Are air-borne mycotoxins a public health concern in Portugal?

Introduction - Microscopic filamentous fungi, under suitable environmental conditions, can lead to the production of highly toxic chemical substances, commonly known as mycotoxins. The most widespread and studied mycotoxins are metabolites of some genera of moulds such as Aspergillus, Penicillium and Fusarium. Quite peculiar conditions may influence mycotoxin biosynthesis, such as climate, geographical location, cultivation practices, storage and type of substrate. Toxicity has been extensively investigated for the most important mycotoxins, such as aflatoxins, ochratoxin A and Fusarium toxins, and much information derived from toxicokinetics in animal models has also been obtained. The adverse effects are mainly related to genotoxicity, carcinogenicity, mutagenicity, teratogenicity and immunotoxicity. Aim of the study - To identify fungal species able to produce important mycotoxins in different Portuguese settings.

Estudo de dislipidemias familiares monogénicas raras

A dislipidemia é um distúrbio do perfil lipídico, seja por elevação ou diminuição de partículas lipídicas. O objetivo deste trabalho é fazer uma revisão dos casos com dislipidemia rara em estudo no Instituto Nacional de Saúde Doutor Ricardo Jorge, apresentando os dados clínicos e moleculares mais relevantes. O perfil lipídico foi determinado para cada caso índex e familiares e o estudo molecular dos genes envolvidos foi realizado por amplificação por PCR e sequenciação de Sanger. Foram estudados, ou está em curso o estudo, de 14 casos índex com os seguintes diagnósticos clínicos: Deficiência familiar em lipoproteína lípase (3), Lipodistrofia familiar parcial de Dunningan Tipo 2 (1), Deficiência em lípase ácida lisossomal (3), Abeta/hipobetalipoproteinemia (2), Deficiência em HDL (1), Hipertrigliceridemia autossómica recessiva (3), Sitosterolemia (1). O fenótipo clínico de cada caso índex é variável dependendo de cada condição. Foi encontrada a causa genética da doença em 8/14 doentes, estando os restantes ainda em estudo. Doentes com as várias dislipidemias raras apresentadas têm um risco acrescido de ter outras doenças graves como pancreatite, doença cardiovascular ou complicações neurológicas e devem, por esta razão, ser identificados o mais precocemente possível, de forma a minimizar ou prevenir os efeitos nefastos destas condições.

Desvio de posicionamento em radioterapia para patologias de cabeça e pescoço e próstata: revisão de literatura

Introdução – Numa era em que os tratamentos de Radioterapia Externa (RTE) exigem cada vez mais precisão, a utilização de imagem médica permitirá medir, quantificar e avaliar o impacto do erro provocado pela execução do tratamento ou pelos movimentos dos órgãos. Objetivo – Analisar os dados existentes na literatura acerca de desvios de posicionamento (DP) em patologias de cabeça e pescoço (CP) e próstata, medidos com Cone Beam Computed Tomography (CBCT) ou Electronic Portal Image Device (EPID). Metodologia – Para esta revisão da literatura foram pesquisados artigos recorrendo às bases de dados MEDLINE/PubMed e b-on. Foram incluídos artigos que reportassem DP em patologias CP e próstata medidos através de CBCT e EPID. Seguidamente foram aplicados critérios de validação, que permitiram a seleção dos estudos. Resultados – Após a análise de 35 artigos foram incluídos 13 estudos e validados 9 estudos. Para tumores CP, a média (μ) dos DP encontra-se entre 0,0 e 1,2mm, com um desvio padrão (σ) máximo de 1,3mm. Para patologias de próstata observa-se μDP compreendido entre 0,0 e 7,1mm, com σ máximo de 7,5mm. Discussão/Conclusão – Os DP em patologias CP são atribuídos, maioritariamente, aos efeitos secundários da RTE, como mucosite e dor, que afetam a deglutição e conduzem ao emagrecimento, contribuindo para a instabilidade da posição do doente durante o tratamento, aumentando as incertezas de posicionamento. Os movimentos da próstata devem-se principalmente às variações de preenchimento vesical, retal e gás intestinal. O desconhecimento dos DP afeta negativamente a precisão da RTE. É importante detetá-los e quantificá-los para calcular margens adequadas e a magnitude dos erros, aumentando a precisão da administração de RTE, incluindo o aumento da segurança do doente. - ABSTRACT - Background and Purpose – In an era where precision is an increasing necessity in external radiotherapy (RT), modern medical imaging techniques provide means for measuring, quantifying and evaluating the impact of treatment execution and movement error. The aim of this paper is to review the current literature on the quantification of setup deviations (SD) in patients with head and neck (H&N) or prostate tumors, using Cone Beam Computed Tomography (CBCT) or Electronic Portal Image Device (EPID). Methods – According to the study protocol, MEDLINE/PubMed and b-on databases were searched for trials, which were analyzed using selection criteria based on the quality of the articles. Results – After assessment of 35 papers, 13 studies were included in this analysis and nine were authenticated (6 for prostate and 3 for H&N tumors). The SD in the treatment of H&N cancer patients is in the interval of 0.1 to 1.2mm, whereas in prostate cancer this interval is 0.0 to 7.1mm. Discussion – The reproducibility of patient positioning is the biggest barrier for higher precision in RT, which is affected by geometrical uncertainty, positioning errors and inter or intra-fraction organ movement. There are random and systematic errors associated to patient positioning, introduced since the treatment planning phase or through physiological organ movement. Conclusion – The H&N SD are mostly assigned to the Radiotherapy adverse effects, like mucositis and pain, which affect swallowing and decrease secretions, contributing for the instability of patient positioning during RT treatment and increasing positioning uncertainties. Prostate motion is mainly related to the variation in bladder and rectal filling. Ignoring SD affects negatively the accuracy of RT. Therefore, detection and quantification of SD is crucial in order to calculate appropriate margins, the magnitude of error and to improve accuracy in RTE and patient safety.

Crioterapia como tratamento de entorses de tornozelos de atletas: revisão sistemática

A crioterapia é prática comum na medicina esportiva, pela praticidade, facilidade de acesso e baixo custo, possuindo vantajoso uso na Saúde Pública. No entanto, os efeitos analgésicos do gelo tem pouca base objetiva e sistematizada em termos de técnicas, duração e frequência. O objetivo deste estudo foi sintetizar através da revisão sistemática (RS) as evidências relativas à efetividade da crioterapia para o tratamento das entorses de tornozelo de atletas. A RS é um método de pesquisa observacional e retrospectivo, pelo qual se tratam artigos, preferencialmente Ensaios Clínicos Aleatórios – ECA, como sujeitos da investigação, com rigorosos critérios de inclusão e exclusão e, quando possível, realiza-se uma macro estatística dos resultados – metaanálise. No presente RS, foram consultados cinco bancos de dados - Medline, Embase, Cochrane, Lilacs e PEDro para buscar ECA sobre crioterapia com os desfechos dor, edema, rigidez e função. Resultados: 289 estudos foram identificados inicialmente, dos quais nove com tratamentos isolados ou associados à crioterapia, porém apenas um preencheu aos critérios de inclusão, cujo N era 121 atletas, dos quais 64 receberam a crioterapia (funcional) e 57 no grupo controle (imobilização). Maior probabilidade para o evento dor foi observada no grupo controle, após 3 e 12 meses. A RS revelou uma lacuna em ECA dentro do tema, mas não encontrou efeito adverso na prática da crioterapia, sendo um princípio analgésico importante, sobretudo em lesões de tecidos moles.

The impact of exercise training on liver transplanted familial amyloidotic polyneuropathy (FAP) patients

Liver transplantation is nowadays the only effective answer to adjourn the outcome of functional limitations associated with familial amyloidotic polyneuropathy (FAP), a neurodegenerative disease characterized by sensory and motor polyneuropathies. Nevertheless, there is a detrimental impact associated with the after-surgery period on the fragile physical condition of these patients. Exercise training has been proven to be effective on reconditioning patients after transplantation. However, the effects of exercise training in liver transplanted FAP patients have not been scrutinized yet.

Development of novel ionic liquids based on valproate anion

Valproic acid (2-propyl pentanoic acid) is a pharmaceutical drug used for treatment of epileptic seizures absence, tonic-clonic (grand mal), complex partial seizures, and mania in bipolar disorder [1]. Valproic acid is a slightly soluble in water and therefore as active pharmaceutical ingredient it is most commonly applied in form of sodium or magnesium valproate salt [1].However the list of adverse effects of these compounds is large and includes among others: tiredness, tremor, sedation and gastrointestinal disturbances [2]. Ionic liquids (ILs) are promising compounds as Active Pharmaceutical Ingredients (APIs)[3]. In this context, the combinations of the valproate anion with appropriate cation when ILs and salts are formed can significantly alter valproate physical, chemical and thermal properties.[4] This methodology can be used for drug modification (alteration of drug solubility in water, lipids, bioavailability, etc)[2] and therefore can eliminate some adverse effect of the drugs related to drug toxicity due for example to its solubility in water and lipids (interaction with intestines). Herein, we will discuss the development of ILs based on valproate anion (Figure 1) prepared according a recent optimized and sustainable acid-base neutralization method [4]. The organic cations such as cetylpyridinium, choline and imidazolium structures were selected based on their biocompatibility and recent applications in pharmacy [3]. All novel API-ILs based on valproate have been studied in terms of their physical, chemical (viscosity, density, solubility) and thermal (calorimetric studies) properties as well as their biological activity.

Modulation of osteoclastogenesis by antihypertensive drugs

Despite its rigid structure, bone is a dynamic tissue that is in constant remodeling. This process requires the action of the bone-resorbing osteoclasts and the bone-synthesing osteoblasts. One of the adverse effects attributed to some antihypertensive agents is the ability to alter normal bone metabolism. However, their effective actions on human bone cells remain to be clarified. In this work, the effects of five calcium channel blockers, a class of antihypertensive drugs (AHDs), were investigated on osteoclastic differentiation. Osteoclastic cell cultures were established from precursor cells isolated from human peripheral blood, and were maintained in the absence (control) or in the presence of 10-8-10-4 M of different AHDs (amlodipine, felodipine, diltiazem, lercanidipine and nifedipine). Cell cultures were characterized throughout a 21 day period for tartrate-resistant acid phosphatase (TRAP) activity, number of TRAP+ multinucleated cells, presence of cells with actin rings and expressing vitronectin and calcitonin receptors, and apoptosis rate. Also, the involvement of several signaling pathways on the cellular response was addressed. It was observed that the tested AHDs had the ability to differentially affect osteoclastogenesis. At low doses, amlodipine and felodipine caused an increase on osteoclastic differentiation, while the other drugs inhibited it. At higher doses, all the molecules caused a decrease on the process. The tested AHDs also showed different effects on the analysed signaling pathways. In conclusion, AHDs appeared to have a direct effect on human osteoclast precursor cells, affecting their differentiation. Interestingly, some of them increased while others inhibited the process. Unraveling the mechanisms beneath these observations might help to explain the adverse effects on bone tissue described for this drug class.

Central obesity and dietary intake in HIV/AIDS patients

OBJECTIVE: To assess the association between dietary intake and central obesity among people living with HIV/AIDS and receiving highly active antiretroviral therapy. METHODS: A cross-sectional study was conducted involving 223 adult individuals in the city of São Paulo city in 2002. The study population was classified according to central obesity, defined as waist-to-hip ratio >0.95 for men and >0.85 for women. The dietary variables studied were energy consumption (in calories and calories/kilo of body weight), macronutrients (in grams and % of energy intake), total fiber (grams) and fruit and vegetables intake (grams). The potential confounders examined were sex, skin color, age, schooling, income, body mass index, physical activity, smoking habits, peripheral CD4+ T lymphocyte count and length of protease inhibitor use. The multiple logistic regression model was performed in order to evaluate the association between central obesity and dietary intake. RESULTS: The prevalence of central obesity was 45.7% and it was associated with greater consumption of lipids: for every increase of 10g of lipid intake the odds of central obesity increased 1.28 times. Carbohydrate consumption showed negative association (OR=0.93) with central obesity after adjustment for control variables. CONCLUSIONS: The results suggest that the amount of carbohydrates and lipids in the diet, regardless of total energy intake, may modify the chance of developing central obesity in the studied population. Nutritional interventions may be beneficial for preventing central obesity among HIV/AIDS patients.

Occupational exposure to Aflatoxin B1 in swine production and possible contamination sources

Although the adverse health consequences of ingestion of food contaminated with aflatoxin B1 (AFB1) are known, relatively few studies are available on the adverse effects of exposure in occupational settings. Taking this into consideration, our study was developed aiming to elucidate the possible effects of occupational exposure to AFB1 in Portuguese swine production facilities using a specific biomarker to assess exposure to AFB1. In total, 28 workers participated in this study, providing blood samples, and a control group (n  = 30) was composed of subjects without any type of agricultural activity. Fungal contamination was also studied by conventional methods through air, surfaces, and new and used floor coverage. Twenty-one workers (75%) showed detectable levels of AFB1 with values ranging from <1 ng/ml to 8.94 ng/ml and with a mean value of 1.91 ± 1.68 ng/ml. In the control group, the AFB1 values were all below 1 ng/ml. Twelve different Aspergillus species were identified. Aspergillus versicolor presented the highest airborne spore counts (3210 CFU/m3) and was also detected in higher values in surfaces (>300 CFU/cm2). Data indicate that exposure to AFB1 occurs in swine barns, and this site serves as a contamination source in an occupational setting.

A incidência da avaliação sumativa externa (provas de aferição) nas práticas docentes do 1.º ciclo do Ensino Básico e nos projetos curriculares de turma

Dissertação de Mestrado, Educação (Desenvolvimento e Concepção de Projectos Educativos), 19 de Março de 2013, Universidade dos Açores.

Diagnosis and control of polypharmacy in the elderly

The article had the purpose of commenting on studies on polypharmacy in the elderly, focusing on diagnosis and control. Polypharmacy is defined as the use of a number of medications at the same time and the use of additional drugs to correct drug adverse effects. The fact that the elderly take more medications for the treatment of several diseases makes them more susceptible to the occurrence of adverse reactions. Prophylactic actions such as balanced prescriptions are vital to reduce the incidence of these reactions and prevent longer hospital stay, increased costs and aggravation of the elderly health condition.

Influência da espessura do substrato dental sobre a eficácia clareadora e citotoxicidade de diferentes protocolos de clareamento

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Lubrificação de compressores que aspiram fluido frigorigéneo a temperaturas inferiores a -30° C

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Redução da concentração de cloro combinado em águas de piscinas com aplicação de um zeólito

Tendo em conta a contaminação normal de compostos azotados existente na água de uma piscina, derivados na sua maioria do próprio banhista, é inevitável a formação de subprodutos, quando estes reagem com o cloro como desinfectante. De todos os subprodutos de desinfecção que se formam, as cloraminas, incluídas no controlo químico da água de piscina no parâmetro cloro combinado, são as mais conhecidas. Estes compostos são responsáveis por irritações oculares, das mucosas e do trato respiratório. São estes os compostos responsáveis pelo comummente designado ‘cheiro a cloro’ característico de muitas piscinas. Para além destes efeitos nefastos da sua presença na água, estes compostos possuem um poder desinfectante muito menor ao do ácido hipocloroso, a forma activa do cloro com maior capacidade desinfectante. Por todas estas razões, uma piscina com uma concentração de cloro combinado elevada não é adequada para uso. Com a premissa comprovada em diversos estudos do uso de zeólitos para diminuição de compostos amoniacais por adsorção, é objectivo deste estudo comprovar a sua viabilidade no uso da redução destes compostos nas águas de piscinas. Para tal, foram realizados estudos em contínuo, numa piscina piloto onde foram aplicados hipoclorito de sódio e amoníaco, e ensaios em descontínuo, para que fosse determinada a capacidade e o tempo necessário ao equilíbrio de adsorção para este par adsorvente/adsorvato. Nos ensaios em contínuo, a clinoptilolite adsorveu 1,652 g Cl2/kg de clinoptilolite, em aproximadamente 300 horas de funcionamento, a 23,5 ºC. Nos ensaios em descontínuo, foram estudadas diferentes concentrações iniciais de cloro combinado. Os ensaios foram realizados a 20 ºC. Para uma concentração inicial de 4,06 mg/L Cl2, obteve-se uma capacidade de adsorção de 0,28 g Cl2/kg de clinoptilolite, ao fim de 360 horas. Para uma concentração inicial de 2 mg / L Cl2, o ensaio teve uma duração de 360 horas, e não se verificou estabilização. No entanto, findo este tempo, ocorreu a adsorção de 0,28 g Cl2/kg de clinoptilolite. Para uma concentração inicial de 0,56 mg/L Cl2, obteve-se um valor inferior, de 0,027 g Cl2/kg de clinoptilolite ao fim de 168 horas.

Records of predatory, con-specific and human induced mauls on fish from the Northeast Atlantic and Black Sea

Present study aims to describe records of mauled and con-specific injures in various fish inhabiting different environment and to discuss possible impacts on fish behavior and ontogenesis. The fish specimens were collected from the Black Sea and Azores Islands (NE Atlantic). Individuals of European flounder, Pleuronectes flesus, common stingray, Dasyatis pastinaca and turbot, Scophthalmus maximus with missing dorsal and caudal fins and flesh, were found in the Black Sea. Specimens with severe mauls of the ocean sunfish, Mola mola, almaco jack, Seriola rivoliana and sargo, Diplodus sargus were recorded from the Azores Islands. All of them were caught alive and survived severe mauls caused by predators or by accidents with propellers, fishing nets. The NE Atlantic records, although possibly caused by natural predation, are more probably than not the result of negative interactions with human activity. Numerous records of mauled fish species from both regions show that the problem with adverse effects of fisheries is quite important. Predatory and con-specific injuries obviously are compatible with basic fish vital functions of described cases. The problem with negative anthropogenic interactions seems to be insufficiently investigated and need more attention by responsible managers and decision makers.