Reabilitação oral na maxila atrófica

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas MonizA reabilitação oral é a área da Medicina Dentária que permite devolver ao paciente a qualidade de vida, tanto a nível funcional como estético, existente antes da perda de peças dentárias. A reabsorção óssea é um processo fisiológico que ocorre ao longo da vida, exacerbandose quando ocorre a perda de função. Assim, é importante saber como solucionar as situações em que existe necessidade de reabilitação oral, tal como quando esta é acompanhada de falta de estrutura óssea. A reabsorção óssea pode ser classificada usando a Classificação de Atwood e que se divide em 6 tipos, havendo necessidade de enxerto óssea apenas para os graus 4,5 e 6 de atrofia maxilar. O enxerto ósseo tem como objectivo preencher zonas onde ocorreu reabsorção óssea para que estas possam ser devidamente reabilitadas. Este substituto ósseo pode ter diferentes origens, podendo ser humano, animal ou mesmo sintético. Entre as diferentes técnicas de enxerto ósseo aplicadas à maxila encontramos a técnica de distracção osteogénica, a técnica de enxerto com blocos ósseos, a técnica de enxerto com osso particulado, a técnica de enxerto de elevação do soalho do seio maxilar, a técnica de enxerto interposicional e a técnica de enxerto utilizando proteínas morfogénicas. Com base em diversos artigos, a presente monografia tem como objectivo identificar as diferentes técnicas que podem ser utilizadas para solucionar problemas de reabilitação oral ao nível dos diferentes graus de atrofia da maxila

Avaliação da frequência alélica e haplotípica do sistema HLA para os loci HLA-A, HLA-B e HLA-DRB1 de receptores renais e doadores intervivo do estado do Pará, Brasil/ Evaluation of the allelic and haplotypic frequency of the HLA system for HLA-A, HLA-B e HLA-DRB1 loci of renal receptors and living donors from the state of Pará, Brazil

Introdução: A descoberta dos antígenos leucocitários humano (HLA) trouxe o reconhecimento de que a compatibilidade do sistema HLA entre doador e receptor é um fator importante em transplantes de órgãos, tecidos e células. No transplante renal, a compatibilidade desse sistema está associada a sobrevida do enxerto em longo prazo e a incompatibilidade está envolvida diretamente na reatividade imunológica do receptor contra células do doador, o que pode levar a processos de rejeição celular e humoral. Objetivo: Esse trabalho teve como objetivo avaliar a frequência alélica e haplotípica de doadores e pacientes renais paraenses e possível associação com doenças. Método: As frequências alélicas e haplotípicas do HLA-A, -B e -DRB1 foram avaliadas em 475 doadores e receptores renais registrados na Fundação HEMOPA. Os programas Arlequin v.3.11 e PyPop v.0.7 foram utilizados para calcular as frequências alélicas e haplotípicas, equilíbrio de Hardy-Weinberg, teste de neutralidade e cálculo de desequilíbrio de ligação. As patologias que apresentaram prevalência maior que cinco dentre os pacientes estudados foram escolhidas para realizar a associação com os alelos HLA. A verificação da frequência dos alelos e haplótipos foi realizada com comparativos entre artigos publicados e utilização de ferramentas de pesquisa em sistemas de informação e sites sobre estudos em populações. Resultados: As doenças de base mais encontradas nos pacientes foram hipertensão arterial sistêmica, doença renal crônica e glomerulonefrite crônica. Os alelos mais comuns encontrados nos indivíduos paraenses foram HLA-A*02, HLA-A*24, HLA-A*31, HLA-B*35, HLA-B*15, HLA-B*51, HLA-DRB1*04, HLA-DRB1*13 e HLA-DRB1*01. Os loci do estudo apresentaram-se em equilíbrio de Hardy-Weinberg e o maior desequilíbrio de ligação foi entre os lócus B e DRB1. O haplótipo mais frequente nos indivíduos paraenses foi A*02 B*44 DRB1*07. Enquanto nos pacientes e doadores, os haplótipos mais observados foram A*02 B*51 DRB1*11 e A*02 B*44 DRB1*04, respectivamente. Conclusões: Esse é o primeiro estudo sobre a diversidade HLA com doadores e pacientes candidatos a transplante renal na região Norte do país. Nossos resultados de frequência alélica e haplotípica foram semelhantes aos encontrados em outros estudos na população brasileira. Esses dados reforçam o conceito de que os genes HLA são uma ferramenta confiável para investigar a composição étnica de uma população.

Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter study

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Purpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP). Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed. Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression. Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.Open access funding provided by FCT|FCCN (b-on). This work was supported by the Laboratório de Genética and the Instituto de Saúde Ambiental (ISAMB) of the Faculdade de Medicina of Universidade de Lisboa and the Instituto de Investigação Científica Bento da Rocha Cabral. The writing of the manuscript was also supported by funds from Fundação para a Ciência e a Tecnologia to ISAMB (ref. UIDB/04295/2020 and UIDP/04295/2020). This work was also part of a doctoral project funding by the company CUF with a PhD grant in Medicine awarded in 2021 and by the Portuguese Society of Ophthalmology with a PhD grant awarded in 2019.info:eu-repo/semantics/publishedVersio

Influenza severe cases in hospitals, between 2014 and 2016 in Portugal

Rede Portuguesa de Laboratórios para o Diagnóstico da GripeBackground: Since 2009, the Portuguese Laboratory Network (PLNID) for Influenza Diagnosis has integrated 15 Laboratories in mainland and Atlantic Islands of Azores and Madeira. This PLNID added an important contribute to the National Influenza Surveillance Program regarding severe and hospitalized influenza cases. The present study aims to describe influenza viruses detected in influenza like illness (ILI) cases: outpatients (Outp), hospitalized (Hosp), and intensive care units (ICU), between 2014 and 2016. Methods: The PLNID performs influenza virus diagnosis by biomolecular methodologies. Weekly reports to the National Influenza Reference Laboratory ILI cases tested for influenza. Reports include data on detecting viruses, hospital assistance, antiviral therapeutics, and information on death outcome. Were reported during two winter seasons 8059 ILI cases,being 3560 cases in 2014/15 (1024 in Outp, 1750 Hosp, and 606 in ICU) and 4499 cases in 2015/2016 (1933 in Outp, 1826 Hosp, and 740 in ICU). Results: The higher percentage of influenza positive cases were detected in Outp in both seasons, 18% during 2014/15 and 20% in 2015/16. In 2014/15,influenza cases were more frequent in individuals older than 65 years old and these required more hospitalizations,even in ICU. In 2015/16,the influenza cases were mainly detected in individuals between 15-64 years old. A higher proportion of influenza positive cases with hospitalization in ICU were observed in adults between 45-64 years old.During the study period,the predominant circulating influenza viruses were different in the two seasons: influenza B and A(H3) co-circulated in 2014/15,and influenza A(H1)pdm09 was predominant during 2015/16. Even when influenza A is notthe dominant virus, A(H3) and A(H1)pdm09 subtypes correlate with higher detection rate in hospitalized cases (Hosp and UCI), with higher frequencies in adults older than 45. Influenza B,detected in higher proportion in outpatients, was frequently relatedwith influenza cases in younger age groups: 0-4 and 5-14 years old. Conclusions: This study highlights the correlation of theinfluenza virus type/subtype that circulates in each season with the possible need for hospitalization and intensive care in special groups of the population. Circulation of influenza A subtypes can cause more frequentdisease in individuals older than 45, with need of hospitalization including intensive care. On the other hand, influenza B is more frequently associated with less severe cases and with infection in children and younger adults. Influenza B circulation might predict lower number of hospitalizations.The identification of influenza type in circulation,byPLNID ineach season, could guide action planning measures in population health care.info:eu-repo/semantics/publishedVersio

Efeitos do brinquedo terapêutico em serviços hospitalares pediátricos / Effects of therapeutic toy in pediatric hospital services

O seguinte estudo tem como objetivo descrever os efeitos do brinquedo terapêutico em serviços hospitalares pediátricos. Trata-se de uma revisão integrativa da literatura, de abordagem qualitativa, de natureza exploratória e descritiva. A elaboração da pergunta norteadora ocorreu fazendo uso do acrônimo PICo (população, interesse e contexto), sendo P (pediatria), I (uso de brinquedo terapêutico) e C (emergências e urgências), o que gerou na seguinte indagação: Como se dá a utilização do brinquedo terapêutico nos serviços de emergências e urgências pediátricas? O levantamento nas bases de dados foi efetuado na Medical Literature Analysis and Retrieval System On-line (MEDLINE), por meio da PubMed; Banco de Dados em Enfermagem (BDENF) e Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), por intermédio da Biblioteca Virtual de Saúde (BVS), e a Biblioteca Virtual (Scielo). Os Descritores em Ciências da Saúde (DeCS) utilizados foram: “jogos e brinquedos”, “terapêutica”, "hospitais" e “pediatria”, cruzados entre si pelo operador booleano AND. A utilização do brinquedo terapêutico pode contribuir para explorar os interesses, expectativas e necessidades das crianças. As brincadeiras puderam desenvolver características como controle de situação, autonomia, competição, solidariedade, assim como relação família-paciente. Em virtude do que foi mencionado, percebe-se que crianças podem se beneficiar do brinquedo terapêutico. Nesse sentido, é importante que haja capacitação dos profissionais em relação ao saber usar os brinquedos a fim de promover um atendimento mais leve e humanizado para aquela criança que está em dor e sofrimento

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

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

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease