As competências linguísticas de crianças de 4 e 5 anos: estratégias de Intervenção

Este trabalho pretende fomentar uma reflexão sobre as vantagens do desenvolvimento das competências linguísticas na educação pré-escolar. O objetivo deste estudo foi a criação de tarefas pedagógicas que trabalhassem especificamente as competências linguísticas na área da fonologia, da morfossintaxe, da semântica e da pragmática. As tarefas de avaliação, bem como as práticas pedagógicas, foram aplicadas a 15 crianças, que frequentavam a sala dos 4 anos do Centro Paroquial do Estoril. A aplicação das atividades realizadas com as crianças revelaram que o tipo de abordagem pedagógica específica nestas competências influenciaram o desempenho linguístico das crianças no comportamento da consciência linguística (fonológica, morfossintática, semântica e pragmática) tornando o seu discurso oral mais eficaz, fazendo com que a criança tenha consciência da sua utilização o que facilitará a integração dos conceitos da linguagem escrita como a compreensão da leitura (interpretação, identificação da ideia principal, etc…) e o desenvolvimento do discurso escrito. Concluímos que as atividades pedagógicas fazem a criança entrar no mundo linguístico e conhecê-lo de forma a poder integrá-lo e dominá-lo

Paracentese de seguimento na peritonite bacteriana espontânea : utilidade

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016A Peritonite Bacteriana Espontânea (PBE) é uma complicação frequente na cirrose descompensada, com mortalidade no primeiro episódio de cerca de 30%. As mais recentes recomendações (AASLD) indicam que a paracentese às 48 horas de antibioterapia só deverá ser realizada se houver má resposta clínica e laboratorial. Por protocolo, o serviço de gastroenterologia do Hospital Santa Maria (HSM) realiza paracentese a todos os doentes após 48. Para avaliar a sua utilidade na abordagem da população com diagnóstico de PBE do serviço, realizou-se um estudo retrospetivo que incidiu num período de 53 meses. Foram incluídos todos os doentes com uma contagem de neutrófilos>250/mm3 na paracentese diagnóstica, (n=77). 79% dos doentes estavam a ter o primeiro episódio de PBE, e cerca de 84,4% não realizava profilaxia para esta. Na avaliação do líquido ascítico às 48h de antibioterapia, 12,99% evoluíram de forma positiva e mesmo assim alteraram a antibioterapia, e 16,88% não tiveram uma boa resposta e não mudaram de antibiótico. Com estes resultados conclui-se que a paracentese de seguimento não é um procedimento essencial na decisão terapêutica, e propõe-se uma abordagem mais baseada na clínica, como de resto já era aplicada, poupando o doente a procedimentos invasivos desnecessários.The Spontaneous Bacterial Peritonitis (SBP) is a usual complication of decompensated cirrhosis, and it has a mortality rate of 30% on the first episode. The most recent guidelines (AASLD) point that the paracentesis 48 hours after starting antibiotic therapy should only be performed if there’s a bad clinical and laboratorial response. By protocol, the gastroenterology service of the Santa Maria Hospital (SMH) performs a paracentesis to all there patients after 48h. To evaluate it utility on the population from service with the diagnosis of SBP, it has been performed a retrospective study that comprised 53 months. Their were included all patients with neutrophil count above 250/mm3 in the diagnoses paracentesis, (n=77). 79% of the patients were having the first SBP episode, and 84,4% weren’t doing prophylactic therapy for it.12,99% of the patients changed their antibiotic, even thou they had a favorable response in the evaluation of the ascites 48h after starting the therapy, and 16,88% didn’t change their antibiotics, even with a bad evolution. With this outcomes we can conclude that de follow-up paracentesis isn´t an essential procedure in the therapeutic decision, and we propose a clinical approach, saving the patient from unnecessary procedures

Evaluation of current antiemetic therapy response in patients undergoing MEC or HEC regimens in Portugal

Chemotherapy-induced nausea and vomiting (CINV) negatively impact cancer patients' quality of life and treatment outcomes. This study evaluated the achievement of complete response to CINV prophylaxis during the first five days after chemotherapy in adult outpatient cancer clinics with solid malignant tumours receiving Moderate or Highly Emetogenic Chemotherapy (MEC or HEC) in Portugal. During the study, patients completed three evaluations, and nausea severity and CINV impact on patients' daily life was assessed. A complete response (no emetic episodes, no use of rescue antiemetic medication, and no more than mild nausea) was observed in 72% of the cycles (N = 161) throughout the five days after chemotherapy. Amongst the patient population, 25% classified their CINV episodes as severe. Though more than half of the patients achieved a complete response, suggesting that a therapeutic effort is being made to minimise this side effect, the overall scenario is barely optimistic. Significantly, new CINV-control measures in MEC/HEC patients should be adopted, specifically avoiding the single use of dexamethasone and 5-HT3 and raising awareness of using NK1-RAs. Thus, it is critical to improve CINV prophylactic treatment and implement practical international antiemetic guidelines in Portuguese clinical practice, envisaging the improvement of supportive care for cancer patients.info:eu-repo/semantics/publishedVersio

A longitudinal analysis

Funding Information: This research was funded by Fundação Álvaro Carvalho (funding manager), Câmara Municipal de Cascais, Fundação Vox Populi, Fundação Manuel Viegas Guerreiro, and Claude and Sofia Foundation. Publisher Copyright: Copyright © 2023 Carvalho, Henriques, Queirós, Rodrigues, Mendonça, Rodrigues, Canhão, de Sousa, Antunes and Guimarães.Background and aim: The kinetics of antibody production in response to coronavirus disease 2019 (COVID-19) infection is not well-defined yet. This study aimed to evaluate the antibody responses to SARS-CoV-2 and its dynamics during 9-months in a cohort of patients infected during the first phase of the pandemic. As a secondary aim, it was intended to evaluate the factors associated with different concentrations of IgG antibodies. Methods: A prospective cohort study was conducted from June 2020 to January 2021. This study recruited a convenience sample of adult individuals who where recently diagnosed with COVID-19 and were living in mainland Portugal. A total of 1,695 blood samples were collected from 585 recovered COVID-19 patients up to 9 months after SARS-CoV-2 acute infection. A blood sample was collected at baseline and three, 6 and 9 months after SARS-CoV-2 acute infection to assess the concentration of IgG antibody against SARS-CoV-2. Results: The positivity rate of IgG reached 77.7% in the first 3 months after symptom onset. The IgG persists at all subsequent follow-up time-points, which was 87.7 and 89.2% in the 6th and 9th months after symptom onset, respectively. Three distinct kinetics of antibody response were found within the 9 months after infection. Kinetic 1 (K1) was characterized by a constant low IgG antibody concentration kinetic (group size: 65.2%); kinetic 2 (K2), composed by constant moderate IgG kinetic (group size: 27.5%) and kinetic 3 (K3) characterized by higher IgG kinetic (group size: 7.3%). People with ≥56 years old (OR: 3.33; CI 95%: [1.64; 6.67]; p-value: 0.001) and symptomatic COVID-19 (OR: 2.08; CI 95%: [1.08; 4.00]; p-value: 0.031) had higher odds of a “Moderate IgG kinetic.” No significant association were found regarding the “Higher IgG kinetic.” Conclusion: Our results demonstrate a lasting anti-spike (anti-S) IgG antibody response at least 9 months after infection in the majority of patients with COVID-19. Younger participants with asymptomatic disease have lower IgG antibody positivity and possibly more susceptible to reinfection. This information contributes to expanding knowledge of SARS-CoV-2 immune response and has direct implications in the adoption of preventive strategies and public health policies.publishersversionpublishe

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Metodologia de captura-recaptura na vigilância da doença dos legionários

A doença dos legionários (DL) é uma pneumonia atípica grave, causada por bactérias do género Legionella. Como todos os sistemas de informação, o Programa de Vigilância Epidemiológica Integrada de DL tem problemas de subnotificação que impede o conhecimento exacto da incidência da doença. O objectivo deste estudo foi estimar o número de casos de DL na região Norte, durante o período entre 2004 e 2009, recorrendo à metodologia de captura-recaptura. A estimativa do número de casos não detectados foi de 167 e o número total estimado de casos de doença na região foi de 614.Fundação para a Ciência e a Tecnologia (FCT

Mutant KRAS modulates colorectal cancer cells invasive response to fibroblast-secreted factors through the HGF/C-MET axis

Genetic alterations influence the malignant potential of cancer cells, and so does thetumor microenvironment. Herein, we combined the study of KRAS oncogenic effectsin colorectal cancer cells with the influence of fibroblast-derived factors. Resultsrevealed that mutant KRAS regulates cell fate through both autonomous and nonau-tonomous signaling mechanisms. Specifically, processes such as proliferation andcell-cell aggregation were autonomously controlled by mutant KRAS independentlyof the stimulation with fibroblasts conditioned media. However, cancer cell invasionrevealed to be a KRAS-dependent nonautonomous effect, resulting from the cooper-ation between fibroblast-derived HGF and mutant KRAS regulation of C-METexpression. C-MET downregulation upon KRAS silencing rendered cells less respon-sive to HGF and thus less invasive. Yet, in one cell line, KRAS inhibition triggeredinvasion upon stimulation with fibroblasts conditioned media. Inhibition of PIK3CAoncogene did not promote invasion, thus showing a KRAS-specific effect. Moreover,the invasive capacity also depended on the HGF-C-MET axis. Overall, our studyawards oncogenic KRAS an important role in modulating the response to fibroblast-secreted factors either by promoting or impairing invasion, and depicts the HGF-C-MET axis as a putative therapeutic target to impair the invasive properties of mutantKRAS cancer cells.info:eu-repo/semantics/publishedVersio