Status Epilepticus

O Estado de Mal Epiléptico é uma situação com expressão clínica variável, relacionando-se o seu prognóstico com a etiologia subjacente. O Estado de Mal Convulsivo constitui uma emergência médica associada com elevadas taxas de morbilidade e de mortalidade, sendo essencial uma intervenção terapêutica precoce e adequada. Os autores apresentam um esquema de protocolo terapêutico a utilizar neste quadro

The new SWOT for a sustainable world

In today’s complex and changing business environment the concern with sustainability has gained more notoriety. However, companies still do not have a sustainable perspective, but a short-term one, where their values are constantly forgotten and this concept is no longer welcomed. This research demonstrates the need for companies to adapt and to start acting in this direction. Following a set of interviews conducted with professionals with management positions of high responsibility, findings reveal that although sustainability is on the management mind, strategies and tools need to be adapted to be at the core of the organization’s strategic formulation. To support this process, a new SWOT analysis to fit a forward-looking sustainable world is proposed. Furthermore, due to the aggregative nature of the model, it represents an essential tool for an open innovation. “SWOT i” integrates the concern with sustainability as one of its pillars, placing the values and impacts that each decision can have at the center of the strategic formulation, allowing their performance to leverage.info:eu-repo/semantics/publishedVersio

Users satisfaction regarding the service provided in community pharmacies

During the last century, the pharmacy professionals have significantly being professionalized, the user is a high priority and not just limited to the sale of pharmaceuticals. As such, it is necessary to know the users, their needs and expectations, their opinions and preferences. This transversal study, observational, correlational, aimed to: determine the degree of satisfaction with the attendance in community pharmacies, if there is a relationship between factors of a personal nature (age and gender) and satisfaction, trying to identify which aspects improve in order to increase satisfaction levels. The sample consisted of 525 respondents. Data collection was conducted in the period from October 2012 to January 2013 in four locations in northern Portugal. It was used a questionnaire consisting of three parts: the first contained items of personal characterization, the second consisted of the scale "Pharmacy Services Questionnaire" (FSQ) validated for the Portuguese language, developed by Larson et al. (2002) and the last had questions about the respondents' opinion. The results showed that the degree of satisfaction with the services of community pharmacies was in majority an average to 39 % and good for 46,1% . Having in mind the factor by gender, females showed a higher degree of satisfaction. Regarding the age group, older users had the highest degree of satisfaction. It was concluded that, generally, community pharmacies bring a higher degree of satisfaction in the older and the female users. "How the pharmacy professionals explain possible side effects" and "how the pharmacy professional answers your questions.", are the two aspects that must be improved to achieve a higher degree of satisfaction. KEYWORDS Satisfaction, Users, Customer Service, Pharmacotherapy Monitoring, Community Pharmacie

COW´S MILK PROTEIN ALLERGY WITH GASTROINTESTINAL MANIFESTATIONS

A alergia as proteínas do leite de vaca (APLV) constituiu a alergia alimentar mais frequente em crianças com idade inferior a tres anos, podendo as suas manifestações gastrointestinais ocorrer em qualquer idade. Na suspeita clínica de APLV baseada na anamnese e exame físico, deve instituir-se dieta de eliminação durante um período variável consoante o quadro clínico, seguida de uma prova de provocação oral (PPO) que ira confirmar ou excluir o diagnostico. Exames complementares como testes cutâneos e IgEs séricas especificas poderão ser necessários. O tratamento baseia-se na dieta de eliminação e pressupõe aconselhamento nutricional e vigilância do crescimento. Habitualmente repete-se a PPO após tres a 12 meses de dieta de eliminação, verificando-se aquisição de tolerância em mais de 80% das crianças aos três anos de idade. O objetivo deste artigo e fazer uma breve revisão e atualizacao sobre as manifestações gastrointestinais da APLV em idade pediátrica, apresentando uma proposta de abordagem fundamentada em recomendações internacionais recentes.Cow’s milk protein allergy (CMPA) is the leading cause of food allergy in children under three years of age, although its gastrointestinal manifestations may occur in all age groups. In the suspicion of CMPA based on the anamnesis and physical examination, an elimination diet should be initiated for a variable length of time according to the clinical picture, followed by an oral food challenge (OFC) confirming or excluding the diagnosis. Complementary exams such as skin prick tests and specific IgE may be necessary. Treatment is based on an elimination diet and demands nutritional counselling and growth monitoring. Usually an OFC is repeated after three to 12 months of elimination diet. Tolerance is achieved at three years of age in more than 80% of the children. The aim of this work is to make a brief review and update on CMPA in pediatric age, proposing a management approach based on recent international recommendations

Development of a biosponge based on Luffa cylindrica and crosslinked chitosan for Allura red AC adsorption

A new bioadsorbent from Luffa cylindrica and cross-linked chitosan was proposed in the present study. Luffa was used as a natural support medium for chitosan crosslinked with glutaraldehyde (LCsG) and epichlorohydrin (LCsE). Biosponges were applied to remove Allura red from aqueous solutions. LCsG and LCsE were produced using different concentrations of chitosan (1%, 3% and 5% (m v−1)) and crosslinking agents (0.5%, 1.0% and 1.5% (v v−1)). Based on the FT-IR spectra, functional groups characteristic of chitosan crosslinked with glutaraldehyde and epichlorohydrin confirmed the crosslinking. In addition, the biosorbent revealed highly efficient functional groups and morphology with irregularities favorable for adsorption. It was found that the increase in the percentage of glutaraldehyde and epichlorohydrin increased the sample's swelling degree, and the degree of cross-linking was greater than 80% for all LCsG. The results regarding the degree of swelling and degree of crosslinking corroborated with the evaluation of the biosponge's adsorptive potential. The Sips model predicted the equilibrium isotherms, with a maximum adsorption capacity of 89.05 mg g−1 for LCsG and 60.91 mg g−1 for LCsE. The new procedure was successful. Luffa was excellent support for chitosan, resulting in an attractive, low-cost bioadsorbent, preventing renewable sources

A dual channel naphthyl-BODIPY probe for the detection of cations in mixed aqueous solution

The development of chemosensors for the sensing of metal ions is one of the most active research fields with great potential for environmental, physiological and medicinal applications, especially in the case of Pd2+, Hg2+ and the trivalent cations Fe3+ and Al3+. For example, mercury is one of the most toxic metal ions, even at very low concentrations. Accumulation of mercury over time in humans leads to cognitive and motion disorders and Minamata disease. On the other hand, trivalent metal cations such as Fe3+ and Al3+ play crucial roles in physiological processes and its abnormal levels in human tissues and cells could induce anemia, diabetes, Alzheimer´s and Parkinson’s diseases. Therefore, the efficient detection of these cations is a timeless topic in several areas of investigation. We report herein the chromo-fluorogenic behavior toward metal cations of a new BODIPY probe bearing a 4-N,N-dimethylnaphthyl group attached to the meso position of the BODIPY core and a formyl group in position 2. This receptor is a dual channel probe that can be used for the chromogenic and fluorogenic detection, in mixed aqueous solutions, of trivalent (Fe3+and Al3+) and divalent cations (Hg2+and Pd2+) with biological and medicinal relevance.The authors acknowledge Fundação para a Ciência e Tecnologia (Portugal) for funding through CQUM (Pest-C/QUI/UI0686/2019) and project PTDC/QUI COL/28052/2017. The NMR spectrometer Bruker Avance III 400 is part of the National NMR Network (REDE/1517/RMN/2005)

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