Impact of brain biopsy on management of nonneoplastic brain disease

Introduction: Diagnostic yield of brain biopsy in neoplastic brain disease is high and its clinical impact is well established. In nonneoplastic brain disease with negative conventional investigation, decision to undergo invasive procedures is difficult due to its inherent risk and known lower diagnostic yield. Research question: What is the clinical impact of brain biopsy results on management of nonneoplastic brain disease ? Material and methods: A multidisciplinary team retrospectively reviewed and included all nonneoplastic brain disease cases submitted to biopsy between 2009 and 2019, in a tertiary hospital in Lisbon. Baseline characteristics were registered, including immunosuppression status, diagnostic workup, and treatment prior to biopsy. Diagnostic yield, clinical impact and in-hospital complication rates were assessed. Results: Sixty-four patients were included, 20 (31.3%) of them immunosuppressed (15 HIV ​+ ​patients). Thirty-five (67.7%) were previously treated with steroids or antiinfectious agents, with higher percentage (93.3%) in the immunosuppressed group. Biopsy results were diagnostic in 46 (71.9%) cases. More frequent diagnosis was infectious in 20 (31.2%), neoplastic in 12 (18.8%) and inflammatory diseases in 8 (12.5%). Brain biopsy resulted on impact on patient's clinical management in 56 (87.5%), of which 37(57.8%) were submitted to treatment change. In-hospital complications were registered in 4 (6.6%) patients. Discussion and conclusion: Brain biopsy had clinical impact, including a change in treatment, in most patients studied, and may be considered a useful diagnostic option in nonneoplastic brain disease. However, associated complication rate is not negligible, and previous thorough workup, patient selection and risk-benefit assessment are important.info:eu-repo/semantics/publishedVersio

Household disaster preparedness: a survey research results after the wildfires in the Pedrógão Grande, Figueiró dos Vinhos and Castanheira de Pera, Portugal, 2017

Os incêndios florestais constituem uma séria ameaça à saúde das populações e ao ambiente. A preparação das famílias para fazer face a desastres e emergências é crucial para a sua proteção e para a resiliência da comunidade. Aproximadamente um ano depois do incêndio florestal de 2017 ocorrido na região portuguesa de Pedrógão Grande, foi realizado um inquérito sobre medidas de preparação, envolvendo uma amostra aleatória e representativa de 330 pessoas da população afetada. Analisaram-se as relações entre as variáveis sociodemográficas e a adoção de medidas básicas de preparação pelas famílias, bem como do índice de preparação, através de odds ratio, estimadas por regressão logística. A taxa de resposta ao inquérito foi de 83%. Alimentos que não requerem refrigeração nem preparação culinária e o abastecimento de água foram as medidas de preparação mais referidas (85% e 63% respetivamente). Aproximadamente 79% dos respondentes referiram dispor de um rádio a pilhas e 47% de uma lanterna a pilhas, mas apenas 35% verificava regularmente a carga das pilhas. A forma preferida para obter informações durante um desastre ou emergência era a televisão (36,4%), o telefone (22%) e o rádio (15%). A análise do índice de preparação revela a existência de pequenas diferenças a nível local e que as mulheres tendem a adotar menos medidas de preparação que os homens. A existência de doenças crónicas está relacionada com a adoção de um maior número de medidas de preparação.Wildfires are a serious threat to populations’ health and the environment. Household preparedness for disasters and emergency is crucial to help people to protect themselves and improve community resilience. A sur vey on preparedness household measures was conducted in 2018 in a random representative sample (n=330) of the population af fected by the 2017 wildfire in the Por tuguese region of Pedrógão Grande. Associations between sociodemographic variables and the preparedness measures as well the preparedness index were tested by odds ratio estimated by logistic regression. A response rate of 83% was obtained. Non-perishable food and water supplies were the preparedness measures most referred (85% and 63% respectively). To have a battery operated radio (79%) and a flashlight (47%) were also referred but only 35% checked the batteries regularly. The preferred primary means of getting information during a disaster or emergency were television (36,4%), telephone (22%) and radio (15%). The preparedness index analysis shows a slightly dif ference at local level and that women tended to be less prepared than men. Having a chronical disease is associated with the adoption of a higher number of preparedness measures.info:eu-repo/semantics/publishedVersio

Effectiveness of the introduction of Proprioceptive Training in the exercise programs for Knee Osteoarthritis

Trabalho apresentado em EULAR Annual European Congress of Rheumatology, 11-14 de junho 2014, Paris, FrançaN/

Indifferentiated osteoclastic-type giant cell carcinoma

Initially described 40 years ago (Rosai), the undifferentiated osteoclastic-type giant cell carcinoma (IOGCC) is a variant of ductal adenocarcinoma and accounts for less than 1% of exocrine pancreatic tumors. Its extreme rarity, with consequent existence of few reports and clinical experience, leads to the arousal of doubts with regard to its histogenesis, types of approach and therapeutical attitudes. It is important to note that in Portugal no similar case is registered in medical literature. A 61 year old patient admitted to the Internal Medicine Ward 3 at Coimbra University Hospital presents with a volumous intra-abdominal mass in the left hypochondrium and microcytic anemia. During the investigation, a pancreatic neoplasm was identified, and the patient was submitted to surgical resection, the anatomo-pathological study of the tumor having revealed IOGCC. The particularities of the case, current available therapeutical options and its evolution are discussed, as well as a revision of the existing literature

Development and validation of psoriatic arthritis switch quality assessment tool (PASQAL)-an outcomes measurement tool to assess the quality of biologic switch decisions in psoriatic arthritis

Background: Switching between biologic therapies is a recommended strategy for Psoriatic Arthritis (PsA) patients that show an insufficient response or adverse events. Although the choice of the subsequent biologic may be dependent on many factors, assessing the quality of the switch decision is of utmost relevance. Objectives: To develop and validate two outcomes measurement tools (for patients with peripheral and axial PsA phenotypes) that address the quality of treatment decisions in PsA regarding the switch of biologic therapies in clinical practice. Methods: A Task Force and an Expert Panel were specifically assembled for this purpose. The Psoriatic Arthritis Switch Quality Assessment tool (PASQAL) de-velopment comprised a modified-Delphi method in a four-step procedure: 1) literature search and experts' opinion collection about quality indicators for PsA management; 2) Delphi design to address the development of the measurement tool; 3) three Delphi questionnaire rounds; 4) final consensus meeting. This phase resulted in the definition of two measurement tools, one to evaluate the quality of biologic switch in peripheral (pPASQAL) and another one in axial PsA (axPASQAL). For the validation of PASQAL, 12 experienced rheumatologists were asked to evaluate and classify the biologic switch of 80 clinical cases (40 with predominant peripheral and 40 with predominant axial PsA). Clinical judgement was defined to be the "gold standard" against which the performance of PASQAL was assessed. The results were used to assess tools' performance (sensitivity/specificity analysis) and the agreement between the tools and the gold standard (Cohen's kappa). Results: PASQAL consists of 6 domains (joint disease activity, dactylitis, enthesis, physical function, quality of life, and skin and nail manifestations), respective instruments and thresholds. The classification of the biologic switch was divided into three quality levels: "Good", based on treat-to-target thresholds; "Mode-rate", based on improvement from baseline; and the remaining as "Insufficient". pPASQAL was found to be highly sensitive (92%) with the "Good" quality level and specific (97%) with the "Insufficient" quality le vel. Whilst axPASQAL showed overall higher sensitivity and specificity for all quality levels, as well as a higher level of agreement between the tool and the gold standard than pPASQAL (k=0.87 vs k=0.71). Conclusion: PASQAL was developed and showed good criterion validity for the evaluation of the quality of switch in both peripheral and axial PsA phenotypes. These tools may be used in research as well as in clinical practice, to support rheumatologists in making more informed therapeutic decisions.publishersversionpublishe

Micropropagação in vitro de ricinus communis l. utilizando a citocinina 6-bencilaminopurina.

A micropropagação é utilizada principalmente nas plantas de difícil propagação, permitindo a obtençãoo de grande número de plantas sadias e geneticamente uniformes, em curto período de tempo. A citocinina 6-bencilaminopurina (BAP) tem sido muito eficaz para promover multiplicação em diversas esp»cies e parece ser a citocinina, por excelência, para multiplicação de partes aéreas e indução de gemas adventícias. Objetivou-se, com este trabalho induzir, in vitro, o superbrotamento da cultivar de mamona BRS Nordestina , através dos explantes gema apical e eixo embrionrio, afim de determinar o melhor meio nutritivo suplementado com BAP. Sementes foram desinfestadas em solução de hipoclorito de sódio a 2,5% de cloro ativo e lavadas quatro vezes em água bidestilada estéril, permanecendo 24h na última água; posteriormente, foram cultivadas em tubos contendo meio MS e em frascos com sais de MS suplementado com vitaminas do meio B5 utilizando-se BAP nas concentrações -10,00; 0,05; 0,10; 0,30 mg.L ; em todos os meios foram adicionados 0,05 -1 mg.L de GA . Utilizaram-se 10 frascos por tratamento, cada um contendo três 3 explantes em delineamento inteiramente casualizado. O tratamento com 0,30 -1 -1mg.L de BAP e 0,05 mg.L de GA favoreceu o melhor superbrotamento de 3 brotos sadios, com uma m»dia de 6,13 brotos por explante. O BAP induz o superbrotamento nesta cultivar de mamona.bitstream/CNPA/19899/1/BOLETIM84.pd

Seleção in vitro de fungos endofíticos para o controle biológico de Botrytis cinera em Eucalyptus benthamii.

O Eucalyptus benthamii é uma das principais espécies de eucalipto plantadas na região Sul do Brasil, por sua resistência a geadas e por seu uso na produção florestal de madeira para fins energéticos. Na produção de mudas, uma das principais doenças ocorrentes em viveiros é o mofo-cinzento, causado pelo fungo Botrytis cinerea. Uma das alternativas para o controle dessa doença é o controle biológico com fungos endofíticos, os quais podem competir com os patógenos foliares de mudas de eucalipto. O objetivo deste trabalho foi isolar os fungos endofíticos provenientes de mudas de E. benthamii, identificá-los e selecioná-los para o controle de B. cinerea. Eles foram isolados do interior de tecidos vegetais desinfectados, identificados de acordo com critérios macro e micromorfológicos e classificados a partir de testes de controle biológico in vitro. Os resultados evidenciaram o potencial antagonista dos fungos Aspergillus sp., Penicillium sp. e Trichoderma sp. Nenhum desses fungos causou lesões em mudas de E. benthamii

Association of Fusarium and Phomopsis with peroba rosa seeds

Peroba rosa (Aspidosperma polyneuron) is a native forest species endangered due to intense predatory exploitation. The objective of this study was to evaluate the association and fungi transmission in peroba rosa seeds from four regions of Paraná. Germination and vigor were evaluated using the paper roll method. Sanitary analysis consisted of the detection of endophytic and epiphytic fungi using potato-dextrose-agar medium and Fusarium selective medium. For transmission, non-disinfested seeds were sown in vermiculite and kept in greenhouse. Germination ranged from 9.3% to 60%. Fusarium sp. and Phomopsis sp. were found as epiphytic and also as endophytic. There was transmission of Fusarium sp. and Phomopsis sp. from seeds to seedlings, causing malformation and necrosis on roots and cotyledons

Method for Isolation‬ ‪of Myxozoan proliferative stages‬ ‪from fish at high yield and purity:‬ ‪An essential prerequisite for in vitro,‬ ‪in vivo and genomics-based‬ ‪research developments.

Myxozoans are a diverse group of microscopic cnidarian parasites and some representatives are associated with important diseases in fish, in both marine and freshwater aquaculture systems. Research on myxozoans has been largely hampered by the inability to isolate myxozoan parasites from their host tissues. In this study, we developed and optimized a method to isolate the myxozoan proliferative stages of different size and cellularity from fish blood, using DEAE-cellulose ion exchange chromatography. We optimized several parameters and obtained 99–100% parasite purity, as well as high survival and infectivity. Using polyclonal pan-carp blood cell-specific antibodies, we further developed a rapid cytometric assay for quantification of the proliferative stages, not only in highly concentrated DEAE-C isolates but also in dilute conditions in full blood. Early developmental stages of myxozoans are key to parasite proliferation, establishment, and pathology in their hosts. The isolation of these stages not only opens new possibilities for in vivo and in vitro studies, but also for obtaining purified DNA and protein extracts for downstream analyses. Hence, we provide a long-desired tool that will advance the functional research into the mechanisms of host exploitation and immune stimulation/evasion in this group, which could contribute greatly to the development of therapeutic strategies against myxozoans

Eficiência simbiótica e componentes de produção de caupi (Vigna unguiculata (L) Walp) em área irrigada do semi-árido baiano.

O objetivo deste trabalho foi o de avaliar a eficiência simbiótica e os componentes de produção do cultivo de feijão caupi inoculado com estirpes específicas em uma área irrigada do semi-árido baiano