Vacinas para vírus sincicial respiratório : o estado da arte

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizIntrodução: As infeções respiratórias virais causaram quase 2,38 milhões de mortes em 2016, sendo a sexta principal causa de mortalidade em todas as idades e a principal causa de morte entre crianças com menos de 5 anos. O Vírus Sincicial Respiratório (RSV) é um dos principais vírus a causar estas infeções. Atualmente não existe vacina nem tratamento específico para as infeções causadas pelo RSV. Objetivos: Esta revisão sistemática teve como principal objetivo caraterizar e descrever os ensaios clínicos em humanos de vacinas contra o RSV nos últimos 5 anos em adultos e crianças, de modo a perceber o porquê da não existência de uma vacina em uso clínico. Materiais e métodos: Foi efetuada pesquisa na base de dados PubMed, com os termos: ((Respiratory syncycial virus) and (Human vaccines)). Na pesquisa foram colocados filtros ao nível temporal de artigos publicados apenas nos últimos 5 anos (2016 a setembro de 2021) e também a nível do tipo de artigo, sendo apenas selecionados os ensaios clínicos publicados em inglês. Resultados: A pesquisa efetuada no PubMed, permitiu a obtenção de 33 resultados, mas apenas 19 cumpriam todos os critérios de inclusão e foram utilizados. Nestes ensaios clínicos foram utilizadas diversas estratégias para a produção da vacina contra o RSV, entre elas a utilização como imunogénio da proteína de fusão (F) do RSV. Os ensaios clínicos foram maioritariamente de fase 1, destacando-se as vacinas dos estudos de McFarland et al. (2020) e Beran et al. (2018). Verifica-se que apesar de haver eficácia das vacinas na diminuição de infeções mais graves, a prevenção já não é tão fácil de obter. Conclusão: O estudo de Auguste et al. (2017) tem a respetiva vacina a ser testada em mulheres grávidas do terceiro trimestre para avaliar a proteção do bebé nos primeiros meses de vida. Espera-se a continuação e desenvolvimento destas vacinas e outras vacinas.Introduction: Viral respiratory infections occur when a virus infects respiratory mucosal cells. These infections are the sixth leading cause of mortality at all ages, with nearly 2.38 million deaths in 2016, and the leading cause of death among children under 5 years of age. The Respiratory Syncytial Virus (RSV) is one of the main viruses causing the aforementioned infections, and there are few treatments available to prevent and treat the consequential illness. Objectives: This systematic review characterizes and describes the clinical trials in humans of vaccines against the RSV in the last 5 years, both in adults and in children, in order to understand the reason behind the unexistence of a vaccine in clinical use for this virus. Materials and methods: The PubMed database was searched with the terms ((Respiratory syncycial virus) and (Human vaccines)). For this search, a temporal filter was applied, so to only return articles published in the last 5 years (2016 to September 2021), together with an article type filter, with only english clinical trials being considered. Results: The previously described search returned a total of 33 articles, but only 19 met all the inclusion criteria and were used. After an analysis of the relevant articles, several strategies were identified for producing a vaccine for the RSV, including the use of RSV F protein (Fusion). Clinical trials were mostly phase 1, highlighting the vaccines from the studies by McFarland et al. (2020) and Beran et al. (2018). The vaccines are effective in reducing more serious infections, but the effective prevention measures are harder to enforce. Conclusion: The study by Auguste et al. (2017) has the respective vaccine being tested in third trimester pregnant women to assess the baby's protection in the first months of life. Vaccines development is expected to continue, with the goal of significantly reducing infections and contagions

Leptomeningeal carcinomatosis in a patient with lung adenocarcinoma treated with whole brain radiation therapy and intrathecal chemotherapy

Publisher Copyright: © Author(s) (or their employer(s)) and Sinapse 2021.Leptomeningeal carcinomatosis is a rare complication of several types of cancer. There are many possible clinical features, and the diagnosis is made with brain imaging and cytological analysis of cerebrospinal fluid. Treatment is widely debated and, concerning overall survival, there does not seem to exist a treatment option which is definitely superior. The present work describes the case of a 53-year-old man diagnosed with leptomeningeal carcinomatosis secondary to lung adenocarcinoma, who was treated with whole brain radiation therapy and, upon relapse, with intrathecal chemotherapy, showing both an above-average overall survival and a high performance status.publishersversionpublishe

Lipid profile of dehydrated eggs with emphasis on the contents of trans fatty acids

O presente trabalho objetivou a determinação do perfil lipídico de ovos integrais desidratados, bem como de gemas desidratadas, a fim de enfatizar seu conteúdo de ácidos graxos de configuração trans. A fração lipídica das amostras foi extraída com hexano/isopropanol e, a seguir, metilada. Os ácidos graxos foram identificados via cromatografia gasosa. Constatou-se que a natureza lipídica dos ovos tem caráter predominantemente insaturado: 63,65% dos lipídios totais nos ovos integrais e 62,63% nas gemas. Além disso, foram identificados apenas traços de gorduras trans (0,24% nos ovos integrais e 0,27% nas gemas).The objective of this work was to determine fatty acids composition in dehydrated eggs and egg yolks emphasizing its contents of trans fatty acids. The fatty acids fraction of the samples was extracted with hexane/isopropanol (3:2) and then methylated. The profile of the fatty acids was identified by gas chromatography with predominant evidence of insaturated character: 63.65 and 62.63% of the lipids were unsatureted in the eggs and in the egg yolks, respectively. Traces of trans fatty were also identified (0.24% in the hole eggs and 0.27% in the egg yolks).Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Cognitive function, cerebral microbleeds, radiotherapy, and bevacizumab in survivors of pediatric brain tumors

We read with great interest a recent paper published by Roddy et al showing a high (48.8%) 5-year cumulative incidence of cerebral microbleeds (CMB) and its association with cognitive dysfunction in a group with pediatric brain tumors who received cranial radiation therapy (CRT).1 We believe that exposing the association of CMB (or the associated underlying microvascular pathology) with cognitive impairment in this population will help draw attention to the importance of the topic in this specific growing population.info:eu-repo/semantics/publishedVersio

Wolbachia-based biocontrol for dengue reduction using dynamic optimization approach

Aedes aegypti females mosquitoes are the principal transmitters of dengue and other arboviral infections. In recent years, it was disclosed that, when deliberately infected with Wolbachia symbiont, this mosquito species loses its vectorial competence and becomes less capable of transmitting the virus to human hosts. Thanks to this important discovery, Wolbachia-based biocontrol is now accepted as an ecologically friendly and potentially cost-effective method for prevention and control of dengue and other arboviral infections. In this paper, we propose a dengue transmission model that accounts for the presence of wild Aedes aegypti females and those deliberately infected with wMelPop Wolbachia strain, which is regarded as the best blocker of dengue and other arboviral infections. However, wMelPop strain of Wolbachia considerably reduces the individual fitness of mosquitoes, what makes rather challenging to achieve the gradual extrusion of wild mosquitoes and ensure their posterior replacement by Wolbachia-carriers. Nonetheless, this obstacle have been overcome by employing the optimal control approach for design of specific intervention programs based on daily releases of Wolbachia-carrying mosquitoes. The resulting optimal release programs ensure the population replacement and eventual local extinction of wild mosquitoes in the finite time and also entail a significant reduction in the number of expected dengue infections among human hosts under the long-term setting

Transfusion-associated adverse events incidence and severity after the implementation of an active hemovigilance program with 24 h follow-up. A prospective cohort study

Background: Hemovigilance (HV) is usually based on voluntary reports (passive HV). Our aim is to ascertain credible incidence, severity, and mortality of transfusion-associated adverse events (TAAEs) using an active HV program. Study Design and Methods: Prospective cohort study to estimate transfusion risk after 46,488 transfusions in 5830 patients, using an active HV program with follow-up within the first 24 h after transfusion. We compared these results to those with the previously established passive HV program during the same 30 months of the study. We explored factors associated with the occurrence of TAAEs using generalized estimating equations models. Results: With the active HV program TAAEs incidence was 57.3 (95% CI, 50.5–64.2) and mortality 1.1 (95% CI, 0.13–2.01) per 10,000 transfusions. Incidence with the new surveillance model was 14.0 times higher than with the passive. Most events occurred when transfusions had already finished (60.2%); especially pulmonary events (80.4%). Three out of five deaths and 50.3% of severe TAAEs were pulmonary. In the multivariate analysis surgical patients had half TAAEs risk when compared to medical patients (OR, 0.53; 95% CI, 0.34–0.78) and women had nearly twice the risk of a pulmonary event compared to men (OR, 1.84; 95% CI, 1.03–3.32). Patient's age, blood component type, or blood component shelf-life were unrelated to TAAEs risk. Discussion: Active hemovigilance programs provide additional data which may lead to better recognition and understanding of TAAEs and their frequency and severit

Modelos de regressão multinível: uma aplicação na educação

Dissertação de mestrado em EstatísticaOs Modelos de Regressão Multinível são importantes na análise de estudos educacionais, pois têm em conta a natureza hierárquica da população em estudo, o que não seria possível com os modelos de regressão clássica. Neste trabalho apresentam-se os aspectos principais subjacentes aos Modelos de Regressão Multinível, sendo abordados vários modelos de entre os quais se selecionou aquele que melhor se ajusta aos dados. Os Modelos de Regressão Multinível foram aplicados aos dados dos alunos portugueses obtidos no âmbito dos testes estandardizados administrados pelo Programa Internacional de Avaliação de Estudantes (PISA) 2009 na disciplina de matemática. Pretende-se com esta aplicação analisar o desempenho escolar dos alunos portugueses nesta disciplina, tentando perceber os principais determinantes do sucesso dos alunos, bem como estudar a contribuição das escolas portuguesas no desempenho escolar dos seus alunos. A principal conclusão deste trabalho é que existe um efeito significativo da escola a que os alunos pertencem na determinação dos seus resultados escolares, e o nível socioeconómico e cultural dos alunos é um dos principais determinantes do desempenho escolar dos alunos.Multilevel Regression Models are important in the analysis of educational studies as they have into account the hierarchical nature of the population under study, something that is not possible with classical regression models. This thesis presents the main aspects underlying the multilevel regression models, where various models are discussed and the one that best fits the data is selected. Multilevel Regression Models were applied to the data on Portuguese students obtained under the standardized tests administered by the Programme for International Student Assessment (PISA) 2009 in the discipline of mathematics. The aim of this application was to analyse the academic performance of Portuguese students in this discipline while trying to understand which factors are the most important determinants of students’ success, as well as studying the contribution of Portuguese schools to the academic achievement of their students. The main conclusion of this study is that there is a significant e ect of the school in the achievements of students, and that the socio-economic and cultural context is one of the main determinants of students’ academic performance

A Importância da Voz Materna em Bebés Vulneráveis

UID/EAT/00693/2013Uma das preocupações nos cuidados neonatais é gerir o equilíbrio entre os sistemas de regulação fisiológica e de interação neuro-comportamental do bebé vulnerável durante a hospitalização. O método canguru tem-se evidenciado uma medida eficaz com resultados positivos na regulação fisiológica e comportamental do bebé pré-termo e no envolvimento parental nos cuidados neonatais. É em situação de contacto pele-a-pele que melhor se promove a estimulação multimodal e onde emergem as trocas vocais e de intimidade afetiva nas díades, incentivando o papel dos pais como parceiros interlocutores privilegiados nos cuidados prestados ao recém-nascido pré-termo. Apesar do incentivo para a interação vocal nos cuidados prestados ao bebé pré-termo poucos estudos se têm debruçado acerca da observação empírica das trocas vocais de díades pré-termo. Nesta comunicação faremos referência ao protocolo de um estudo de observação das interações vocais de 36 díades pré-termo filmadas nas condições da voz materna falada vs cantada durante o método canguru em contacto visual. A apresentação será ilustrada por excertos de filmagens.publishersversionpublishe

Preparation of β-glucan scaffolds by hydrogel foaming with supercritical CO2

New materials and processing techniques are being constantly developed for the production of scaffolds for tissue engineering applications. Traditionally, foaming of polymers with supercritical fluids is one of the procedures used to create porous matrices. However, this technique cannot be applied to hydrophilic polymers which suffer degradation below their melting temperature. Foaming of hydrogels is an alternative to conventional gas foaming for the processing of hydrophilic polymers by dissolution of supercritical CO2 in the water of the hydrogels [1]. Through a fast depressurization, a highly porous structure is obtained, which results in the foamed matrix of polymer after water removal. In this work, β-glucan aerogels are produced by hydrogel foaming with supercritical CO2. Among polysaccharides, β-glucans have not been widely explored yet for tissue engineering applications. Depending on their origin, they posses different structures and properties. In our study, hydrogels were created from barley and yeast β-glucans. The produced aerogels were characterized in terms of morphology, mechanical properties and degradation rate in physiological fluids.MINECO (CTQ2013-44143-R)MINECO and UVa for Cierva fellowship (JCI-2012-14992)