Prevalência das complicações biológicas no tratamento com implantes, em pacientes reabilitados na FMDUL

Objetivo: Determinar a prevalência de complicações biológicas em implantes, numa população de doentes reabilitados com implantes na Pós-graduação em Periodontologia da FMDUL, entre Janeiro de 2016 e Julho de 2021. Pretende-se também identificar e relacionar a existência de complicações com outros fatores associados aos doentes e aos implantes. Materiais e Métodos: Através da consulta do livro de registos do bloco operatório, e dos processos digitais e físicos dos doentes da Pós-graduação em Periodontologia, foram incluídos para análise todos os implantes colocados, juntamente com dados referentes aos doentes (idade, género, doenças sistémicas (diabetes ou outras), hábitos tabágicos, historial de periodontite, historial de complicações, número de implantes colocados) e dados referentes aos implantes (posição, marca, diâmetro, comprimento, tipo de reabilitação). Resultados: Verificou-se uma prevalência de complicações biológicas de 6,9% ao nível dos implantes e 12,2% ao nível dos doentes. Foi possível relacionar a presença de complicações com o género feminino, histórico prévio de complicações e número de implantes colocados no mesmo doente (4 ou mais implantes no mesmo doente apresentam maior risco), e com a ausência de reabilitação protética. Conclusão: A prevalência de peri-implantites de 6,9% ao nível dos implantes e 12,2% ao nível dos doentes, relacionou-se com o género, histórico de complicações, número de implantes colocados, e ausência de reabilitação protética. Sugerem-se mais estudos observacionais que compreendam mais implantes e permitam relacionar os vários fatores associados aos doentes e aos implantes.Aim: To determine the prevalence of biological complications of implants, in a population of patients rehabilitated in the Post-graduate program of Periodontology in FMDUL, between January 2016 and July 2021. It is also intended to identify and relate the existing complications with other factors associated with the patients and the implants. Materials and Methods: Through access to the operating room book registry, digital and physical files of the patients in the Post-graduate program of Periodontology, implants placed in the various patients were included, as well as data regarding factors associated with the patients (age, gender, systemic diseases (diabetes and others), smoking habits, history of periodontitis, history of previous complications, and number of implants placed) and factors associated with the implants (position, brand, diameter, length, type of rehabilitation). Results: A prevalence of biological complications of 6,9% at implant-level and 12,2% at patient-level was obtained. It was possible to correlate the presence of complications with the female gender, previous history of complications, number of implants placed (4 or more implants in the same patient present a higher risk), and the absence of rehabilitation. Conclusion: The prevalence of peri-implantitis of 6,9% at implant-level and 12,2% at patient-level, associated with the gender, a previous history of complications, the number of implants placed in the same patient, and the absence of rehabilitation. Further observational studies comprehending more implants and patients are suggested, to allow associations between complications and patient/implant related factors

Does Stroke Impair Learning in Children?

Objective. To assess cognitive development and learning in children who have had strokes. Method. Twenty-nine stroke patients and 18 children with no brain lesions and no learning impairments were evaluated. For the cognitive assessment, Piaget's clinical method was used. Writing, arithmetic, and reading abilities were assessed by the school performance test. Results. The mean age at evaluation was 9.6 years. Among the 29 children, 20 had early lesions (mean of 2.4 years old). The stroke was ischemic in 18 subjects; there were 7 cases of recurrence. Six children could not answer the tests. A high index of cognitive delay and low performance in writing, arithmetic, and reading were verified. Comparison with the control group revealed that the children who have had strokes had significantly lower performances. Conclusion. In this sample, strokes impaired cognitive development and learning. It is important that children have access to educational support and cognitive rehabilitation after injury. These approaches may minimise the effects of strokes on learning in children

Oregano essential oil: an effective and non-toxic approach for prevent or treat resistant candida species

Vulvovaginal candidiasis (VVC) is one of the most prevalent vaginal infectious diseases, and the emergence of drug-resistant Candida strains has presented a growing challenge in its treatment. This highlights the urgent need to develop effective and non-toxic alternative treatments. In this context, essential oils (EOs) have emerged as a promising alternative considering low toxicity and high antimicrobial activity. This work is divided into two parts, the first consists of evaluating the effect of the vapor phase of oregano EO (VP-OEO) on biofilms of antifungal-resistant Candida species (Candida albicans and Candida glabrata) quantified by colony forming units enumeration and determine their mode of action by flow cytometry. Interestingly, the VP-EOs has shown to be more effective against Candida growth than their liquid form. Indeed, the results revealed high antifungal activity of VP-OEO against these drug-resistant strains, significantly reducing biofilm formation and mature biofilms, with impact on membrane integrity and metabolic activity of the fungal cells. The second part consists of the design and evaluation of nanoencapsulated OEO (KNP-OEO) as another alternative application of OEO for VVC treatment. These nanoparticles provided stability to OEO and controlled release of the EO. The results demonstrated complete inhibition of C. albicans growth. Moreover, in in vivo assay with BALB/C female mice, a single intravaginal application of KNP-OEO reduced C. albicans growth and preserved a healthy vaginal microbiota, including Lactobacillus species. In conclusion, these studies highlight the promising efficacy of OEO as an alternative for VVC treatment. Both approaches, VP-OEO and OEO-KNP, showed effective antifungal activity against drug-resistant strains while preserving vaginal health. These therapeutic options not only combat antifungal resistance, but also potentially propose a safer option for women's health due to their natural characteristics. However, further research is needed to confirm these promising results and advance the development of these alternative VVC therapies.This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020 unit and grant ref 2020.05720.BD for Liliana Fernandes. Also, this study was supported by LABBELS—Associate Laboratory in Biotechnology, Bioengineering and Microelectromechanical Systems, LA/P/0029/2020 and Maria Elisa Rodrigues thanks FCT for funding through program DL 57/2016—Norma transitória. Sofia Costa de Oliveira acknowledges national funds through FCT, I.P., within the scope of the project "RISE - LA/P/0053/2020. Nuno Pereira Mira acknowledges support from FCT through its funding of research focused on Candida-lactobacilii interactions through LactoCan project (contract number: PTDC/BIA-MIC/31515/2017), iBB (contract: UIDB/04565/2020) and i4HB funding (contract: LA/P/0140/2020). Lorena Cussó acknowledges support by Agencia Estatal de Investigación (PRE2020-095268 MCIN / AEI /10.13039/501100011033 and by "ESF Investing in your future"), by Instituto de Salud Carlos III (PT20/00044) and co-funded by European Union (ERDF, "A way to make Europe")info:eu-repo/semantics/publishedVersio

Perspectivas atuais sobre síndrome de cushing: bases diagnósticas e terapêuticas

Introduction: Cushing's syndrome (CS) is a medical condition resulting from chronic and excessive exposure to high levels of cortisol, whether of endogenous or exogenous origin. Common symptoms include central obesity, redistribution of body fat, muscle weakness, high blood pressure, increased blood glucose, skin fragility and susceptibility to infections. Objective: To evaluate the diagnostic and therapeutic aspects of Cushing's syndrome. Methodology: This is a bibliographic review that included original articles and systematic reviews in English and Portuguese, which addressed the diagnosis and treatment of CS, published between 2012 and 2024, selected from the PubMed, Scopus and SciELO databases. After careful selection, 21 articles were chosen to compose this bibliographic review. Results: CS is a complete condition and can use several diagnostic methods to discover the condition and etiology, such as measuring nocturnal salivary cortisol, urinary free cortisol, low-dose dexamethasone suppression test and imaging tests. Treatment varies depending on the etiology and includes transsphenoidal surgery, surgical excision of the extrapituitary tumor, or adrenalectomy. Pharmacological measures can be applied, such as inhibitors of cortisol synthesis and ACTH secretion. Considerations: CS presents a wide range of clinical symptoms, and biochemical confirmation of hypercortisolism and measurement of ACTH is crucial, in addition to the use of imaging tests. Management aims to resolve the underlying cause, using surgical and pharmacological interventions, with the aim of promoting a better quality of life for patients.Introdução: A síndrome de Cushing (SC) é uma condição médica resultante da exposição crônica e excessiva aos níveis elevados de cortisol, seja de origem endógena ou exógena. Os sintomas comuns incluem obesidade central, redistribuição de gordura corporal, fraqueza muscular, hipertensão arterial, aumento da glicose sanguínea, fragilidade cutânea e suscetibilidade a infecções. Objetivo: Avaliar os aspectos diagnósticos e terapêuticos da síndrome de cushing. Metodologia: Trata-se de uma revisão bibliográfica que incluiu artigos originais e revisões sistemáticas em inglês e português, que abordaram os diagnóstico e tratamento da SC, publicados entre 2012 e 2024, selecionados nas bases de dados PubMed, Scopus e SciELO. Após a seleção criteriosa, foram escolhidos 21 artigos para compor esta revisão bibliográfica. Resultados: A SC é um quadro completo e pode utilizar de diversos métodos diagnósticos para descoberta do quadro e etiologia, como medição do cortisol salivar noturno, cortisol livre urinário, teste de supressão de dexametasona em baixa dose e exames de imagem. O tratamento varia a depender da etiologia e inclui cirugia transesfenoidal, excisão cirúrgica do tumor extra-hipofisário, ou adrenalectomia. Medidas farmacológicas podem ser aplicadas, como os inibidores da síntese de cortisol e de secreção de ACTH. Considerações: A SC apresenta uma ampla gama de sintomas clínicos, e a confirmação bioquímica do hipercortisolismo e a mensuração do ACTH é crucial, além da utilização de exames de imagem. O manejo visa resolver a causa subjacente, utilizando de intervenções cirúrgicas e farmacológicas, com intuito de promover melhor qualidade de vida aos pacientes

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

Práticas artísticas no ensino básico e secundário

A matéria-prima de que trata esta revista é base de trabalho para um ensino artístico alargado, estendendo-se fora dos limites da aula, transgredindo os limites formais dos curricula, implicando património e riqueza cultural, sensibilizando para o imaterial, criando públicos apreciadores e também agentes criadores. É toda uma comunidade que se interliga através dos valores imateriais que sempre foram os da arte. A tarefa do educador é muito alargada: exige-se que esteja à altura deste desígnio humanista, que é também um desafio ao destino da humanidade: pela educação artística constroem-se futuros, e sem arte há intolerância, materialismo, indiferença, alienação, morte. Os tempos que se vivem são exigentes. As questões da pós modernidade estão muito acesas, desde as que nos obrigam ao desassossego, como a sustentabilidade e a poluição, como as que nos implicam politicamente, como a justiça, os direitos civis, a desigualdade. Tudo isto é matéria com a qual se amassa um barro que pode ser mais ou menos criativo: trata-se de extrair a matéria-prima com que se pode fazer os blocos que constroem o futuro. Aos profissionais da educação e do ensino, esta consciência, ao mesmo tempo desamparada – os cortes da economia neoliberal transformaram a arte em indústria, e a sua educação em criação de consumidores – e ao mesmo tempo vigilante e interventiva. Os artigos que responderam a esta chamada, respondem, cada um a seu modo, a este desassossego, a este desconforto, a este mal-estar contemporâneo. Dispuseram-se segundo uma sequência que se articula com base em temas afins que se podem descrever sucintamente: Todos os que participaram neste número mostraram a sua matéria-prima, a sua reação à falta que a arte nos faz. A chamada soa, e ressoa, e é necessário que seja por todos ouvida, em todos os países. É simples: as artes estão em perigo. Perigo porque há menos horas, menos professores, menos opções, menos conhecimento. As reduções no horário, a eliminação de disciplinas tão importantes como a história da arte, fazem de cada professor um agente da resistência, um ser mais implicado na sobrevivência da chama da criação. Matéria-prima: matéria para resgatar a verdade humana, a arte, a expressão mais valiosa da sua vaidade. Resgatar o homem que Michel Foucault (1988: 412) vê ameaçado, como um rosto na areia, desenhado à beira-mar.info:eu-repo/semantics/publishedVersio

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe

ADESÃO AO TRATAMENTO NA CLÍNICA NEUROPSIQUIÁTRICA: UMA REVISÃO SISTEMÁTICA

Adherence to treatment in psychiatric outpatient clinics is a vital element of mental health care. Although significant challenges are faced, it is possible to improve adherence through educational strategies, support and collaboration between patients and healthcare professionals. By recognizing the importance of this aspect and working to overcome obstacles, we can improve outcomes for patients and promote more robust and resilient mental health in our communities. This study aimed to investigate the main factors influencing adherence to treatment in psychiatric outpatient clinics. To this end, a systematic literature review was conducted, selecting scientific articles published between 2019 and 2024, available in the Scielo, Medline and Lilacs databases. After an in-depth analysis and discussion of the results, it was concluded that adherence to treatment in psychiatric outpatient clinics is influenced by a variety of factors, including continuity in therapeutic follow-up, patients' mentalization capacity, the model of care and sociodemographic and clinical influences, highlighting the need for personalized and integrated approaches to improve care in these settings.A adesão ao tratamento em ambulatórios psiquiátricos é um elemento vital do cuidado em saúde mental. Embora sejam enfrentados desafios significativos, é possível melhorar a adesão por meio de estratégias educacionais, de suporte e de colaboração entre pacientes e profissionais de saúde. Ao reconhecer a importância desse aspecto e trabalhar para superar os obstáculos, pode-se melhorar os resultados para os pacientes e promover uma saúde mental mais robusta e resiliente em nossas comunidades. Este estudo teve como objetivo investigar os principais fatores que influenciam a adesão ao tratamento nos ambulatórios psiquiátricos. Para isso, foi conduzida uma revisão sistemática da literatura, selecionando artigos científicos publicados entre 2019 e 2024, disponíveis nas bases de dados Scielo, Medline e Lilacs. Após uma análise aprofundada e discussão dos resultados, chegou-se à conclusão de que a adesão ao tratamento nos ambulatórios psiquiátricos é influenciada por uma variedade de fatores, incluindo a continuidade no acompanhamento terapêutico, a capacidade de mentalização dos pacientes, o modelo de atendimento e as influências sociodemográficas e clínicas, destacando a necessidade de abordagens personalizadas e integradas para melhorar o cuidado nesses ambientes

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio