Hepatitis A in Portugal – epidemiological overview of incidence in the last decade

Background. Hepatitis A is an acute liver disease with faecal-oral transmission caused by a hepatotrophic picornavírus - Hepatitis A Virus (HAV). Food contamination with HAV can occur at any time: cultivation, harvesting, processing, handling and even after cooking.1,2 Food and water contamination happens more frequently in developing countries where the disease is common but can also happen in developed countries. Although uncommon, foodborne outbreaks have occurred due to people consuming contaminated fresh and frozen imported food products. Therefore, monitoring the disease is an essential tool for the early implementation of preventive measures, applying the One Health approach to both the human and environmental dimensions to mitigate the impact that an outbreak may have on the population.3 Methods. Retrospective observational study, which analyses the incidence of reported cases of Hepatitis A in Portugal between 2012 and 2022. Data presented were collected from the Directorate-General for Health (DGS) and the European Center for Disease Prevention and Control (ECDC). Descriptive statistics were performed using Microsoft Excel® software. Results. Portugal had 806 cases of Hepatitis A between 2012 and 2022, the majority of which were male (n=597, 74.1%), aged between 25 and 44 years (n=397; 49.3%). Between 2012 and 2016, there was a gradual increase in incidence, from 0.1 in 2012 to 0.5 per 100 000 population in 2016. In 2017, there was a peak in incidence (4.7 per 100 000 population), corresponding to an outbreak of Hepatitis A that year. After 2017, the incidence gradually decreased. However, it never reached values lower than those of 2012, even during the years of the COVID-19 pandemic. During the study period, the incidence in men and women was similar, except between 2016 and 2019, where the incidence in men was higher. In terms of age, the incidence of Hepatitis A by age group showed high heterogeneity over the years, without a predominance. Conclusions. In Portugal, the incidence, except for 2017, was relatively low. However, most diagnoses occur in adults when the disease can present greater severity, with consequences in terms of morbidity and mortality. The decrease in incidence is a good indicator of improved hygiene and sanitary conditions, but it increases the possibility of outbreaks since the population tends to see its natural immunity against the disease reduced. It is essential to monitor the incidence of the disease in the population of Portugal to develop timely public health strategies to control potential outbreaks of Hepatitis A. Strategies to be implemented must take into account not only the human dimension in terms of prevention with vaccination, diagnosis and treatment of the disease but also measures in the environmental dimension, since transmission of the disease occurs via the faecal-oral route, it is essential to implement legislation and measures that promote food and water safety and alert the population to risk behaviours. References. 1Hofmeister MG, Foster MA, Teshale EH. Epidemiology and Transmission of Hepatitis A Virus and Hepatitis E Virus Infections in the United States. 2019. 2Castaneda D, Gonzalez AJ, Alomari M, et al. From hepatitis A to E: A critical review of viral hepatitis. World J Gastroenterol 2021; 27: 1691–1715. 3Jefferies M, Rauff B, Rashid H, et al. Update on global epidemiology of viral hepatitis and preventive strategies. Australia World J Clin Cases 2018; 6:589–599.N/

Optical coherence tomography angiography in herpetic leucoma

Herpes simplex virus (HSV) keratitis remains a leading infectious cause of blindness worldwide. Although all forms of HSV keratitis are commonly recurrent, the risk is greatest in stromal keratitis, which is the most likely to result in corneal scarring, thinning, and neovascularization. Recent studies showed the ability of Optical Coherence Tomography Angiography (OCTA) to detect and study vascular abnormalities in the anterior segment, including abnormal corneal vessels. This study intends to investigate the potential of OCTA device to image and describe quantitatively the vascularization in eyes diagnosed with herpetic leucoma and to discuss and review the usefulness of this technique in this pathology. A Cross-sectional study was made, including 17 eyes of 15 patients with leucoma secondary to herpetic keratitis. All eyes underwent anterior segment Slit-Lamp photography (SLP), and OCTA with en-face, b-scans and c-scans imaging. The vessel density (VD) was analyzed in the inferior, nasal and temporal corneal margin in all patients, and in the central area, in eyes with central corneal neovascularization (CoNV). The measurements were calculated after binarization with ImageJ software, using OCTA scans with 6 × 6 mm in a depth of 800 μm. Patients included had a mean age 53.267 ± 21.542 (years ± SD). The mean total vessel area was 50.907% ± 3.435%. VD was higher in the nasal quadrant (51.156% ± 4.276%) but there were no significant differences between the three analyzed areas (p = 0.940). OCTA was able to identify abnormal vessels when SLP apparently showed no abnormal vessels; OCTA was able to distinguish between larger and smaller vessels even in central cornea; OCTA scans allowed the investigation of several corneal planes and the relation of them with clinical findings. OCTA can be useful in both qualitative and quantitative follow-up of patients and may become a non-invasive alternative to objectively monitor treatment response in eyes with corneal vascularization due to herpetic infection.info:eu-repo/semantics/publishedVersio

Redesenhar e requalificar o lugar informal - o Bairro na cidade : o bairro do Barruncho, Odivelas.

Dissertação para obtenção do grau de Mestre em Arquitetura, apresentada na Universidade de Lisboa - Faculdade de Arquitetura

Ensaio de hipóteses: perspectivas clássica e bayesiana

Mestrado em Matemática Aplicada à Economia e à Gestãoinfo:eu-repo/semantics/publishedVersio

Data-driven prescription patterns in patients under maintenance treatment for respiratory diseases from the Portuguese prescription database

We aimed to identify prescription patterns in respiratory patients using an unsupervised (data-driven) method, in a random sample of patients aged >14 years (n=8799), retrieved from the Portuguese Electronic Medical Prescription database. Respiratory patients were defined if >2 packs of maintenance treatment for respiratory diseases were prescribed in 2016. We analysed all the prescriptions (n=39810) for respiratory diseases and exacerbations by medication type. Two-step clustering was based on the presence of ICS, LABA, LTRA, LAMA, LABA, SABA, SAMA and on the speciality of prescriber.info:eu-repo/semantics/publishedVersio

Soil conservation in mechanized olive orchards in portuguese Trás-os-Montes region

Traditional practices for tillage in portuguese olive orchards can affect negatively environment, soil quality in particular. Alternative practices will be tested to avoid the negative impacts, reducing soil erosion, improving soil quality and increasing harvesting machinery trafficability. Field trials will take place in a olive orchard in the north of Portugal (Trás-os-Montes region)

Conservação do solo em olivais mecanizados na região de Trás-os-Montes

A olivicultura, pela descontinuidade espacial e relativamente baixa cobertura assegurada pelas copas, envolve riscos actuais de erosão que podem ser importantes. Em Trás-os-Montes, são consideráveis as áreas de elevada e muito elevada erosão potencial e os olivais ocupam aqui, tendencialmente, terrenos situados naquelas classes de risco. Por seu turno, olivais onde as operações culturais são mais largamente mecanizadas devem merecer atenção acrescida, na perspectiva do risco de degradação do solo. Nestes olivais, o efeito na condição estrutural do solo do tráfego de equipamentos como os de colheita mecânica da azeitona, pode propiciar acréscimos no risco de erosão hídrica, seja pela condição de superfície gerada, seja pela época do ano em que a tarefa se realiza. Práticas de conservação do solo, baseadas numa gestão cuidada da cobertura vegetal do terreno, impõem-se nestes sistemas sendo que, por outro lado, a cobertura nas entrelinhas pode constituir o garante de melhor transitabilidade dos equipamentos, em especial os de colheita mecânica. Por razões de escala, é nos olivais mecanizados que melhor se fará a demonstração do contributo de práticas de conservação do solo para a mitigação de impactos sobre o ambiente e para a redução de custos de produção. O projecto apresentado será desenvolvido por ESAB, APPITAD e DRATM (coordenação), tendo como objectivos demonstrar as potencialidades da aplicação de medidas de conservação do solo em olivais mecanizados, centradas na gestão da cobertura vegetal do terreno e identificar necessidades de ajustamento nessas medidas, visando a sua adopção nas explorações olivícolas transmontanas. Dois sistemas de conservação aplicando mobilização reduzida ou nula serão contrastados com o tradicional. No campo de demonstração, em dois anos, os três sistemas serão acompanhados, em parcelas de cerca de 100m2, quanto a erosão, água no solo, vegetação infestante, condição estrutural do solo. Parâmetros definidores da capacidade de trabalho das máquinas serão avaliados aquando das operações culturais. Pela grande relevância socioeconómica, actual e futura, do sector, espera-se que o projecto constitua ponto de partida seguro para a alteração generalizada de práticas que, já hoje, comprometem uma gestão sustentável dos escassos recursos regionais como a água e o solo

CAMILA: formal software engineering supported by functional programming

This paper describes two experiences in teaching a formal approach to software engineering at undergraduate level supported by Camila a functional programming based tool Carried on in diferent institutions each of them addresses a particular topic in the area requirement analysis and generic systems design in the first case specification and implementation development in the second Camila the common framework to both experiences animates a set based language extended with a mild use of category theory which can be reasoned upon for program calculation and classification purpose. The project afiliates itself to but is not restricted to the research in exploring Functional Programming as a rapid prototyping environment for formal software model. Its kernel is fully connectable to external applications and equipped with a component repository and distribution facilities. The paper explains how Camila is being used in the educational practice as a tool to think with providing a kind of cross fertilization between students under standing of diferent parts of the curriculum. Furthermore it helps in developinga number of engineering skills namely the ability to analyze and classify information problems and models and to resort to the combined use of diferent programming frameworks in approaching them

Patient experience in home respiratory therapies : where we are and where to go

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.C.J. has a post-doctoral grant (SFRH/BPD/115169/2016) funded by Fundação para a Ciência e a Tecnologia (FCT), co-financed by the European Social Fund (POCH) and Portuguese national funds from MCTES (Ministério da Ciência, Tecnologia e Ensino Superior).info:eu-repo/semantics/publishedVersio