Twin twin transfusion and fetomaternal transfusion

Introdução: Os autores descrevem um caso de transfusão feto materna (TFM) significativa com repercussão fetal, após ablação de anastomoses vasculares placentares, por síndrome de transfusão feto fetal (STFF). Caso Clínico:31 anos, saudável, primigesta, gravidez espontânea gemelar, monocoriónica biamniótica. A ecografia do 1º trimestre, efetuada às 12 semanas, mostrava concordância dos valores do comprimento crânio caudal (CCC), mas discordância dos valores da medida da translucência da nuca (TN). O rastreio combinado do 1º trimestre foi negativo. Às 16 semanas foi diagnosticado um STFF – estadio II/III de Quintero. A amniocentese revelou um cariótipo normal 46, XY no feto dador e um cariótipo anormal 47, XYY no feto receptor. Às 17 semanas foi efetuada ablação laser das anastomoses vasculares placentares, tendo ocorrido a morte do feto dador às 18 semanas. Às 22 semanas foi diagnosticada anemia fetal, por TFM, confirmada por citometria de fluxo. Às 26 semanas foi constatada dilatação de ansa intestinal - suspeita de atrésia intestinal. Parto por cesariana às 37 semanas. RN: sexo masculino, 2660g, Índice de Apgar 5/8/10. Confirmada atrésia ileal tipo II e efetuada enterectomia segmentar. Evolução clínica favorável. Conclusão: Trata-se de um caso de transfusão feto-fetal seguido de transfusão feto-materna, com atrésia intestinal em provável relação com anemia fetal, em feto com cromossomopati

Structural and insulator-to-metal phase transition at 50 GPa in GdMnO3

We present a study of the effect of very high pressure on the orthorhombic perovskite GdMnO3 by Raman spectroscopy and synchrotron x-ray diffraction up to 53.2 GPa. The experimental results yield a structural and insulator-to-metal phase transition close to 50 GPa, from an orthorhombic to a metrically cubic structure. The phase transition is of first order with a pressure hysteresis of about 6 GPa. The observed behavior under very high pressure might well be a general feature in rare-earth manganites.Comment: 4 pages, 3 figures and 2 table

Hipersonolência Diurna. Narcolepsia, Qual a Etiologia?

Introdução: A narcolepsia é uma doença do sono REM com desregulação do ciclo de sono-vigília, consequente sonolência diurna e eventual associação a alucinações hipnagógicas, paralisia do sono e cataplexia. A sua prevalência é de 0,05 a 0,02% no adulto mas desconhecida na idade pediátrica. Caso clínico: Criança de seis anos, previamente saudável com sonolência excessiva até 18 horas/dia e discinésia oromandibular, desequilíbrio na marcha e movimentos coreiformes dos membros superiores. Duas semanas antes realizara vacinação para a gripe pandémica. Registou-se ainda hiperfagia diurna e nocturna durante cinco dias com resolução espontânea, episódios de cataplexia perante riso e alterações emocionais e tremor da cabeça e dos membros superiores com melhoria clínica progressiva após oito dias. Realizou RMN-CE e EEG sem alterações. O exame líquido céfalo-raquidiano e PCR para painel de vírus herpes, Mycoplasma pneumoniae e enterovírus negativas. Nesta fase realizou polissonografia com teste de latências múltiplas do sono (TLMS) sem alterações. Exame cultural do exsudado faríngeo, TASO e anticorpo AntiDnase B negativos. Da exaustiva investigação que realizou apresentava serologias ELISA e WB compatíveis com infecção por Borrelia burdorferi, pelo que cumpriu ceftriaxone 14 dias. Serologias para influenza A mostraram IgM 39 UA/mL com IgG 194 UA/mL com segunda amostra com IgM 43 UA/mL e IgG 162 UA/mL (VR IgM<20;IgG<20). O estudo da autoimunidade revelou ANA 1/320, anticorpos anticardiolipina e antinucleares extraíveis negativos. Restantes autoanticorpos e doseamento de complemento normal. Anticorpos Anti-NMDA e VKCG negativos. Doseamento de hipocretina muito diminuído com HLA DR2 e DQB1*0602 presentes. A polissonografia com TLMS, sete meses após a primeira, confirmou sonolência excessiva com quatro inícios do sono REM sugestivos de narcolepsia. Faz terapêutica com metilfenidato, a sonolência diurna diminuiu e cumpre o seu horário escolar sem limitações. Comentários: O diagnóstico de narcolepsia foi sugerido pela clínica e confirmado pelo teste de latências múltiplas. O valor de hipocretina diminuído pode sugerir uma etiologia autoimune. Uma infecção como a borreliose ou a vacinação prévia para H1N1, responsabilizada por outros casos de narcolepsia podem ter sido desencadeantes de uma alteração imunitária responsável pela doença, nesta criança com a susceptibilidade HLA DR2 e DBQ1*0602

Diet and Asthma: A Narrative Review

Asthma is a chronic respiratory disease that impacts millions of people worldwide. Recent studies suggest that diet may play a role in asthma pathophysiology. Several dietary factors have been recognized as potential contributors to the development and severity of asthma for its inflammatory and oxidative effects. Some food groups such as fruits and vegetables, whole grains, and healthy fats appear to exert positive effects on asthma disease. On the other hand, a high consumption of dietary salt, saturated fats, and trans-fat seems to have the opposite effect. Nonetheless, as foods are not consumed separately, more research is warranted on the topic of dietary patterns. The mechanisms underlying these associations are not yet fully understood, but it is thought that diet can modulate both the immune system and inflammation, two key factors in asthma development and exacerbation. The purpose of this review is to examine how common food groups and dietary patterns are associated with asthma. In general, this research demonstrated that fruits and vegetables, fiber, healthy fats, and dietary patterns considered of high quality appear to be beneficial to asthma disease. Nonetheless, additional research is needed to better understand the interrelation between diet and asthma, and to determine the most effective dietary interventions for asthma prevention and management. Currently, there is no established dietary pattern for asthma management and prevention, and the nuances of certain food groups in relation to this disease require further investigation

Migration to middle-income countries and tuberculosis-global policies for global economies.

BACKGROUND: International migration to middle-income countries is increasing and its health consequences, in particular increasing transmission rates of tuberculosis (TB), deserve consideration. Migration and TB are a matter of concern in high-income countries and targeted screening of migrants for active and latent TB infection is a main strategy to manage risk and minimize transmission. In this paper, we discuss some aspects of TB control and migration in the context of middle-income countries, together with the prospect of responding with equitable and comprehensive policies. MAIN BODY: TB rates in middle-income countries remain disproportionally high among the poorest and most vulnerable groups in large cities where most migrant populations are concentrated. Policies that tackle migrant TB in high-income countries may be inadequate for middle-income countries because of their different socio-economic and cultural scenarios. Strategies to control TB in these settings must take into account the characteristics of middle-income countries and the complexity of TB as a disease of poverty. Intersectoral policies of social protection such as cash-transfer programs help reducing poverty and improving health in vulnerable populations. We address the development of new approaches to improve well-established strategies including contact tracing and active and latent TB screening as an 'add on' to the existing health care guidelines of conditional cash transfer programs. In addition, we discuss how it might improve health and welfare among both poor migrants and locally-born populations. Authorities from middle-income countries should recognise that migrants are a vulnerable social group and promote cooperation efforts between sending and receiving countries for mitigation of poverty and prevention of disease in this group. CONCLUSIONS: Middle-income countries have long sent migrants overseas. However, the influx of large migrant populations into their societies is relatively new and a growing phenomenon and it is time to set comprehensive goals to improve health among these communities. Conditional cash transfer policies with TB screening and strengthening of DOTS are some strategies that deserve attention. Reduction of social and health inequality among migrants should be incorporated into concerted actions to meet TB control targets

Neurodevelopment and Dietary Intake in Toddlers: A Cross-Sectional Study from the Healthy Children 2021 Project

Little is known about the potential associations between neurodevelopment, dietary diversity and food processing in the toddler period. This study aimed to estimate the association between these dietary quality dimensions and neurodevelopment in toddlers. Data for this cross-sectional analysis came from the Healthy Children 2021 project and included 212 toddlers (51.9% females, aged 1236 months) from 15 Portuguese childcare centers. Neurodevelopment was assessed through Bayley Scales of Infant and Toddler Development. Dietary intake was gathered by a two-day non-consecutive dietary recall. The food items were categorised with NOVA classification. Dietary diversity was explored through Minimum Dietary Diversity (MDD). Logistic regression models adjusted for potential confounders were performed. Girls with a higher energy contribution of unprocessed/minimally processed foods and with an above median MDD score had higher odds of achieving a higher neurodevelopment score (aOR:1.04; 95%CI 1.01; 1.08 and aOR:2.26; 95%CI 1.01; 5.06, respectively); no significant association was observed in boys. Our findings suggest that these dietary dimensions are associated with a higher neurodevelopment in toddler girls. This should be further studied as a possible early link between dietary factors and neurodevelopment. Promotion of healthy eating can be promising in improving neurocognitive development and might help to introduce public health recommendations for toddlers nutrition.</jats:p

Colorimetric paper-based sensors against cancer biomarkers

Cancer is a major cause of mortality and morbidity worldwide. Detection and quantification of cancer biomarkers plays a critical role in cancer early diagnosis, screening, and treatment. Clinicians, particularly in developing countries, deal with high costs and limited resources for diagnostic systems. Using low-cost substrates to develop sensor devices could be very helpful. The interest in paper-based sensors with colorimetric detection increased exponentially in the last decade as they meet the criteria for point-of-care (PoC) devices. Cellulose and different nanomaterials have been used as substrate and colorimetric probes, respectively, for these types of devices in their different designs as spot tests, lateral-flow assays, dipsticks, and microfluidic paper-based devices (μPADs), offering low-cost and disposable devices. However, the main challenge with these devices is their low sensitivity and lack of efficiency in performing quantitative measurements. This review includes an overview of the use of paper for the development of sensing devices focusing on colorimetric detection and their application to cancer biomarkers. We highlight recent works reporting the use of paper in the development of colorimetric sensors for cancer biomarkers, such as proteins, nucleic acids, and others. Finally, we discuss the main advantages of these types of devices and highlight their major pitfalls.This research was funded by Portuguese Foundation for Science and Technology (FCT), under the scope of the strategic funding of UIDB/04469/2020 unit and through Mariana Carneiro PhD grant reference SFRH/BD/131959/2017.info:eu-repo/semantics/publishedVersio

Test-strips for monitoring cancer biomarkers in point-of-care

Authors acknowledge funding to Fundação para a Ciência e Tecnologia, I.P., through the PhD grant reference SFRH/BD/131959/2017info:eu-repo/semantics/publishedVersio