Implications for acetylsalicylic acid-sensitive pregnant women

Low-dose acetylsalicylic acid (ASA) is widely used during pregnancy to prevent obstetric complications of placental dysfunction, such as preeclampsia, stillbirth and fetal growth restriction, and obstetric complications in pregnant women with antiphospholipid syndrome. ASA-sensitive pregnant women cannot benefit from the effects of ASA due to the possibility of severe or potentially life-threatening hypersensitivity reactions to ASA. ASA desensitization is a valuable and safe therapeutic option for these women, allowing them to start daily prophylaxis with ASA and prevent pregnancy complications. The authors discuss the recent advances in obstetric conditions preventable by ASA and the management of ASA hypersensitivity in pregnancy, including ASA desensitization. To encourage the implementation of ASA desensitization protocols in ASA-sensitive pregnant women, they also propose a practical approach for use in daily clinical practice.publishersversionpublishe

What do asthmatic patients think about telemedicine visits?

Introduction. Due to the Coronavirus disease 2019 (COVID-19) outbreak and the national emergency state, virtual visits were implemented as an alternative to in-person visits. With this study we aimed to establish asthma patients' general satisfaction with the quality of health care provided by virtual visits (phone or video calls). Materials and methods. A questionnaire (9 questions) was published on the Facebook page of the Portuguese Association of Asthmatics. It was available online for general self-reported asthmatic patients to answer during one month, starting on 11st May 2020. The survey only allowed one answer per registered user. Results. Fifty-five responses were obtained. Patients were satisfied with communication with providers (> 88%); nevertheless, one-half evaluated the virtual visit as inferior when compared to in-person visits. About one third attributed a classification of 6 or less (0-10 scale, 0 being the worst and 10 the best consultation possible), but still most of the patients would either recommend it or use this kind of medical visits in the future, even outside the actual pandemic context. Patients also referred some important limitations, as lack of physical examination and the fact that the medical visit was more impersonal. Only 27% had technical issues accessing virtual visits. Positive aspects were also named, such as virtual visits being practical and avoiding the need to move to the hospital. Discussion and conclusions. Our survey revealed that small changes could further increase patients' satisfaction, adherence and confidence in telemedicine. Although presenting some limitations, virtual visits seem to be generally well accepted by asthmatic patients and it might be a good alternative for in-person visits, at leastin such difficult times when social distancing is recommended.info:eu-repo/semantics/publishedVersio

Alergia às Proteínas do Leite de Vaca: Uma Nova Era

A alergia às proteínas do leite de vaca apresenta uma prevalência, gravidade e persistência crescentes. A dieta de evicção é difícil de cumprir e as reações adversas potencialmente graves associadas à ingestão acidental do alimento são frequentes. Discute-se o caso clínico de uma criança de seis anos com história pessoal de alergia às proteínas do leite de vaca desde os três meses de vida, com vários episódios de anafilaxia por ingestão acidental de leite de vaca. Aos quatro anos foi submetida, com sucesso, a protocolo de indução de tolerância ao leite de vaca, permitindo- lhe atualmente uma dieta livre. Esta estratégia terapêutica mostra-se revolucionária por permitir modificar a história natural da alergia às proteínas do leite de vaca grave e persistente, com impacto muito positivo na qualidade de vida dos doentes e da sua família

Alergia às Proteínas do Leite de Vaca: Uma Nova Era

A alergia às proteínas do leite de vaca apresenta uma prevalência, gravidade e persistência crescentes. A dieta de evicção é difícil de cumprir e as reações adversas potencialmente graves associadas à ingestão acidental do alimento são frequentes. Discute-se o caso clínico de uma criança de seis anos com história pessoal de alergia às proteínas do leite de vaca desde os três meses de vida, com vários episódios de anafilaxia por ingestão acidental de leite de vaca. Aos quatro anos foi submetida, com sucesso, a protocolo de indução de tolerância ao leite de vaca, permitindo- lhe atualmente uma dieta livre. Esta estratégia terapêutica mostra-se revolucionária por permitir modificar a história natural da alergia às proteínas do leite de vaca grave e persistente, com impacto muito positivo na qualidade de vida dos doentes e da sua família

Amphioxus functional genomics and the origins of vertebrate gene regulation.

Vertebrates have greatly elaborated the basic chordate body plan and evolved highly distinctive genomes that have been sculpted by two whole-genome duplications. Here we sequence the genome of the Mediterranean amphioxus (Branchiostoma lanceolatum) and characterize DNA methylation, chromatin accessibility, histone modifications and transcriptomes across multiple developmental stages and adult tissues to investigate the evolution of the regulation of the chordate genome. Comparisons with vertebrates identify an intermediate stage in the evolution of differentially methylated enhancers, and a high conservation of gene expression and its cis-regulatory logic between amphioxus and vertebrates that occurs maximally at an earlier mid-embryonic phylotypic period. We analyse regulatory evolution after whole-genome duplications, and find that-in vertebrates-over 80% of broadly expressed gene families with multiple paralogues derived from whole-genome duplications have members that restricted their ancestral expression, and underwent specialization rather than subfunctionalization. Counter-intuitively, paralogues that restricted their expression increased the complexity of their regulatory landscapes. These data pave the way for a better understanding of the regulatory principles that underlie key vertebrate innovations