Active Drug Users Admitted to an Internal Medicine Ward: Report of an Experience

Contexto: Nos últimos anos tem-se verificado um aumento da patologia médica associada à toxicodependência, em particular infecciosa, condicionando internamento hospitalar. O próprio internamento, por seu lado, é muitas vezes complicado por problemas directamente associados ao estado de dependência física e psíquica, nomeadamente síndrome de abstinência, comportamento indisciplinado e alta precoce por abandono. Os autores pretenderam caracterizar o impacto desta população numa enfermaria de Medicina Interna durante um ano (1998). Métodos: Foram revistos todos os processos dos doentes internados durante o ano de 1998 numa enfermaria de Medicina Interna. Foram identificados dois grupos: o primeiro constituído por todos os toxicodependentes (definido como doentes com consumo activo de substâncias ilícitas na altura da admissão hospitalar - grupo TD); o segundo pela restante população internada (grupo controlo). Foram identificados para todos os doentes: motivos do internamento, duração do mesmo, e mortalidade; dados demográficos (sexo e idade); todos os episódios infecciosos (na admissão e nosocomiais) e serologias positivas para os vírus da imunodeficiência humana, hepatite B e hepatite C. No grupo TD foram ainda caracterizados os hábitos de consumo e as complicações do mesmo em internamento (em particular síndrome de privação). Resultados: Foram identificados 80 toxicodependentes(5,8% do total de internamentos): 50 homens (7,1 %) e 30 mulheres (4,5%). A idade média no grupo TD foi de 31 anos (no grupo controlo foi de 68,5 anos). Em 70% do grupo TD foi identificada serologia positiva para o VIH e em 48,7% para o VHC (no grupo controlo essa prevalência foi de 2,4% e 1,2%, respectivamente). A mortalidade foi de 11,3% e de 12,7 % respectivamente nos grupos TD e controlo, sendo a demora média de 18,7 e de 16,0 dias. Foram identificados 46 casos de tuberculose (18,8% em doentes TD e 2,4 % nos restantes), 293 de pneumonia (28,7% e 21%) e 54 casos de infecção dos tecidos moles (27,5% e 1,5% respectivamente). Só foram identificados 4 casos de endocardite (2 em cada grupo) e 6 de hepatite aguda (todos no grupo TD). No grupo TD verificaram-se 33 casos de síndrome de privação (41,3%). 16 das altas (20%) foram precoces; destes doentes, 4 tinham diagnóstico de tuberculose. Desta população 10 doentes (12,5%) eram sem abrigo (9 homens, 1 mulher) e 66 (82,5%) eram consumidores de drogas endovenosas. Conclusões: No ano de 1998 os doentes toxicodependentes constituíram uma percentagem significativa da população internada, tendo tido demora média e mortalidade semelhantes às da restante população, embora fossem significativamente mais jovens. A maioria foi internada por patologia infecciosa, sendo de assinalar a alta prevalência de tuberculose e de infecção pelo VIH e VHC. É igualmente relevante o elevado número de altas precoces nesta população, algumas das quais de doentes com patologia potencialmente contagiosa

Diluted manganese on the bond-centered site in germanium

The functional properties of Mn-doped Ge depend to large extent on the lattice location of the Mn impurities. Here, we present a lattice location study of implanted diluted Mn by means of electron emission channeling. Surprisingly, in addition to the expected substitutional lattice position, a large fraction of the Mn impurities occupies the bond-centered site. Corroborated by ab initio calculations, the bond-centered Mn is related to Mn-vacancy complexes. These unexpected results call for a reassessment of the theoretical studies on the electrical and magnetic behavior of Mn-doped Ge, hereby including the possible role of Mn-vacancy complexes

Myocardial Perfusion in Rheumatoid Arthritis Patients: Associations with Traditional Risk Factors and Novel Biomarkers

Introduction. Cardiovascular (CV) diseases are a major cause of death in rheumatoid arthritis (RA) patients. Novel biomarkers [B-type natriuretic peptide (BNP); osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B ligand (RANKL) ratio; and dickkopf-1 (DKK-1)] have been used in CV risk assessment. We analysed, in established RA patients, the presence of silent myocardial ischemia and its association with clinical variables, BNP, and bone and atheroma biomarkers. Methods. From a single-center tertiary referral hospital, RA patients asymptomatic for CV disease were submitted to myocardial perfusion scintigraphy (MPS) under adenosine stress and biomarkers measurements. Logistic regression was used to estimate crude odds ratios (OR) and 95% confidence intervals (CI). Results. In 189 patients, perfusion defects were frequent (25%) and associated with BNP ≥ 100 pg/mL (OR = 5.68; 95% CI: 2.038–15.830), fourth log OPG/RANKL ratio quartile (OR = 2.88; 95% CI: 1.091–7.622), and DKK-1 ≥ 133 pmol/L (OR = 2.69; 95% CI: 1.058–6.840). Similar associations were confirmed in those with C-reactive protein > or ≤ 3 mg/L. No relationship was found with the majority of traditional CV factors nor with disease variables. Conclusions. Our results corroborated the hypothesis that MPS could reveal subclinical CV dysfunction, supported the utility of BNP measurements as a screening tool, and put in perspective the potential usefulness of complementary approaches in CV risk assessment in RA patients

Antineoplastic drugs in urban wastewater: Occurrence, nanofiltration treatment and toxicity screening*

Antineoplastic drugs are pharmaceuticals that have been raising concerns among the scientific community due to: (i) their increasing prescription in the fight against the disease of the twentieth century (cancer); (ii) their recalcitrance to conventional wastewater treatments; (iii) their poor environmental biodegradability; and (iv) their potential risk to any eukaryotic organism. This emerges the urgency in finding solutions to mitigate the entrance and accumulation of these hazardous chemicals in the environment. Advanced oxidation processes (AOPs) have been taken into consideration to improve the degradation of antineoplastic drugs in wastewater treatment plants (WWTPs), but the formation of by-products that are more toxic or exhibit a different toxicity profile than the parent drug is frequently reported. This work evaluates the performance of a nanofiltration pilot unit, equipped with a Desal 5DK membrane, in the treatment of real WWTP effluents contaminated (without spiking) with eleven pharmaceuticals, five of which were never studied before. Average removals of 68 & PLUSMN; 23% were achieved for the eleven compounds, with decreasing risks from feed to permeate for aquatic organisms from receiving waterbodies (with the exception of cyclophosphamide, for which a high risk was estimated in the permeate). Aditionally, no significative impact on the growth and germination of three different seeds (Lepidium sativum, Sinapis alba, and Sorghum saccharatum) were determined for permeate matrix in comparison to the control.& nbsp;This research was financially supported by: (i) Project POCI-01-0145-FEDER-031297 (CytoStraTech) -funded by FEDER funds through COMPETE2020-Programa Operacional Competitividade e Internacionalizacao (POCI) and by national funds (PIDDAC) through FCT/MCTES; (ii) NORTE-01-0145-FEDER-000069 (Healthy Waters) co-funded by European Regional Development Fund (ERDF) , through North Portugal Regional Operational Programme (NORTE 2020) , under the PORTUGAL 2020 Partnership Agreement; (iii) UIDB/04750/2020 (EPIUnit) and LA/P/0064/2020 (ITR) , funded by national funds through the FCT-Foundation for Science and Technology, I.P.; (iv) LA/P/0045/2020 (ALiCE) , Base Fundings UIDB/00511/2020 and UIDP/00511/2020 (LEPABE) and UIDB/50020/2020 and UIDP/50020/2020 (LSRE-LCM) , funded by national funds through FCT/MCTES (PIDDAC) . This work was also funded by Fundacao para a Ciencia e Tecnologia/Ministerio da Ciencia, Tecnologia e Ensino Superior (FCT/MCTES, Portugal) through national funds to iNOVA4Health (UIDB/04462/2020 and UIDP/04462/2020) and the Associate Laboratory LS4FUTURE (LA/P/0087/2020) . Teresa I.A. Gouveia and Vanessa Jorge Pereira would like to thank the Portuguese Foundation for Science and Technology (FCT) for Ph.D. (SFRH/BD/147301/2019) and CEECIND/02919/2018 grants, respectively

The enigmatic monotypic crab plover Dromas ardeola is closely related to pratincoles and coursers (Aves, Charadriiformes, Glareolidae)

The phylogenetic placement of the monotypic crab plover Dromasardeola (Aves, Charadriiformes) remains controversial. Phylogenetic analysis of anatomical and behavioral traits using phenetic and cladistic methods of tree inference have resulted in conflicting tree topologies, suggesting a close association of Dromas to members of different suborders and lineages within Charadriiformes. Here, we revisited the issue by applying Bayesian and parsimony methods of tree inference to 2,012 anatomical and 5,183 molecular characters to a set of 22 shorebird genera (including Turnix). Our results suggest that Bayesian analysis of anatomical characters does not resolve the phylogenetic relationship of shorebirds with strong statistical support. In contrast, Bayesian and parsimony tree inference from molecular data provided much stronger support for the phylogenetic relationships within shorebirds, and support a sister relationship of Dromas to Glareolidae (pratincoles and coursers), in agreement with previously published DNA-DNA hybridization studies

ANÁLISE DO CONHECIMENTO DOS ACADÊMICOS DA UNIEVANGÉLICA SOBRE O FLÚOR

O  flúor  é  utilizado  na  prevenção  e  controle  da  doença  cárie, pois interfere no processo de desmineralização e remineralização dos dentes. O  conhecimento  sobre  os  métodos  de  utilização  do  flúor  e  seus  efeitos  é importante  para  toda  a  população  para  que  o  flúor  seja  utilizado  de  maneira adequada.

Health promoting potential of herbal teas and tinctures from Artemisia campestris subsp maritima: from traditional remedies to prospective products

This work explored the biotechnological potential of the medicinal halophyte Artemisia campestris subsp. maritima (dune wormwood) as a source of health promoting commodities. For that purpose, infusions, decoctions and tinctures were prepared from roots and aerial-organs and evaluated for in vitro antioxidant, anti-diabetic and tyrosinase-inhibitory potential, and also for polyphenolic and mineral contents and toxicity. The dune wormwood extracts had high polyphenolic content and several phenolics were identified by ultra-high performance liquid chromatography-photodiode array-mass-spectrometry (UHPLC-PDA-MS). The main compounds were quinic, chlorogenic and caffeic acids, coumarin sulfates and dicaffeoylquinic acids; several of the identified phytoconstituents are here firstly reported in this A. campestris subspecies. Results obtained with this plant's extracts point to nutritional applications as mineral supplementary source, safe for human consumption, as suggested by the moderate to low toxicity of the extracts towards mammalian cell lines. The dune wormwood extracts had in general high antioxidant activity and also the capacity to inhibit a-glucosidase and tyrosinase. In summary, dune wormwood extracts are a significant source of polyphenolic and mineral constituents, antioxidants and a-glucosidase and tyrosinase inhibitors, and thus, relevant for different commercial segments like the pharmaceutical, cosmetic and/or food industries.FCT - Foundation for Science and Technology [CCMAR/Multi/04326/2013]; Portuguese National Budget; FCT [IF/00049/2012, SFRH/BD/94407/2013]; Research Foundation - Flanders (FWO) [12M8315N]info:eu-repo/semantics/publishedVersio

Risk stratification for small for gestational age for the Brazilian population: a secondary analysis of the Birth in Brazil study.

Risk-stratification screening for SGA has been proposed in high-income countries to prevent perinatal morbidity and mortality. There is paucity of data from middle-income settings. The aim of this study is to explore risk factors for SGA in Brazil and assess potential for risk stratification. This population-based study is a secondary analysis of Birth in Brazil study, conducted in 266 maternity units between 2011 and 2012. Univariate and multivariate logistic regressions were performed, and population attributable fraction estimated for early and all pregnancy factors. We calculated absolute risk, odds ratio, and population prevalence of single or combined factors stratified by parity. Factors associated with SGA were maternal lupus (ORadj 4.36, 95% CI [2.32-8.18]), hypertensive disorders in pregnancy (ORadj 2.72, 95% CI [2.28-3.24]), weight gain < 5 kg (ORadj 2.37, 95% CI [1.99-2.83]), smoking at late pregnancy (ORadj 2.04, 95% CI [1.60-2.59]), previous low birthweight (ORadj 2.22, 95% CI [1.79-2.75]), nulliparity (ORadj 1.81, 95% CI [1.60-2.05]), underweight (ORadj 1.61, 95% CI [1.36-1.92]) and socioeconomic status (SES) < 5th centile (ORadj 1.23, 95% CI [1.05-1.45]). Having two or more risk factors (prevalence of 4.4% and 8.0%) was associated with a 2 and fourfold increase in the risk for SGA in nulliparous and multiparous, respectively. Early and all pregnancy risk factors allow development of risk-stratification for SGA. Implementation of risk stratification coupled with specific strategies for reduction of risk and increased surveillance has the potential to contribute to the reduction of stillbirth in Brazil through increased detection of SGA, appropriate management and timely delivery

The dynamics of apparent horizons in Robinson-Trautman spacetimes

We present an alternative scheme of finding apparent horizons based on spectral methods applied to Robinson-Trautman spacetimes. We have considered distinct initial data such as representing the spheroids of matter and the head-on collision of two non-rotating black holes. The evolution of the apparent horizon is presented. We have obtained in some cases a mass gap between the final Bondi and apparent horizon masses, whose implications were briefly commented in the light of the thermodynamics of black holes.Comment: 9 pages, 7 figure