An integrated view

Funding Information: This work was supported by “Fundação para a Ciência e a Tecnologia”—FCT MJM (PD/BD/114256/2016), MPM (PTDC/BIM-MET/4265/2014 and PTDC/MEC-MET/29314/2017), MGA (PTDC/BIM-MET/4712/2014), iNOVA4Health (UIDB/Multi/04462/2020), by the European Commission Marie Skłodowska-Curie Action H2020 (mtFOIE GRAS, grant agreement n. 734719), by the Sociedade Portuguesa de Diabetologia, and by the research infrastructure CONGENTO, project LISBOA-01-0145-FEDER-022170, co-financed by Lisboa Regional Operational Programme (Lisboa2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund and by Fundação para a Ciência e Tecnologia (Portugal). NMR data were collected at the UC-NMR facility which is supported in part by FEDER – European Regional Development Fund through the COMPETE Programme (Operational Programme for Competitiveness) and by National Funds through FCT – Fundação para a Ciência e a Tecnologia (Portuguese Foundation for Science and Technology) through grants REEQ/481/QUI/2006, RECI/QEQ-QFI/0168/2012, CENTRO-07-CT62-FEDER-002012, and Rede Nacional de Ressonância Magnética Nuclear (RNRMN). Publisher Copyright: Copyright © 2022 Meneses, Sousa-Lima, Jarak, Raposo, Alves and Macedo.Objective: In the last years, changes in dietary habits have contributed to the increasing prevalence of metabolic disorders, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). The differential burden of lipids and fructose on distinct organs needs to be unveiled. Herein, we hypothesized that high-fat and high-fructose diets differentially affect the metabolome of insulin-sensitive organs such as the liver, muscle, and different adipose tissue depots. Methods: We have studied the impact of 12 weeks of a control (11.50% calories from fat, 26.93% from protein, and 61.57% from carbohydrates), high-fat/sucrose (HFat), or high-fructose (HFruct) feeding on C57Bl/6J male mice. Besides glucose homeostasis, we analyzed the hepatic levels of glucose and lipid-metabolism-related genes and the metabolome of the liver, the muscle, and white (WAT) and brown adipose tissue (BAT) depots. Results: HFat diet led to a more profound impact on hepatic glucose and lipid metabolism than HFruct, with mice presenting glucose intolerance, increased saturated fatty acids, and no glycogen pool, yet both HFat and HFruct presented hepatic insulin resistance. HFat diet promoted a decrease in glucose and lactate pools in the muscle and an increase in glutamate levels. While HFat had alterations in BAT metabolites that indicate increased thermogenesis, HFruct led to an increase in betaine, a protective metabolite against fructose-induced inflammation. Conclusions: Our data illustrate that HFat and HFruct have a negative but distinct impact on the metabolome of the liver, muscle, WAT, and BAT.publishersversionpublishe

USO DE TECNOLOGIAS E APLICATIVOS MÓVEIS NO AUTOCUIDADO DE PESSOAS VIVENDO COM HIV/AIDS: REVISÃO INTEGRATIVA DE LITERATURA

This study was developed to analyze the available scientific findings about the use of mobile technologies and applications in the self-care of people living with HIV/AIDS. This is an integrative literature review, through the databases: Latin American and Caribbean Literature on Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Public Medline (PubMed), using the following descriptors (Decs): "HIV" AND "mobile applications" AND "Self-care". With application of inclusion and exclusion criteria, nine articles comprised the final sample of this study. As for the target audience of the study, all articles addressed the theme of self-care in people living with HIV/AIDS. Regarding the technologies developed for self-care, the contents addressed seek to intervene in essential issues that influence daily the quality of life of people with HIV/AIDS. Issues such as: stigma, related symptoms, development of other comorbidities due to low immunity, depression, alcohol and drug use, are the basic factors for the development of self-care strategies that arrive daily for these people using applications as a means of sharing information, in order to generate quality of life, in addition to enabling the interaction of people living with HIV/AIDS It is concluded that these technologies address factors  that influence daily in the lives of people living with HIV/AIDS, hence the importance of developing self-care strategies that will be made available in real time through mobile devices.Este estudio fue desarrollado para analizar los hallazgos científicos disponibles sobre el uso de tecnologías y aplicaciones móviles en el autocuidado de personas que viven con VIH/SIDA. Se trata de una revisión integradora de la literatura, a través de las bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Public Medline (PubMed), utilizando los siguientes descriptores (Dics): "VIH" Y "aplicaciones móviles" Y "Autocuidado".  En cuanto a las tecnologías desarrolladas para el autocuidado, los contenidos abordados buscan intervenir en cuestiones esenciales que influyen diariamente en la calidad de vida de las personas con VIH/SIDA. Temas como: estigma, síntomas relacionados, desarrollo de otras comorbilidades por baja inmunidad, depresión, consumo de alcohol y drogas, son los factores básicos para el desarrollo de estrategias de autocuidado que llegan diariamente a estas personas utilizando aplicaciones como medio de intercambio de información, con el fin de generar calidad de vida, además de posibilitar la interacción de las personas que viven con VIH/SIDA Se concluye que estas tecnologías abordan factores  que influyen diariamente en la vida de las personas que viven con VIH/SIDA, de ahí la importancia de desarrollar estrategias de autocuidado que estarán disponibles en tiempo real a través de dispositivos móviles.Estudo desenvolvido com o objetivo de analisar os achados científicos disponíveis acerca do uso de tecnologias e aplicativos móveis no autocuidado de pessoas vivendo com HIV/AIDS. Trata-se de uma revisão integrativa de literatura, por meio das bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Eletronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Public Medline (PubMed), utilizando os seguintes descritores (Decs): “HIV” AND “aplicativos moveis” AND “Autocuidado”. Com aplicação dos critérios de inclusão e exclusão, nove artigos compuseram a amostra final deste estudo. Quanto ao público-alvo do estudo, todos os artigos abordaram o tema autocuidado em pessoas que vive com HIV/AIDS. Em relação as tecnologias desenvolvidas para o autocuidado, os conteúdos abordados procuram intervir em questões essenciais que influenciam diariamente na qualidade de vida de pessoas com HIV/AIDS. Questões como: estigma, sintomas relacionados, desenvolvimento de outras comorbidades por conta da imunidade em baixa, depressão, o uso de álcool e drogas, são fatores bases para o desenvolvimento de estratégias de autocuidado que chegam diariamente para essas pessoas utilizando dos aplicativos como meio de compartilhamento de informações, com o intuito de gerar qualidade de vida, além de possibilitar a interação de pessoas que vivem com HIV/AIDS Conclui-se que essas tecnologias abordam fatores que influenciam diariamente na vida de pessoas que vivem com HIV/AIDS, daí a importância de desenvolver estratégias de autocuidado que serão disponibilizadas em tempo real através principalmente dos dispositivos móveis

Validación del Nursing Activities Score en unidades de cuidados intensivos portuguesas

Objective: to describe the process of adaptation and validation of the Nursing Activities Score to the Portuguese context. Method: this was a pilot study of adaptation and validation of the Nursing Activities Score with a sample consisting of 67 patients hospitalized in the intensive care units of three Portuguese hospitals. The construct validity was assessed through factor analysis procedures and the internal consistency of the items was measured through the Cronbach’s alpha coeffi cient. Results: a mean workload value of 63.04% (SD = 14.25; Median = 61.30) was obtained. Psychometric data revealed a Cronbach’s alpha of 0.71 in the total scale, indicating an acceptable accuracy. Confi rmatory factor analysis suggested an appropriate adjustment between the model and the data (χ2 (199) = 214.5, p = 0.214; CFI = 0.95; RMSA = 0.035). Conclusion: in the present study, the Portuguese version of the Nursing Activities Score was found to be a valid instrument, enabling a safe assessment of the workload of nurses.Objetivo: descrever o processo de adaptação e validação do Nursing Activities Score para o contexto português. Método: trata-se de um estudo-piloto de adaptação e validação do Nursing Activities Score, com amostra de 67 doentes internados em unidades de cuidados intensivos de três hospitais portugueses. A validade de constructo avaliou-se mediante procedimentos de análise fatorial e a consistência interna dos itens através do coefi ciente Alpha de Cronbach. Resultados: obteve-se um valor médio da carga de trabalho de 63,04% (DP = 14,25; Mediana = 61,30). Os dados psicométricos revelaram um Alpha de Cronbach de 0,71, na escala total, indicando uma fi delidade aceitável. A análise fatorial confi rmatória sugeriu um ajustamento adequado entre o modelo e os dados (χ2(199) = 214,5, p = 0,214; CFI = 0,95; RMSA = 0,035). Conclusão: neste estudo, a versão portuguesa do Nursing Activities Score revelou-se um instrumento válido, permitindo avaliar a carga de trabalho dos enfermeiros com segurançaObjetivo: describir el proceso de adaptación y validación del Nursing Activities Score al contexto portugués. Método: estudio piloto de adaptación y validación del Nursing Activities Score, con muestra de 67 pacientes internados en unidades de cuidados intensivos de tres hospitales portugueses. La validez del constructo se evaluó mediante análisis factorial y por consistencia interna de los ítems evaluados a través del coefi ciente Alpha de Cronbach. Resultados: se obtuvo un valor medio de carga de trabajo de 63,04% (SD=14,25; Mediana=61,30). Los datos psicométricos expresaron un Alpha de Cronbach de 0,71 en la escala total, indicando fi delidad aceptable. El análisis factorial confi rmatorio sugirió un ajuste adecuado entre el modelo y os datos (χ2 (199)=214,5; p=0,214; CFI=0,95; RMSA=0,035). Conclusión: en este estudio, la versión portuguesa del Nursing Activities Score demostró ser un instrumento válido, permitiendo evaluar la carga de trabajo de los enfermeros con precisión

ENDOCARDITE INFECCIOSA: MECANISMOS, DIAGNÓSTICO E TRATAMENTO

Infective endocarditis is a complex and potentially serious cardiovascular condition characterized by inflammation of the endocardium, the inner layer of the heart. This inflammation is usually triggered by the presence of microorganisms, such as bacteria or fungi, that invade the cardiac surface. This infection can compromise valve functionality and lead to serious complications. Objectives: Comprehensively address the underlying mechanisms, effective diagnostic methods, and available treatment options. Methodology: Analytical reading of articles with the theme of the theme was carried out, upon reading the articles were subjected to inclusion and exclusion criteria, within the inclusion criteria original articles were considered, which addressed the topic researched and allowed full access to the content of the study, published from 2015 to 2023. The research was carried out through online access in the Scientific Electronic Library Online (SCIELO), PubMed, Latin American Caribbean Literature in Health Sciences (LILACS) in the month of January 2024. Results and Discussions: The mechanisms underlying infective endocarditis involve the colonization and invasion of microorganisms in the endocardium, triggering a local inflammatory response. Accurate identification of infectious agents is crucial, highlighting bacterial diversity and the importance of blood cultures to guide treatment. In terms of diagnosis, technological advances such as transesophageal echocardiography have played a significant role in the early detection of valve vegetations. However, the clinical complexity and challenges in patients with subtle manifestations highlight the continued need for improved diagnostic methods. Conclusion: Infective endocarditis is a serious condition that involves inflammation of the inner layer of the heart. Its mechanisms are often linked to the presence of bacteria in the blood. Diagnosis is challenging, but tests such as blood cultures and echocardiograms are essential. Treatment involves the use of long-term antibiotics and, in some cases, surgery. A multidisciplinary approach and prevention are crucial to effectively deal with this potentially lethal disease.A endocardite infecciosa é uma condição cardiovascular complexa e potencialmente grave, caracterizada pela inflamação do endocárdio, a camada interna do coração. Essa inflamação é, geralmente, desencadeada pela presença de microrganismos, como bactérias ou fungos, que invadem a superfície cardíaca. Essa infecção pode comprometer a funcionalidade valvar e levar a complicações sérias. Objetivo: Abordar de maneira abrangente os mecanismos subjacentes, os métodos de diagnóstico eficazes e as opções de tratamento disponíveis. Metodologia: Foi realizada a leitura analítica dos artigos com a temática proposta, mediante a leitura dos artigos foram submetidos a critérios de inclusão e de exclusão, dentre os de inclusão foram considerados artigos originais, que abordassem o tema pesquisado e permitissem acesso integral ao conteúdo do estudo, publicados no período de 2015 a 2023. A pesquisa foi realizada através do acesso online nas bases de Scientific Electronic Library Online (SCIELO), PubMed, Literatura Latino-Americana do Caribe em Ciências da Saúde (LILACS) no mês de janeiro de 2024. Resultados e Discussões: Os mecanismos subjacentes à endocardite infecciosa envolvem a colonização e a invasão de microrganismos no endocárdio, desencadeando uma resposta inflamatória local. A identificação precisa dos agentes infecciosos é crucial, destacando a diversidade bacteriana e a importância de culturas sanguíneas para orientar o tratamento. No âmbito do diagnóstico, avanços tecnológicos como a ecocardiografia transesofágica têm desempenhado um papel significativo na detecção precoce de vegetações valvares. No entanto, a complexidade clínica e os desafios em pacientes com manifestações sutis ressaltam a necessidade contínua de métodos diagnósticos aprimorados. Conclusão: A endocardite infecciosa é uma condição grave que envolve a inflamação da camada interna do coração,os seus mecanismos estão ligados, frequentemente, à presença de bactérias no sangue. O diagnóstico é desafiador, mas exames como hemoculturas e ecocardiogramas são fundamentais. O tratamento envolve o uso de antibióticos de longa duração e, em alguns casos, cirurgia. A abordagem multidisciplinar e a prevenção são cruciais para lidar, eficazmente, com essa doença potencialmente letal

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Local iron homeostasis in the breast ductal carcinoma microenvironment

Abstract BACKGROUND: While the deregulation of iron homeostasis in breast epithelial cells is acknowledged, iron-related alterations in stromal inflammatory cells from the tumor microenvironment have not been explored. METHODS: Immunohistochemistry for hepcidin, ferroportin 1 (FPN1), transferrin receptor 1 (TFR1) and ferritin (FT) was performed in primary breast tissues and axillary lymph nodes in order to dissect the iron-profiles of epithelial cells, lymphocytes and macrophages. Furthermore, breast carcinoma core biopsies frozen in optimum cutting temperature (OCT) compound were subjected to imaging flow cytometry to confirm FPN1 expression in the cell types previously evaluated and determine its cellular localization. RESULTS: We confirm previous results by showing that breast cancer epithelial cells present an 'iron-utilization phenotype' with an increased expression of hepcidin and TFR1, and decreased expression of FT. On the other hand, lymphocytes and macrophages infiltrating primary tumors and from metastized lymph nodes display an 'iron-donor' phenotype, with increased expression of FPN1 and FT, concomitant with an activation profile reflected by a higher expression of TFR1 and hepcidin. A higher percentage of breast carcinomas, compared to control mastectomy samples, present iron accumulation in stromal inflammatory cells, suggesting that these cells may constitute an effective tissue iron reservoir. Additionally, not only the deregulated expression of iron-related proteins in epithelial cells, but also on lymphocytes and macrophages, are associated with clinicopathological markers of breast cancer poor prognosis, such as negative hormone receptor status and tumor size. CONCLUSIONS: The present results reinforce the importance of analyzing the tumor microenvironment in breast cancer, extending the contribution of immune cells to local iron homeostasis in the tumor microenvironment context.info:eu-repo/semantics/publishedVersio