The efficacy of combined adjuvant radiotherapy with surgical excision in the treatment of keloids

Introdução: O queloide é um distúrbio dermatológico benigno que ocorre devido à ativação persistente e excessiva dos fibroblastos, ativação esta que potencia uma acumulação anormal do colagénio na região cicatricial. Devido à sua elevada taxa de recorrência, atualmente são adotados tratamentos combinados. Este estudo tem como objetivo avaliar a eficácia da radioterapia adjuvante no tratamento de queloides após a sua remoção cirúrgica. Métodos: Foi realizado um estudo retrospetivo em pacientes submetidos a excisão cirúrgica do queloide e radioterapia adjuvante, entre Maio de 2016 e Março de 2020. A informação foi recolhida dos registos clínicos de Cirurgia Plástica e Radioterapia do Hospital São João, Porto, Portugal. The patient and observer scar assessment scale (POSAS) foi efetuada em todos os 13 pacientes. O tratamento utilizado foi remoção cirúrgica da cicatriz associado a uma sessão de radioterapia com 9Gy durantes as primeiras 24 horas após a cirurgia mais uma sessão de 9Gy após 7 dias. Resultados: Foram avaliados ao todo 13 pacientes, 16 queloides, durante um período de seguimento médio de 13,5 meses IC95% (5,84; 21,16). Não foram observadas complicações major do tratamento efetuado. Segundo o POSAS, a taxa global de satisfação foi muito favorável (média de 2,29 numa escala de 1 a 10). Apenas uma recorrência foi observada (6,25%). Conclusão: A cicatriz queloide é difícil de tratar devido à sua alta taxa de recorrência. Não existe um consenso atual sobre qual o melhor tratamento a realizar. Este estudo mostra que a excisão cirúrgica associada à radioterapia adjuvante pode ser uma excelente opção sobretudo para os queloides refratários. O resultado estético global foi muito satisfatório e a taxa de recorrência foi baixa.Purpose: Keloid scar is a benign dermal condition that occurs due to excessive activation of fibroblast, which leads to an abnormal accumulation of collagen. As a result of its high recurrence rate it is performed nowadays combined treatments. This study aims to evaluate, in real-life patients, the efficacy of adjuvant radiotherapy when used associated with surgical excision. Methods: We conducted a retrospective study on patients with keloid scars who underwent surgical excision and adjuvant radiotherapy, between May 2016 and March 2020. The data was collected from the radiology and plastic surgery medical charts. The patient and observer scar assessment scale (POSAS) was performed in all 13 patients. The treatment used was surgical removal of the scar associated with 9 Gy radiotherapy dose within the first 24 hours after the surgery, plus another session after 7 days. Results: 13 patients and 16 keloid scars were evaluated during a mean follow-up period of 13,5 months 95%CI (5,84; 21,16). There was no major adverse event from the treatment used. According to POSAS, the overall satisfaction rate was significantly good (mean of 2,29 on a scale from 1 to 10). Only one recurrence was observed (6,25%). Conclusion: Keloid scars are difficult to treat due to their high recurrence rate. There is no consent about which treatment is the best. This study showed that surgical excision combined with adjuvant radiotherapy is an excellent option, even for refractory keloids. The aesthetical result was satisfactory, and the recurrence rate was low

Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal

Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.info:eu-repo/semantics/publishedVersio

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Género, Diversidade e Cidadania

Esta obra enquadra-se nas comemorações do Ano Europeu da Igualdade de Oportunidade para Todos pela centralidade que confere à questão da igualdade e pelas reflexões que apresenta em torno da persistência dos fenómenos de discriminação em função de diversos factores, entre os quais o sexo e, a partir deles, da reprodução e manutenção das desigualdades sociais, nomeadamente as que afectam as relações entre homens e mulheres, na diversidade das respectivas identidades de pertença e de contextos de vivência, individuais e colectivas

Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal.

Acknowledgements: We gratefully acknowledge the engagement and willingness of all participants to share information critical to the investigation. We are grateful to the authors and laboratories that originated and submitted the genetic sequences released in GenBank. The acquisition of equipment associated with whole-genome sequencing used in this study (including the Illumina NextSeq 2000) was funded by the HERA (Human and Environmental Risk Assessment) project (Grant/2021/PHF/23776), supported by the European Commission through the European Centre for Disease Prevention and Control (ECDC), and partially funded by the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 (Operational Programme for Competitiveness and Internationalisation (POCI)), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020) under the PORTUGAL 2020 Partnership Agreement through the European Regional Development Fund (ERDF), and by the Portuguese Science and Technology Foundation (FCT). This study was also supported by the ERINHA-Advance project (funded by the European Union’s Horizon 2020 Research & Innovation program, grant agreement no. 824061) and benefited from co-funding from the European Union’s Horizon 2020 Research and Innovation programme under grant agreement no. 773830 (One Health European Joint Programme), in particular by the co-funding of the post-doctoral fellowships of J.S.D. and V.M. and the development of INSaFLU. We also thank M. Pinheiro (iBiMED at the Universidade de Aveiro) for his continuous support in updating the INSaFLU platform and the Infraestrutura Nacional de Computação Distribuída (INCD) for providing computational resources for testing it. INCD was funded by the FCT and FEDER under the project 22153-01/SAICT/2016. M.P.D. is funded by the Gates Cambridge Scholarship (no. OPP1144). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The GAT-Intendente team also thanks A. Vasques, L. Fortuna, J. Moreira, I. Correia and Á. Baginha.Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population

Núcleos de Ensino da Unesp: artigos 2013: volume 2: metodologias de ensino e a apropriação de conhecimento pelos alunos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Núcleos de Ensino da Unesp: artigos 2013: volume 2: metodologias de ensino e a apropriação de conhecimento pelos alunos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP