work. Thus, the main aims of this preliminary study were 1) to identify the general characteristics of the PA programmes developed by the Portuguese Local Public Administration 2) to determine the extent of implementation of quality initiatives in these programmes.</p> <p>Methods</p> <p>Data were collected by an on-line questionnaire sent to all Continental Municipalities (n = 278). Categorical data were expressed as absolute counts and percentages. Continuous data were expressed as the mean and SD. An open-ended question was analysed using qualitative content analysis with QSR NVivo software. Associations between categorical variables were tested by the use of contingency tables and the calculation of chi-square tests. Significance level was set at p ≤ 0.05.</p> <p>Results</p> <p>Results showed: i) a total of 125 PA programmes were identified in the 18 districts of the Portugal mainland; ii) the main goal of the majority (95.2%) was the participants' health promotion; iii) different characteristics of the programmes were found according to different regions of the country; iv) certain characteristics of the programmes were associated to the existence of other features; v) only one PA programme developed quality initiatives.</p> <p>Conclusions</p> <p>In conclusion, although there are many PA programmes for elderly people spread throughout the country, aiming at improving the health of participants, the overwhelming majority does not adopt quality control initiatives. Considering that the quality of a service increases customer satisfaction, the continuous quality improvement of the PA programmes for elderly people should therefore be implemented since they can be useful and critical for elderly satisfaction and adherence.</p