The impact of social risk in a paediatric department

Introdução: Os maus tratos a crianças correspondem a qualquer acção ou omissão não acidental, que ameace a sua segurança, dignidade e correcto desenvolvimento biopsicossocial. Pretendeu-se avaliar o seu impacto no internamento de Pediatria. Metodologia: Estudo retrospectivo dos doentes internados no Serviço de Pediatria de um hospital terciário entre 1/10/10 e 30/09/11, sinalizados ao Núcleo Hospitalar de Apoio a Crianças e Jovens em Risco (NHACJR). Foi considerada alta clínica o momento em que o doente já não apresentava critérios clínicos para o internamento. Na avaliação do impacto económico foi considerado o valor do custo diário de assistência hospitalar (85,00€) referido no DR 1ªsérie, de Janeiro de 2009. Resultados: Num total de 1052 internamentos, foi solicitada avaliação ao NHACJR em 4,1% (43) dos episódios. Os lactentes representaram 53,5% das sinalizações. O desemprego verificou-se em 66% dos pais e 37,2% destes tinham completadoo 3º ciclo de ensino básico. O modelo de família nuclear foi identificado em 37,2% dos casos. A presença de indicadores de risco social sem evidência aparente de maus tratos ocorreu em 48,8%. A negligência foi identificada em 39,5% das crianças, seguida dos maus tratos físicos com 6,9%. Quatro internamentos foram por motivos exclusivamente sociais, com um tempo médio de internamento de 10,5 dias. Dez crianças com critérios clínicos de internamento vieram a ter adiamento da alta hospitalar por motivos sociais, com um prolongamento médio do tempo de internamento de 33,2 dias. Neste grupo de catorze casos ocorreram seis infecções nosocomiais, um traumatismo crânio-encefálico e o custo adicional estimado de assistência hospitalar foi de 31.790,00€. Comentários: O impacto das razões sociais no internamento em Pediatria não é negligenciável quer do ponto de vista clínico quer económico. Uma reflexão multidisciplinar sobre a necessidade de maior apoio social na comunidade revela-se necessária, tendo por base os direitos da criança hospitalizada e o contexto socioeconómico actual

3D Printing of Dietary Products for the Management of Inborn Errors of Intermediary Metabolism in Pediatric Populations

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/The incidence of Inborn Error of Intermediary Metabolism (IEiM) diseases may be low, yet collectively, they impact approximately 6–10% of the global population, primarily affecting children. Precise treatment doses and strict adherence to prescribed diet and pharmacological treatment regimens are imperative to avert metabolic disturbances in patients. However, the existing dietary and pharmacological products suffer from poor palatability, posing challenges to patient adherence. Furthermore, frequent dose adjustments contingent on age and drug blood levels further complicate treatment. Semi-solid extrusion (SSE) 3D printing technology is currently under assessment as a pioneering method for crafting customized chewable dosage forms, surmounting the primary limitations prevalent in present therapies. This method offers a spectrum of advantages, including the flexibility to tailor patient-specific doses, excipients, and organoleptic properties. These elements are pivotal in ensuring the treatment’s efficacy, safety, and adherence. This comprehensive review presents the current landscape of available dietary products, diagnostic methods, therapeutic monitoring, and the latest advancements in SSE technology. It highlights the rationale underpinning their adoption while addressing regulatory aspects imperative for their seamless integration into clinical practice.Peer reviewe

Predicting pharmaceutical inkjet printing outcomes using machine learning

Inkjet printing has been extensively explored in recent years to produce personalised medicines due to its low cost and versatility. Pharmaceutical applications have ranged from orodispersible films to complex polydrug implants. However, the multi-factorial nature of the inkjet printing process makes formulation (e.g., composition, surface tension, and viscosity) and printing parameter optimization (e.g., nozzle diameter, peak voltage, and drop spacing) an empirical and time-consuming endeavour. Instead, given the wealth of publicly available data on pharmaceutical inkjet printing, there is potential for a predictive model for inkjet printing outcomes to be developed. In this study, machine learning (ML) models (random forest, multilayer perceptron, and support vector machine) to predict printability and drug dose were developed using a dataset of 687 formulations, consolidated from in-house and literature-mined data on inkjet-printed formulations. The optimized ML models predicted the printability of formulations with an accuracy of 97.22%, and predicted the quality of the prints with an accuracy of 97.14%. This study demonstrates that ML models can feasibly provide predictive insights to inkjet printing outcomes prior to formulation preparation, affording resource- and time-savings

Compósitos de colagénio/apatite de origem marinha para aplicação em engenharia de tecidos mineralizados

Devido ao aumento de lesões associadas ao envelhecimento da população, a regeneração do tecido ósseo tem sido alvo de estudo. Apesar da vasta investigação neste sentido, os auto-enxertos continuam a prevalecer como tratamento de primeira linha, apesar das suas limitações. A extração de compostos de recursos marinhos para uso em abordagens de engenharia de tecidos emerge como uma alternativa promissora para regeneração de lesões ósseas. Neste capítulo apresenta-se um biomaterial promissor para aplicação em engenharia de tecidos duros tendo como base uma estratégia de valorização de sub-produtos marinhos, nomeadamente pele e dentes de tubarão.Os autores agradecem o apoio financeiro recebido da União Europeia através do Programa INTERREG—POCTEP, no âmbito dos Projetos 0687_NOVOMAR_1_P e 0245_IBEROS_1_E, através do Programa de cooperação transnacional Espaço Atlântico, no âmbito do Projeto MARMED (2011-1/164) e através do 7º Programa-Quadro de Investigação e Desenvolvimento Tecnológico (FP7), através do Projeto POLARIS (REGPOT-CT2012-316331). Os autores gostariam de agradecer também ao Centro Tecnológico del Mar (CETMAR, Vigo, Espanha) e COPEMAR SA (Espanha) pelo fornecimento dos subprodutos de tubarão. G.S.D agradece ao Programa Norte2020 (Portugal2020) pela bolsa de doutoramento (NORTE-08-5369-F SE-000044) e R.P. agradece à Fundação para a Ciência e a Tecnologia pelo contrato IF/00347/2015

Experimental characterization and test-beam results of MACACO III Compton camera

The IRIS group at IFIC-Valencia is developing a Compton camera prototype with the aim of applying it in hadron therapy treatment monitoring. Recently, a third version of the prototype MACACO (Medical Applications CompAct COmpton camera) has been built. The system is composed of three Lanthanum (III) bromide scintillator crystals coupled to silicon photomultipliers. To improve its performance for the final application, several detectors are tested, two different silicon photomultipliers (25 and 50 um) have been chosen as possible candidates. The 25 up photodetector provided better performance in therms of dynamic range, energy resolution (5.2/ FWHM at 511 keV) and stability with temperature variations. MACACO III has also been tested in the CNA cyclotron (Seville) with 18 MeV proton beam to produce 4.439 MeV gamma rays. Data have been acquired with a graphite target in five different positions at 2.5 nA nominal beam intensity. Images with 4.439 MeV photons have been reconstructed, demonstrating the system capability to reconstruct images at energies relevant for hadron therapy. Moreover, the system has been able to distinguish 1mm displacements in the target position

Marine collagen/apatite composite scaffolds envisaging hard tissue applications

The high prevalence of bone defects has become a worldwide problem. Despite the significant amount of research on the subject, the available therapeutic solutions lack efficiency.  Autografts, the most common used approaches to treat bone defects have limitations such as donor site morbidity, pain and lack of donor site. Marine resources emerge as an attractive alternative to extract bioactive compounds for further use in bone tissue engineering approaches. On one hand they can be isolated from by-products, at low costs, creating value from products that are considered waste for the fish transformation industry. One the other hand, religious constraints will be avoided. We isolated two marine origin materials, collagen from shark skin (Prionace glauca) and calcium phosphates from teeth of two different shark species (Prionace glauca and Isurus oxyrinchus), and further proposed to mix them to produce 3D composite structures for hard tissue applications. Two crosslinking agents, EDC/NHS and HMDI, were tested to enhance scaffoldsâ properties, with EDC/NHS resulting in better properties. The characterization of the structures showed that the developed composites could support attachment and proliferation of osteoblast-like cells. A promising scaffold for the engineering of bone tissue is thus proposed, based on a strategy of marine by-products valorisation.This work was funded by INTERREG under the POCTEP Project 0687_NOVOMAR_1_P and the Atlantic Area Transnational Cooperation Programme Project MARMED (2011-1/164), as well as by European Union FP7 under the project POLARIS (REGPOT-CT2012-316331).info:eu-repo/semantics/publishedVersio

Gamma-ray sources imaging and test-beam results with MACACO III Compton camera

Hadron therapy is a radiotherapy modality which offers a precise energy deposition to the tumors and a dose reduction to healthy tissue as compared to conventional methods. However, methods for real-time monitoring are required to ensure that the radiation dose is deposited on the target. The IRIS group of IFIC-Valencia developed a Compton camera prototype for this purpose, intending to image the Prompt Gammas emitted by the tissue during irradiation. The system detectors are composed of Lanthanum (III) bromide scintillator crystals coupled to silicon photomultipliers. After an initial characterization in the laboratory, in order to assess the system capabilities for future experiments in proton therapy centers, different tests were carried out in two facilities: PARTREC (Groningen, The Netherlands) and the CNA cyclotron (Sevilla, Spain). Characterization studies performed at PARTREC indicated that the detectors linearity was improved with respect to the previous version and an energy resolution of 5.2 % FWHM at 511 keV was achieved. Moreover, the imaging capabilities of the system were evaluated with a line source of 68Ge and a point-like source of 241Am-9Be. Images at 4.439 MeV were obtained from irradiation of a graphite target with an 18 MeV proton beam at CNA, to perform a study of the system potential to detect shifts at different intensities. In this sense, the system was able to distinguish 1 mm variations in the target position at different beam current intensities for measurement times of 1800 and 600 s.</p