sFlt-1/PIGF no Diagnóstico Preditivo de Pré-eclâmpsia: Estudo de Impacto Económico em Portugal

Overview and Aims: The last decade brought relevant insights into the pathophysiology of preeclampsia (PE), namely the role of the circulating levels of placental growth factor (PlGF) and soluble Fms-like tyrosine kinase-1 (sFlt-1). The purpose of this study is to estimate the financial impact of introducing the sFlt-1/PlGF ratio for the evaluation of women with suspicion of PE in the Portuguese National Healthcare System (SNS). Study Design: budget impact study evaluating short-term costs associated with the introduction of the sFlt-1/PlGF ratio from the SNS payer’s perspective. The time horizon for the study is 1 year. Population: The target population consists of women presenting to the healthcare system with signs or symptoms su ggestive of preeclampsia (estimated in 8500 subjects). Methods: A decision-tree model was used to estimate the budget impact of the introduction of the sFlt-1/PlGF ratio in the SNS. The model compares the management costs in the current clinical practice (“no test” scenario) vs. current diagnostic procedures plus the sFlt-1/PlGF ratio (“test” scenario). Clinical inputs have been derived primarily from literature review and, where data was unavailable, expert opinion. Resources and unit costs have been obtained from Portugal-specific sources. Results: In the current standard practice (no test), total costs were estimated to be €9 863 264 (€1160 per patient), with unnecessary admissions representing about €3,5 million. Total costs in the test scenario sum up to €9 781 194 (€1150 per patient), representing a cost saving to the system of €82 070 (€10 per patient), mainly due to a reduction of false positives and related unnecessary hospitalizations of women not developing PE. Conclusions: There is favorable economic evidence about the introduction of the sFlt- 1/PlGF ratio in the SNS. The generated savings appear to offset the costs related to the test.info:eu-repo/semantics/publishedVersio

Tolerogenic versus Inflammatory Activity of Peripheral Blood Monocytes and Dendritic Cells Subpopulations in Systemic Lupus Erythematosus

Abnormalities in monocytes and in peripheral blood dendritic cells (DC) subsets have been reported in systemic lupus erythematosus (SLE). We aim to clarify the tolerogenic or inflammatory role of these cells based on ICOSL or IFN-α and chemokine mRNA expression, respectively, after cell purification. The study included 18 SLE patients with active disease (ASLE), 25 with inactive disease (ISLE), and 30 healthy controls (HG). In purified plasmacytoid DC (pDC) was observed a lower ICOSL mRNA expression in ASLE and an increase in ISLE; similarly, a lower ICOSL mRNA expression in monocytes of ALSE patients was found. However, a higher ICOSL mRNA expression was observed in ASLE compared to HG in myeloid DCs. Interestingly, clinical parameters seem to be related with ICOSL mRNA expression. Regarding the inflammatory activity it was observed in purified monocytes and CD14(-/low) CD16(+) DCs an increase of CCL2, CXCL9, and CXCL10 mRNA expression in ASLE compared to HG. In myeloid DC no differences were observed regarding chemokines, and IFN-α mRNA expression. In pDC, a higher IFN-α mRNA expression was observed in ASLE. Deviations in ICOSL, chemokine, and IFN-α mRNA expression in peripheral blood monocytes and dendritic cells subpopulations in SLE appear to be related to disease activity

Fasceíte Necrosante após Mobilização e Infiltração Intrarticular do Ombro com Betametasona

Necrotizing Fasciitis is a rapidly progressive, potentially fatal infection of superficial fasciae and subcutaneous tissue, usually resulting from an inciting trauma to the skin. Medical literature refers few cases of necrotizing fasciitis related to intra-articular infiltrations, that often lead to patients death. This report describes the clinical events on a 55 year-old diabetic patient who developed upper extremity Necrotizing Fasciitis, 18 days after shoulder mobilization and intra-articular infiltration, due to Staphylococcus epidermidis. An early surgical debridement was performed and antibiotherapy was established, resulting in a successful outcome, despite the functional disability. We point out, through this case, the possibility of intra-articular injections of drugs causing Necrotizing Fasciitis, especially in risk patients

Análise geomorfológica da Margem Continental Algarvia

The Algarve onshore, stretching out at the piedmont of the basement relieves (e.g. Serra do Caldeirão), documents a large planation surface cut on basement rocks and on the Mesozoic to Miocene sedimentary succession, associated with siliciclastic alluvial to coastal marine Pliocene deposits. Along the coast, Pleistocene terraces can be identified. From west to east, the coast exposes steep cliffs cut on the hard Carboniferous and Jurassic, then more sinuous ones on the softer lithologies of the Miocene and Pliocene, and finally a low sedimentary coast including the lagoon and barrier system of Faro region. The continental shelf comprises tectonic blocks showing at the top a wide planation surface covered by Pliocene and Pleistocene sediments. Marginal plateaux are separated by canyon heads or depressions enlarged by erosion along faults promoted by the Mediterranean bottom current. The plateaux are structural surfaces except in the areas where they have sediments deposited by contour currents

Diagnosis and treatment of acute myocarditis in Portugal. Data from the national multicenter registry on myocarditis

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017.Introduction: The diagnosis of acute myocarditis (aMyo) needs a high level of suspicion. Cardiac magnetic resonance (CMR) may contribute to the diagnosis; but endomyocardial biopsy (EMB) is considered the gold standard, although used infrequently worldwide. Short-term course, albeit unpredictable is usually benign and treatment is mainly supportive. Objectives: To assess the usual care attitudes regarding hospitalized patients (pts) with a diagnosis of aMyo in Portugal, report patient's clinical profiles and current therapeutic approaches, and assess the relevance of CMR to eventual changes in management and/or therapeutic decisions. Methods: Prospective nationwide survey of admitted aMyo pts during a 2-year period (25.04.13–15). Electronic CRFs were completed with admission/discharge data, diagnostic tests, treatments and open-ended questions to evaluate physician's opinions and conclusions. Results: 248 pts from 18 centers were included, 98% caucasian, 35±14 (18–84) years old, 83% male. A recent infectious disease was detected in 57.5% (upper respiratory tract in 71.2%) and 23% had been previously treated with antibiotics. On admission, presentation included angina-like thoracic pain (96%), non-CV symptoms- 58.4% (fever-71%, respiratory- 52.8%, GI- 28.1%), heart failure (HF)- 5.4% and cardiogenic shock- 0.8%; abnormal ECG - 82% (mostly ST elevation-78.5%); increased troponin levels in 95%; echo (in 94%pts) showed left ventricular dilatation (LVD) - 5.7%, segmental LV wall abnormalities (segmAbn) - 34%, reduced LV ejection fraction (RLVEF) - 21% and pericardial effusion (PE) - 11.7%. CMR (in 57%pts), didn't change the management in 70% of cases. Coronary angiography (in 40%) revealed significant CAD in 7.4%. EMB was diagnostic in the 2 pts in which was performed (due to severe progressive HF). Multiple viral serologies (in 32.4% pts) were conclusive in only 0.5%. Most pts were treated with NSAIDs, 39% received ACEi or ARB, 36% a beta-blocker (BB) and 8.4% diuretics; 3.4% needed inotropes. Only 1 death occurred (shock). At discharge, an abnormal ECG persisted in 64.4% of pts; echo (in 50.4%) showed LVD in 6%, segmAbn in 24.6%, RLVEF in 14.6% and PE in 10.2%. Most pts (88.2%) were discharged on NSAIDs, 37.6% on ACEi or ARB, 30.36% on BB, and 6.47% on diuretics. Final diagnosis was aMyo in 54.4% (probable/possible in 96.9% and definitive in only 3.1%) and myopericarditis in 45.6%. Diagnostic criteria were “clinical” in 96.4%, supported by lab results in 87.7% and ECG in 68.8%. Echo or CMR contribution in supporting “clinical diagnosis”, was 38.3% and 48.6% respectively. Disease course was in most cases “mild” (87%). Conclusions: Echo and CMR were performed in most pts with aMyo but diagnosis remained mostly “clinical” according to treating physicians. EMB was very rarely performed. Treatment was largely empirical but an “overuse” of CV drugs and NSAIDs was observed.info:eu-repo/semantics/publishedVersio

Are Economic Growth and Sustainable Development Converging? Evidence from the Comparable Genuine Progress Indicator for Organisation for Economic Co-operation and Development Countries

Academic literature has reflected increasing concerns about the trade-off between preserving the environment and economic growth. To address these concerns, new measurements are needed to evaluate sustainable development, given the limitations of Gross Domestic Product (GDP) in quantifying welfare and sustainability. Genuine Progress Indicator (GPI) is one of those alternative measurements. This paper assesses sustainable development for 28 OECD countries by computing a comparable GPI. Two different approaches to economic growth and sustainable development are discussed. Results suggest that the richest countries are not always the most sustainable. Furthermore, the effect of the financial crisis is verified immediately in the GDP, in contrast to the lagged effect observed in the GPI. Additionally, measures that promote economic growth may not improve sustainability, and may even negatively affect it. Consequently, alternative indicators such as the CGPI can obtain more valuable information for policy-makers seeking to achieve both economic growth and sustainable development. Keywords: CGPI; sustainable development; economic growth JEL Classifications: Q01; Q51; Q56 DOI: https://doi.org/10.32479/ijeep.767

Polar lipids of commercial Ulva spp. of different origins: profiling and relevance for seaweed valorization

Macroalgae of the genus Ulva have long been used as human food. Local environmental conditions, among other factors, can have an impact on their nutrient and phytochemical composition, as well as on the value of the seaweed for food and non-food applications. This study is the first to initiate a comparison between commercial Ulva spp. from different European origins, France (FR, wild-harvested Ulva spp.), and Portugal (PT, farm-raised Ulva rigida), in terms of proximate composition, esterified fatty acids (FA), and polar lipids. The ash content was higher in PT samples, while FR samples had higher levels of proteins, lipids, and carbohydrates and other compounds. The profile of esterified FA, as well as FA-containing polar lipids at the class and species levels were also significantly different. The FR samples showed about three-fold higher amount of n-3 polyunsaturated FA, while PT samples showed two-fold higher content of monounsaturated FA. Quantification of glycolipids and phospholipids revealed, respectively, two-fold and three-fold higher levels in PT samples. Despite the differences found, the polar lipids identified in both batches included some lipid species with recognized bioactivity, valuing Ulva biomass with functional properties, increasing their added value, and promoting new applications, namely in nutraceutical and food markets.UIDB/50011/2020+UIDP/50011/2020, UID/QUI/00062/2019, UIDB/50006/2020, UIDB/50017/2020+UIDP/50017/2020, LISBOA-01-0145-FEDER-402-022125, POCI-01-0145-FEDER-030962, BPD/UI51/5041/2017, BPD/UI51/5042/2018; EC/H2020/727892/EUinfo:eu-repo/semantics/publishedVersio

The unwarped, resolved, deformed conifold: fivebranes and the baryonic branch of the Klebanov-Strassler theory

We study a gravity solution corresponding to fivebranes wrapped on the $S^2$ of the resolved conifold. By changing a parameter the solution continuously interpolates between the deformed conifold with flux and the resolved conifold with branes. Therefore, it displays a geometric transition, purely in the supergravity context. The solution is a simple example of torsional geometry and may be thought of as a non-K\"ahler analog of the conifold. By U-duality transformations we can add D3 brane charge and recover the solution in the form originally derived by Butti et al. This describes the baryonic branch of the Klebanov-Strassler theory. Far along the baryonic branch the field theory gives rise to a fuzzy two-sphere. This corresponds to the D5 branes wrapping the two-sphere of the resolved conifold in the gravity solution.Comment: 41 pages, 7 figure

Sustainable plant polyesters as substrates for optical gas sensors

UIDB/04378/2020 PTDC/BII-BIO/28878/2017 PTDC/SAU-SER/30388/2017 SFRH-BD-110467-2015The fast and non-invasive detection of odors and volatile organic compounds (VOCs) by gas sensors and electronic noses is a growing field of interest, mostly due to a large scope of potential applications. Additional drivers for the expansion of the field include the development of alternative and sustainable sensing materials. The discovery that isolated cross-linked polymeric structures of suberin spontaneously self-assemble as a film inspired us to develop new sensing composite materials consisting of suberin and a liquid crystal (LC). Due to their stimuli-responsive and optically active nature, liquid crystals are interesting probes in gas sensing. Herein, we report the isolation and the chemical characterization of two suberin types (from cork and from potato peels) resorting to analyses of gas chromatography–mass spectrometry (GC-MS), solution nuclear magnetic resonance (NMR), and X-ray photoelectron spectroscopy (XPS). The collected data highlighted their compositional and structural differences. Cork suberin showed a higher proportion of longer aliphatic constituents and is more esterified than potato suberin. Accordingly, when casted it formed films with larger surface irregularities and a higher C/O ratio. When either type of suberin was combined with the liquid crystal 5CB, the ensuing hybrid materials showed distinctive morphological and sensing properties towards a set of 12 VOCs (comprising heptane, hexane, chloroform, toluene, dichlormethane, diethylether, ethyl acetate, acetonitrile, acetone, ethanol, methanol, and acetic acid). The optical responses generated by the materials are reversible and reproducible, showing stability for 3 weeks. The individual VOC-sensing responses of the two hybrid materials are discussed taking as basis the chemistry of each suberin type. A support vector machines (SVM) algorithm based on the features of the optical responses was implemented to assess the VOC identification ability of the materials, revealing that the two distinct suberin-based sensors complement each other, since they selectively identify distinct VOCs or VOC groups. It is expected that such new environmentally-friendly gas sensing materials derived from natural diversity can be combined in arrays to enlarge selectivity and sensing capacity.publishersversionpublishe