C3 Deficiency – A Case Report

O sistema do complemento é um componente essencial do sistema imunitário inato, pelo que as deficiências de proteínas da sua complexa cascata podem ter consequências mais ou menos graves, de acordo com a importância do factor afectado. As complicações mais usuais das deficiências do complemento são infecções recorrentes a bactérias encapsuladas e distúrbios autoimunes. Os autores apresentam um caso clínico de deficiência do factor C3, situação extremamente rara, discutindo a fisiopatologia, apresentação clínica, investigação laboratorial e abordagem terapêutica

Secondary Adrenal Suppression Related to High Doses of Inhaled Corticosteroids in Patients with Severe Asthma

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Exercise-Induced Asthma in Children a Contribution for the Standardization of Challenge Tests

A asma induzida pelo exercício (AIE), apesar de entidade muito prevalente na criança asmática,apresenta aspectos etiopatogénicos não totalmente esclarecidos. De igual modo, os aspectos metodológicos das provas de provocação utilizadas para o diagnóstico da AIE não estão normalizados. Objectivos: Foram objectivos deste trabalho estudar sensibilidade e especificidade de diferentes parâmetros funcionais (DEMI vs VEMS) e equipamentos(bicicleta ergométrica vs tapete rolante) utilizados nas provas de esforço, monitorizar a ocorrência de respostas tardias ao esforço e correlacionar os resultados com os de uma prova de provocação brônquica inespecífica normalizada (metacolina). Métodos: Foram incluídas 22 crianças com asma e 10 com rinite (grupo controle), com 7-15 anos. Todas as crianças foram submetidas a três provas de provocação efectuadas no intervalo de 1 mês, provas de esforço em tapete rolante (T) e com bicicleta ergométrica (B) e prova de metacolina, efectuadas sob condições ambientais controladas e com interrupção da medicação relevante. Resultados: Sensibilidade: T - redução VEMS >=10%=82%; B - redução VEMS>=10%=57%; T - redução DEMI>=10%=86%; B - redução DEMI >=10%=81%. Especificidade: T & B - redução VEMS >=10%=100%; T - redução DEMI>=10%=40%; B - redução DEMI>=10%=33%. Não se identificaram respostas broncoconstritoras tardias ao exercício. As crianças asmáticas com prova de esforço positiva apresentaram uma reactividade à metacolina significativamente superior à dos asmáticos com prova negativa.Conclusões: A prova de esforço em tapete rolante representa o melhor teste para diagnóstico da AIE na criança. O parâmetro funcional normalizado a ser utilizado deverá ser o VEMS, aceitando-se uma redução de 10% como critério de positividade. Os doentes com resposta positiva ao esforço foram igualmente mais reactivos à prova de metacolina, isto é apresentam hiperreactividade brônquica inespecífica mais grave, o que substancia o interesse da terapêutica preventiva anti-inflamatória com corticóides tópicos e/ou antileucotrienos no controle da AIE

PERANCANGAN ALAT PENCACAH SAMPAH PLASTIK SEBAGAI BAHAN BAKU ASPAL

AbstrakAlat pencacah sampah plastik merupakan sebuah alat yang berguna untuk mengurangi jumlah sampah dengan cara mendaur ulang menjadi bahan bahan yang memiliki nilai jual untuk masyarakat khususnya di Kota Kupang dan secara tidak langsung membantu perekonomian. Pencacahan sampah plastik sebenarnya sudah dilakukan namun menggunakan cara manual dengan pisau atau benda lainnya. Waktu yang dibutuhkan lebih lama dan produktivitas pengolahan sampah plastik belum maksimal. perancangan Mesin Pencacah sampah plastik bertujuan untuk membantu para pengumpul plastik mengolah sampah plastik menjadi serpihan-serpihan kecil sehingga memudahkan dalam pengepakan dan pengiriman plastik keluar daerah untuk diolah kembali sebagai bahan baku pembuatan aspal. Prinsip kerja dari mesin pencacah secara umum adalah melakukan proses pomotongan rotary dengan pisau sebagai alat potongnya. Kapasitas mesin yang ditentukan 750-watt dengan putaran 2800 rpm, perancangan ini dilakukan dengan metode VDI 2221. Metode VDI 2221 merupakan salah satu metode untuk menyelesaikan permasalahan dan mengoptimalkan penggunaan material, teknologi dan keadaan ekonomi.Kata kunci: Alat pencacah sampah plastik; proses pomotongan rotary; Metode VDI 2221 AbstractA Plastic waste chopper is a tool that is useful for reducing the amount of waste by recycling it into materials that have sale value for the community, especially in Kupang City, and indirectly help the economy. Plastic waste shredding has been done but using the manual method with a knife or other object. The time needed is longer and the productivity of plastic waste processing is not maximized. The design of the plastic waste chopping machine aims to help plastic collectors process plastic waste into small pieces so that it makes it easier to pack and send plastic out of the area to be reprocessed as raw material for making asphalt. The working principle of a chopping machine, in general, is to carry out the rotary cutting process with a knife as a cutting tool. The specified engine capacity is 750 watts with a rotation of 2800 rpm, this design is carried out using the VDI 2221 method. The VDI 2221 method is a method to solve problems and optimize the use of materials, technology, and economic conditions.Keywords:A Plastic waste chopper; the rotary cutting process; the VDI 2221 metho

Asthma and COPD "Overlap": a Treatable Trait or Common Several Treatable-Traits?

In the last years, disease classification of chronic respiratory diseases (CRD) has been vivaciously discussed and new concepts have been introduced, namely asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO). Controversially the GOLD consensus document of 2020 considered that we should no longer refer to ACO, as they constitute two different diseases that may share some common traits and clinical features. The treatable traits approach has numerous strengths that are applicable to several levels of health care. In this paper we review the application of the treatable traits to CRD and describe in detail the ones already identified in patients with asthma and COPD. Treatable traits in CRD can be divided in pulmonary, extra-pulmonary and behavior/lifestyle risk factors. Patients with both asthma and COPD patients have clearly recognized treatable traits in all these subtopics but it is notorious the severe and frequent exacerbations, the associated cardiovascular disease and the low health related quality of life and productivity of these patients.info:eu-repo/semantics/publishedVersio

A neuroevolutionary approach to feature selection using multiobjective evolutionary algorithms

Feature selection plays a central role in predictive analysis where datasets have hundreds or thousands of variables available. It can also reduce the overall training time and the computational costs of the classifiers used. However, feature selection methods can be computationally intensive or dependent of human expertise to analyze data. This study proposes a neuroevolutionary approach which uses multiobjective evolutionary algorithms to optimize neural network parameters in order to find the best network able to identify the most important variables of analyzed data. Classification is done through a Support Vector Machine (SVM) classifier where specific parameters are also optimized. The method is applied to datasets with different number of features and classes.FCT - Fundação para a Ciência e Tecnologia in the scope of the projects: PEst-OE/EEI/UI0319/2014, UID/MAT/00013/2013, UID/CEC/ 00319/2019 and the European project MSCA-RISE-2015, NEWEX, with reference 734205

Neuroevolutionary multiobjective optimization of injection stretch blow molding process in the blowing phase

Injection stretch blow molding is a very important thermoplastic processing technique producing hollow containers with mechanical performance. One of the main challenges in optimizing this process consists in finding the best thickness profile for each part in order to achieve the desired mechanical properties with less material use. In a previous study, a new methodology based on a neuroevolutionary multiobjective optimization approach was proposed to enhance the entire process, which considers that the process is optimized by phases, starting by the end. In that initial study only the final phase of the process was addressed, where the best thickness profile for an industrial bottle was found in order to satisfy the required mechanical properties with less material use. In the present study, the focus is the second stage of the optimization methodology, concerning the blowing phase of injection blow molding process. The optimal results obtained in the first phase are used as the optimal thickness profile for the bottle with the goal to find the best preform thickness profile which produces the desired bottle. The same procedures are used and the results show that the methodology was successfully applied to its second phase.This work has been supported by the European project MSCA-RISE-2015, NEWEX, with reference 734205

Food Allergy and Anaphylaxis in Infants and Preschool-Age Children

Food allergy (FA) prevalence data in infants and preschool-age children are sparse, and proposed risk factors lack confirmation. In this study, 19 children’s day care centers (DCC) from 2 main Portuguese cities were selected after stratification and cluster analysis. An ISAAC’s (International Study of Asthma and Allergies in Childhood) derived health questionnaire was applied to a sample of children attending DCCs. Outcomes were FA parental report and anaphylaxis. Logistic regression was used to explore potential risk factors for reported FA. From the 2228 distributed questionnaires, 1217 were included in the analysis (54.6%). Children’s median age was 3.5 years, and 10.8% were described as ever having had FA. Current FA was reported in 5.7%. Three (0.2%) reports compatible with anaphylaxis were identified. Reported parental history of FA, personal history of atopic dermatitis, and preterm birth increased the odds for reported current FA. A high prevalence of parental-perceived FA in preschool-age children was identified. Risk factor identification may enhance better prevention

Smoking in acute coronary syndromes--the "smoker's paradox" revisited

INTRODUCTION: Although a well-known risk factor for coronary disease, smoking has long been associated with lower short-term mortality in acute coronary syndromes (ACS). There are few recent works on Portuguese populations examining all aspects of smoking in ACS, particularly the interaction between smoking and other risk factors, and the management and prognosis of patients according to smoking status. OBJECTIVE: We sought to examine clinical characteristics, presentation, in-hospital treatment, angiographic features and prognosis of patients with and without smoking history admitted with ACS. METHODS: A total of 1228 patients consecutively admitted with ACS from January 2004 to March 2007 were analyzed. Patients were classified into two groups, those with present or past smoking habits (n=450) making up Group I and those without smoking habits (n=778), Group II. The main outcome analyzed was overall mortality during hospital stay and at 6 months. RESULTS: Smokers and former smokers were younger and more frequently male (odds ratio [OR] = 22.46; 95% confidence interval [CI]: 12.94-38.96), and less often had diabetes (OR = 0.41; 95% CI: 0.30-0.54), hypertension (OR = 0.31; 95% CI: 0.24-0.39) and renal insufficiency (OR = 0.26; 95% CI: 0.18-0.36). Patients with smoking habits more frequently presented with ST elevation (OR = 1.32; 95% CI: 1.04-1.67), more often received evidence-based medical therapy, namely beta blockers (during hospital stay, OR = 2.42; 95% CI: 1.63-3.56 and at discharge, OR = 1.45; 95% CI: 1.03-2.1) and statins (at discharge, OR = 2.48; 95% CI: 1.2-6.1), and more frequently underwent coronary angiography (OR = 2.15; 95% CI: 1.63-2.84). Although smokers and former smokers had lower in-hospital mortality on univariate analysis (OR = 0.54; 95% CI: 0.31-0.96), this association was not confirmed on multivariate analysis, with adjustment for known short-term mortality predictors (OR = 1.25; 95% CI: 0.61-2.54). Similarly, multivariate analysis failed to confirm lower 6-month mortality for smokers and former smokers (OR = 2.0; 95% CI: 1.17-3.41). CONCLUSIONS: Clinical characteristics and management options differed between ACS patients with and without smoking habits. These differences explained the lower shortterm mortality initially observed between the two groups. In our population of patients admitted with ACS, we did not find a real "smoker's paradox"

Frequência da Anafilaxia Induzida pelo Exercício numa Consulta de Imunoalergologia

Introdução: A anafilaxia induzida pelo exercício (AIE) é uma forma rara de alergia física que ocorre na sequência de esforços físicos. A verdadeira incidência e prevalência da AIE permanecem por esclarecer, não existindo até à data dados publicados a nível nacional. Objectivos: Estimar a frequência da AIE no ambulatório de um serviço de Imunoalergologia e incrementar o conhecimento em relação a esta patologia. Métodos: De 7699 doentes observados na consulta de Imunoalergologia durante o período de um ano, incluímos os correspondentes a quadros de anafilaxia notificados pelo corpo clínico (“pelo menos um episódio de reacção sistémica grave”). Resultados: A AIE foi reportada em 5 de 103 doentes com história de anafilaxia; correspondendo a uma frequência de 0,06% na população observada na consulta. A média etária destes doentes era de 20,2 ± 10,3 anos (entre 10 e 37 anos) e a distribuição por sexo masculino/feminino de 4:1. Todos tinham história pessoal de atopia e de rinite alérgica; dois doentes (40%) tinham asma. As actividades desencadeantes das crises foram a corrida, o futebol, a natação e a dança. Todos os doentes tinham sintomas com o exercício dependente da ingestão prévia de alimentos: cereais em três doentes (trigo – dois, cevada – um), leguminosas em dois (amendoim – um, feijão -frade e feijão -verde – um); com teste cutâneo por picada positivo para os referidos alimentos. Conclusões: A AIE representa 5% dos casos de anafi laxia reportados. Todos os casos identifi cados apresentavam AIE dependente de alimentos, encontrando-se os doentes controlados com a evicção dos alimentos referidos 6 horas antes da prática de exercício e sendo portadores de dispositivo para autoadministração de adrenalina