Ambulatory chest physiotherapy in mild-to-moderate acute bronchiolitis in children under two years of age - A randomized control trial

Objective: The aim of this study was to compare the role of a chest physiotherapy (CP) intervention to no intervention on the respiratory status of children under two years of age, with mild-to-moderate bronchiolitis. Methods: Out of 80 eligible children observed in the Emergency Room, 45 children completed the study with 28 randomized to the intervention group and 17 to the control group. The intervention protocol, applied in an ambulatory setting, consisted of combined techniques of passive prolonged slow expiration, rhinopharyngeal clearance and provoked cough. The control group was assessed with no chest physiotherapy intervention. The efficacy of chest physiotherapy was assessed using the Kristjansson Respiratory Score at the admission and discharge of the visit to the Emergency Room and during clinical visits at day 7 and day 15. Results: There was a significant improvement in the Kristjansson Respiratory Score in the intervention group compared to the control group at day 15 [1.2 (1.5) versus 0.3 (0.5); p -value =0.005 , in the control and intervention groups, respectively], with a mean difference (95% CI) of −0.9 ( −1.6 to −0.3 ). Conclusion: Chest physiotherapy had a positive impact on the respiratory status of children with mild-to-moderate bronchiolitis. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04260919

The influence of the magnetic topology on the wind braking of sun-like stars.

Stellar winds are thought to be the main process responsible for the spin down of main-sequence stars. The extraction of angular momentum by a magnetized wind has been studied for decades, leading to several formulations for the resulting torque. However, previous studies generally consider simple dipole or split monopole stellar magnetic topologies. Here we consider in addition to a dipolar stellar magnetic field, both quadrupolar and octupolar configurations, while also varying the rotation rate and the magnetic field strength. 60 simulations made with a 2.5D, cylindrical and axisymmetric set-up and computed with the PLUTO code were used to find torque formulations for each topology. We further succeed to give a unique law that fits the data for every topology by formulating the torque in terms of the amount of open magnetic flux in the wind. We also show that our formulation can be applied to even more realistic magnetic topologies, with examples of the Sun in its minimum and maximum phase as observed at the Wilcox Solar Observatory, and of a young K-star (TYC-0486-4943-1) whose topology has been obtained by Zeeman-Doppler Imaging (ZDI).We would like to thank Colin Folsom, Pascal Petit for the magnetic field decomposition coefficients of TYC- 0486-4943-1, J´erome Bouvier and the ANR TOUPIES project which aim to understand the evolution of star?s spin rates, the ERC STARS2 (www.stars2.eu) and CNES support via our Solar Orbiter funding

The chick chorioallantoic membrane model: A new in vivo tool to evaluate breast cancer stem cell activity

The high plasticity of cancer stem-like cells (CSCs) allows them to differentiate and proliferate, specifically when xenotransplanted subcutaneously into immunocompromised mice. CSCs are highly tumorigenic, even when inoculated in small numbers. Thus, in vivo limiting dilution assays (LDA) in mice are the current gold standard method to evaluate CSC enrichment and activity. The chick embryo chorioallantoic membrane (CAM) is a low cost, naturally immuneincompetent and reproducible model widely used to evaluate the spontaneous growth of human tumor cells. Here, we established a CAM-LDA assay able to rapidly reproduce tumor specificities— in particular, the ability of the small population of CSCs to form tumors. We used a panel of organotropic metastatic breast cancer cells, which show an enrichment in a stem cell gene signature, enhanced CD44+/CD24-/low cell surface expression and increased mammosphere-forming efficiency (MFE). The size of CAM-xenografted tumors correlate with the number of inoculated cancer cells, following mice xenograft growth pattern. CAM and mice tumors are histologically comparable, displaying both breast CSC markers CD44 and CD49f. Therefore, we propose a new tool for studying CSC prevalence and function—the chick CAM-LDA—a model with easy handling, accessibility, rapid growth and the absence of ethical and regulatory constraints.This work was funded by FEDER—Fundo Europeu de Desenvolvimento Regional— funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by FCT—Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior under the projects PestC/SAU/LA0003/2013, NORTE-01-0145-FEDER-000029, SAICTPAC/0022/2015 and FCT/02/SAICT/2017/030625. FCT funded the research grant of RC (SFRH/BD/135831/2018). IPATIMUP integrated the i3S Research Unit, which was partially supported by FCT in the framework of the project “Institute for Research and Innovation in Health Sciences” (POCI-01-0145FEDER-007274)

The impact of self-stigma in people with diagnosis of severe mental illness: a cross-sectional pilot study from a community psychiatry unit in Porto, Portugal

"Introduction Self-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal. Objectives In Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels. Methods Fifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values<0.05 were considered significant. Results From the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P<0.001), as well as self-stigma and quality of life (rho=-0.585; P<0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P<0.001) was found. Conclusions This study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.

Endoscopic pilonidal sinus treatment versus total excision with primary closure for sacrococcygeal pilonidal sinus disease in the pediatric population

Purpose: To evaluate the effectiveness and safety of Endoscopic Pilonidal Sinus Treatment (EPSiT) in the pediatric population and compare it with excision followed by primary closure (EPC) regarding intra- and postoperative outcomes. Methods: A retrospective analysis of all patients with chronic sacrococcygeal pilonidal sinus submitted to EPSiT and EPC during a 12-month period in our institution was performed. Data concerning patients' demographics and surgical outcomes were collected and compared between the two groups. Results: We analyzed a total of 21 cases that underwent EPSiT and 63 cases of EPC, both groups with similar demographic characteristics. Operative time was similar for both groups (30 vs. 38 min; p > 0.05). No major intraoperative complications were reported. Wound infection rate was lower for EPSiT ((5.2% [n = 1] vs. 20.0% [n = 12]); p > 0.05). Healing time was similar for both groups (28 vs. 37.5 days). Recurrence occurred in 18,9% (n = 15), with 2 cases (10.5%) reported in the EPSiT group versus 13 (21.6%) in EPC. There were no differences between groups regarding postoperative complications, complete wound healing and recurrence rates or healing time (p > 0.05). Conclusions: Our results suggest that EPSiT is as viable as excision followed by primary closure in the management of sacrococcygeal pilonidal sinus in the pediatric population

Skin Disease in Liver and Kidney Transplant Recipients Referred to the Department of Dermatology and Venereology

Introdução: Foram descritas várias doenças cutâneas em doentes transplantados, em relação com a terapêutica imunossupressora instituída. Pretendemos caracterizar o espectro clínico das patologias dermatológicas e comparar os diagnósticos entre os doentes transplantados hepáticos e os doentes transplantados renais. Material e Métodos: Estudo descritivo e retrospectivo através da consulta de processos clínicos de todos os doentes submetidos a transplante hepático ou renal entre 2000 - 2010 referenciados à Consulta de Dermatologia e Venereologia. Resultados: Observámos 319 doentes transplantados (23,5%) e apurámos 410 diagnósticos (230 na sub-população com transplante hepático e 180 na sub-população com transplante renal), divididos em quatro grupos: 1) infecções cutâneas; 2) cancro cutâneo ou lesões precursoras; 3) manifestações cutâneas relacionadas com efeitos secundários de fármacos; 4) outras patologias dermatológicas não iatrogénicas. As infecções cutâneas foram as mais observadas (42,2%), em média 32,7 meses após o transplante. Este grupo incluiu 20,5% de infecções fúngicas, 12,7% virais e 8,5% bacterianas. Identificámos patologia tumoral e lesões precursoras em 11,7% dos casos, em média 44,8 meses após o transplante e assumindo maior importância na sub-população com transplante renal (20,6% vs 4,8% nos transplantados hepáticos; P < 0,001). Os transplantados renais apresentaram predomínio de carcinomas espinocelulares (CEC) sobre os casos de carcinomas basocelulares (CBC), numa razão CEC:CBC de 1,3:1 mas nos transplantados hepáticos verificou-se uma razão CBC: carcinomas de 3,5:1. Ocorreram efeitos secundários de fármacos em 10,5% dos casos e outras patologias dermatológicas não iatrogénicas em 35,6%. Discussão: Apesar da patologia tumoral ser a mais referida na literatura, as infecções cutâneas foram as mais observadas na nossa amostra. As diferenças significativas entre as duas sub-populações estudadas podem estar relacionadas com o maior grau de imunossupressão a que os doentes transplantados renais estão sujeitos. Conclusão: Dada a elevada frequência de patologia cutânea nestes doentes é essencial incluir o acesso a consultas de Dermatologia e Venereologia nos cuidados multi-disciplinares pós-transplante

Análise da Repercussão de uma Sessão Educativa sobre o Glaucoma no Conhecimento da Doença

Introdução: A adesão à terapêutica antiglaucomatosa é fundamental na redução e controlo da pressão intra-ocular. Os doentes com menor nível de conhecimento sobre a sua doença apresentam taxas de não adesão terapêutica superiores. Este estudo tem como objectivo a avaliação da repercussão de uma sessão de esclarecimento sobre o glaucoma e seu tratamento. Material e métodos: Estudo prospectivo que incluiu 24 doentes seguidos em consulta de glaucoma. Procedeu-se ao preenchimento de um questionário validado, sobre a doença e o seu tratamento. De seguida os doentes assistiram a uma sessão de esclarecimento sobre o glaucoma. O preenchimento do questionário foi repetido após a sessão e ao fim de 1 mês. Resultados: A idade média foi 63,7 anos, 45,8% era do sexo feminino. Em 9 das 22 perguntas, mais de 50% dos doentes responderam acertadamente antes da sessão educativa. Após a realização da mesma foram 13 as respostas acertadas por mais de 50% dos doentes (p0,05) e o nível de escolaridade (p>0,05). Conclusão: Através da sessão educativa houve uma melhoria dos conhecimentos dos doentes com glaucoma, relativamente à sua doença

Nutritional intake and food sources in an adult urban Kenyan population

Urbanisation is hastening the transition from traditional food habits to less healthy diets, which are becoming more common among Kenyans. No up-to-date studies on usual dietary intake and the main food sources of adult Kenyans are available. The aim of the present study was to identify the main food sources of nutrients in the diet of urban adult Kenyans and explore potential associations with demographic variables including age, sex, level of education, occupation and body mass index. The study adopted a cross-sectional design. The dietary intake of 486 adult Kenyans from Nairobi was assessed using a validated, culture-sensitive, semi-quantitative food frequency questionnaire. Binary logistic regression models were used to evaluate associations between food sources and demographic variables. Macronutrient intakes as a proportion of total energy intake (TEI) were within international dietary guidelines. Cereals and grain products (34.0%), sugar, syrups, sweets and snacks (9.8%), fruits (9.7%) and meat and eggs (8.8%) were the major contributors to TEI. Cereals and grain products contributed 42.5% to carbohydrates, followed by fruits (12.4%) and sugar, syrups, sweets and snacks (10.6%). The most important sources of protein and total fat were cereals and grain products (23.3% and 19.7%, respectively) and meat and eggs (22.0% and 18.7%, respectively). Sex, age and level of education were associated with the choice of food groups. Although macronutrient intakes were within guidelines, the Kenyan diet was revealed to be high in sugars, salt and fibre, with differences in food sources according to demographic variables. These results can act as an incentive to national authorities to implement nutritional strategies aiming to raise awareness of healthier dietary patterns among Kenyans. © 2022 The Authors. Nutrition Bulletin published by John Wiley & Sons Ltd on behalf of British Nutrition Foundation.This work was supported by National Funds from FCT – ‘Fundação para a Ciência e a Tecnologia’ through project ‘Optimization of fermentation processes for the development of fibre‐rich cereals‐based products: promotion of fibre intake in Africa and Europe’ (ERA‐AFR/0002/2013 BI_I), the doctoral grant ‘Dietary fibre intake and tailored fermentation toward the development of functional cereal fibre‐rich food products: bridge between Africa and Europe’ (SFRH/BD/133084/2017), and also through project UIDB/50016/2020

The blp locus of Streptococcus pneumoniae plays a limited role in the selection of which strains can co-colonize the human nasopharynx.

Nasopharyngeal colonization is important for Streptococcus pneumoniae evolution, providing the opportunity for horizontal gene transfer when multiple strains co-occur. Although colonization with more than one strain of pneumococcus is common, the factors that influence the ability of strains to co-exist are not known. A highly variable blp (bacteriocin-like peptide) locus has been identified in all sequenced strains of S. pneumoniae This locus controls the regulation and secretion of bacteriocins, small peptides that target other bacteria. In this study, we analyzed a series of co-colonizing isolates to evaluate the impact of the blp locus on human colonization to determine whether competitive phenotypes of bacteriocin secretion restrict co-colonization.We identified a collection of 135 nasopharyngeal samples with two or more strains totaling 285 isolates. The blp locus of all strains was characterized genetically with regards to pheromone type, bacteriocin/immunity content and potential for locus functionality. Inhibitory phenotypes of bacteriocin secretion and locus activity were assessed through overlay assays. Isolates from single colonization (n=298) were characterized for comparison.Co-colonizing strains had a high diversity of blp cassettes; approximately one third displayed an inhibitory phenotype in vitro Despite in vitro evidence of competition, pneumococci co-colonized individuals independently of their blp pheromone type (p=0.577), bacteriocin/immunity content, blp locus activity (p=0.798) and inhibitory phenotype (p=0.716). In addition, no significant differences were observed when single and co-colonizing strains were compared.Despite clear evidence of blp-mediated competition in experimental models, our study suggests that the blp locus plays a limited role in restricting pneumococcal co-colonization in humans. IMPORTANCE: Nasopharyngeal colonization with Streptococcus pneumoniae (pneumococcus) is important for pneumococcal evolution as it represents the major site for horizontal gene transfer when multiple strains co-occur, a phenomenon known as co-colonization. Understanding how pneumococcal strains interact within the competitive environment of the nasopharynx is of chief importance in the context of pneumococcal ecology. In this study we used an unbiased collection of naturally co-occurring pneumococcal strains and showed that a biological process frequently used by bacteria for competition - bacteriocin production - is not decisive in the co-existence of pneumococci in the host, contrary to what has been shown in experimental models