Impacto dos programas de prevenção de saúde oral na prevalência de carie dentaria em Portugal ? - Revisão sistemática

O objetivo deste estudo foi realizar uma revisão de literatura integrativa sobre o impacto dos programas de prevenção de saúde oral na prevalência de cárie dentária em Portugal. Uma pesquisa eletrônica na base de dados de publicações científicas PUBMED usando a combinação dos seguintes termos científicos: oral health, Health education, caries, Portugal, oral program e incidence. A pesquisa identificou 139 estudos, dos quais 10 foram considerados relevantes para este estudo. A análise dos dados medidos através destes estudos forneceu importantes elementos de comparação que contribuem para a compreensão da prevalência de cárie na população portuguesa. Os diferentes hábitos e comportamentos em relação à saúde oral em diferentes populações (crianças, adolescentes, adultos) foram caracterizados para identificar os principais determinantes da cárie dentária. A implementação de medidas preventivas contra a cárie dentária e o incentivo à higiene oral, graças às atividades de educação / promoção da saúde, através do papel de higienista dental clinicamente competente no território, aumentariam e melhorariam a saúde oral da população portuguesa

Update of the Xylella spp. host plant database – systematic literature search up to 31 December 2022

Abstract This scientific report provides an update of the Xylella spp. host plant database, aiming to provide information and scientific support to risk assessors, risk managers and researchers dealing with Xylella spp. Upon a mandate of the European Commission, EFSA created and regularly updates a database of host plant species of Xylella spp. The current mandate covers the period 2021–2026. This report is related to the eighth version of the database published in Zenodo in the EFSA Knowledge Junction community, covering literature published from 1 July 2022 up to 31 December 2022, and recent Europhyt outbreak notifications. Informative data have been extracted from 21 selected publications. Twelve new host plants were identified and added to the database. Nine plant species were reported from Portugal and naturally infected by subsp. multiplex or unknown (i.e. not reported). Three plant species were successfully artificially infected by subsp. fastidiosa. No additional data were retrieved for X. taiwanensis, and no additional STs were identified worldwide. New information on the tolerant/resistant response of plant species to X. fastidiosa infection were added to the database. The overall number of Xylella spp. host plants determined with at least two different detection methods or positive with one method (between sequencing and pure culture isolation) reaches now 433 plant species, 197 genera and 68 families. Such numbers rise to 690 plant species, 306 genera and 88 families if considered regardless of the detection methods applied

C'è del "vecchio" nel danese moderno? Orientamento storico-comparativo sulla posizione del danese nel panorama linguistico scandinavo

Sfatando il luogo comune del danese come lingua scandinava fortemente innovativa, si passa in rassegna, analizzandoli, tutti i tratti linguistici conservatori della lingua danese

OpenFoodTox: EFSA's chemical hazards database

<p><strong>Background: EFSA's remit and chemical risk assessment of regulated products and contaminants</strong></p> <p>The European Food Safety Authority (EFSA) has the remit to provide scientific advice to risk managers and decision makers through risk assessment and risk communication on issues related to “food and feed safety, animal health and welfare, plant health, nutrition, and environmental issues”. Risk assessment has been defined as "a scientifically based process consisting of four steps: hazard identification, hazard characterisation, exposure assessment and risk characterisation" (EC, 2002). </p> <p>In the food and feed safety area, hazard identification and hazard characterisation aim to determine safe levels of exposure for regulated products or contaminants as “reference values¹” to protect human health, animal health, environmental-relevant species or the whole ecosystem. Such reference values for a given species are most often derived by using a “reference point²" determined from the critical toxicological study on which an uncertainty factor³ is applied.</p> <p>Since its creation in 2002, the European Food safety Authority (EFSA) has produced risk assessments for <strong>more than 4,750 unique substances</strong> in <strong>over 1,800 Scientific Opinions, Statements and Conclusions</strong> through the work of its scientific Panels, Units and Scientific Committee. </p> <p>For regulated products, these risk assessments have been performed by five <a href="http://www.efsa.europa.eu/en/science/scientific-committee-and-panels">scientific panels</a> and four supporting units. </p> <p> </p> <p> <strong>EFSA's chemical Hazards Database : OpenFoodTox </strong></p> <p>OpenFoodTox is a structured database summarising the outcomes of hazard identification and characterisation for the human health (all regulated products and contaminants), the animal health (feed additives, pesticides and contaminants) and the environment (feed additives and pesticides). </p> <p>OpenFoodTox the substance characterisation, the links to EFSA’s related output, background European legislation, and a summary of the critical toxicological endpoints and reference values.</p> <p>For each individual substance, the data model of OpenFoodTox has been designed using OECD Harmonised Template (OHTs) as a basis to collect and structure the data in a harmonised manner. OpenFoodTox provides open source data for the substance characterisation, EFSA outputs, reference points, reference values and genotoxicity. OpenFoodTox and can be searched under the following link using a microstrategy tool: <a href="https://dwh.efsa.europa.eu/bi/asp/Main.aspx?rwtrep=400">https://dwh.efsa.europa.eu/bi/asp/Main.aspx?rwtrep=400</a></p> <p>In order to disseminate OpenFoodTox to a wider community, two sets of data can be downloaded:</p> <p><strong>1. </strong>Five individual spreadsheets extracted from the EFSA microstrategy tool providing for all compounds: a. substance characterisation, b. EFSA outputs, c. reference points, d. reference values and, e. genotoxicity.</p> <p><strong>2. </strong>The full database.</p> <p>OpenFoodTox contributes actively to EFSA’s 2020 Science Strategy (EFSA, 2016) and to the aim of widening EFSA’s evidence base and optimising access to its data as a valuable open source toxicological database that can be shared with all scientific advisory bodies and stakeholders with an interest in chemical risk assessment. In addition, OpenFoodTox has been submitted to the OECD’s Global Portal to Information on Chemical Substances (<a href="https://www.echemportal.org/">eChemPortal</a>) so that individual substances can be searched as part of the national and international databases. Further description and associated references are described in the EFSA journal editorial (Dorne et al., 2017).</p> <p> </p> <p><strong>Using OpenFoodTox to develop innovative <em>in silico</em> models</strong></p> <p>Recently, <em>in silico</em> models using OpenFoodTox have been developed for ecological risk assessment  (bees and rainbow trout) and  human risk assessment using rat toxicological data (Como et al., 2017; Benefenati et al., 2017; Toporov et al., 2017, Toporov et al., 2018). These <em>in silico </em>models provide alternative means to animal experiments for the  hazard identification and characterisation of chemicals, and are becoming of increasing interest in the risk assessment community to deliver the 3Rs (replacement, reduction, refinement) (Hartung, 2004; OECD, 2005) particularly since the banning of animal testing for the approval of cosmetics as consumer products (Regulation (EC) No. 1223/2009, Art.18(2)).</p> <p> </p> <p> </p> <p>Definitions</p> <p>¹Reference Value : The estimated maximum dose (on a body mass basis) or the concentration of an agent to which an individual may be exposed over a specified period without appreciable risk. Reference values are established by applying an uncertainty factor to the reference point. Examples of reference values in human health include acceptable daily intake (ADI) for food and feed additives, and pesticides, tolerable upper intake levels (UL) for vitamins and minerals, and tolerable daily intake (TDI) for contaminants and food contact materials. For acute effects and operators, the acute reference dose (ARfD) and the acceptable operator exposure level (AOEL). In animal health and the ecological area, these include safe feed concentrations and the Predicted no effect concentration (PNEC) respectively (EFSA Scientific Committee, 2018).</p> <p>²Reference point : Defined point on an experimental dose–response relationship for the critical effect. This term is synonymous to Point of departure (USA). Reference points include the lowest or no observed adverse effect level (LOAEL/NOAEL) or benchmark dose lower confidence limit (BDML), used to derive a reference value or Margin of Exposure in human and animal health risk assessment. In the ecological area, these include lethal dose (LD50), effect concentration (EC5/ECx), no (adverse) effect concentration/dose (NOEC/NOAEC/NOAED), no (adverse) effect level (NEL/NOAEL), hazard concentration (HC5/HCx) derived from a Species Sensitivity Distributions (SSD) for the ecosystem (EFSA Scientific Committee,2018).</p> <p>³Uncertainty factor: Reductive factor by which an observed or estimated no observed adverse effect level or other reference point, such as the benchmark dose or benchmark dose lower confidence limit, is divided to arrive at a reference dose or standard that is considered safe or without appreciable risk (WHO, 2009).</p

How to manage children who have come into contact with patients affected by tuberculosis

Childhood tuberculosis (TB) indicates a recent infection, particularly in children aged < 5 years, and therefore is considered a sentinel event insofar as it highlights the presence of an undiagnosed or untreated source case. The risk of acquiring TB is directly proportional to the number of bacilli to which a subject is exposed and the environment in which the contact occurred. This document contains the recommendations of a group of Italian scientific societies for managing a child exposed to a case of TB based on an analysis of the risk factors for acquiring latent tuberculous infection (LTBI) and developing the disease, and the particular aspects TB transmission during the first years of life. The guidance includes a detailed description of the methods used to identify the index case, the tests that the exposed child should receive and the possibilities of preventive chemoprophylaxis depending on the patient's age and immune status, the chemotherapy and monitoring methods indicated in the case of LTBI, the management of a child who has come into contact with a case of multidrug-resistant or extensively drug-resistant TB, and the use of molecular typing in the analysis of epidemics. The group of experts identified risk factors for tuberculous infection and disease in pediatric age as well as gave recommendation on management of contacts of cases of TB according to their age, risk factors and exposure to multidrug-resistant or extensively drug-resistan

Recommendations for treating children with drug-resistant tuberculosis

Tuberculosis (TB) is still one of the most difficult infectious diseases to treat, and the second most frequent cause of death due to infectious disease throughout the world. The number of cases of multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB), which are characterised by high mortality rates, is increasing. The therapeutic management of children with MDR- and XDR-TB is complicated by a lack of knowledge, and the fact that many potentially useful drugs are not registered for pediatric use and there are no formulations suitable for children in the first years of life. Furthermore, most of the available drugs are burdened by major adverse events that need to be taken into account, particularly in the case of prolonged therapy. This document describes the recommendations of a group of scientific societies on the therapeutic approach to pediatric MDR- and XDR-TB. On the basis of a systematic literature review and their personal clinical experience, the experts recommend that children with active TB caused by a drug-resistant strain of Mycobacterium tuberculosis should always be referred to a specialised centre because of the complexity of patient management, the paucity of pediatric data, and the high incidence of adverse events due to second-line anti-TB treatment

Recommendations Concerning the First-Line Treatment of Children with Tuberculosis

This document describes the recommendations of a group of scientific societies concerning the first-line therapeutic approach to paediatric tuberculosis (TB). The treatment of pulmonary TB should be based on the existence of parenchymal involvement and the risk of antibiotic resistance. The treatment of extra-pulmonary TB is based on the regimens used for severe pulmonary TB. The administration of corticosteroids is recommended only in cases of miliary TB, tuberculous meningitis and tuberculous pericarditis. Vitamin B6 may be indicated in the case of isoniazid-treated TB in breastfeeding infants, severely malnourished subjects, or patients with other diseases at high risk of vitamin deficiency. Once having started treatment, children with TB should be carefully followed up in order to evaluate compliance, the response to treatment, the need for treatment changes, and the presence of drug-related adverse events. Primary care paediatricians can support reference centres in providing family healthcare education and encouraging treatment compliance