Absolute Hyperglycemia versus Stress Hyperglycemia Ratio for the Prognosis of Hospitalized Patients with COVID-19 in the First Months of the Pandemic: A Retrospective Study

Diabetes is a risk factor for greater severity of coronavirus disease 2019 (COVID-19). The stress hyperglycemia ratio (SHR) is an independent predictor of critical illness, and it is reported to have a stronger association than absolute hyperglycemia. The aim of this study was to assess the relationship of absolute hyperglycemia and SHR with the severity of COVID-19, since there are no studies investigating SHR in patients with COVID-19. We conducted a retrospective observational study on hospitalized patients with COVID-19 in the first months of the pandemic, regarding absolute hyperglycemia, SHR, and severity outcomes. Of the 374 patients, 28.1% had a previous diagnosis of type 2 diabetes. Absolute hyperglycemia (64.8% versus 22.7%; p < 0.01) and SHR [1.1 (IQR 0.9-1.3) versus 1.0 (IQR 0.9-1.2); p < 0.001] showed a statistically significant association with previous diabetes. Absolute hyperglycemia showed a significant association with clinical severity of COVID-19 (79.0% versus 62.7%; p < 0.001), need for oxygen therapy (74.8% versus 54.4%; p < 0.001), invasive mechanical ventilation (28.6% versus 11.6%; p < 0.001), and intensive care unit (30.3% versus 14.9%; p = 0.002), but not with mortality; by contrast, there was no statistically significant association between SHR and all these parameters. Our results are in agreement with the literature regarding the impact of absolute hyperglycemia on COVID-19 severity outcomes, while SHR was not a significant marker. We therefore suggest that SHR should not be evaluated in all patients admitted in the hospital for COVID-19, and we encourage the standard measures at admission of blood glucose and HbA1c levels.info:eu-repo/semantics/publishedVersio

Municipal service delivery: the role of transaction costs in the choice between alternative governance mechanisms

Service provision by local governments can be delivered using in-house bureaucracies, private firms, and partnerships with other governments or the not-for-profit sector. This production decision has been a major focus of discussion among scholars, practitioners and political agents for the last quarter of a century. The transaction costs framework is an important tool to analyse decisions regarding the production of local services. In this paper, the authors employ this framework to analyse service delivery in Portugal and find that service characteristics and the local political environment play a key role in local officials’ choice among the three governance mechanisms to deliver public service

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Version anglaise disponible dans la Bibliothèque numérique du CRDI: NIEO : twixt policy and practic

Changes in fish assemblage structure after implementation of Marine Protected Areas in the south western coast of Portugal.

Marine Protected Areas (MPAs) are increasingly being recommended as management tools for biodiversity conservation and fisheries. With the purpose of protecting the region's biodiversity and prevent the over exploitation of marine resources, in February 2011 the no-take MPAs of Ilha do Pessegueiro and Cabo Sard~ao were implemented within the “Parque Natural do Sudoeste Alentejano e Costa Vicentina “(PNSACV) Marine Park, south western coast of Portugal. As such, commercial and recreational fishing became prohibited in these areas. In order to evaluate the effects of these no-take MPAs, the structure of their fish assemblages and of adjacent control areas without fishing restrictions were studied between 2011 (immediately after implementation) and 2013 (two years after implementation). A total of 4 sampling campaigns were conducted (summer 2011, winter 2012, summer 2013 and winter 2013) using trammel nets and bottom trawl. Ichthyofaunal assemblages from the no-take MPAs (treatment) were compared with adjacent areas (controls) and changes evaluated as a function of time since protection. Results revealed significant increase in fish abundance after the implementation of the no-take MPAs. Furthermore, significant differences in the structure of fish assemblages (abundance and fish size) between protected and neighbouring areas were rapidly observed upon the implementation of the no-take MPAs. In addition, specimens of larger size occurred more frequently within Ilha do Pessegueiro no-take MPA in the last year of the study. Overall, despite the young age of these no-take MPAs, changes on the structure of their fish assemblages were already evident after only two years of protection, indicating that management measures such as MPA designation may play an important role to promote fisheries sustainable exploitation as well as to protect species with conservation interest

Tumor maligno da bainha dos nervos periféricos do pulmão: A propósito de um caso clínico Malignant peripheral nerve sheath tumors: A case report

Os tumores malignos da bainha dos nervos periféricos correspondem a um grupo raro de sarcomas de tecidos moles que tendem a ocorrer em doentes com neurofibromatose tipo 1 ou vários anos após tratamentos de radioterapia. A sua localização torácica é uma entidade muito rara. A sintomatologia habitual deve-se ao efeito de massa exercido sobre os nervos, podendo persistir durante meses ou anos antes do diagnóstico. A escassez de doentes com este tipo de tumor faz com que a abordagem terapêutica ainda permaneça em debate, sendo a cirurgia o procedimento de eleição. O prognóstico destes doentes é mau dada a grande recorrência local e metastização. O caso clínico descrito serve de tema à discussão.Malignant peripheral nerve sheath tumors comprehend a rare group of soft tissue sarcomas that tend to occur in patients with neurofibromatosis type 1 or several years after radiotherapy treatments. Its thoracic localization is a very unusual entity. The typical symptoms are due to nerve roots compression which can persist for several months or years before diagnosis. Due to very few patients with this type of tumor its therapeutic approach is still a matter of permanent debate, being surgery the main treatment. This tumor has a bad prognosis because of high local recurrence and metastasis. The clinical case we describe serves as a glimpse for discussion

Tumor maligno da bainha dos nervos periféricos do pulmão: A propósito de um caso clínico

Resumo: Os tumores malignos da bainha dos nervos periféricos correspondem a um grupo raro de sarcomas de tecidos moles que tendem a ocorrer em doentes com neurofibromatose tipo 1 ou vários anos após tratamentos de radioterapia. A sua localização torácica é uma entidade muito rara. A sintomatologia habitual deve-se ao efeito de massa exercido sobre os nervos, podendo persistir durante meses ou anos antes do diagnóstico. A escassez de doentes com este tipo de tumor faz com que a abordagem terapêutica ainda permaneça em debate, sendo a cirurgia o procedimento de eleição. O prognóstico destes doentes é mau dada a grande recorrência local e metastização. O caso clínico descrito serve de tema à discussão. Abstract: Malignant peripheral nerve sheath tumors comprehend a rare group of soft tissue sarcomas that tend to occur in patients with neurofibromatosis type 1 or several years after radiotherapy treatments. Its thoracic localization is a very unusual entity. The typical symptoms are due to nerve roots compression which can persist for several months or years before diagnosis. Due to very few patients with this type of tumor its therapeutic approach is still a matter of permanent debate, being surgery the main treatment. This tumor has a bad prognosis because of high local recurrence and metastasis. The clinical case we describe serves as a glimpse for discussion. Palavras-chave: Tumor maligno, bainha nervo periférico, Key-words: Malignant tumour, peripheral nerve sheat

Ochratoxin A in the morning and afternoon portions of urine from Coimbra and Valencian populations

The widespread contamination of foodstuffs and beverages by mycotoxins, such as ochratoxin A (OTA), has made the monitoring of human contamination levels essential.http://www.sciencedirect.com/science/article/B6TCS-4RY6WKJ-1/1/4c16511b1a2109e4107233b7f0e3b98