RCAAP Repository

Arte, vaidade, um novo olhar. Se há coisa que a arte inclua na sua definição é a sua vaidade: os homens morrem, a sua arte permanece, é cuidada, merece ser conhecida, ensinada, mostrada, protegida, divulgada. Neste propósito se justifica o projeto GAMA: há obras em risco de desconhecimento, outras que precisam de voltar a ser olhadas, outras ainda que não são conhecidas. A plataforma do Congresso CSO tem permitido uma valorização e disseminação de muitos autores. As afinidades vão-se desenhando. Aqui está enunciado um projeto de formação artística não formal: criação de públicos, disseminação, geração de interações, promoção de conhecimentos, deslocações, construções, interrogações.

Recentemente foi avaliada em consulta domiciliaria de medicina geral e familiar uma doente hipertensa de 94 anos, com diversas comorbilidades e polifarmácia, que apresentou análises com hiponatrémia (127 mmol/L), tendo já sido internada há um mês por prostração (sódio de 110 mmol/L). A desprescrição do diurético tiazídico (hidroclorotiazida 25 mg) corrigiu progressivamente a natremia, mantendo-se a pressão arterial controlada.

Introduction: Immunity against measles may result from previous contact with the virus or vaccination. In this study we aimed to evaluate the prevalence of immunity to measles in healthcare professionals of a central hospital. Material and methods: Retrospective study, with description of the results of measles-specific IgG assay in healthcare professionals, between May 2010 and March 2018. Results: The results of 1339 healthcare professionals were analyzed. The average age was 39.3 ± 10.11 years, 71.1% female. The prevalence of positive IgG was 81.5%, higher among professionals in the age groups 40 - 49 and over 50 years (91.9% and 94.6% respectively). Healthcare professionals who presented negative or equivocal IgG were mostly under 40 years old (83.1%) (p < 0.05). Discussion: The prevalence of serological immunity to measles in healthcare professionals was found to be lower than in other studies. That may be due to differences between the characteristics of the studied samples. Susceptibility to measles was higher in lower age groups. These results may reflect low vaccination coverage in this age group, an incomplete vaccination schedule, or the possibility of older healthcare professionals having the disease, which may confer an immune response with higher IgG levels. Conclusion: Knowing the prevalence of susceptibility to measles in healthcare professionals enabled the establishment of prevention strategies for outbreaks that may occur. Vaccination remains the best preventative measure, but a third dose of vaccine may be considered in certain epidemiological contexts, particularly in the youngest exposed healthcare professionals.

Background: There is limited knowledge on health-related quality of life (HRQoL) in late-stage Parkinson's disease (PD). Objective: To assess factors associated with HRQoL in patients with late-stage PD, with a focus on health care provision. Methods: The Care of Late Stage Parkinsonism (CLaSP) project is the largest study on late-stage PD to date. The current study analyzed data of 401 patients from 6 European countries in whom HRQoL was assessed with the 8-item PD Questionnaire in patients without dementia. Factors potentially associated with HRQoL were assessed and examined in linear regression analyses. Results: Better HRQoL was associated with living at home, greater independence in activities of daily living (Schwab and England Scale), less severe disease (Hoehn and Yahr stage), better motor function (Unified PD Rating Scale Part III), and lower non-motor symptoms burden (Non-Motor Symptoms Scale [NMSS]) across all NMSS domains. Having a PDspecialist as physician for PD, contact with a PDnurse, and no hospital admission during the past 3 months were associated with better HRQoL, but having seen a physiotherapist or occupational therapist was associated with worse HRQoL. Conclusions: The results emphasize the importance of optimizing treatment for motor and multiple non-motor symptoms to improve HRQoL in patients with late-stage PD. PD-specific health care resources, particularly PDnurses, are likely important in addressing issues to improve HRQoL in this population. Worse HRQoL in those who had recently seen a physiotherapist or occupational therapist may reflect referral based on factors not measured in this study.

O objectivo da presente investigação prende-se com o nosso interesse em 1) estudar a relação entre culpa e vergonha e as dimensões anaclítica e introjectiva da personalidade; e 2) estudar a relação entre culpa e vergonha e a sintomatologia depressiva. Para atingir estes objectivos formulámos três hipóteses de investigação. A primeira estabelece que a correlação entre a culpa e a dimensão introjectiva da personalidade é mais elevada do que a correlação entre a culpa e a dimensão anaclítica da personalidade. A segunda hipótese estabelece que a correlação entre a vergonha e a dimensão anaclítica da personalidade é mais elevada do que a correlação entre a vergonha e a dimensão introjectiva da personalidade. Por fim, a terceira hipótese estabelece que a correlação entre a culpa e a sintomatologia depressiva é mais elevada do que a correlação entre a vergonha e a sintomatologia depressiva. Participaram na investigação 145 estudantes de duas instituições de Ensino Superior da cidade de Lisboa com idades compreendidas entre 19 e 47 anos. Todos os participantes responderam a um questionários sobre dados sócio-demográficos, à versão portuguesa do Questionário de Experiências Depressivas, à tradução portuguesa do Test of Self- Conscious Affect e à versão portuguesa da Escala de Depressão do Centro de Estudos Epidemiológicos. Os resultados obtidos não confirmam as hipóteses formuladas, mas foi verificado: 1) a ausência de correlação entre culpa e a dimensão introjectiva da personalidade mas correlação positiva, moderada e significativa entre culpa e dimensão anaclítica da personalidade; 2) correlação positiva moderada e significativa entre vergonha e as dimensões anaclítica e introjectiva da personalidade; e 3) uma correlação mais elevada entre vergonha e sintomatologia depressiva do que entre culpa e sintomatologia depressiva.

Muscular cramp is a common symptom in healthy people, especially among the elderly and in young people after vigorous or peak exercise. It is prominent in a number of benign neurological syndromes. It is a particular feature of chronic neurogenic disorders, especially amyotrophic lateral sclerosis. A literature review was undertaken to understand the diverse clinical associations of cramp and its neurophysiological basis, taking into account recent developments in membrane physiology and modulation of motor neuronal excitability. Many aspects of cramping remain incompletely understood and require further study. Current treatment options are correspondingly limited.

The novel coronavirus disease-2019 (COVID-19), caused by the pathogen severe acute respiratory syndrome-CoV-2, is causing a global pandemic, with over 26.9 million cases and 880,000 deaths as of September 6, 2020. While there has been speculation and observational research about the impact of COVID-19 on asthma, much remains unknown. The goal of this article is to provide a scoping review on pediatric asthma and COVID-19 and summarize what we do and do not know from the first wave of the pandemic.

Parkinson's disease (PD) is a progressive neurodegenerative disease. The currently available treatment options only have a symptomatic effect. With disease progression almost all antiparkinsonian pharmacological classes are tried, but the gold standard of pharmacological management is still L-dopa. Various strategies can be used to raise the dopaminergic tone. Catechol-O-methyltransferase (COMT) inhibitors attain this goal by decreasing L-dopa peripheral metabolism. Areas covered: Opicapone (Ongentys®) is a new COMT inhibitor developed to fulfill the need for more potent, safer and longer acting COMT inhibitors. This review puts into context opicapone's indications, its chemical and preclinical data, the pharmacodynamics and pharmacokinetic characteristics, and the efficacy and safety results delivered by clinical trials. Expert opinion: Opicapone is an efficacious COMT inhibitor. Its proprieties make it adequate for a once-a-day oral dose regimen. It has proved to reduce the off-time and to increase the on-time without troublesome dyskinesias in PD patients with motor fluctuations. The reported adverse events suggest an overall safe and well-tolerated profile. The most common adverse events were dyskinesia, and there were no issues of concern for hepatotoxicity, severe diarrhoea or chromaturia. Further evidence is still needed to conclude how it compares with other drugs for the treatment of motor fluctuations.

Objective: To summarize the 2010 EFNS/MDS-ES evidence-based treatment recommendations for the management of Parkinson's disease (PD). This summary includes the treatment recommendations for early and late PD. Methods: For the 2010 publication, a literature search was undertaken for articles published up to September 2009. For this summary, an additional literature search was undertaken up to December 2010. Classification of scientific evidence and the rating of recommendations were made according to the EFNS guidance. In cases where there was insufficient scientific evidence, a consensus statement ('good practice point') is made. Results and conclusions: For each clinical indication, a list of therapeutic interventions is provided, including classification of evidence.

Clinical Trials Corner of Journal of Huntington’s Disease will regularly review ongoing and recently completed clinical trials in Huntington’s disease. In this inaugural issue, we list all currently registered and ongoing clinical trials, expand on LEGATO-HD and IONIS-HTTRx, and cover two recently finished trials: Amaryllis and Pride-HD.

In recent years an increased level of motor neuronal excitation has been proposed as important in the neuronal degeneration so characteristic of amyotrophic lateral sclerosis (ALS/MND) (Van Den Bosch et al., 2006). This notion derives from the finding that levels of glutamate, an excitatory neurotransmitter, are raised in the cerebrospinal fluid in about 20% of patients with ALS/MND (Plaitakis and Caroscio, 1987) and glutamate transport is abnormal in brain and spinal cord tissue at autopsy (Rothstein et al., 1992; Yamanaka and Komine, 2018). Further, measurements of short interval cortical inhibition (SICI) in ALS/MND, using a threshold tracking protocol involving paired pulse transcranial magnetic stimulation of motor cortex, have shown that increased cortical excitability, determined by reduced cortical inhibition, may precede the clinical onset of ALS, and that this becomes more marked as the disease progresses (Vucic et al., 2008; Shibuya et al., 2017).

Introduction: Parkinson´s disease (PD) is a synucleinopathy that affects millions of people worldwide and leads to progressive disability. Psychosis is highly prevalent in PD patients and is associated with poor prognosis. Until April 2016, there were no licensed drugs available in the United States of America (USA) for the treatment of PD psychosis (PDP). Pimavanserin is the first Food and Drug Administration approved medicine for the treatment of hallucinations and delusions associated with PDP. Areas covered: A MEDLINE literature search, publicly available information provided by ACADIA Pharmaceuticals, and expert opinion were used for this review. A review of PDP, its current treatment and limitations is followed by the rationale for development of pimavanserin. The mechanism of action, preclinical data, pharmacokinetics, pharmacodynamics, and clinical data supporting the efficacy and safety of pimavanserin in PDP are reviewed. We also describe the potential benefits of pimavanserin in other contexts such as schizophrenia and sleep disorders. Expert opinion: Pimavanserin is an antipsychotic with a unique mechanism of action (5-HT2A receptor inverse agonist) and no measurable dopaminergic activity; it has been demonstrated to be efficacious, well tolerated and safe for the treatment of PDP. The development of pimavanserin as an antipsychotic represents a major breakthrough in the pharmacotherapy of psychotic symptoms associated with PD.

With the coronavirus disease of 2019 (COVID-19) becoming a full-blown outbreak in Africa, coupled with many other challenges faced on the African continent, it is apparent that Africa continues to need diagnostics to enable case identification and recovery to this and future challenges. With the slow vaccination rates across the continent, reliable diagnostic tests will be in demand, likely for years to come. Thus, access to reliable diagnostic tools to detect the severe acute respiratory syndrome of the coronavirus-2 (SARS-CoV-2), the virus responsible for COVID-19, remain a critical pillar to monitor and contain new waves of COVID-19. Increasing the local capacity to manufacture and roll-out vaccines and decentralized COVID-19 testing are paramount for fighting the pandemic in Africa.

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are safe procedures that may present sub-optimal results in superobesity (SO). A meta-analysis was performed aiming to summarize the available evidence on weight loss (primary outcome) and comorbidities resolution of LRYGB and LSG in patients with SO (BMI ≥ 50 kg/m2). From the 16 included studies, 7 integrated the meta-analysis. LRYGB showed a significantly higher weight loss at 6 to 12-months, but not after 24 months and a higher dyslipidemia resolution at 12 months. When compared with LSG, LRYGB achieved better weight loss after 6 and 12 months and higher dyslipidemia resolution after 1 year. There were no significant differences for resolution of the other co-morbidities studied.

The data presented here capture the structure of kitchen lay- outs belonging to consumers vulnerable to foodborne dis- eases and food risk-takers. Data were collected in the frame of the SafeConsume project by multidisciplinary research teams that visited consumers during preparing a meal and had the possibility to examine their cooking routines. Dis- tances between sink and stove, sink and refrigerator, stove and refrigerator, sink and working place (countertop or ta- ble), stove and working place were analyzed to correlate food safety practices applied during cooking with kitchen arrange- ments. The results arising from analyzing the ergonomics of kitchens versus potential cross-contamination events are presented in Mihalache et al., [1]. These data contribute to a better understanding of real kitchen layouts and can be used as a starting point for future research regarding food safety-oriented arrangements instead of ergonomics-focused designs, for food safety risk assessments, as study cases for explaining specific measures that can be established to im- prove food handling and hygiene practices in homes and for sociological research pointing consumers’ behavior during cooking.

Estudos anteriores demonstraram que os complexos organometálicos de molibdénio (II) possuem boas actividades anti-tumorais. Assim, sintetizaram-se novos complexos, de forma a expandir a gama de compostos com estas características, e realizar experiências mais esclarecedoras. A maioria dos complexos estudados apresentou actividades anti-tumorais interessantes. Foram feitos testes de inibição de crescimento para 8 compostos (A, B, C, D, E, F, G e H) em três linhas celulares: HeLa (linha celular derivada do cancro cervical humano), MCF-7 (linha celular derivada do cancro mamário humano) e N1E-115 (neuroblastoma derivado de rato, células não diferenciadas e diferenciadas). As células foram incubadas com os compostos numa gama de concentrações (1 a 1000 μM) durante 48 horas. O efeito antiproliferativo foi medido pelo ensaio do MTT. Os valores de IC50 obtidos para os diferentes compostos, variaram entre 2,1 e 458,6 μM, apresentando diferenças entre as linhas celulares. Estudou-se igualmente a estabilidade dos compostos durante o tempo de incubação, e concluiu-se que os compostos B e E mantêm a sua estrutura. Para avaliar a possibilidade de intercalação dos compostos com a molécula de DNA, efectuaram-se estudos espectrofotométricos e determinou-se a viscosidade de soluções de DNA com diferentes concentrações de compostos. Os resultados obtidos parecem indicar que os compostos B, G e H são intercaladores. Finalmente, os estudos biológicos, mostraram que existe degradação do DNA das células incubadas com os compostos. Embora a análise morfológica e a citometria de fluxo permitissem identificar células em apoptose, esta não foi detectada por electroforese. Por citometria de fluxo foi também possível detectar o aumento de espécies reactivas de oxigénio nas células incubadas com os compostos em estudo. Os mecanismos de acção dos compostos parecem assim envolver a indução de apoptose e a produção de espécies reactivas de oxigénio, contudo os estudos realizados não permitiram esclarecer a relevância de cada um destes processos.

In recent decades, knowledge regarding stroke pathophysiology has greatly increased. Information regarding mechanism and pathogenesis of brain ischemia derived from basic, translational, and clinical studies has allowed the design of randomized clinical trials (RCTs) that by using advanced brain imaging methods evaluated the role of individual patterns of penumbra and perfusion in the extension of therapeutic windows for reperfusion treatments. The results of these RCTs successfully allowed the number of patients who receive acute stroke treatment to be increased.

The SARS-CoV-2 pandemic is a global public health crisis, with significant morbidity, mortality and socio-economical impacts. Vaccines were developed and granted emergency approvals by most drug agencies to tackle this crisis, but the safety profile of these vaccines is not fully clarified. We present a series of four cases of varicella zoster virus (VZV) reactivation after vaccination against SARS-CoV-2, who presented at the Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon (Portugal), from 30 January 2021 to 30 April 2021.

We describe maleic-acid derivatives as robust cysteine-selective reagents for protein labelling with comparable kinetics and superior stability relative to maleimides. Diamide and amido-ester derivatives proved to be efficient protein-labelling species with a common mechanism in which a spontaneous cyclization occurs upon addition to cysteine. Introduction of chlorine atoms in their structures triggers ring hydrolysis or further conjugation with adjacent residues, which results in conjugates that are completely resistant to retro-Michael reactions in the presence of biological thiols and human plasma. By controlling the microenvironment of the reactive site, we can control selectivity towards the hydrolytic pathway, forming homogeneous conjugates. The method is applicable to several scaffolds and enables conjugation of different payloads. The synthetic accessibility of these reagents and the mild conditions required for fast and complete conjugation together with the superior stability of the conjugates make this strategy an important alternative to maleimides in bioconjugation.

Dry microwave imaging (MWI) systems are more practical, hygienic, and fast to operate since they do not require immersion liquid. However, the dielectric contrast between air and the part of the body under examination is larger, causing larger refraction effects. Including refraction in the image reconstruction algorithm significantly increases the computational effort, especially when imaging nonuniform shapes. Hence, our systematic study aims to evaluate the impact of neglecting refraction effects on MWI by using quantitative metrics and define objective guidelines that are lacking in the literature. We perform comparative studies with a spherical numerical phantom (which is typically used to represent simplified breast or head phantoms) by varying the phantom relative permittivity values between 4 and 40, metallic targets diameter between 5 and 15 mm, and the number of probing antennas. Additionally, the refraction effects are evaluated with anthropomorphic body phantoms representing a breast and the axillary region. We numerically and experimentally show that refraction tends to have a greater impact on imaging results when phantom relative permittivity values exceed 8, while it has a minor effect in the remaining tested cases. This favors potential fast real-time image reconstruction. This letter provides useful criteria to decide whether refraction should be considered or not for imaging reconstruction when developing new dry medical MWI setups.