Community socioeconomic deprivation and SARS-CoV-2 infection risk: findings from Portugal

Background: Socioeconomic differences have been observed in the risk of acquiring infectious diseases, but evidence regarding SARS-CoV-2 remains sparse. Hence, this study aimed to investigate the association between SARS-CoV-2 infection risk and socioeconomic deprivation, exploring whether this association varied according to different phases of the national pandemic response. Methods: A cross-sectional study was conducted. Data routinely collected for patients with a laboratorial result recorded in SINAVE®, between 2 March and 14 June 2020, were analysed. Socioeconomic deprivation was assessed using quintiles of the European Deprivation Index (Q1-least deprived to Q5-most deprived). Response phases were defined as before, during and after the national State of Emergency. Associations were estimated using multilevel analyses. Results: The study included 223 333 individuals (14.7% were SARS-CoV-2 positive cases). SARS-CoV-2 infection prevalence ratio increased with deprivation [PR(Q1)=Ref; PR(Q2)=1.37 (95% CI 1.19-1.58), PR(Q3)=1.48 (95% CI 1.26-1.73), PR(Q4)=1.73 (95% CI 1.47-2.04), PR(Q5)=2.24 (95% CI 1.83-2.75)]. This was observed during the State of Emergency [PR(Q5)=2.09 (95% CI 1.67-2.62)] and more pronounced after the State of Emergency [PR(Q5)= 3.43 (95% CI 2.66-4.44)]. Conclusion: The effect of socioeconomic deprivation in the SARS-CoV-2 infection risk emerged after the implementation of the first State of Emergency in Portugal, and became more pronounced as social distancing policies eased. Decision-makers should consider these results when deliberating future mitigation measures. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association.A.I.R. was supported by National Funds through FCT (Foundation for Science and Technology, Portuguese Ministry of Science, Technology and Higher Education), under the programme of 'Stimulus of Scientific Employment-Individual Support' within the contract CEECIND/02386/2018

Clinical and hospitalisation predictors of COVID-19 in the first month of the pandemic, Portugal

COVID-19 mainly presents as a respiratory disease with flu-like symptoms, however, recent findings suggest that non-respiratory symptoms can occur early in the infection and cluster together in different groups in different regions. We collected surveillance data among COVID-19 suspected cases tested in mainland Portugal during the first wave of the pandemic, March-April 2020. A multivariable logistic-regression analysis was performed to ascertain the effects of age, sex, prior medical condition and symptoms on the likelihood of testing positive and hospitalisation. Of 25,926 COVID-19 suspected cases included in this study, 5,298 (20%) tested positive. Symptoms were grouped into ten clusters, of which two main ones: one with cough and fever and another with the remainder. There was a higher odds of a positive test with increasing age, myalgia and headache. The odds of being hospitalised increased with age, presence of fever, dyspnoea, or having a prior medical condition although these results varied by region. Presence of cough and other respiratory symptoms did not predict COVID-19 compared to non-COVID respiratory disease patients in any region. Dyspnoea was a strong determinant of hospitalisation, as well as fever and the presence of a prior medical condition, whereas these results varied by region.The author(s) received no specific funding for this work

Measles outbreak in a tertiary level hospital, Porto, Portugal, 2018: challenges in the post-elimination era

A measles outbreak has been occurring in a healthcare setting in Porto, Portugal, since early March 2018, posing public health challenges for a central hospital and the community. Up to 22 April, 96 cases were confirmed, 67 in vaccinated healthcare workers, mostly between 18-39 years old. Following identification of the first cases, control measures were rapidly implemented. Concomitantly, other measles cases were notified in the Northern Region of the country. No common epidemiological link was identified.info:eu-repo/semantics/publishedVersio

Determination of tranexamic acid in human plasma by UHPLC coupled with tandem mass spectrometry targeting sub-microgram per milliliter levels

Tranexamic acid (TXA) is an antifibrinolytic drug, with the ability to inhibit lysine binding at plasminogen receptors, used in adult trauma patients with on-going or at risk of significant haemorrhage. To understand the pharmacokinetics and pharmacodynamics of this drug in variable age groups undergoing surgeries with high blood loss, effective methods for determination of TXA in biological samples at sub-μg mL−1 are still required. We describe herein the development and validation of a method based on ultra-high performance liquid chromatography coupled to triple quadrupole-tandem mass spectrometry to quantify TXA in human plasma. An inexpensive, simple and efficient sample clean-up was implemented, not requiring matrix-matching calibration. Sample preparation consisted in protein precipitation using acetonitrile containing 0.5% (v/v) formic acid, followed by hydrophilic interaction based chromatographic separation, with elution in isocratic mode using a combination of acetonitrile and water (75:25, v/v), with quantification of TXA based on selected reaction monitoring. Good linearity was achieved (r2 > 0.997) for TXA concentrations ranging from 30 to 600 ng mL−1, with LOD of 18 ng mL−1 in plasma. The developed method proved to be selective, sensitive, accurate (96.4–105.7% of nominal values) and precise (RSD ≤ 4.5%). TXA was found to be stable in plasma extracts standing 24 h at room temperature (20 °C) or in the autosampler, and after three freeze-thawing cycles. Mean recovery values of TXA spiked plasma samples were ≥91.9%. No significant matrix effects were observed. The proposed methodology was successfully applied to the clinical study of plasma samples recovered during scoliosis surgery of pediatric patients pretreatment with TXA.info:eu-repo/semantics/publishedVersio

Inferior petrosal sinus catheterization: technical aspects

OBJETIVO: O cateterismo dos seios petrosos inferiores (SPI) ajuda a diferenciar as formas hipofisária e ectópica na síndrome de Cushing (SC). O objetivo desse trabalho é descrever a técnica empregada em nosso serviço, discutir a solução de dificuldades e verificar o índice de sucesso atingido. CASUÍSTICA E MÉTODO: Foram submetidos a cateterismo bilateral dos SPI 42 pacientes com SC, entre setembro de 2000 e setembro de 2005. As dificuldades para o posicionamento do cateter foram correlacionadas com as soluções empregadas. RESULTADOS: As variações anatômicas, a semelhança entre o SPI e a veia emissária do plexo basilar e a dificuldade de contrastar as estruturas a contrafluxo para localizá-las foram os principais problemas. Foram utilizados cateter pré-moldado, fio-guia semicurvo e dirigível, road-maping e venografia por injeção contralateral, além de critérios para diferenciar o SPI da veia emissária. Dos 84 SPI abordados, um apresentava trombose, e dos 83 possíveis, 80 (96,4%) foram cateterizados. Não se observaram complicações. CONCLUSÃO: A cateterização dos SPI pode ser feita na maioria dos pacientes. A identificação da veia emissária do plexo basilar e o uso de flebografia por injeção contralateral melhoraram o desempenho do método.PURPOSE: Inferior petrosal sinus catheterization and sampling for corticotropin dosage helps to differentiate hypophisary and ectopic forms of Cushing syndrome. The aim of this paper is to describe the technique used in inferior petrosal sinus catheterization in our service, emphasizing the solution found for frequent difficulties, and verify the success rate achieved. PATIENTS AND METHODS: Between September/2000 and September/2005, forty-two (eighty-four sinuses) patients were submitted to inferior petrosal sinus sampling. The difficulties for correct catheter positioning were identified and correlated with their solutions. RESULTS: Anatomical variations, similarity between IPS and emissary vein of the basilar plexus and unfavorable flow to the contrastation of the structures (retrograde catheterization) were the main problems. Using pre-shaped catheters, curved, steerable guide-wires, road-maping and venography by contalateral injection, besides criteria to differentiate IPS from the emissary vein. Of the 84 sinuses approached, one was thrombosed, and 80 (96.4%) of 83 possible were selectively catheterized. No clinical complication occurred. CONCLUSION: IPSC can be safe and successfully performed in most cases. The identification of the emissary vein of the basilar plexus and use of venography by contralateral injection, improved the method performance

Effect of fluxinin meglumin, recombinant bovine somatotropin and/or human chorionic gonadotropin in reducing embryo mortality in nelore cows (Bos taurus indicus).

Pharmacologic strategies have been employed to reduce the embryonic mortality in cattle (2, 4)

Solos da Ilha da Trindade.

Apesar de sua pequena extensão, há uma enorme variabilidade pedológica (estudo dos solos em seu ambiente natural) na Ilha da Trindade (Figura 1), associada a processos vulcânicos muito recentes que edificaram uma ilha com forte diversidade litológica, topográfica, que repercutem na vegetação e atividade biológica singulares. A relação entre os fatores geoambientais supracitados permite o reconhecimento de distintos pedoambientes (Figura 2), cujas particularidades fazem com que Trindade apresente um conjunto único de solos, que se destaca, inclusive, daqueles encontrados no continente brasileiro. A Ilha é, neste sentido, um lugar extremamente importante para as pesquisas pedológicas