Hipotiroxinemia em recém-nascidos pré-termo

Introdução: A hipotiroxinemia é a disfunção tiroideia mais frequente em recém-nascidos prematuros e foi implicada em défices do neurodesenvolvimento e aumento da morbimortalidade perinatal. Pode ser definida por níveis sanguíneos de tiroxina total (T4T) dois desvios-padrão (DP) abaixo da média, ou abaixo de um limiar de 6 μg/dL, com tirotropina (TSH) normal ou baixa. Objectivos: Determinar a prevalência da hipotiroxinemia e correlacioná-la com a morbilidade neonatal durante as primeiras semanas de vida. Métodos: Estudo retrospectivo que incluiu os neonatos consecutivos com peso de nascimento ≤ 1500 g e/ou idade gestacional ≤ 30 semanas, de Janeiro de 2006 a Setembro de 2007. Foram excluídos os nados em outras instituições ou falecidos antes dos três dias de vida. Foram analisados os processos clínicos. O rastreio metabólico (incluindo TSH e T4T) foi efectuado ao 3º e ao 15º dia de vida. Resultados: Foram incluídos 38 recém-nascidos (idade gestacional: 28 ± 2,3 semanas, peso ao nascimento: 1133 ± 254 gramas). Os valores de T4T (no 3º dia) foram de 5,53 ± 3,17 μg/dL e correlacionaram-se positivamente com a idade gestacional e peso. Não se encontrou correlação com a TSH. No 3º dia de vida, 60,5% dos recém-nascidos apresentaram T4T <6 μg/dL, com TSH normal ou baixa. Em relação ao resto da amostra, os prematuros com valores mais baixos de T4T evidenciaram diferenças significativas quanto a períodos de internamento mais longos, ventilação durante mais tempo e mais alterações na ecografia transfontanelar. Conclusões: Encontrou-se elevada prevalência de hipotiroxinemia em prematuros e associação com pior prognóstico neonatal. Assim, impõe-se a necessidade de estudos mais alargados e da avaliação sistemática da função tiroideia, por exemplo pela repetição do rastreio às duas semanas de vida.Background. Hypothyroxinemia is the most common thyroid dysfunction in preterm babies and it has been linked to neuro - developmental deficits and increased perinatal mortality and morbidity. It can be defined as blood total thyroxine (TT4) levels below two standard deviations (SD) under the mean, or under a cut-off value of 6 μg/dL, with normal or low thyro - tropin (TSH). Aims. Assess the prevalence of hypothyroxinemia and correlate it to neonatal morbidity during first weeks of life. Methods. Retrospective study including consecutive neonates with birth weight ≤ 1500 g and/or gestational age ≤ 30 weeks, between January 2006 and September 2007. We excluded those born in other institutions or deceased before 3 days of life. Clinical data recorded were analysed. Metabolic screening (including TSH and TT4) was performed at day three and day fifteen. Results. Were enrolled 38 newborns (gestational age: 28 ± 2.3 weeks, birth weight: 1133 ± 254 grams). TT4 levels (on day 3) were 5.53 ± 3.17 μg/dL. TT4 correlated positively with gestational age and birth weight but not TSH. TT4 levels < 6 μg/dL, with normal or low TSH, were found in 60.5% of the babies in day three. Comparing with the others, preterm infants with lower levels of TT4, had significantly longer periods of hospitalization, more days in ventilation and more cerebral US scan abnormalities. Conclusions. We found high prevalence of hypothyroxinemia of prematurity and association with bad neonatal prognosis. So a sufficiently powered study is required and also routine assessment of preterm thyroid function, for example by the recall of a second screening at two weeks of life

Embryonal rhabdomyosarcoma of the uterine cervix: a rare case report

Embryonal rhabdomyosarcoma of the female genital tract is a rare tumour. It tends to occur during childhood in the vagina and, rarely, it can arise in the uterine cervix, with a peak incidence in the second decade. We report a case of a 18-year-old female with an embryonal rhabdomyosarcoma (sarcoma botryoides) presenting himself as a cervical polyp. This tumour consisted of rhabdomyoblasts with miscellaneous differentiation surrounded by a loose, myxoid stroma. The patient was successfully treated with cervical conization and adjuvant chemotherapy. She is now disease-free at the 28th month follow-up. Awareness of this uncommon lesion in the cervix and its clinical implications is important to prevent misdiagnosis. Therapy has recently inclined to conservative and fertility-sparing treatment

The value of multiparametric prediction scores in heart failure varies with the type of follow‐up after discharge: a comparative analysis

© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.Aims: Multiple prediction score models have been validated to predict major adverse events in patients with heart failure. However, these scores do not include variables related to the type of follow-up. This study aimed to evaluate the impact of a protocol-based follow-up programme of patients with heart failure regarding scores accuracy for predicting hospitalizations and mortality occurring during the first year after hospital discharge. Methods and results: Data from two heart failure populations were collected: one composed of patients included in a protocol-based follow-up programme after an index hospitalization for acute heart failure and a second one-the control group-composed of patients not included in a multidisciplinary HF management programme after discharge. For each patient, the risk of hospitalization and/or mortality within a period of 12 months after discharge was calculated using four different scores: BCN Bio-HF Calculator, COACH Risk Engine, MAGGIC Risk Calculator, and Seattle Heart Failure Model. The accuracy of each score was established using the area under the receiver operating characteristic curve (AUC), calibration graphs, and discordance calculation. AUC comparison was established by the DeLong method. The protocol-based follow-up programme group included 56 patients, and the control group, 106 patients, with no significant differences between groups (median age: 67 years vs. 68.4 years; male sex: 58% vs. 55%; median ejection fraction: 28.2% vs. 30.5%; functional class II: 60.7% vs. 56.2%, I: 30.4% vs. 31.9%; P = not significant). Hospitalization and mortality rates were significantly lower in the protocol-based follow-up programme group (21.4% vs. 54.7%; P < 0.001 and 5.4% vs. 17.9%; P < 0.001, respectively). When applied to the control group, COACH Risk Engine and BCN Bio-HF Calculator had, respectively, good (AUC: 0.835) and reasonable (AUC: 0.712) accuracy to predict hospitalization. There was a significant reduction of COACH Risk Engine accuracy (AUC: 0.572; P = 0.011) and a non-significant accuracy reduction of BCN Bio-HF Calculator (AUC: 0.536; P = 0.1) when applied to the protocol-based follow-up programme group. All scores showed good accuracy to predict 1 year mortality (AUC: 0.863, 0.87, 0.818, and 0.82, respectively) when applied to the control group. However, when applied to the protocol-based follow-up programme group, a significant predictive accuracy reduction of COACH Risk Engine, BCN Bio-HF Calculator, and MAGGIC Risk Calculator (AUC: 0.366, 0.642, and 0.277, P < 0.001, 0.002, and <0.001, respectively) was observed. Seattle Heart Failure Model had non-significant reduction in its acuity (AUC: 0.597; P = 0.24). Conclusions: The accuracy of the aforementioned scores to predict major events in patients with heart failure is significantly reduced when they are applied to patients included in a multidisciplinary heart failure management programme.This work was supported by national funds, Fundação para a Ciência e a Tecnologia, reference number UIDB/00306/2020.info:eu-repo/semantics/publishedVersio

Editorial: Occupational health psychology: From burnout to well-being at work

This Research Topic entitled Occupational Health Psychology (OHP): From Burnout to Well-being at Work tried to bring together two applied disciplines within psychology: health psychology and industrial/organizational psychologyinfo:eu-repo/semantics/publishedVersio

Effect of ultrasonication, thermosonication and ultraviolet irradiation on the quality of strawberies (fragaria anannassa) and red bell peppers (capsicum annuum L.)

The objective of this work was to study the effect of ultrasonication, thermosonication and UV-C irradiation on the quality attributes of strawberries (Fragaria anannassa) and red bell peppers (Capsicum annuum, L.). Thermosonication studies were carried out at 50ºC and 65ºC. Control water treatments at the same temperatures were conducted. The analysed quality factors were colour and texture for both products, in addition to anthocyanins content in the case of strawberries. Results showed that UV-C constituted a harmless treatment, with little or no effect on color, texture or anthocyanins content. Ultrasonication caused small colour changes and no significant effects on texture of both products. Thermosonication at 65ºC resulted in undesirable changes of color, anthocyanins and texture of strawberries, and color of red bell peppers. When compared to water treated samples, thermosonicated ones showed higher texture retention. This effect was much more pronounced on red bell peppers

The genetic susceptibility linking preterm birth and periodontal disease : a review

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?

© The European Society of Cardiology 2018. All rights reserved.Introduction: The most recent studies in cardiac resynchronization therapy (CRT) have been focused on attempts to improve response rate, such as the determination of the optimal placement of the left ventricular (LV) lead. The position of the LV lead guided by the site of latest electrical delay (ED), seems to be a promising strategy. The same strategy may be useful in assessing the ideal positioning of right ventricular (RV) lead in CRT. Purpose: To determine the most favorable position of the RV lead (septal versus apical) in CRT, by measuring the ED of the LV poles during septal or apical RV pacing in patients with triple-site CRT (TRIV). Methods: A single-center prospective study of consecutive patients (Oct. 2014 to Oct. 2017) submited to CRT device implantation (Quadra Allure MPTM, which allows post-implantation ED measurement) in TRIV mode - with a quadripolar lead in the LV, a RV lead positioned at the septum and a RV lead at the apex. In the follow-up, the lead position was confirmed and determined by fluoroscopic evaluation (anterior, lateral and postero-lateral in the short axis and basal, mid and apical on the long axis). The ED was measured at the 4-pole LV lead, during apical and septal RV pacing and the relation between the ED and lead position was evaluated. Results: Twenty two patients were included: 82% male, median age 78 years; 50% implanted CRT with defibrillator; 27% had ischemic heart disease and 73% non-ischemic etiology; all patients had permanent atrial fibrillation and the QRS duration was of 176±29ms. The position of the LE lead poles was classified as lateral in 44% and postero-lateral in 56%, basal in 28%, medial in 39% and apical in 34%. We evaluated 160 ED. The mean ED between the apical RV lead and the LV poles was significantly higher than the delay between septal RV lead and the LV poles [161±33ms vs 75±45ms (p<0.001)]. This difference remained significant in LV poles located in a lateral position (76±62 vs. 166±36ms; p<0.001) or in a postero-lateral position (74±30 vs. 157±31ms; p<0.001); the same ocurred for LV poles in a basal (99±62 vs. 179±24ms, p<0.001), mid (72±38 vs. 167±31ms, p<0.001) and apical location (57±24 vs. 140±32ms, p<0.001). Conclusion: The LV lead position is an important determinant of the success of CRT, but is conditioned by anatomical and technical characteristics. The optimization of CRT may then depend on the positioning of RV lead. This study demonstrated that the apical (vs. septal) RV lead positioning presents higher ED in relation to LV lead, regardless of the latter position.info:eu-repo/semantics/publishedVersio

Quantifying sub-elite youth football weekly training load and recovery variation

Monitoring the training load in football is an important strategy to improve athletic performance and an effective training periodization. The aim of this study was two-fold: (1) to quantify the weekly training load and recovery status variations performed by under-15, under-17 and under-19 sub-elite young football players; and (2) to analyze the influence of age, training day, weekly microcycle, training and playing position on the training load and recovery status. Twenty under-15, twenty under-17 and twenty under-19 players were monitored over a 2-week period during the first month of the 2019-2020 competitive season. Global positioning system technology (GPS) was used to collect external training loads: total distance covered, average speed, maximal running speed, relative high-speed running distance, high metabolic load distance, sprinting distance, dynamic stress load, accelerations and decelerations. Internal training load was monitored using ratings of perceived exertion (RPE) and session rating of perceived exertion (sRPE). Recovery status was obtained using the total quality recovery (TQR) scale. The results show an age-related influence for external training load (p <= 0.001; d = 0.29-0.86; moderate to strong effect), internal training load (p <= 0.001, d = 0.12-0.69; minimum to strong effect) and recovery status (p <= 0.001, d = 0.59; strong effect). The external training load presented differences between training days (p < 0.05, d = 0.26-0.95; moderate to strong effect). The playing position had a minimum effect on the weekly training load (p < 0.05; d = 0.06-0.18). The weekly microcycle had a moderate effect in the TD (p < 0.05, d = 0.39), RPE (p < 0.05; d = 0.35) and sRPE (p < 0.05, d = 0.35). Interaction effects were found between the four factors analyzed for deceleration (F = 2.819, p = 0.017) and between inter-day, inter-week and age for total covered distance (F = 8.342, p = 0.008). This study provided specific insights about sub-elite youth football training load and recovery status to monitor training environments and load variations. Future research should include a longer monitoring period to assess training load and recovery variations across different season phases.This research was supported by the Douro Higher Institute of Educational Sciences and the Portuguese Foundation for Science and Technology, I.P. (project UIDB04045/2021). Documentinfo:eu-repo/semantics/publishedVersio

The Latest Trends in Electric Vehicles Batteries

Global energy demand is rapidly increasing due to population and economic growth, especially in large emerging countries, which will account for 90% of energy demand growth to 2035. Electric vehicles (EVs) play a paramount role in the electrification revolution towards the reduction of the carbon footprint. Here, we review all the major trends in Li-ion batteries technologies used in EVs. We conclude that only five types of cathodes are used and that most of the EV companies use Nickel Manganese Cobalt oxide (NMC). Most of the Li-ion batteries anodes are graphite-based. Positive and negative electrodes are reviewed in detail as well as future trends such as the effort to reduce the Cobalt content. The electrolyte is a liquid/gel flammable solvent usually containing a LiFeP6 salt. The electrolyte makes the battery and battery pack unsafe, which drives the research and development to replace the flammable liquid by a solid electrolyte