Descritores biológicos num gradiente de enriquecimento orgânico

Mestrado em ToxicologiaEste estudo teve como objectivo avaliar os efeitos do efluente de origem doméstica eliminado através do emissário submarino da Guia no ambiente marinho receptor. Foram recolhidas, em Julho de 2005, amostras em três locais (L1, L2 e L3) na vizinhança do emissário submarino, para a caracterização físico-química dos sedimentos e para o estudo da estrutura da comunidade macrobentónica. L1 localiza-se entre os dois ramos do emissário perto da área de difusão do efluente, enquanto que L2 e L3 distam daquele em 2 e 3 km, respectivamente. Verificou-se que os sedimentos superficiais da área de estudo são de areia fina com um baixo conteúdo em finos e sem sinais de ocorrer a acumulação de sólidos voláteis totais na zona de difusão dos efluentes. O valor mais baixo de Eh (-28mV) foi determinado no local de amostragem mais próximo dos difusores (L1). Na caracterização da macrofauna bentónica foram recolhidas, no conjunto dos três locais de amostragem, 122 espécies e cerca de 5800 indivíduos que apresentaram uma biomassa total de cerca de 220g. Verificou-se que a abundância e a biomassa decresceram com a distância ao emissário enquanto que a riqueza em espécies e o índice de diversidade de Shannon- Wiener aumentaram neste sentido. Em L1 dominaram em termos de abundância e de biomassa espécies oportunistas (Capitella spp. e Nassarius reticulatus, respectivamente) que contribuíram em mais de 70% para a abundância e em mais de 48% para a biomassa daquele local. A abundância destas espécies diminuiu com a distância ao emissário sendo em L3 o complexo Capitella spp. substituído por Hyalinoecia bileneata considerada uma espécie típica daquela zona costeira. Também as curvas de dominância da abundância e da biomassa (curvas ABC) sugerem a presença de uma comunidade macrobentónica moderadamente perturbada em L1 diminuindo a evidência da perturbação à medida que a distância ao emissário aumenta. Estes resultados suportam a hipótese de que a perturbação desta comunidade se deve ao enriquecimento orgânico associado ao funcionamento do emissário submarino. Nos mesmos locais de amostragem eterminaram-se os níveis de imposex em Nassarius reticulatus. Não se observaram diferenças significativas entre os valores de comprimento de pénis (FPL) e de comprimento relativo de pénis (RPLI) nos três locais de amostragem, os quais variaram entre 0,093 e 0,124 e, entre 0,871 e 1,202, respectivamente. No entanto, verificou-se que o índice de sequência do vaso deferente (VDSI) e a percentagem de fêmeas afectadas por imposex % I aumentaram significativamente com a distância ao emissário (ANOVA: F= 34.9; P <0.001 para VDSI; F= 40,4; P <0,001 para % I). O VDSI variou entre 0,418 e 0,842 enquanto que a % I variou entre 40,53 e 70,25%. Colocou-se a hipótese de que o gradiente de intensidade de imposex acima descrito se poderia dever à acção de compostos estrogénicos eventualmente presentes no efluente. Para testar esta hipótese realizaram-se ensaios laboratoriais para avaliar o efeito de uma mistura de compostos com actividade estrogénica (MCAE), geralmente presentes em águas residuais domésticas, no desenvolvimento de imposex. Para tal, expuseram-se fêmeas de N. reticulatus a tributilestanho (TBT) e a TBT (250 ng Sn-TBT/L) com concentrações crescentes de MCAE (composta por 17 β-estradiol, 17α- etinilestradiol, estrona e nonilfenol). Verificou-se, conforme esperado, que o TBT induz o desenvolvimento de imposex em todos os tratamentos em que foi introduzido mas não houve alterações significativas nos níveis daquele parâmetro na presença de MCAE, indicando que aqueles compostos estrogénicos, nas condições experimentais utilizadas, não interferem no desenvolvimento de imposex. ABSTRACT: This study aims to assess the effects of screened but untreated sewage from a major city, discharged to the marine environment via an offshore outfall (Guia). In July 2005, samples from three sites (L1, L2 and L3) were taken for the sediment physical and chemical characteristics study and for the benthic community structure study. L1 is located between the branches of the outfall in the discharge area, and L2 and L3 are, respectivelly, 2 and 3 km distant from L1. The superficial sediments in the study area were composed of fine sand with a low content of particles with less than 63 μm and without signs of volatile solids accumulation close to the outfall. The lowest Eh value (-28mV) was observed at the vicinity of the diffusers (L1). A total of 122 species, representing around 5800 specimens with a total wet weight biomass of 220g, were identified in the three sites. It was observed that abundance and biomass decreased with the distance to the outfall while species richness and Shannon-Wiener diversity index increased. Opportunist species dominated in abundance (Capitela spp.) and biomass (Nassarius reticulatus) in L1, contributing to more than 70% of the total abundance and to more than 48% of the total biomass, respectively. The abundance of those taxa decreased with the distance to the outfall being the complex Capitella spp. absent at L3 site and replaced by Hyalinoecia bilineata. The Abundance/Biomass comparison (ABC) curves also indicate that the macrobenthic community was moderately disturbed in L1. The results support the hypothesis of community disturbance due to organic enrichment related to the operation of the outfall. Imposex was asssessed in Nassarius reticulatus populations in the same sampling sites. There were no significant differences in female penis length (FPL) and relative penis length index (RPLI), which varied between 0,093 and 0,124 and, between 0,871 and 1,202, respectively. However, the vas deferens sequence index (VDSI) and the percentage of females affected with imposex (% I) increased sinificantly with the distance to the outfall (ANOVA: F= 34.9; P <0.001 for VDSI; F= 40,4; P <0,001 for % I): the VDSI ranged from 0,418 to 0,842 and % I varied from 40,53 to 70,25%. In an attempt to evaluate if a mixture of estrogenic active chemicals (MCAE), at environmentally relevant concentrations, could cause a reduction of imposex development under laboratory conditions, we have tested if exposure to a mixture of 17 β-estradiol, 17α- ethinylestradiol, estrone and nonylphenol could ameliorated the severity of imposex induced by tributyltin (TBT) in Nassarius reticulatus. After 30 days of exposure, results demonstrated a significant increase in FPL in all treatments where TBT (250 ng Sn-TBT/L) was present. However, the addition of MCAE to TBT had no significant effects on the development of imposex suggesting that these estrogenic compounds may have no influence on imposex expression in this specie

O impacto do tratamento das crianças com leucemia: uma mini revisão de literatura

A leucemia é uma doença que acomete os glóbulos brancos, comprometendo o sistema de defesa do organismo. Os tipos de leucemia se enquadram tanto entre agudas e crônicas quanto entre mieloides e linfoides, sendo as mais comuns: Leucemia Mieloide Crônica e Leucemia Mieloide Aguda. Desta forma, esta mini revisão, tem como objetivo identificar e compreender de que maneira as famílias de pacientes portadores de leucemia enfrentam o diagnóstico, bem como as percepções sobre os procedimentos invasivos, as reações maternas e o uso do coping religioso/ espiritual mediante a doença. Trata-se de uma mini revisão integrativa da literatura de caráter descritivo, baseada na seguinte questão: Quais os reflexos no tratamento da leucemia infantojuvenil na rede de apoio ao paciente? Com isso, realizou-se uma busca de artigos nas seguintes bases de dados: Scientific Eletronic Library Online (SCIELO) e National Library Medicine and National Instituites of Health (PUBMED) e Google Acadêmico, todos com artigos publicados entre 2018 e 2023. Além disso, foram utilizados descritores como: criança, adolescente, leucemia, cuidadores, espiritualidade, relações familiares e emoções para efetuar a busca dos artigos selecionados. Grande parte dos artigos selecionados ressaltaram que houveram mudanças tanto na dinâmica familiar quanto nos perfis emocionais dos cuidadores, principalmente das mães, em função da situação da criança adoecida. Ademais, o coping religioso/ espiritual e a negação do diagnóstico foram apontados como maneiras de enfrentamento. Pode-se concluir que o uso da religiosidade e da espiritualidade geraram impactos positivos nas redes de apoio aos pacientes com leucemia. Além disso, a aproximação entre os familiares, as alterações emocionais e a qualidade dos cuidados prestados contribuíram para uma melhora no suporte ao paciente durante o tratamento

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Recomendações para o diagnóstico e tratamento do adenocarcinoma gástrico (Grupo de Investigação de Cancro Digestivo)

.