Asbestose pulmonar: mecanismos celulares da sua patogenia

A asbestose pulmonar continua a ser uma das doenças ocupacionais mais graves do nosso tempo. Apesar de clínica e epidemiologicamente bem caracterizada pouco se sabe ainda dos mecanismos celulares responsáveis pela sua ocorrência. Assim, a partir da informação até ao momento disponível sobre este assunto, tentámos delinear os vários mecanismos envolvidos na resposta do pulmão profundo à inalação de fibras de asbesto. Numa primeira parte caracterizam-se os vários tipos de fibras de asbesto existentes bem como os seus diferentes padrões de deposição e transporte. Numa segunda parte descrevem-se os possíveis mecanismos celulares envolvidos na patogenia da asbestose pulmonar, nomeadamente a acção dos macrófagos alveolares, dos neutrófilos e dos respectivos mediadores. A análise do perfil linfocitário de lavados bronco-alveolares de pacientes com asbestose é também descrita, salientando-se um acentuado aumento na relação CD4/CD8.Pulmonary asbestosis is still one serious occupational disease ofour times. Although the clinical and epidemiological featu res ofthe disease are well caracterized, the cellular mechanisms involved are still poorly understood. Taking advantage ofall the information available on this subject, we tried to depict the several mechanisms involved in the answer ofthe deep lung to the inhalation ofasbestos jibers. ln the jirst part ofthis article we characterized the diferent kinds ofasbestos jibers as well as their patterns oftransport and deposition in the deep lung.ln the second part we discribed the possible cellular mechanisms underlying the pathogeny of pulmonary asbestosis. The e.fJect ofthe alveolar macrophages, polinuclear neuthrophils and the action oftheir mediators is discribed. Analysis of the bronco alveolar lavage jluid lynphocitary profile of pacients with pulmonary asbestosis is also discribed, revealing significant increase in the CD4/CD8 ratio

New textile for personal protective equipment—plasma chitosan/silver nanoparticles nylon fabric

Fabric structures are prone to contamination with microorganisms, as their morphology and ability to retain moisture creates a proper environment for their growth. In this work, a novel, easily processed and cheap coating for a nylon fabric with antimicrobial characteristics was devel- oped. After plasma treatment, made to render the fabric surface more reactive sites, the fabric was impregnated with chitosan and silver nanoparticles by simply dipping it into a mixture of different concentrations of both components. Silver nanoparticles were previously synthesized using the Lee–Meisel method, and their successful obtention was proven by UV–Vis, showing the presence of the surface plasmon resonance band at 410 nm. Nanoparticles with 25 nm average diameter observed by STEM were stable, mainly in the presence of chitosan, which acted as a surfactant for silver nanoparticles, avoiding their aggregation. The impregnated fabric possessed bactericidal activ- ity higher for Gram-positive Staphylococcus aureus than for Gram-negative Pseudomonas aeruginosa bacteria for all combinations. The percentage of live S. aureus and P. aeruginosa CFU was reduced to less than 20% and 60%, respectively, when exposed to each of the coating combinations. The effect was more pronounced when both chitosan and silver were present in the coating, suggesting an effective synergy between these components. After a washing process, the antimicrobial effect was highly reduced, suggesting that the coating is unstable after washing, being almost completely removed from the fabric. Nevertheless, the new-coated fabric can be successfully used in single-use face masks. To our knowledge, the coating of nylon fabrics intended for face-mask material with both agents has never been reported.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 BioTecNorte operation (NORTE-01-0145-FEDER-000004). funded by the European Regional Development, Fund under the scope of Norte2020—Programa Operacional Regional do Norte

Cold atmospheric plasma, a novel approach against bladder cancer, with higher sensitivity for the high-grade cell line

Antitumor therapies based on Cold Atmospheric Plasma (CAP) are an emerging medical field. In this work, we evaluated CAP effects on bladder cancer. Two bladder cancer cell lines were used, HT-1376 (stage III) and TCCSUP (stage IV). Cell proliferation assays were performed evaluating metabolic activity (MTT assay) and protein content (SRB assay). Cell viability, cell cycle, and mitochondrial membrane potential (Δψm) were assessed using flow cytometry. Reactive oxygen and nitrogen species (RONS) and reduced glutathione (GSH) were evaluated by fluorescence. The assays were carried out with different CAP exposure times. For both cell lines, we obtained a significant reduction in metabolic activity and protein content. There was a decrease in cell viability, as well as a cell cycle arrest in S phase. The Δψm was significantly reduced. There was an increase in superoxide and nitric oxide and a decrease in peroxide contents, while GSH content did not change. These results were dependent on the exposure time, with small differences for both cell lines, but overall, they were more pronounced in the TCCSUP cell line. CAP showed to have a promising antitumor effect on bladder cancer, with higher sensitivity for the high-grade cell line.info:eu-repo/semantics/publishedVersio

Chemical characterization of Sambucus nigra L. flowers aqueous extract and its biological implications

The main goal of this study was to chemically characterize an aqueous S. nigra flower extract and validate it as a bioactive agent. The elderflower aqueous extraction was performed at different temperatures (50, 70 and 90 °C). The extract obtained at 90 °C exhibited the highest phenolic content and antiradical activity. Therefore, this extract was analyzed by GC-MS and HPLC-MS, which allowed the identification of 46 compounds, being quercetin and chlorogenic acid derivatives representative of 86% of the total of phenolic compounds identified in hydrophilic fraction of the aqueous extract. Naringenin (27.2%) was the major compound present in the lipophilic fraction. The antiproliferative effects of the S. nigra extract were evaluated using the colon cancer cell lines RKO, HCT-116, Caco-2 and the extracts antigenotoxic potential was evaluated by the Comet assay in RKO cells. The RKO cells were the most susceptible to S. nigra flower extract (IC50=1250 µg mL1). Moreover, the extract showed antimicrobial activity against Gram-positive bacteria, particularly Staphylococcus aureus and S. epidermidis. These results show that S. nigra-based extracts can be an important dietary source of bioactive phenolic compounds that contribute to health-span improving life quality, demonstrating their potential as nutraceutical, functional foods and/or cosmetic components for therapeutic purposes.This research was funded by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020 unit and for Scientific Employment Stimulus 2017 (CEECIND/01507/2017) provided to Ana M. Sousa.info:eu-repo/semantics/publishedVersio

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Asbestose pulmonar: mecanismos celulares da sua patogenia

A asbestose pulmonar continua a ser uma das doenças ocupacionais mais graves do nosso tempo. Apesar de clínica e epidemiologicamente bem caracterizada pouco se sabe ainda dos mecanismos celulares responsáveis pela sua ocorrência. Assim, a partir da informação até ao momento disponível sobre este assunto, tentámos delinear os vários mecanismos envolvidos na resposta do pulmão profundo à inalação de fibras de asbesto. Numa primeira parte caracterizam-se os vários tipos de fibras de asbesto existentes bem como os seus diferentes padrões de deposição e transporte. Numa segunda parte descrevem-se os possíveis mecanismos celulares envolvidos na patogenia da asbestose pulmonar, nomeadamente a acção dos macrófagos alveolares, dos neutrófilos e dos respectivos mediadores. A análise do perfil linfocitário de lavados bronco-alveolares de pacientes com asbestose é também descrita, salientando-se um acentuado aumento na relação CD4/CD8.Pulmonary asbestosis is still one serious occupational disease ofour times. Although the clinical and epidemiological featu res ofthe disease are well caracterized, the cellular mechanisms involved are still poorly understood. Taking advantage ofall the information available on this subject, we tried to depict the several mechanisms involved in the answer ofthe deep lung to the inhalation ofasbestos jibers. ln the jirst part ofthis article we characterized the diferent kinds ofasbestos jibers as well as their patterns oftransport and deposition in the deep lung.ln the second part we discribed the possible cellular mechanisms underlying the pathogeny of pulmonary asbestosis. The e.fJect ofthe alveolar macrophages, polinuclear neuthrophils and the action oftheir mediators is discribed. Analysis of the bronco alveolar lavage jluid lynphocitary profile of pacients with pulmonary asbestosis is also discribed, revealing significant increase in the CD4/CD8 ratio

Consensus document on chronic coronary syndrome assessment and risk stratification in Portugal: A position paper statement from the [Portuguese Society of Cardiology's] Working Groups on Nuclear Cardiology, Magnetic Resonance and Cardiac Computed Tomography, Echocardiography, and Exercise Physiology and Cardiac Rehabilitation

Despite constant medical evolution, the reimbursement policy of Portuguese National Health Service (NHS) for the study and risk stratification of coronary heart disease has remained unchanged for several decades. Lack of adjustment to contemporary clinical practice has long been evident. However, the recent publication of the European Guidelines for diagnosis and treatment of chronic coronary syndromes further highlighted this gap and the urgent need for a change. Prompted by these Guidelines, the Working Group on Nuclear Cardiology, Cardiac Magnetic Resonance and Cardiac CT, the Working Group on Echocardiography and the Working Group on Stress Pathophysiology and Cardiac Rehabilitation of the Portuguese Society of Cardiology, began a process of joint reflection on the current limitations and how these recommendations could be applied in Portugal. To this end, the authors suggest that the new imaging methods (stress echocardiogram, cardiac computed tomography and cardiac magnetic resonance), should be added to exercise treadmill stress test and myocardial perfusion scintigraphy in the available exam portfolio within the Portuguese NHS. This change would allow full adoption of European guidelines and a better use of tests, according to clinical context, availability and local specificities. The adoption of clinical guidance standards, based on these assumptions, would translate into a qualitative improvement in the management of these patients and would promote an effective use of the available resources, with potential health and financial gains.Apesar dos avanc ̧os da medicina, há já várias décadas que os exames comparticipados pelo Servic ̧o Nacional de Saúde (SNS) para o estudo e estratificac ̧ão de risco da doenc ̧a coronária se mantêm inalterados em cuidados de saúde primários. Apesar do desajuste à prática clínica contemporânea ser há muito evidente, a recente publicac ̧ão das Recomendac ̧ões Europeias para o diagnóstico e tratamento da síndrome coronária crónica veio realc ̧ar ainda mais este desfasamento e evidenciar a necessidade imperiosa de mudanc ̧a na forma como são estudados estes pacientes em Portugal. No seguimento desta publicac ̧ão, o Grupo de Estudo de Cardiologia Nuclear, Ressonância Magnética (RM) e Tomografia Computorizada (TC) Cardíaca, o Grupo de Estudo de Ecocardiografia e o Grupo de Estudos de Patofisiologia do Esforc ̧o e Reabilitac ̧ão Car- díaca da Sociedade Portuguesa de Cardiologia iniciaram um processo de reflexão conjunta sobre as limitac ̧ões atuais e a forma como poderiam ser aplicadas as recomendac ̧ões internacionais no nosso país. Para tal, os autores sugerem que os novos métodos de imagem (ecocardiograma de esforc ̧o ou de sobrecarga, TC e RM cardíaca) se associem à prova de esforc ̧o e cintigrafia de perfusão do miocárdio no portfólio de exames oferecidos pelo SNS. Esta alterac ̧ão permitiria uma plena adoc ̧ão das recomendac ̧ões europeias e uma melhor utilizac ̧ão dos meios, de acordo com o contexto clínico, a disponibilidade e as particularidades locais. A adoc ̧ão de ‘‘normas de orientac ̧ão clínica’’ baseadas nestes pressupostos traduzir-se-ia numa melhoria qualitativa na abordagem e otimizac ̧ão terapêutica destes pacientes, ao mesmo tempo em que potenciaria uma gestão eficaz dos recursos disponíveis, com potenciais ganhos de saúde e financeiros