Late Neuroborreliosis in an Erasmus Programme Student

Lyme disease is an endemic zoonosis, the most prevalent tick-transmitted infection in temperate areas of Europe, North America and Asia. It is a multisystemic disease with cutaneous, musculoskeletal, neurologic and cardiac manifestations, according to the stage of the disease. We describe a case of late neuroborreliosis in an Erasmus programme student living in Porto. We discuss the importance of the epidemiological suspicion, the clinical approach, the diagnostic criteria and the most adequate treatment

Human Psittacosis: A Case Report

Psittacosis is a rare disease caused by Chlamydophila psittaci, an intracellular bacteria transmitted by contaminated birds. The clinical and radiological presentations are nonspecific. We describe a case of a 42-year-old woman, with known exposure to birds, who presented to the emergency department with one-week evolution of myalgia, polyarthritis, and respiratory symptoms. At admission, she had fever, respiratory failure, raised inflammatory markers and bilateral interstitial infiltrates at chest radiography. Considering the clinical findings and epidemiological background, we raised the hypothesis of a Chlamydophila psittaci atypical pneumonia that was serologically confirmed. Tetracyclines are the mainstay of treatment and the macrolides are an effective alternative. We highlight the importance of the epidemiological context in the early diagnosis and treatment of this infection

Incorporation of beads into oral films for buccal and oral delivery of bioactive molecules

The association of alginate beads and guar-gum films in a single delivery system was idealized to promote a more effective buccal and oral delivery of bioactive molecules. A response surface method (experimental design approach) was performed to obtain optimal formulations of alginate beads to be incorporated into guar gum oral films as combined buccal and oral delivery systems for caffeine delivery. The combined formulation was further characterized regarding physicochemical properties, drug release, cell viability and buccal permeability. Beads average size, determined by dynamic light scattering (DLS), was of 3.37 ± 6.36 μm. Film thickness was set to 62 μm. Scanning electron microscopy micrographs revealed that beads were evenly distributed onto the film matrix and beads size was in accordance to data obtained from DLS analysis. Evaluation of Fourier-transform infrared spectra did not indicate the formation of new covalent bonds between the matrix of guar-gum films, alginate beads and caffeine. In vitro release assays by dialysis membrane allowed understanding that the combination of guar-gum films and alginate beads assure a slower release of caffeine when compared with the delivery profile of free caffeine from alginate beads or guar-gum films alone. MTT assay, performed on human buccal carcinoma TR146 cell line, allowed concluding that neither guar-gum film, alginate beads nor guar-gum film incorporated into alginate beads significantly compromised cell viability after 12 h of exposure. As demonstrated by in vitro permeability assay using TR146 human buccal carcinoma cell lines, combination of guar-gum films and alginate beads also promoted a slower release and, thus, lower apparent permeability (1.15E–05 ± 3.50E-06) than for caffeine solution (2.68E–05 ± 7.30E-06), guar-gum film (3.12E–05 ± 4.70E-06) or alginate beads (2.01E–05 ± 3.90E-06). The conjugation of alginate beads within an orodispersible film matrix represents an effective oral/buccal delivery system that induces a controlled release along with an enhanced intimate contact with cell layers that may promote higher in vivo bioavailability of carried drugs.Fil: Castro, Pedro M.. Escola Superior de Biotecnologia Da Universidade Católica Portuguesa; Portugal. Cooperativa de Ensino Superior, Politécnico E Universitário; PortugalFil: Sousa, Flávia Aparecida Fernandes de. Universidad de Porto; Portugal. Cooperativa de Ensino Superior, Politécnico E Universitário; Portugal. Instituto Nacional de Engenharia Biomédica; PortugalFil: Magalhães, Rui. Escola Superior de Biotecnologia Da Universidade Católica Portuguesa; PortugalFil: Pizones Ruiz Henestrosa, Víctor Manuel. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Industrias. Instituto de Tecnología de Alimentos y Procesos Quimicos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Tecnología de Alimentos y Procesos Quimicos.; ArgentinaFil: Pilosof, Ana Maria Renata. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Industrias. Instituto de Tecnología de Alimentos y Procesos Quimicos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Tecnología de Alimentos y Procesos Quimicos.; ArgentinaFil: Madureira, Ana Raquel. Escola Superior de Biotecnologia Da Universidade Católica Portuguesa; PortugalFil: Sarmento, Bruno. Cooperativa de Ensino Superior, Politécnico E Universitário; Portugal. Universidad de Porto; PortugalFil: Pintado, Manuela. Escola Superior de Biotecnologia Da Universidade Católica Portuguesa; Portuga

Chronic hepatitis C treatment in HIV co‐infection in Portugal: Results from a cohort OF 2133 patients presented by GEPCOI (Portuguese Coinfection Study Group)

Direct-acting antiviral drugs (DAAs) have recently changed the paradigm of hepatitis C therapy, significantly improving treatment response rates, patient life expectancy and quality of life. In Portugal, sofosbuvir (SOF) and SOF/ledipasvir (SOF/LDV) were fully reimbursed by the National Health System since early 2015 and generalized use of interferon-free DAA based regimens became current practice. During 2016, the remaining DAAs were sequentially added and covered by the same health access policy. The Portuguese Study Group of Hepatitis and HIV Co-infection (GEPCOI) collected data from 15 clinical centres in Portugal, pertaining to the HCV treatment experience with DAA regimens. A cohort of 2133 patients was analysed, representing one of the largest DAA treated HCV/HIV co-infected individuals. The global sustained virologic response (SVR) achieved was 95% in this real-life cohort setting. Linear regression analysis showed significant differences in treatment response rates when using SOF plus ribavirin (RBV) combination in genotype 2 or 3 infected individuals (P < .002) and in those with liver cirrhosis (P < .002). These findings corroborate that early treatment is mandatory in HIV/HCV co-infected patients, as response rates may be negatively influenced by higher fibrosis stages and suboptimal DAA regimens. The current national Portuguese health policy should continue to promote wider treatment access and individualized therapy strategies, aiming at the elimination of HCV infection in this high-risk co-infected population.info:eu-repo/semantics/publishedVersio

SARS-CoV-2 Infection Drives a Glycan Switch of Peripheral T Cells at Diagnosis

COVID-19 is a highly selective disease in which SARS-CoV-2 infection can result in different clinical manifestations ranging from asymptomatic/mild to severe disease that requires hospitalization. In this study, we demonstrated that SARS-CoV-2 infection results in a glycosylation reprogramming of circulating lymphocytes at diagnosis. We identified a specific glycosignature of T cells, defined upon SARS-CoV-2 infection and apparently triggered by a serological factor. This specific glycan switch of T cells is detected at diagnosis being more pronounced in asymptomatic patients. We further demonstrated that asymptomatic patients display an increased expression of a viral-sensing receptor through the upregulation of DC-SIGN in monocytes. We showed that higher levels of DC-SIGN in monocytes at diagnosis correlates with better COVID-19 prognosis. This new evidence pave the way to the identification of a novel glycan-based response in T cells that may confer protection against SARS-CoV-2 infection in asymptomatic patients, highlighting a novel prognostic biomarker and potential therapeutic target.info:eu-repo/semantics/publishedVersio

Poor Immune Reconstitution in HIV-Infected Patients Associates with High Percentage of Regulatory CD4(+) T Cells

CD4(+) regulatory T cells (Tregs) are essential for the maintenance of the immune system's equilibrium, by dampening the activation of potential auto-reactive T cells and avoiding excessive immune activation. To correctly perform their function, Tregs must be maintained at the right proportion with respect to effector T cells. Since this equilibrium is frequently disrupted in individuals infected with the human immunodeficiency virus (HIV), we hypothesize that its deregulation could hamper immune reconstitution in patients with poor CD4(+) T cell recovery under highly active antiretroviral therapy (HAART). We analysed Tregs percentages amongst CD4(+) T cells in 53 HIV-infected patients under HAART, with suppression of viral replication and distinct levels of immune reconstitution. As controls, 51 healthy individuals were also analysed. We observed that amongst the patients with Nadir values (the lowest CD4(+) T cell counts achieved) = 10% of total CD4(+) T cells) had the worse CD4(+) T cell reconstitution. In accordance, the well-described direct correlation between the Nadir value and CD4(+) T cell reconstitution is clearly more evident in individuals with high Tregs proportions. Furthermore, we observed a strong negative correlation between Tregs percentages and CD4(+) T cell recovery among immunological non-responder HIV+ individuals. All together, this work shows that high Tregs frequency is an important factor associated with sub-optimal CD4(+) T cell recovery. This is particularly relevant for immunological non-responders with low Nadir values. Our results suggest that the Tregs proportion might be of clinical relevance to define cut-offs for HAART initiation

A infância representada no livro escolar: tipos de textos e estereótipos sociais

Esta investigação inscreve-se dominantemente no âmbito dos estudos da criança e ancora a sua área específica nas questões linguísticas, assumindo os pressupostos teóricos e metodológicos da análise do discurso (de tradição francófona), considerando também contributos de áreas conexas. Analisa textos de manuais/livros escolares usados no sistema de ensino português, pretendendo tornar visíveis as imagens que estes constroem das crianças e da infância, bem como os recursos linguísticos mais relevantes associados a tal construção. Procura desvendar a representatividade das tipologias textuais nos manuais e de que forma estas contribuem para a construção das referidas imagens. Conclui que as crianças dos textos são seres sem voz e sem poder, consumidoras, mas não coprodutoras de cultura, com os textos inculcando valores conformadores da manutenção da ordem social estabelecida, sendo a forma como as tipologias textuais estão organizadas contribuidora para se alcançar esse propósito.This research forms primarily part of the child studies and is based on its specific field of linguistic issues, assuming the theoretical and methodological assumptions of the speech analysis (of French-speaking tradition), having also regard the inputs of related fields. It analyses texts from handbooks/textbooks used on the Portuguese educational system, intending to reveal pictures that these books construct about children and childhood, as well as the most relevant linguistic resources associated with such construction. This paper aims at unravelling the representation of the text typologies in the handbooks and how these can contribute for building of such pictures. From this, one can conclude that children from the texts are voiceless and have no power, they are consumers but not co-producers of culture, with these texts instilling conservative values for maintaining the established social order, but also that the way texts typologies are organized to contribute for reaching that propose.Esta investigación se ensere en el ámbito de los estudios del niño y más precisamente en la área de las cuestiones lingüísticas, asumiendo los presupuestos teóricos e metodológicos de la análisis del discurso (de tradición francófona), considerando también aportes de las áreas conexas. Analiza textos de manuales/libros escolares usados en el sistema de enseñanza portugués, pretendiendo tornar visibles las imágenes que este construyen de los niños y de la infancia, bien como los recursos lingüísticos más relevantes asociados a esa construcción. Busca desvendar la representatividad de las tipologías textuales en los manuales y de qué forma contribuyen para la construcción de las referidas imágenes. Concluye que los niños de los textos son seres sin voz y sin poder, consumidores, pero no coproductores de cultura y que los textos inculcan valores conformadores de manutención del orden social establecido, mas también que la forma como las tipologías textuales están organizadas contribuye para alcanzar ese propósito.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT), Portugal. Fundos Nacionais através da FCT (Fundação para a Ciência e a Tecnologia) e cofinanciado pelo Fundo Europeu de Desenvolvimento Regional (FEDER) através do COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) no âmbito do CIEC (Centro de Investigação em Estudos da Criança, da Universidade do Minho) com a referência POCI-01-0145-FEDER-007562info:eu-repo/semantics/publishedVersio

Guideline for the Prevention and Treatment of Infections Associated with Immunosuppressive Therapy for Autoimmune Diseases

We propose a guideline about the risk, prevention and treatment of infection in the patient under immunomodulatory or immunosuppressive therapy in the context of autoimmune or autoinflammatory disease. It is divided into three sections: drugs and associated risk of infection; immunizations; risk, prevention, and treatment of specific infections. The treatment of autoimmune diseases involves the use of immunosuppressive or immunomodulatory therapies, with an increasing number of new drugs being used. It is associated with an increased risk of infection, which may be present globally or only for specific agents, varying widely depending on the pharmacological class and even within the same class. The prevention strategy and clinical management need to be individually tailored and there are several key factors: characterization of the disease that prompts the immunosuppression, understanding of the mechanism of action of the immunosuppressive drug, knowledge of previous infections, recognition of risk factors, laboratory test results, vaccine administration, monitoring of clinical signs and symptoms and patient education.O presente protocolo aborda o risco, prevenção e tratamento da infeção no doente sob terapêutica imunomoduladora ou imunossupressoraem contexto de doença autoimune ou autoinflamatória. Subdivide-se nas seguintes secções: fármacos e risco associado de infeção; imunizações; risco, prevenção e tratamento de infeções específicas. Com um número crescente de novos fármacos em utilização nos últimos anos, o tratamento de doenças autoimunes envolve a utilização de terapêuticas imunossupressoras ou imunomoduladoras e associa-se a aumento do risco de infeção, que pode estar presente de uma forma global ou apenas para infeções por agentes específicos, variando amplamente consoante a classe farmacológica e mesmo dentro desta. Na estruturação da estratégia preventiva são fundamentais a caracterização da patologia que motiva a imunossupressão, a compreensão do mecanismo de ação do imunossupressor, a aferição de infeções prévias, o reconhecimento de fatores de risco, a realização de rastreios laboratoriais, a administração de vacinas, a educação do doente e a monitorização de sintomas e sinais clínicos, na dependência de uma gestão clínica necessariamente individualizada.info:eu-repo/semantics/publishedVersio

Para o estudo da evolução do ensino e da formação em administração educacional em Portugal

Estudos sobre a evolução do ensino de disciplinas, na formação de professores em Portugal, são recentes. O controle burocrático centralizado reteve as dimensões do controle político-administrativo. De certo modo, protegeu a esfera educativa das influências modernizantes, do capitalismo industrial e das lógicas mercantis e gerencialistas. Defendeu a educação do domínio político, da intervenção de movimentos sociais, das propagandas de ideais democráticos e da cidadania. A utilização da designação "Administração educacional" ilustra as dificuldades sentidas, ao longo dos últimos anos, em termos da construção acadêmica de uma área, seja pela falta de tradição, seja pelos antecedentes históricos.In Portugal, studies about the evolution of disciplines teaching in the teachers formation are recent. The centralized bureaucratic control has held back the dimensions of politic administrative control. In a certain way, it has protected the education against the new-fashioned influences, manufacturing capitalism, and mercantile and managerial logics. This centralized bureaucratic control has also profected the education against the politic dominion, the intervention of social movements, the advertising of democratic ideals, and against the citizenship. The use of the term "Educational administration" shows the difficulties met by the searchers along the latest years, since there is no tradiction nor historic antecedence