Implementação do rastreio auditivo neonatal universal de surdez no Hospital CUF Porto

A incidência de perda auditiva bilateral é de 1 a 3 por cada recém-nascidos saudáveis e de 30 a 40 por 1000 recém-nascidos de risco. No Hospital Cuf Porto (HCP) o Rastreio Auditivo Neonatal Universal (RANU) teve inicio em Dezembro de 2010 em paralelo com abertura dos serviços de Obstetrícia / Neonatologia. As otoemissões acústicas (OEA) são o teste utilizado pois são reconhecidas como um método de rastreio auditivo simples, seguro e bem aceite. O objectivo deste trabalho é salientar a importância do RANU na identificação da perda auditiva antes da alta hospitalar, apresentando as suas vantagens na detecção e intervenção precoce minimizando as consequências da perda auditiva. Este trabalho, pretende ainda demonstrar as vantagens do RANU como estratégia fundamental no planeamento e na introdução de medidas de diagnóstico e terapêutica. É assim apresentada uma análise retrospectiva dos resultados obtidos nas OEA por produtos de distorção (OEAPD) entre Janeiro de 2011 e Dezembro de 2012, com uma amostra constituída por n=572. Os resultados revelam uma percentagem de “PASS” (OEAPD presentes) na primeira fase do rastreio, com um valor de 88,8% relativamente ao número total de rastreios efectuados. Relativamente à percentagem de “REFER” (OEAPD ausentes) – na mesma fase do rastreio- obtiveram-se 11,2% de situações face ao total de rastreados. Destes – que correspondem a um n=64 – 42.2% das situações referem-se a “REFER” bilateral (n=27). Relativamente às situações de “REFER” unilateral (n=37), encontramos uma percentagem de 57,8% dos casos. De acordo com a casuística apresentada, correspondente aos resultados obtidos e atendendo à realidade da população rastreada (dado que até ao momento não se confirmou perda auditiva em nenhum dos indivíduos rastreados), pode-se concluir que os OEA podem ser um método de rastreio simples e fiável, fundamental para a detecção e intervenção precoce nas perdas auditivas.

Fatores de risco para mortalidade neonatal em crianças com baixo peso ao nascer

OBJETIVO: Analisar os fatores de risco associados aos óbitos neonatais em crianças com baixo peso ao nascer. MÉTODOS: Realizou-se um estudo de coorte, composto pelos nascidos vivos com peso entre 500 g e 2.499 g, residentes no Recife (PE), entre 2001 e 2003, produtos de gestação única e sem anencefalia. Os dados sobre os 5.687 nascidos vivos e 499 óbitos neonatais, provenientes do Sistema de Informações sobre Nascidos Vivos e do Sistema de Informações sobre Mortalidade, foram integrados pela técnica de linkage. Em modelo hierarquizado, as variáveis dos níveis distal (fatores socioeconômicos), intermediário (fatores de atenção à saúde) e proximal (fatores biológicos) foram submetidas à análise univariada e regressão logística multivariada. RESULTADOS: Com o ajuste das variáveis na regressão logística multivariada, as variáveis do nível distal que permaneceram significantemente associadas com o óbito neonatal foram: a coabitação dos pais, número de filhos vivos e tipo de hospital de nascimento; no nível intermediário: número de consultas no pré-natal, complexidade do hospital de nascimento e tipo de parto; e no nível proximal: sexo, idade gestacional, peso ao nascer, índice de Apgar e presença de malformação congênita. CONCLUSÕES: Os principais fatores associados à mortalidade neonatal nos nascidos vivos com baixo peso estão relacionados com a atenção à gestante e ao recém-nascido, redutíveis pela atuação do setor saúde.

Enzymatic determination of choline in milk using a FIA system with potentiometric detection

The development of a FIA system for the determination of total choline content in several types of milk is described. The samples were submitted to hydrochloric acid digestion before injection into the system and passed through an enzymatic reactor containing choline oxidase immobilised on glass beads. This enzymatic reaction releases hydrogen peroxide which then reacts with a solution of iodide. The decrease in the concentration of iodide ion is quantified using an iodide ion selective tubular electrode based on a homogeneous crystalline membrane. Validation of the results obtained with this system was performed by comparison with results from a method described in the literature and applied to the determination of total choline in milks. The relative deviation was always < 5%. The repeatability of the method developed was assessed by calculation of the relative standard deviation (RSD) for 12 consecutive injections of one sample. The RSD obtained was < 0.6%.

Towards the detection of deception in interactive multimedia environments

A classical application of biosignal analysis has been the psychophysiological detection of deception, also known as the polygraph test, which is currently a part of standard practices of law enforcement agencies and several other institutions worldwide. Although its validity is far from gathering consensus, the underlying psychophysiological principles are still an interesting add-on for more informal applications. In this paper we present an experimental off-the-person hardware setup, propose a set of feature extraction criteria and provide a comparison of two classification approaches, targeting the detection of deception in the context of a role-playing interactive multimedia environment. Our work is primarily targeted at recreational use in the context of a science exhibition, where the main goal is to present basic concepts related with knowledge discovery, biosignal analysis and psychophysiology in an educational way, using techniques that are simple enough to be understood by children of different ages. Nonetheless, this setting will also allow us to build a significant data corpus, annotated with ground-truth information, and collected with non-intrusive sensors, enabling more advanced research on the topic. Experimental results have shown interesting findings and provided useful guidelines for future work. Pattern Recognition

Sensors for the detection and quantification of bacterial contamination in water for human use

The deterioration of water quality by Cyanobacteria cause outbreaks and epidemics associated with harmful diseases in Humans and animals because of the toxins that they release. Microcystin-LR is one of the hepatotoxins most widely studied and the World Health Organization, recommend a maximum value of 1mgL 1 in drinking water. Highly specific recognition molecules, such as molecular imprinted polymers are developed to quantify microcystins in waters for human use and shown to be of great potential in the analysis of these kinds of samples. The obtained results were auspicious, the detection limit found, 1.5mgL 1, being of the same order of magnitude as the guideline limit recommended by the WHO. This technology is very promising because the sensors are stable and specific, and the technology is inexpensive and allows for rapid on-site monitoring.

A multiresidue method for the analysis of carbamate and urea pesticides from soils by microwave-assisted extraction and liquid chromatography with photodiode array detection

A multiresidue approach using microwave-assisted extraction and liquid chromatography with photodiode array detection was investigated for the determination of butylate, carbaryl, carbofuran, chlorpropham, ethiofencarb, linuron,metobromuron, and monolinuron in soils. The critical parameters of the developed methodology were studied. Method validation was performed by analyzing freshly and aged spiked soil samples. The recoveries and relative standard deviations reached using the optimized conditions were between 77.0 ± 0.46% and 120 ± 2.9% except for ethiofencarb (46.4 ± 4.4% to 105 ± 1.6%) and butylate (22.1 ± 7.6% to 49.2 ± 11%). Soil samples from five locations of Portugal were analysed.

Square-wave adsorptive-stripping voltammetric detection in the quality control of fluoxetine

Electroanalytical methods based on square-wave adsorptive-stripping voltammetry (SWAdSV) and flow-injection analysis with square-wave adsorptive-stripping voltammetric detection (FIA-SWAdSV) were developed for the determination of fluoxetine (FXT). The methods were based on the reduction of FXT at a mercury drop electrode at -1.2 V versus Ag/AgCl, in a phosphate buffer of pH 12.0, and on the possibility of accumulating the compound at the electrode surface. The SWAdSV method was successfully applied in the quantification of FXT in pharmaceutical products, human serum samples, and in drug dissolution studies. Because the presence of dissolved oxygen did not interfere significantly with the analysis, it was possible to quantify FXT in several pharmaceutical products using FIA-SWAdSV. This method enables analysis of up to 120 samples per hour at reduced costs.

Development of an FIA system with amperometric detection for determination of bentazone in estuarine waters

On the basis of its electrochemical behaviour a new flow-injection analysis (FIA) method with amperometric detection has been developed for quantification of the herbicide bentazone (BTZ) in estuarine waters. Standard solutions and samples (200 µL) were injected into a water carrier stream and both pH and ionic strength were automatically adjusted inside the manifold. Optimization of critical FIA conditions indicated that the best analytical results were obtained at an oxidation potential of 1.10 V, pH 4.5, and an overall flow-rate of 2.4 mL min–1. Analysis of real samples was performed by means of calibration curves over the concentration range 2.5x10–6 to 5.0x10–5 mol L–1, and results were compared with those obtained by use of an independent method (HPLC). The accuracy of the amperometric determinations was ascertained; errors relative to the comparison method were below 4% and sampling rates were approximately 100 samples h–1. The repeatability of the proposed method was calculated by assessing the relative standard deviation (%) of ten consecutive determinations of one sample; the value obtained was 2.1%.

Resultados preliminares do rastreio neonatal de doenças das células falciformes no Hospital Geral do Bengo, Caxito, Angola

As Hemoglobinopatias são doenças hereditárias com uma prevalência de 10 a 30% de portadores na população africana. As alterações das hemoglobinas envolvem a síntese estrutural e quantitativa dos aminoácidos que compõem as diferentes cadeias de globinas. A Doença das Células Falciformes compreende um grupo de hemoglobinopatias que apresentam um conjunto de sinais e sintomas, sendo a forma mais grave da doença. Dada a importância do tema e a escassez de dados no Caxito, Angola, iniciou-se o rastreio Neonatal de Doenças das Células Falciformes no Hospital Geral do Bengo (HGB), onde se localiza o CISA (Centro de Investigação em Saúde de Angola). Objetivos: - Determinar a frequência de recém-nascidos normais (AA), portadores (AS) e patológicos (SS); - Calcular os valores médios dos índices hematrimétricos por classe fenótipica.

Maltol determination in food by microwave assisted extraction and electrochemical detection

An electrochemical method is proposed for the determination of maltol in food. Microwave-assisted extraction procedures were developed to assist sample pre-treating steps. Experiments carried out in cyclic voltammetry showed an irreversible and adsorption controlled reduction of maltol. A cathodic peak was observed at -1.0 V for a Hanging Mercury Drop Electrode versus an AgCl/Ag (in saturated KCl), and the peak potential was pH independent. Square wave voltammetric procedures were selected to plot calibration curves. These procedures were carried out with the optimum conditions: pH 6.5; frequency 50 Hz; deposition potential 0.6 V; and deposition time 10 s. A linear behaviour was observed within 5.0 × 10-8 and 3.5 × 10-7 M. The proposed method was applied to the analysis of cakes, and results were compared with those obtained by an independent method. The voltammetric procedure was proven suitable for the analysis of cakes and provided environmental and economical advantages, including reduced toxicity and volume of effluents and decreased consumption of reagents.

Determinantes contextuais da mortalidade neonatal no Rio Grande do Sul por dois modelos de análise

OBJETIVO: Analisar os determinantes da mortalidade neonatal, segundo modelo de regressão logística multinível e modelo hierárquico clássico. MÉTODOS: Estudo de coorte com 138.407 nascidos vivos com declaração de nascimento e 1.134 óbitos neonatais registrados em 2003 no estado do Rio Grande do Sul. Foram vinculados os registros do Sistema de Informações sobre Nascidos Vivos e Mortalidade para o levantamento das informações sobre exposição no nível individual. As variáveis independentes incluíram características da criança ao nascer, da gestação, da assistência à saúde e fatores sociodemográficos. Fatores associados foram estimados e comparados por meio da análise de regressão logística clássica e multinível. RESULTADOS: O coeficiente de mortalidade neonatal foi 8,19 por mil nascidos vivos. As variáveis que se mostraram associadas ao óbito neonatal no modelo hierárquico foram: baixo peso ao nascer, Apgar no 1º e 5º minutos inferiores a oito, presença de anomalia congênita, prematuridade e perda fetal anterior. Cesariana apresentou efeito protetor. No modelo multinível, a perda fetal anterior não se manteve significativa, mas a inclusão da variável contextual (taxa de pobreza) indicou que 15% da variação da mortalidade neonatal podem ser explicados pela variabilidade nas taxas de pobreza em cada microrregião. CONCLUSÕES: O uso de modelos multiníveis foi capaz de mostrar pequeno efeito dos determinantes contextuais na mortalidade neonatal. Foi observada associação positiva com a taxa de pobreza, no modelo geral, e com o percentual de domicílios com abastecimento de água entre os nascidos pré-termos.

Screening of grapes and wine for azoxystrobin, kresoxim-methyl and trifloxystrobin fungicides by HPLC with diode array detection

The Quinone outside Inhibitors (QoI) are one of the most important and recent fungicide groups used in viticulture and also allowed by Integrated Pest Management. Azoxystrobin, kresoxim-methyl and trifloxystrobin are the main active ingredients for treating downy and powdery mildews that can be present in grapes and wines. In this paper, a method is reported for the analysis of these three QoI-fungicides in grapes and wine. After liquid–liquid extraction and a clean-up on commercial silica cartridges, analysis was by isocratic HPLC with diode array detection (DAD) with a run time of 13 min. Confirmation was by solid-phase micro-extraction (SPME), followed by GC/MS determination. The main validation parameters for the three compounds in grapes and wine were a limit of detection up to 0.073mg kg-1, a precision not exceeding 10.0% and an average recovery of 93% ±38.

Hearing evaluation of portuguese school communities: school‑based audiology and hearing screening

Introduction: Hearing loss h sone raised impact in the development and academic progress of a child. In several developed countries, early detection is part of the national health plan through universal neonatal hearing screening (UNHS) and also with school hearing screening programs (SHSP), but only a few have published national data and revised protocols. Currently in Portugal, the UNHS is implemented in the main district hospitals but not the SHPS, as well we still do not make use of concrete data nor publication of studies on the national reality. Objectives: The incidence of the hearing loss and of otological problems was studied in school communities in the north of the country with 2550 participants between 3 and 17 years old. Methods: Statistical data collected within the schools with a standard auditory hearing screening protocol. All participants were evaluated with the same protocol, an audiological anamnesis, otoscopy and audiometric exam screening (500, 1000, 2000 and 4000 Hz) were fulfilled. Results: Different otological problems were identified and the audiometric screening exam counted auditory thresholds that outpointed uni and bilateral hearing loss in about 5.7% of the cases. Conclusions: The study has demonstrated that auditory school screening should take place as early as possible and be part of the primary health care to identify and direct children to appropriate rehabilitation, education and attendance. Thus, reducing high costs with late treatment.

Multiplexed electrochemical immunosensor for detection of celiac disease serological markers

Celiac disease (CD) is a gluten-induced autoimmune enteropathy characterized by the presence of antibodies against gliadin (AGA) and anti-tissue transglutaminase (anti-tTG) antibodies. A disposable electrochemical dual immunosensor for the simultaneous detection of IgA and IgG type AGA and antitTG antibodies in real patient’s samples is presented. The proposed immunosensor is based on a dual screen-printed carbon electrode, with two working electrodes, nanostructured with a carbon–metal hybrid system that worked as the transducer surface. The immunosensing strategy consisted of the immobilization of gliadin and tTG (i.e. CD specific antigens) on the nanostructured electrode surface. The electrochemical detection of the human antibodies present in the assayed serum samples was carried out through the antigen–antibody interaction and recorded using alkaline phosphatase labelled anti-human antibodies and a mixture of 3-indoxyl phosphate with silver ions was used as the substrate. The analytical signal was based on the anodic redissolution of enzymatically generated silver by cyclic voltammetry. The results obtained were corroborated with commercial ELISA kits indicating that the developed sensor can be a good alternative to the traditional methods allowing a decentralization of the analyses towards a point-of-care strategy.

Detection of ZnS phases in CZTS thin-films by EXAFS

Copper zinc tin sulfide (CZTS) is a promising Earthabundant thin-film solar cell material; it has an appropriate band gap of ~1.45 eV and a high absorption coefficient. The most efficient CZTS cells tend to be slightly Zn-rich and Cu-poor. However, growing Zn-rich CZTS films can sometimes result in phase decomposition of CZTS into ZnS and Cu2SnS3, which is generally deleterious to solar cell performance. Cubic ZnS is difficult to detect by XRD, due to a similar diffraction pattern. We hypothesize that synchrotron-based extended X-ray absorption fine structure (EXAFS), which is sensitive to local chemical environment, may be able to determine the quantity of ZnS phase in CZTS films by detecting differences in the second-nearest neighbor shell of the Zn atoms. Films of varying stoichiometries, from Zn-rich to Cu-rich (Zn-poor) were examined using the EXAFS technique. Differences in the spectra as a function of Cu/Zn ratio are detected. Linear combination analysis suggests increasing ZnS signal as the CZTS films become more Zn-rich. We demonstrate that the sensitive technique of EXAFS could be used to quantify the amount of ZnS present and provide a guide to crystal growth of highly phase pure films.