Dispositivos médicos na abordagem de doentes com epilepsia

O número crescente de dispositivos médicos desenvolvidos e comercializados para melhorar a gestão de doentes com epilepsia reflete o crescente interesse em traduzir os avanços tecnológicos e o conhecimento sobre epilepsia numa melhor prestação de cuidados de saúde a esta população. O objetivo desta revisão narrativa da literatura é analisar as opções de dispositivos médicos disponíveis para deteção, tratamento e registo de crises epiléticas e a sua possível aplicação clínica. Os artigos incluídos foram selecionados através da base de dados PubMed, utilizando a query "(Epilepsy[MeSH Terms]) AND (SUDEP)) AND (Medical Device)) AND (English[Language])". A deteção de crises epiléticas é essencial para a intervenção precoce e para otimizar a terapêutica de cada doente. No ambulatório, essa deteção é um desafiado devido à sua imprevisibilidade. Tradicionalmente, o eletroencefalograma é o método direto de deteção utilizado em contexto hospitalar. Métodos indiretos de deteção, como eletrocardiograma, fotopletismografia, oxímetro, atividade eletrodérmica, acelerómetro e eletromiografia, mostraram potencial para detetar crises epiléticas em ambulatório. Vários dispositivos médicos foram desenvolvidos com base nos métodos mencionados, com o objetivo de fornecer aos doentes soluções que possam usar no seu dia-a-dia. Alguns dos designs disponíveis são o eletroencefalograma com elétrodos retroauriculares, pulseiras, braçadeiras e sensores de pressão na cama. Equipados com diferentes funções, esses dispositivos podem ajudar na deteção precoce de crises epiléticas e melhorar a qualidade de vida de doentes e cuidadores. Existem também dispositivos disponíveis para o tratamento de crises epiléticas. Por meio de técnicas de neuromodulação, como a estimulação do nervo vago, a estimulação cerebral profunda e a neuroestimulação responsiva, esses dispositivos são apresentados como soluções para doentes com epilepsias refratárias não elegíveis para cirurgia ressetiva. Os doentes com epilepsia têm várias aplicações disponíveis online para o registo adequado de crises epiléticas. Essas aplicações ajudam os médicos na otimização da terapêutica com base na evolução clínica. A ampla gama de dispositivos disponíveis cria a oportunidade de personalizar a abordagem às necessidades específicas do doente. O conhecimento das características de cada dispositivo pode ajudar os médicos a melhorar a abordagem dos doentes com epilepsia.The increasing number of medical devices developed and marketed towards management of patients with epilepsy reflects the growing interest in translating technological advances and knowledge about epilepsy into better healthcare for this population. The objective of this narrative literature review is to analyze the available options of medical devices for detecting, treating, and recording epileptic seizures, and their potential clinical application. The included articles were selected from the PubMed database using the query "(Epilepsy[MeSH Terms]) AND (SUDEP)) AND (Medical Device)) AND (English[Language])" The detection of epileptic seizures is essential for early intervention and to optimize the therapy for each patient. In outpatient settings, this detection is further challenging due to their unpredictability. Traditionally electroencephalography is the direct detection method used in a hospital environment. Indirect methods, such as electrocardiogram, photoplethysmography, oximeter, electrodermal activity, accelerometer, and electromyography, have shown potential for detecting seizures in the outpatient setting. Several medical devices have been developed based on the mentioned methods, with the aim of providing patients with solutions they can use in their daily lives. Behind-the-ear EEG, wristbands, armbands and bed sensors are some of the designs available. Equipped with different features, these devices can answer the need for early seizure detection and improve patients' and caregivers' quality of life. There are also devices available for the treatment of epileptic seizures. Through neuromodulation techniques such as vagus nerve stimulation, deep brain stimulation, and responsive neurostimulation, these devices are presented as solutions for patients with refractory epilepsy not eligible for ressective surgery. Patients with epilepsy have several apps available online for proper recording of seizures. These apps help doctors optimize therapy based on clinical evolution. The wide range of devices available creates the opportunity to personalize the approach to patient's specific needs. Understanding each device's characteristics can help clinicians improve management of patients with epilepsy

SUB-LETHAL EFFECTS OF EXPOSURE TO ATRAZINE IN GILL CELLS OF SEA LAMPREY DOWNSTREAM MIGRANTS

In Portugal, atrazine (ATZ) was one of the most widely used herbicides in agriculture, and despite prohibited since 2007, it still continued to be detected in the surface and ground waters. Recent research demonstrated that the conditions experienced by anadromous fishes, while in freshwater, may be critical to their subsequent fitness and survival in the sea. Several studies established a decline in wild populations, most probably caused by a reduction in recruitment related with pollution. In the case of sea lamprey (Petromyzon marinus) trophic migration to the ocean, expose fish to several stress factors, including chemical stress. Thus, it is crucial to assess the effects of sub-lethal exposure to ATZ and predict potential consequences to juveniles of sea lamprey

Frequency of micronuclei and of other nuclear abnormalities in erythrocytes of the grey mullet from the Mondego, Douro and Ave estuaries—Portugal

Fish are bioindicators of water pollution, and an increased rate of their erythrocyte nuclear morphological abnormalities (ENMAs)—and particularly of erythrocyte micronuclei (EMN)—is used as a genotoxicity biomarker. Despite the potential value of ENMAs andMN, there is scarce information about fish captured in Iberian estuaries. This is the case of the Portuguese estuaries of the Mondego, Douro and Ave, suffering from different levels of environmental stress and where chemical surveys have been disclosing significant amounts of certain pollutants. So, the aim of this study was to evaluate genotoxicants impacts and infer about the exposure at those ecosystems, using the greymullet (Mugil cephalus) as bioindicator and considering the type and frequency of nuclear abnormalities of erythrocytes as proxies of genotoxicity. Sampling of mullets was done throughout the year in the important Mondego, Douro and Ave River estuaries (centre and north-western Portugal). The fish (total n=242) were caught in campaigns made in spring–summer and autumn– winter, using nets or fishing rods. The sampled mullets were comparable between locations in terms of the basic biometric parameters. Blood smears were stained with Diff-Quik to assess the frequencies of six types of ENMAs and MN (given per 1,000 erythrocytes). Some basic water physicochemical parameters were recorded to search for fluctuations matching the ENMAs. Overall, the most frequent nucleus abnormality was the polymorphic type, sequentially followed by the blebbed/ lobed/notched, segmented, kidney shaped, vacuolated,MNand binucleated. The total average frequency of the ENMAs ranged from 73‰in the Mondego to 108‰in the Ave. The polymorphic type was typically ≥50 % of the total ENMAs, averaging about 51‰, when considering all three estuaries. The most serious lesion—the MN—in fish from Mondego and Douro had a similar frequency (≈0.38‰), which was significantly lower than that in the Ave (0.75‰). No significant seasonal differences existed as to the MN rates and seasonal differences existed almost only in the Douro, with the higher values in AW. In general, the pattern of ENMAs frequencies was unrelated with the water physicochemical parameters. Considering the data for both the total ENMAs and for each specific abnormality, and bearing in mind that values of MN in fish erythrocytes >0.3‰ usually reflect pollution by genotoxicants, it is suggested that mullets were likely being chronically exposed to such compounds, even in the allegedly less polluted ecosystem (Mondego). Moreover, data supported the following pollution exposure gradient: Mondego<Douro<Ave. The scenario and inferences nicely agree with the published data from chemical monitoring.This work was partially supported by the European Regional Development Fund (ERDF) funds through the Competitiveness and Trade Expansion Program (COMPETE), and by National Funds provided by Fundação para a Ciência e a Tecnologia (FCT), via the research projects PTDC/MAR/70436/2006, PEst-C/MAR/LA0015/ 2011, PEst-C/MAR/LA0015/2013, and also by the PhD grant SFRH/BD/25746/2005

Oxidative stress responses and histological hepatic alterations in barbel, Barbus bocagei, from Vizela river, Portugal

Barbel (Barbus bocagei) a common species in Portuguese rivers was studied to assess the impact of water contamination on hepatic oxidative stress response, lipid peroxidation and histology. The Vizela River is a tributary of the Ave River, located in one of the most industrialized areas of Portugal. The oxidative stress biomarkers analyzed included superoxide dismutase, catalase, glutathione S-transferase, glutathione reductase, glucose 6‑phosphate dehydrogenase and xanthine oxidase activities. Levels of reduced glutathione and lipid peroxidation were also evaluated. Except xanthine oxidase activity, that did not show any alteration, all the other enzymatic activities were increased in the liver of barbel captured in the Vizela River when compared with reference barbel. While, no differences were observed for glutathione reductase content, lipid peroxidation was higher in barbel from the Vizela River. Liver histological alterations were determined and their severity scored. Though lymphocyte foci were only observed in Vizela River barbel, macrophage aggregates were also present in reference barbel, although the severity score was higher in Vizela fish. The results of this study show that barbel liver oxidative stress responses, lipid peroxidation and histology are sensitive to the contaminants present in Vizela River water and are valuable biomarkers for monitoring purposes.Barbos (Barbus bocagei), una especie común en los ríos portugueses, se utilizó para evaluar el impacto de la contaminación del agua en la respuesta hepática al estrés oxidativo, en la peroxidación lipídica y en la histología del órgano. El río Vizela es un afluente del río Ave, situado en una de las regiones más industrializadas de Portugal. Los biomarcadores de estrés oxidativo analizados fueron la actividad de las enzimas superóxido dismutasa, catalasa, glutatión S-transferasa, glutation reductasa, glucosa 6 fosfato deshidrogenasa y de la xantina oxidasa. Los niveles de glutatión reducido y de la peroxidación lipídica también fueron evaluados. Excepto la xantina oxidasa, que no mostró ninguna alteración, todas las otras actividades enzimáticas han sufrido incrementos en el hígado de los barbos capturados en el río Vizela, cuando se comparan con los barbos de referencia. No se observaron diferencias para el contenido de glutatión reductasa, pero la peroxidación lipídica fue mayor en los barbos del río Vizela. Las alteraciones en la histología hepática fueron identificadas y clasificadas de acuerdo con su gravedad. Mientras que los linfocitos de focos se observaron sólo en barbos del Río Vizela, los agregados de macrófagos también estuvieron presentes en barbos locales de referencia, aunque la gravedad de las alteraciones fue mayor en los peces del río Vizela. Los resultados de este estudio muestran que las respuestas de estrés oxidativo, la peroxidación lipídica y la histología hepática son sensibles a los contaminantes presentes en el agua del Río Vizela, demonstrando ser biomarcadores valiosos para propósitos de monitoreo

Acoustic barriers as an acoustic deterrent for native potamodromous migratory fish species

This study focused on the use of sound playbacks as acoustic deterrents to direct native potamodromous migratory species away from all kind of traps. The effects of two acoustic treatments, a repeated sine sweep up to 2 kHz (sweep-up stimulus) and an intermittent 140 Hz tone, were tested in three fish species native to Iberia: Salmo trutta, Pseudochondrostoma duriense and Luciobarbus bocagei. In contrast with S. trutta, the endemic cyprinids P. duriense and L. bocagei exhibited a strong repulse reaction to the frequency sweep-up sound. The 140 Hz stimulus did not seem to alter significantly the behaviour of any of the studied species. These results highlight the potential of acoustic stimuli as fish behavioural barriers and their application to in situ conservation measures of native Iberian fish populations, to protect them from hydropower dams. In addition, this study shows that acoustic deterrents can be used selectively on target species.The project n 13737: Original Solutions - ENI and CITAB-UTAD was funded project: ANI/QREN/FEDER. The Science and Technology Foundation, Portugal funded M.C.P.A. (strategic projects UID/MAR/04292/2013 granted to MARE) and P.J.F. (UID/BIA/00329/2013 granted to cE3c). The scientific plan was achieved under European Investment Funds by FEDER/ COMPETE/POCI– Operational Competitiveness and Internationalization Programme, under Project POCI- 01-0145-FEDER-006958 and National Funds by FCT - Portuguese Foundation for Science and Technology, under the project UID/AGR/04033.info:eu-repo/semantics/publishedVersio

Toxicity of the 3,4-methylenedioxymethamphetamine and its enantiomers to Daphnia magna after isolation by semipreparative chromatography

MDMA (3,4-methylenedioxymethamphetamine) is a chiral psychoactive recreational drug sold in illicit markets as racemate. Studies on the impact of MDMA on aquatic organisms are scarce. While enantioselectivity in toxicity in animals and humans has been reported, none is reported on aquatic organisms. This study aimed to investigate the ecotoxicological effects of MDMA and its enantiomers in Daphnia magna. For that, enantiomers (enantiomeric purity > 97%) were separated by liquid chromatography using a homemade semipreparative chiral column. Daphnids were exposed to three concentrations of (R,S)-MDMA (0.1, 1.0 and 10.0 µg L−1) and two concentrations of (R)- and (S)-enantiomers (0.1 and 1.0 µg L−1) over the course of 8 days. Morphophysiological responses were dependent on the substance form and daphnia development stage, and they were overall not affected by the (R)-enantiomer. Changes in swimming behaviour were observed for both the racemate and its enantiomers, but enantioselective effects were not observed. Reproductive or biochemical changes were not observed for enantiomers whereas a significant decrease in acetylcholinesterase and catalase activity was noted at the highest concentration of (R,S)-MDMA (10 µg L−1). Overall, this study showed that sub-chronic exposure to MDMA racemate and its enantiomers can interfere with morphophysiological and swimming behaviour of D. magna. In general, the (R)-enantiomer demonstrated less toxicity than the (S)-enantiomer.This work was financially supported by national funds through the FCT/MCTES (PIDDAC), under the project PTDC/CTA-AMB/6686/2020, and partially supported through the projects UIDB/04423/2020 and UIDP/04423/2020 (Group of Natural Products and Medicinal ChemistryCIIMAR)

Monitorização da qualidade das areias em zonas balneares: relatório

A qualidade ambiental das praias tem vindo a adquirir uma importância crescente entre os critérios de escolha de destino turístico. Apesar de nos últimos anos a legislação ter evoluído no sentido do ordenamento da zona costeira e do tratamento de águas residuais, o único indicador da qualidade relacionado com a saúde publica que pode permitir aos utentes uma escolha orientada, é a qualidade da água balnear. Justifica-se o estudo da qualidade microbiológica da areia, tendo em consideração que a actual directiva 2006/7/EC defende toda uma estrutura de protecção de qualidade da água balnear e zona envolvente bem como a saúde dos seus utilizadores. Também a Organização Mundial de Saúde no guia “Guidelines for safe recreational waters Volume 1 - Coastal and fresh waters” (publicado em 2003) exprime a preocupação com a qualidade das areias da praia por estas poderem constituir um reservatório de agentes de infecção, sobretudo em zonas balneares onde a utilização da areia apresenta maior relevância. Perante esta motivação, a Associação das Bandeiras Azuis para a Europa, o Instituto do Nacional de Saúde Dr. Ricardo Jorge e o Instituto do Ambiente reuniram esforços no sentido de desenvolver mais este projecto para validar a metodologia desenvolvida em estudos anteriores e alargar a sua aplicação ao território insular.Associação Bandeira Azul da Europ

Jardins Botânicos Portugueses: Jardim Botânico da Universidade de Trás-os-Montes e Alto Douro

Câmara Municipal de Lisboainfo:eu-repo/semantics/publishedVersio

Portuguese botanical gardens: before and after 2020

info:eu-repo/semantics/publishedVersio