Relation among Caregivers’ Burden, Abuse and Behavioural Disorder in People with Dementia

Dementia produces a loss of independence to carry out the activities of daily life. The great demand for care that these people need usually falls on the family through informal care. This study aims to analyse the burden showed by the informal caregiver of a person with dementia. In addition, we analyse whether this burden present in informal caregivers could be related to abusive behaviour. We also study the relationship between the stage of the disease, the appearance of behavioural disorders and the level of burden in the caregiver using the Scales of Zarit, CASE and FAST. The data showed that 45.50 per cent of caregivers have light burden or burden. After the research, it was identified that the presence of behavioural disorders in patients with dementia showed a correlation with the increase in both the main caregiver burden and abuse. An increase in the level of burden is followed by an increase in the level of abuse (r = 0.844; p = 0.000). Furthermore, we analysed several conditions that could have a correlation with this burden and abuse. It was found that burden in the caregiver could be linked with the presence of behavioural disorders, like aggression (r = 0.577; p = 0.008) and irritability (r = 0.600; p = 0.005) at the moderate stage of the disease. On the other hand, there is a positive correlation between the probability that people with dementia suffer abuse in the moderate stage of the disease and the presence of aggression (r = 0.732; p = 0.000), lack of inhibition (r = 0.571; p = 0.009) and irritability (r = 0.827; p = 0.000). Taking this data into account, burden and abuse seem to be linked to the presence of behavioural disorders in patients with dementia in the moderate stage

Transthyretin binding to A-Beta peptide – Impact on A-Beta fibrillogenesis and toxicity

AbstractIt has been suggested that transthyretin (TTR) is involved in preventing A-Beta fibrillization in Alzheimer’s disease (AD). Here, we characterized the TTR/A-Beta interaction by competition binding assays. TTR binds to different A-Beta peptide species: soluble (Kd, 28nM), oligomers and fibrils; diverse TTR variants bind differentially to A-Beta. Transmission electron microscopy (TEM) analysis demonstrated that TTR is capable of interfering with A-Beta fibrillization by both inhibiting and disrupting fibril formation. Co-incubation of the two molecules resulted in the abolishment of A-Beta toxicity. Our results confirmed TTR as an A-Beta ligand and indicated the inhibition/disruption of A-Beta fibrils as a possible mechanism underlying the protective role of TTR in AD

Halogenated polycyclic aromatic hydrocarbons associated with drinking water disinfection

Introduction: Disinfection by-products (DBPs) have been identified in chlorinated water. This fact justifies the growing concern about the potential health effects of emerging unregulated DBPs, some of which appear to be more genotoxic than the regulated DBPs[1]. Polycyclic aromatic hydrocarbons (PAHs) are among the most persistent contaminants detected in environmental samples such as river sediments and tap water. A few studies have already proven that water disinfection can lead to the formation of halogenated derivatives of PAHs, such as chlorinated and brominated PAHs[2] . The available toxicological studies have shown that these compounds possess, in general, greater mutagenicity than the corresponding parent PAHs. Our research group has also shown that exposure of HepG2 cells to a dose-range of 6-Cl-benzo[a]pyrene (6-ClBaP) and BaP resulted in cytotoxicity above 50 µM and that, at the equimolar doses of 100 and 125 µM, 6-ClBaP was able to induce a significantly higher level of DNA damage than BaP[3] . The present study had two main objectives: 1) identification of the major chlorinated and brominated derivatives of benzo[a]anthracene (BaA) and pyrene (Pyr) formed as disinfection by-products and 2) evaluation of their potential hazard to humans, through the characterization of their potential cytotoxic and genotoxic effects in a human cell line.The authors wish to thank Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa for financial support by the grant BRJ-DSA/2012- Doenças Oncológica

Recommendations for triage, prioritization and treatment of breast cancer patients during the COVID-19 pandemic

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) associated disease (COVID-19) outbreak seriously challenges globally all health care systems and professionals. Expert projections estimate that despite social distancing and lockdown being practiced, we have yet to feel the full impact of COVID-19. In this manuscript we provide guidance to prepare for the impact of COVID-19 pandemic on breast cancer patients and advise on how to triage, prioritize and organize diagnostic procedures, surgical, radiation and medical treatments

Drinking water contaminants: toxicity of halogenated polycyclic aromatic hydrocarbons

Food may be contaminated with polycyclic aromatic hydrocarbons (PAHs) in the process of smoking or heating. These contaminants or their derivatives can also be present in drinking water when raw water contacts with discharges of untreated industrial/waste water effluents, forest fires or by solubilisation of organic material from contaminated soils. A few studies have shown that water disinfection can lead to halogenated derivatives of PAHs (HPAHs) as chlorinated and brominated derivatives, and there are evidences that these compounds may have greater mutagenicity than the parent PAHs. In this study the cytotoxic and genotoxic effects of chlorinated/brominated derivatives of pyrene (Pyr) and benzo[a]anthracene (BaA), 1-ClPyr, 1-BrPyr and 7-ClBaA, which can be formed as water disinfection by-products, were studied in HepG2 cells to assess their potential hazard to human health. The formation of 1-ClPyr, 1-BrPyr and 7-ClBaA under aqueous disinfection conditions in waters contaminated with Pyr and BaA, was confirmed with an optimized gas chromatography method. Cells exposed (24h) to several concentrations of BaA and 7-ClBaA (1 to 200μM) displayed a dose-related and significant increase of cytotoxicity (neutral red assay) with IC50 values of 3.37 and 12.63µM respectively. For Pyr, 1-ClPyr and 1-BrPyr (10 to 200μM), a lower but significant dose-related cytotoxicity was observed. At non-cytotoxic concentrations (10 and 15µM), 7-ClBaA was able to induce a significantly higher level of oxidative DNA damage in HepG2 cells than its parent compound, as assessed by the FPG-modified comet assay. Under these conditions neither Pyr nor its derivatives were genotoxic. In conclusion, the disinfection process may give rise to genotoxic HPAHs with potential impact on human health and it should be performed in raw waters with minimal content of total organic carbon. In real conditions, humans may be exposed to a mixture of these organic compounds and thus their combined toxic effects should be further evaluated

Doença Pulmonar Obstrutiva Crónica em Portugal: estudo Pneumobil (1995) e estudo de prevalência de 2002 revisitados

ResumoIntroduçãoA doença pulmonar obstrutiva crónica (DPOC) tem sido, ao longo dos anos, uma importante causa de morbilidade e mortalidade no mundo. Em 1995, a implementação de um rastreio da função respiratória pareceu a forma mais adequada para alertar para os sintomas respiratórios negligenciados e sensibilizar para os rastreios espirométricos. Em 2002, foram criadas novas normas consensuais de diagnóstico e o reconhecimento de que a prevalência da DPOC depende dos critérios de definição de obstrução das vias aéreas. O objetivo deste estudo foi revisitar estes 2 estudos e publicar alguns dos resultados e respetivas metodologias.MétodosDos 12 684 indivíduos que constavam da base de dados do Pneumobil, apenas os indivíduos com 40 e mais anos (n = 9061) foram considerados para esta análise. No estudo de 2002 foi incluída uma amostra aleatorizada e representativa de 1384 indivíduos, com idades entre os 35 e os 69 anos.ResultadosA prevalência da DPOC foi de 8,96% no estudo Pneumobil e de 5,34% no estudo de 2002. Em ambos os estudos, a presença da DPOC foi superior no sexo masculino, tendo-se verificado uma associação positiva entre a presença da DPOC e os grupos etários mais velhos. Nos fumadores e ex-fumadores encontrou-se maior proporção de casos com DPOC.ConclusõesA prevalência em Portugal é mais baixa do que noutros países europeus, o que pode estar relacionado com uma menor prevalência de tabagismo. De um modo geral, os fatores de risco mais importantes que mostraram a associação com a DPOC foram a idade maior do que 60 anos, o sexo masculino e a exposição tabágica. Todos os aspetos e as limitações que se referem a diferentes critérios de definição e a metodologias de recrutamento realçam a necessidade de métodos padronizados para determinar a prevalência da DPOC e os fatores de risco associados, cujos resultados possam ser comparados entre países, como acontece no projeto BOLD.AbstractBackgroundChronic Obstructive Pulmonary Disease (COPD) has been a leading cause of morbidity and mortality worldwide, over the years. In 1995, the implementation of a respiratory function survey seemed to be an adequate way to draw attention to neglected respiratory symptoms and increase the awareness of spirometry surveys. By 2002 there were new consensual guidelines in place and the awareness that prevalence of COPD depended on the criteria used for airway obstruction definition. The purpose of this study is to revisit the two studies and to turn public some of the data and respective methodologies.MethodsFrom Pneumobil study database of 12,684 subjects, only the individuals with 40+ years old (n = 9.061) were selected. The 2002 study included a randomized representative sample of 1,384 individuals with 35-69 years old.ResultsThe prevalence of COPD was 8.96% in Pneumobil and 5.34% in the 2002 study. In both studies, presence of COPD was greater in males and there was a positive association between presence of COPD and older age groups. Smokers and ex-smokers showed a higher proportion of cases of COPD.ConclusionsPrevalence in Portugal is lower than in other European countries. This may be related to lower smokers’ prevalence. Globally, the most important risk factors associated with COPD were age over 60 years, male gender and smoking exposure. All aspects and limitations regarding different recruitment methodologies and different criteria for defining COPD cases highlight the need of a standardized method to evaluate COPD prevalence and associated risks factors, whose results can be compared across countries, as it is the case of BOLD project

Clinical use of biomarkers in breast cancer: Updated guidelines from the European Group on Tumor Markers (EGTM)

Abstract Biomarkers play an essential role in the management of patients with invasive breast cancer. For selecting patients likely to respond to endocrine therapy, both oestrogen receptors (ERs) and progesterone receptors (PRs) should be measured on all newly diagnosed invasive breast cancers. On the other hand, for selecting likely response to all forms of anti-HER2 therapy (trastuzumab, pertuzumab, lapatinib or ado-trastuzumab emtansine), determination of HER2 expression or gene copy number is mandatory. Where feasible, measurement of ER, PR and HER2 should be performed on recurrent lesions and the primary invasive tumour. Although methodological problems exist in the determination of Ki67, because of its clearly established clinical value, wide availability and low costs relative to the available multianalyte signatures, Ki67 may be used for determining prognosis, especially if values are low or high. In oestrogen receptor (ER)-positive, HER2-negative, lymph node–negative patients, multianalyte tests such as urokinase plasminogen activator (uPA)-PAI-1, Oncotype DX, MammaPrint, EndoPredict, Breast Cancer Index (BCI) and Prosigna (PAM50) may be used to predict outcome and aid adjunct therapy decision-making. Oncotype DX, MammaPrint, EndoPredict and Prosigna may be similarly used in patients with 1–3 metastatic lymph nodes. All laboratories measuring biomarkers for patient management should use analytically and clinically validated assays, participate in external quality assurance programs, have established assay acceptance and rejection criteria, perform regular audits and be accredited by an appropriate organisation

Occurrence of Salmonella spp. in eggs from backyard chicken flocks in Portugal and Romania - results of a preliminary study

The aim of this study was to conduct a preliminary investigation on the occurrence of Salmonella spp. in eggs from chickens raised in backyards in Portugal and Romania. A lack of compliance with safety practices by chicken owners, was demonstrated, especially in Portugal, as 96% of the eggs were visibly dirty and 92.5% were stored at room temperature. In Romania the 202 analysed eggs were Salmonella free, whereas in Portugal six of the 200 eggs sampled were positive for Salmonella spp. (3%). A positive egg for Salmonella spp. was found in 10.7% of the 56 backyard flocks sampled in Portugal. One egg exhibited contamination both in the shellmembrane mixture and in its content, while in the remaining eggs, the pathogen was found either in the shellmembrane (n = 2) or in the yolk and white mixture (n = 3). The serotypes S. Typhimurium (with identical PFGE patterns) and S. Enteritidis were isolated from five eggs and one egg, respectively. Whilst S. Enteritidis was sensitive to the 14 antibiotics tested, S. Typhimurium isolates presented divergent antimicrobial resistant phenotypes and three were classified as multi-drug resistant.info:eu-repo/semantics/acceptedVersio