Recomendação de Curvas de Crescimento para Crianças Nascidas Pré-Termo

Em 2013, a Secção de Neonatologia da Sociedade Portuguesa de Pediatria, face à existência de várias curvas de avaliação de crescimento para crianças nascidas pré-termo e à falta de homogeneidade de critérios na sua escolha, nomeou um grupo de peritos que procedeu à revisão crítica das curvas disponíveis e recomenda as que considera mais adequadas para utilização na prática clínica em fases específicas da vida: ao nascimento (Fenton 2013), durante o internamento na unidade de Neonatologia (Fenton 2013 e Ehrenkranz 1999) e a longo prazo (OMS 2006). As decisões foram tomadas com base na classificação sistemática do nível de evidência e do grau de recomendação. A presente recomendação: é válida enquanto não forem publicados os resultados do estudo do consórcio multicêntrico INTERGROWTH-21st, recentemente incumbido da construção de valores de referência, mais próximos do padrão, de crianças nascidas pré-termo; tem o propósito de auxiliar os clínicos na decisão clínica, mas não ser o único instrumento de avaliação do crescimento das crianças nascidas pré-termo; pode não proporcionar elementos suficientes para orientação do crescimento de todas estas crianças

Risk Factors for Active Asthma at School Age: an 8-Year Prospective Study

A sibilância recorrente na infância é uma entidade clínica prevalente e heterogénea do pontode vista da história natural e do prognóstico. Efectuou-se um estudo prospectivo com 8 anos de duração, com o objectivo de relacionar a evolução clínica da sibilância recorrente nos primeiros anos de vida, com factores de prognóstico associados com a persistência da sintomatologia. Uma coorte de 308 crianças com sibilância recorrente, com idade ≤6 anos, foi incluída no estudo em 1993. Foi aplicado um questionário clínico, realizados testes cutâneos por prick e efectuado doseamento sérico de IgE total. Em 1996 procedeu-se a uma primeira reavaliação sistemática destas crianças. Em 2001 foi efectuada nova reavaliação sistemática, possível em 81% destas crianças (n=249), com repetição dos testes cutâneos e realização de avaliação funcional respiratória,em período intercrise, com espirometria com prova de broncodilatação (BD). As crianças reavaliadas apresentavam média etária de 11 anos (8-14 anos) e relação sexo M/F de 1.7/1. Permaneciam sintomáticas em 61% dos casos. A prevalência de atopia foi de 48% em 1993, 65% em 1996 e 75% em 2001. Pela realização de um modelo de regressão logística múltiplo foram identificados como factores de risco para asma activa em idade escolar: história pessoal de rinite alérgica (OR=15.8, IC95%=6.1-40.8; p<0.001), asma paterna (OR=7.2, IC95%=1.7-29.7; p=0.007), história pessoal de eczema atópico (OR=5.9, IC95%=2.2-15.7; p<0.001), asma materna (OR=5.4, IC95%=1.7-17.1; p=0.004), evidência de sensibilização alergénica (OR=3.4, IC95%=1.2-10.4;p=0.03) e início dos sintomas ≥2 anos de idade (OR=2.1, IC95%=1.1-4.8; p=0.04); a frequência de infantário antes dos 12 meses de idade foi identificada como factor protector (OR=0.4, IC95%=0.2- 0.9; p=0.04). Desenvolveram sensibilização alergénica de novo (ácaros do pó >80%) 66 das 128 crianças não atópicas em 1993 (52%). Apresentavam obstrução brônquica 36% das crianças: 47% das sintomáticas e 18% das assintomáticas (p<0.001). A prova de BD foi positiva em 35%: 47% nos sintomáticos e 13% nos assintomáticos (p<0.001). Concluindo, foram identificados como factores de mau prognóstico, antecedentes pessoais de doença alérgica, história parental de asma, presença de sensibilização alergénica e início dos sintomas na segunda infância. Os sintomas clínicos podem preceder em anos a sensibilização alergénica, realçando a importância da instituição precoce de medidas de controlo ambiental. Alterações nas provas funcionais respiratórias, mais frequentes nas asmas activas, estavam também presentes em crianças actualmente sem clínica, reforçando a necessidade de valorizar marcadores objectivos nesta cada vez mais prevalente doença respiratória crónica

[The Impact of the COVID-19 Pandemic on the Healthcare System and on the Mental Health of Primary Health Care Providers]

Introduction: The COVID-19 pandemic forced the reorganization of primary health care services. The aim of this study was to describe how the health services responded to organizational requests; how the health services involved and supported their employees; how professionals perceived their involvement in the procedures and what support was provided to them. Additions aims included assessing the levels of anxiety and depression of professionals and their association with the perceived support, availability of personal protective equipment and involvement in pandemic-related tasks. Material and Methods: Cross-sectional, analytical study directed at professionals from three health center groups using an online questionnaire. We collected information from sociodemographic data, access to personal protective equipment, perceived support, workload and levels of anxiety and depression. Between each variable and the levels of anxiety and depression, multivariate logistic regression was applied. Results: There were responses from 237 professionals (83.8% women; mean age 43.7 years; 43.2% physicians). Almost 60% worked with COVID-19 patients. The availability of personal protective equipment in March versus June 2020 increased (17.7% vs 55.3%). There was a risk management plan in 86% of the workplaces. A high workload (90%) and time pressure (74.6%) were identified. Physicians and nurses had a higher prevalence of depression associated with workload and fatigue (p < 0.001). Protective anxiety factors were having space to talk about problems, support in face of these problems and having a place to relax in the health unit. A lower risk of depression was found in the administrative staff group, in those who felt supported, and in those who actively participated in the contingency plans. Conclusion: The COVID-19 pandemic led to considerable changes in the dynamics of primary health care. The time pressure to carry out tasks and the level of concentration required were associated with a higher risk of mental disease. The support felt by healthcare professionals regarding their problems and concerns and the existence of places to relax in the health units were identified as protective factors. Health promotion, the maintenance of the social contacts of healthcare professionals and their involvement in the processes should be taken into account in the organizational dynamics of the institutions

Raw clays from Morocco for degradation of pollutants by Fenton-like reaction for water treatment

Three raw clays from Morocco were used as heterogeneous catalysts for Fenton-like oxidation of organic pol-lutants in water. The selected pollutants were two dyes used in the textile industry, Congo Red (CR) and Tar-trazine (Tar, known also as a food coloring compound, E102) and Caffeine (Caf), a stimulant drug present in popular beverages such as coffee and tea, commonly used in Morocco. Two different processes were used for their degradation: (i) Fenton-like reaction; and (ii) electro-Fenton-like reaction. Process (i) was used for Tar and Caf degradation in the presence of clays from different region of Morocco (Middle Atlas -ClayMA, Fez -ClayF, and Ourika -ClayO), the best results being obtained with ClayO and ClayMA, on which 60.0% and 23.4% of conversion and 41.0% and 20.5% of mineralization were achieved for Tar and Caf, respectively. Process (ii) was used for degrading CR by clay-modified electrodes (CME) using the rawclays from Fez and Ourika regions (ClayF and ClayO). The stability of the CME was assessed by cyclic voltammetry studies, which proved that they are stable in the experimental conditions used. The electrodegradation of CR dye, performed without hydrogen peroxide in the reaction medium, achieve 67.0% of mineralization at the end of electrolysis (2 h)

Expert Opinion on Laparoscopic Surgery for Colorectal Cancer Parallels Evidence from a Cumulative Meta-Analysis of Randomized Controlled Trials

PMID: 22532846 [PubMed - indexed for MEDLINE] PMCID: PMC3332109 Free PMC ArticlePeer reviewedPublisher PD

The fate of steroid estrogens: Partitioning during wastewater treatment and onto river sediments

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2010 Springer Science+Business Media B.V.The partitioning of steroid estrogens in wastewater treatment and receiving waters is likely to influence their discharge to, and persistence in, the environment. This study investigated the partitioning behaviour of steroid estrogens in both laboratory and field studies. Partitioning onto activated sludge from laboratory-scale Husmann units was rapid with equilibrium achieved after 1 h. Sorption isotherms and Kd values decreased in the order 17α-ethinyl estradiol > 17α-estradiol > estrone > estriol without a sorption limit being achieved (1/n >1). Samples from a wastewater treatment works indicated no accumulation of steroid estrogens in solids from primary or secondary biological treatment, however, a range of steroid estrogens were identified in sediment samples from the River Thames. This would indicate that partitioning in the environment may play a role in the long-term fate of estrogens, with an indication that they will be recalcitrant in anaerobic conditions.EPSR

Anacardium plants: Chemical,nutritional composition and biotechnological applications

Anacardium plants are native to the American tropical regions, and Anacardium occidentale L. (cashew tree) is the most recognized species of the genus. These species contain rich secondary metabolites in their leaf and shoot powder, fruits and other parts that have shown diverse applications. This review describes the habitat and cultivation of Anacardium species, phytochemical and nutritional composition, and their industrial food applications. Besides, we also discuss the secondary metabolites present in Anacardium plants which display great antioxidant and antimicrobial effects. These make the use of Anacardium species in the food industry an interesting approach to the development of green foods.AK. Jugran acknowledges the partial funding from Uttarakhand council for Biotechnology, Pantnagar, Uttarakhand, India (File No. UCB/R&D Project/2018-311) for this work. M. Martorell would like to thank the support offered by CONICYT PIA/APOYO CCTE AFB170007. N. Martins would like to thank the Portuguese Foundation for Science and Technology (FCT-Portugal) for the Strategic project ref. UID/BIM/04293/2013 and ?NORTE2020 - Northern Regional Operational Program? (NORTE-01-0145-FEDER- 000012)

IRAK4 gene polymorphism and odontogenic maxillary sinusitis

Objectives This study aimed to evaluate whether a specific interleukin-1 receptor-associated kinase-4 (IRAK4) gene polymorphism had any influence on the development of changes in maxillary sinus, particularly in the presence of etiological factors of dental origin.Materials and methods The study population included 153 Portuguese Caucasians that were selected from a database of 504 retrospectively analysed computed tomography (CT) scans. A genetic test was performed, and a model was created through logistic analysis and regression coefficients. The statistical methodologies included were the independent Chi test, Fisher's exact test, binary logistic regression and the receiver operating characteristic (ROC) curve.Results The estimated prevalence of IRAK4 gene polymorphism found in a Portuguese Caucasian population was 26.8 % (CI 95 %) [20.1, 34.7 %]. A model to predict the inflammatory response in the maxillary sinus in the presence etiological factors of dental origin was constructed. This model had the following as variables: previously diagnosed sinusitis, sinus pressure symptoms, cortical bone loss observed on CT, positive genetic test result and radiographic examination that revealed the roots of the teeth communication with the maxillary sinus, which are interpreted as risk factors.Conclusions The constructed model should be considered an initial clinical tool. The area under the ROC curve found, AUC=0.91, revealed that the model correctly predicts the outcome in 91.1 % of cases.info:eu-repo/semantics/publishedVersio