Large-Scale Controlled-Condition Experiment to Evaluate Light Weight Deflectometers for Modulus Determination and Compaction Quality Assurance of Unbound Pavement Materials

Compaction control using lightweight deflectometers (LWD) is currently being evaluated in several states and countries and fully implemented for pavement construction quality assurance (QA) by a few. Broader implementation has been hampered by the lack of a widely recognized standard for interpreting the load and deflection data obtained during construction QA testing. More specifically, reliable and practical procedures are required for relating these measurements to the fundamental material property—modulus—used in pavement design. This study presents a unique set of data and analyses for three different LWDs on a large-scale controlled-condition experiment. Three 4.5x4.5 m2 test pits were designed and constructed at target moisture and density conditions simulating acceptable and unacceptable construction quality. LWD testing was performed on the constructed layers along with static plate loading testing, conventional nuclear gauge moisture-density testing, and non-nuclear gravimetric and volumetric water content measurements. Additional material was collected for routine and exploratory tests in the laboratory. These included grain size distributions, soil classification, moisture-density relations, resilient modulus testing at optimum and field conditions, and an advanced experiment of LWD testing on top of the Proctor compaction mold. This unique large-scale controlled-condition experiment provides an excellent high quality resource of data that can be used by future researchers to find a rigorous, theoretically sound, and straightforward technique for standardizing LWD determination of modulus and construction QA for unbound pavement materials.

Adubação de sistemas: antecipação de adubação nitrogenada para a cultura do milho em integração lavoura-pecuária

Traditionally in no-tillage systems, fertilization is done to the catch crop. In general nutrient cycling in crop systems has not been treated as an important tool in the process of nutrient supplying for plants. The type and the condition in which vegetable residuesis decomposed can affect the efficiency of nutrient cycling.This study assessed the effect of anticipated nitrogen fertilization in crop-livestock systems on cultivated cornproduction, rate ofnutrient release from plant residue, and theN-minerallevels of soil. The study was carried out in the city Abelardo Luz (SC) in a Clayey Oxisol. The experimental design was a randomized block design with three replications. The treatments were arranged in a 2 x 2 factorial arrangement. The first factor was N Fertilization Time: in the N-Pasture level, nitrogen (200 kg ha-1 N) and N-Grains level, no nitrogen was applied. The second factor was the Grazing Height, characterized by two sward heights of oat at 15 cm (Low Height Pasture) and at 30 cm (High Height Pasture). Corn hybrid ‘Máximus’ was sowed in 10thOctober, 31 days after the removal of animals. In the twelve resulting plots from the combination of treatments on pasture phase (N Fertilization Time x Grazing Height) rates of N-fertilizer (0, 100, 200 e 300 Kg ha-1 of N) as urea were allocated in the split plot.We conclude that anticipated N fertilization of winter cover crop pasture to provide high-quality forage and carry-over N to the subsequent corn crop and may eventually replace side drees nitrogen fertilization on corn and can improve overall N fertilizer efficiency use in integrated crop-livestock systems.The rate of K release from plant residues is very fast, releasing large quantities in the first days after plant desiccation.Despite of considerably high nitrogen dose used in both the pasture and at the grain crop it was not observed nitrate leaching risks during the study period.

Seleção e divergência genética de pessegueiros e nectarineiras e susceptibilidade a danos causados pelo frio na Estación Experimental de Aula Dei (CSIC)

The peaches and nectarines are highly appreciated by consumer, but it is climacteric fruits, with availability in the market in small time. It is necessary to invest to obtain genotypes with fruit quality and small perishability or that it presente less physiological disorders after storage. The aims of this work were i) to evaluate the genetic divergence among 40 peach and nectarine trees genotypes based on postharvest quality and select posible parents; ii) to evaluate the susceptibility to chilling injury in peaches and nectarines after cold storage; iii) to evaluate divergence of peaches and nectarines on the basis in the susceptibility for chiling injury and select superior genotypes; iv) evaluate the correlations between quality and susceptibility to chilling injury of peaches and nectarines v) select parents with the combination of lower susceptibility to chilling injury and higher quality fruit. The study was carried out in EEAD-CSIC, Zaragoza - Spain, during the production cycle 2013/2014. A total of 40 peaches and nectarines genotypes from germplasm collection were evaluated. The quality characteristics as flesh firmness, total soluble solids, titratable acidity, pH, rippining index and flesh color parameters were evaluated. The fruits were submitted to cold storage at 0 °C and 5 °C, with 95% average relative humidity. The evaluations were after 14 and 28 days, it being observed the presence of symptoms, such as wooliness through mealiness, flesh grainy, leatheriness and flesh color changes, through browning, bleeding and off flavor. As a selection parameter was adopted 20% of genotypes that had a higher frequency of superiority for quality characteristics, susceptibility to chilling injury and the combining of both. For quality characteristic presented greater divergence the ‘Queen Giant’, ‘Sudanel Blanco’ and ‘Borracho de Jarque’. Based on the quality the eight genotypes were selected, ‘Andross’, ‘San Jaime’, ‘San Lorenzo’, ‘Borracho de Jarque’, ‘Sudanell 1’, ‘Carson’, ‘Baby Gold 6’ and ‘Stanford’. All genotypes studied exhibited susceptibility to one or more symptoms caused by cold storage during 28 days, independent of temperature. For 14 days, the ‘Baby Gold 6’, ‘Flavortop’ and ‘Queen Giant’ genotypes did not show any physiological disorder caused by cold. In general, the temperature of 0 °C favored fruit postharvest conservation, it have a lower incidence and severity of symptoms caused by cold storage. The storage for 14 days contributed for the lower incidence of damage in the genotypes fruits studied. For 14 days, with both temperatures, it was observed divergence for ‘Queen Giant’, ‘Sudanell Blanco’, ‘Baby Gold 6’ ‘GF3’, ‘Baby Gold 8’, ‘Campiel’ and ‘Campiel Rojo’ genotypes. For 28 days, in the 5 °C condition, ‘Queen Giant’, ‘Big Top’, ‘Flavortop’ and ‘Redhaven’ genotypes were divergents. Based on susceptibility to chilling injury at 0 °C, the eight genotypes were selected, it being these, ‘Queen Giant’, ‘Keimoes’, ‘Flavortop’, ‘Big Top’, 'Redhaven', 'Sudanell 3', 'Bonet I' and ‘Carson’. The quality parameters as rippining index, soluble solids, firmness and titratable acidity presented correlation among them. These, also it had correlation with woolines and bowning, what it indicate that fruits with more ripening can have this symptoms more easily. The browning, mealiness, flesh grainy and off flavor variables were correlationed with the time period and temperartures, what it confirm that these symptoms are the main disorders caused by cold storage. The quality characteristics together susceptibility to chilling injury allowed selected ‘Baby Gold 6’, ‘Sarell’, ‘Keimoes’, ‘GF3’ ‘San Jaime’, ‘Big Top’, ‘Sudanell 1’, ‘Carson’, ‘Baby Gold 8’, and ‘San Lorenzo’ genotypes.

Gender mismatch between donor and recipient is a factor of morbidity but does not condition survival after cardiac transplantation

We intended to evaluate the influence of sex mismatch between donor and recipient, which is still under much debate, on survival and comorbidities after cardiac transplantation. From November 2003 to December 2013, a total of 258 patients were transplanted in our center. From these, 200 receptors were male (77.5%) and constituted our study population, further divided into those who received the heart from a female donor (Group A) - 44 patients (22%) and those who received it from a male donor (Group B) - 156 (78%). Median follow-up was 4.2 ± 3.0 years (1-10 years). The two groups were quite comparable with each other, except for body mass index, systolic pulmonary artery pressure, and transpulmonary gradient, which were significantly lower in Group A. A low donor/recipient weigh ratio (<0.8) was avoided whenever possible. Hospital mortality was not different in the two groups. During follow-up, global survival was similar, as was survival free from acute cellular rejection and cardiac allograft vasculopathy. However, patients in Group A had decreased survival free from serious infections and malignant tumors. Allocation of female donors to male receptors can be done safely, at least in receptors without pulmonary hypertension and when an adequate donor/recipient weigh ratio is ensured.

Is land condition a useful indicator of soil organic carbon stock in Australia?

The grazing lands of northern Australia contain a substantial soil organic carbon (SOC) stock due to the large land area. Manipulating SOC stocks through grazing management has been presented as an option to offset national greenhouse gas emissions from agriculture and other industries. However, research into the response of SOC stocks to a range of management activities has variously shown positive, negative or negligible change. This uncertainty in predicting change in SOC stocks represents high project risk for government and industry in relation to SOC sequestration programs. In this paper, we seek to address the uncertainty in SOC stock prediction by assessing relationships between SOC stocks and grazing land condition indicators. We reviewed the literature to identify land condition indicators for analysis and tested relationships between identified land condition indicators and SOC stock using data from a paired-site sampling experiment (10 sites). We subsequently collated SOC stock datasets at two scales (quadrat and paddock) from across northern Australia (329 sites) to compare with the findings of the paired-site sampling experiment with the aim of identifying the land condition indicators that had the strongest relationship with SOC stock. The land condition indicators most closely correlated with SOC stocks across datasets and analysis scales were tree basal area, tree canopy cover, ground cover, pasture biomass and the density of perennial grass tussocks. In combination with soil type, these indicators accounted for up to 42% of the variation in the residuals after climate effects were removed. However, we found that responses often interacted with soil type, adding complexity and increasing the uncertainty associated with predicting SOC stock change at any particular location. We recommend that caution be exercised when considering SOC offset projects in northern Australian grazing lands due to the risk of incorrectly predicting changes in SOC stocks with change in land condition indicators and management activities for a particular paddock or property. Despite the uncertainty for generating SOC sequestration income, undertaking management activities to improve land condition is likely to have desirable complementary benefits such as improving productivity and profitability as well as reducing adverse environmental impact.

L’implication de SHP-1 en condition élevée de glucose inhibe la signalisation de l’insuline et du PDGF-BB dans les cellules musculaires lisses vasculaires hypoxiques

Résumé : Bien que l’hypoxie soit un puissant inducteur de l’angiogenèse, l’activation des facteurs de croissance est perturbée en hyperglycémie au niveau du pied et du cœur. Cette perturbation entraîne la perte de prolifération et de migration chez les cellules endothéliales, musculaires lisses vasculaires et péricytes empêchant la formation de nouveaux vaisseaux qui mènera à l’amputation des membres inférieurs chez les patients diabétiques. Une étude a démontré qu’une augmentation de la protéine tyrosine phosphatase Src homology-2 domain-containing phosphatase-1 (SHP-1) en condition hyperglycémique chez les péricytes entraînait l’inhibition de la signalisation du PDGF-BB, ce qui résultait en le développement d’une rétinopathie diabétique. Nous avons alors soulevé l’hypothèse que l’expression de SHP-1 dans les cellules musculaires lisses vasculaires affecte la prolifération et la migration cellulaire par l’inhibition de la signalisation de l’insuline et du PDGF-BB en condition diabétique. Nos expérimentations ont été effectuées principalement à l’aide d’une culture primaire de cellules musculaires lisses primaires provenant d’aortes bovines. Comparativement aux concentrations normales de glucose (NG : 5,6 mM), l’exposition à des concentrations élevées de glucose (HG : 25 mM) pendant 48 h a résulté en l’inhibition de la prolifération cellulaire par l’insuline et le PDGF-BB autant en normoxie (20% O2) qu’en hypoxie (24 dernières heures à 1% O2). Lors des essais de migration cellulaire, aucun effet de l’insuline n’a été observé alors que la migration par le PDGF-BB fut inhibée en HG autant en normoxie qu’en hypoxie. L’exposition en HG à mener à l’inhibition de la signalisation de la voie PI3K/Akt de l’insuline et du PDGF-BB en hypoxie. Aucune variation de l’expression de SHP-1 n’a été observée mais son activité phosphatase en hypoxie était fortement inhibée en NG contrairement en HG où on observait une augmentation de cette activité. Finalement, une association a été constatée entre SHP-1 et la sous-unité bêta du récepteur au PDGF. En conclusion, nous avons démontré que l’augmentation de l’activité phosphatase de SHP-1 en hypoxie cause l’inhibition des voies de l’insuline et du PDGF-BB réduisant les processus angiogéniques des cellules musculaires lisses vasculaires dans la maladie des artères périphériques.

Influence of mucuna fallow crop on selected soil properties, weed suppression and taro yields in Taveuni, Fiji

Two field experiments were carried out in Taveuni, Fiji to study the effects of mucuna (Mucuna pruriens) and grass fallow systems at 6 and 12 month durations on changes in soil properties (Experiment 1) and taro yields (Experiment 2). Biomass accumulation of mucuna fallow crop was significantly higher (P<0.05) than grass fallow crop at both 6 and 12 month durations. The longer fallow duration resulted in higher (P<0.05) total soil organic carbon, total soil nitrogen and earthworm numbers regardless of fallow type. Weed suppression in taro grown under mucuna was significantly greater (P<0.05) than under natural grass fallow. Taro grown under mucuna fallow significantly outyielded taro grown under grass fallow (11.8 vs. 8.8 t ha-1). Also, the gross margin of taro grown under mucuna fallow was 52% higher than that of taro grown under grass fallow. © ISHS.

Statistical forecasting of the Australian macadamia crop

Three types of forecasts of the total Australian production of macadamia nuts (t nut-in-shell) have been produced early each year since 2001. The first is a long-term forecast, based on the expected production from the tree census data held by the Australian Macadamia Society, suitably scaled up for missing data and assumed new plantings each year. These long-term forecasts range out to 10 years in the future, and form a basis for industry and market planning. Secondly, a statistical adjustment (termed the climate-adjusted forecast) is made annually for the coming crop. As the name suggests, climatic influences are the dominant factors in this adjustment process, however, other terms such as bienniality of bearing, prices and orchard aging are also incorporated. Thirdly, industry personnel are surveyed early each year, with their estimates integrated into a growers and pest-scouts forecast. Initially conducted on a 'whole-country' basis, these models are now constructed separately for the six main production regions of Australia, with these being combined for national totals. Ensembles or suites of step-forward regression models using biologically-relevant variables have been the major statistical method adopted, however, developing methodologies such as nearest-neighbour techniques, general additive models and random forests are continually being evaluated in parallel. The overall error rates average 14% for the climate forecasts, and 12% for the growers' forecasts. These compare with 7.8% for USDA almond forecasts (based on extensive early-crop sampling) and 6.8% for coconut forecasts in Sri Lanka. However, our somewhatdisappointing results were mainly due to a series of poor crops attributed to human reasons, which have now been factored into the models. Notably, the 2012 and 2013 forecasts averaged 7.8 and 4.9% errors, respectively. Future models should also show continuing improvement, as more data-years become available.

Celiac Crisis in an Adult: Raising Awareness to a Life-Threatening Condition

Objectives: The Authors report the case of a 56-year-old man with celiac disease, who after ingesting a food containing gluten and experiencing a flu-like syndrome, developed severe diarrhea, vomiting, weight loss (15 kg), hypotension, renal dysfunction, hypokalemia and metabolic acidosis. Materials and methods: Admission to the Intensive Care Unit and exclusion of an infectious cause was determined. Results: After receiving noradrenaline, methylprednisolone and correction of ionic disturbances, the patient recovered rapidly and had no further complication. Conclusion: The Authors intend to increase awareness of celiac crisis, because despite being extremely rare in adults, it is potentially fatal and an quick diagnosis and treatment are crucial.

A review of weed management in wheat using crop competition

Wheat occupies a principal place in the diet of humans globally, contributing more to our daily calorie and protein intake than any other crop. For this reason, preventing weed induced yield losses in wheat has high significance for world food sustainability. Herbicides and tillage play an important role in weed control, but their use has often unacceptable consequences for humans and the wider environment. Additionally, the range of herbicides effective on key weeds is dwindling due to the evolution of herbicide resistance. Elevating crop competitiveness against weeds, through a combination of wheat breeding and innovative planting design (planting density, row spacing and orientation), has strong potential to reduce weed-induced yield losses in wheat. The last decade of research has provided a solid foundation for the breeding of weed suppressive wheat cultivars, and continued research in this area should be a focus for the future. In the interim, there is cause for optimism that weeds can be effectively suppressed using existing wheat varieties, through careful cultivar selection and choice of planting design. Further research is required to define the nature of relationships between cultivar traits and competitive planting strategies, across diverse weed flora in multiple countries, sites and seasons. Investment in such innovation promises to produce benefits, not only in terms of sustained wheat yields, but also in terms of human and ecosystem health, through ameliorating chemical and sediment contamination, soil degradation, and CO2 pollution.

EFFECT OF SORGHUM SEED TREATMENT IN BURKINA FASO VARIES WITH BASELINE CROP PERFORMANCE AND GEOGRAPHICAL LOCATION

Sorghum [ Sorghum bicolor (L.) Moench] is a major subsistence crop throughout the region of Sahel. With the exception of seeds and labour, no agricultural inputs are in general used in sorghum production since the grain is of a relatively low commercial value and the risk of losing the crop to drought, flooding, etc. is substantial. A meta-analysis of 118 field experiments was carried out to identify conditions in which two protective seed treatments could support a yield increase of sorghum in Burkina Faso. The two treatments were: i) treatment with the pesticide Calthio C (thiram and chlorpyrifos) and ii) treatment with an aqueous extract from the plant Eclipta alba . Both treatments were found to produce a yield increase (Medians: Calthio C +199 kg ha-1, P<2x10-9; E. alba +90.5 kg ha-1 P<4x10-4). A strong relative effect of Calthio C on yield (+36%) was found for field experiments with a low baseline yield. A strong relative effect of E. alba extract on yield (+22%) was found for experiments with a low baseline of emergence. ANOVA of the 118 field tests showed that baseline crop performance (yield and emergence) and the effect of seed treatments were strongly linked to geographical location (twelve different villages included). Roots from sorghum in the village showing the strongest effect of both seed treatments (>40% yield increase) were found to carry a comparatively high load of the infectious ascomycetes: Fusarium equiseti , Macrophomina phaseolina and Curvularia lunata .

Programa Nacional de Vigilância da Gripe: relatório da época 2015/2016

O vírus da gripe é uma das maiores causas de morbilidade e mortalidade em todo o mundo, afetando um elevado número de indivíduos em cada ano. Em Portugal a vigilância epidemiológica da gripe é assegurada pelo Programa Nacional de Vigilância da Gripe (PNVG), através da integração da informação das componentes clínica e virológica, gerando informação detalhada relativamente à atividade gripal. A componente clínica é suportada pela Rede Médicos-Sentinela e tem um papel especialmente relevante por possibilitar o cálculo de taxas de incidência permitindo descrever a intensidade e evolução da epidemia de gripe. A componente virológica tem por base o diagnóstico laboratorial do vírus da gripe e tem como objetivos a deteção e caraterização dos vírus da gripe em circulação. Para o estudo mais completo da etiologia da síndrome gripal foi efectuado o diagnóstico diferencial de outros vírus respiratórios: vírus sincicial respiratório tipo A (RSV A) e B (RSV B), o rhinovírus humano (hRV), o vírus parainfluenza humano tipo 1 (PIV1), 2 (PIV2) e 3 (PIV3), o coronavírus humano (hCoV), o adenovírus (AdV) e o metapneumovirus humano (hMPV). Desde 2009 a vigilância da gripe conta também com a Rede Portuguesa de Laboratórios para o Diagnóstico da Gripe que atualmente é constituída por 15 hospitais onde se realiza o diagnóstico laboratorial da gripe. A informação obtida nesta Rede Laboratorial adiciona ao PNVG dados relativos a casos de doença respiratória mais severa com necessidade de internamento. Em 2011/2012, foi lançado um estudo piloto para vigiar os casos graves de gripe admitidos em Unidades de Cuidados Intensivos (UCI) que deu origem à atual Rede de vigilância da gripe em UCI constituída em 2015/2016 por 31 UCI (324 camas). Esta componente tem como objetivo a monitorização de novos casos de gripe confirmados laboratorialmente e admitidos em UCI, permitindo a avaliação da gravidade da doença associada à infeção pelo vírus da gripe. O Sistema da Vigilância Diária da Mortalidade constitui uma componente do PNVG que permite monitorizar a mortalidade semanal por “todas as causas” durante a época de gripe. É um sistema de vigilância epidemiológica que pretende detetar e estimar de forma rápida os impactos de eventos ambientais ou epidémicos relacionados com excessos de mortalidade. A notificação de casos de Síndrome Gripal (SG) e a colheita de amostras biológicas foi realizada em diferentes redes participantes do PNVG: Rede de Médicos-Sentinela, Rede de Serviços de Urgência/Obstetrícia, médicos do Projeto EuroEVA, Rede Portuguesa de Laboratórios para o Diagnóstico da Gripe e Rede vigilância da gripe em UCI. Na época de vigilância da gripe de 2015/2016 foram notificados 1.273 casos de SG, 87% dos quais acompanhados de um exsudado da nasofaringe para diagnóstico laboratorial. No inverno de 2015/2016 observou-se uma atividade gripal de baixa intensidade. O período epidémico ocorreu entre a semana 53/2015 e a semana 8/2016 e o valor mais elevado da taxa de incidência semanal de SG (72,0/100000) foi observado na semana 53/2015. De acordo com os casos notificados à Rede Médicos-Sentinela, o grupo etário dos 15 aos 64 anos foi o que apresentou uma incidência cumulativa mais elevada. O vírus da gripe foi detetado em 41,0% dos exsudados da nasofaringe recebidos tendo sido detetados outros vírus respiratórios em 24% destes. O vírus da gripe A(H1)pdm09 foi o predominantemente detetado em 90,4% dos casos de gripe. Foram também detetados outros vírus da gripe, o vírus B - linhagem Victoria (8%), o vírus A(H3) (1,3%) e o vírus B- linhagem Yamagata (0,5%). A análise antigénica dos vírus da gripe A(H1)pdm09 mostrou a sua semelhança com a estirpe vacinal 2015/2016 (A/California/7/2009), a maioria dos vírus pertencem ao novo grupo genético 6B.1, que foi o predominantemente detetado em circulação na Europa. Os vírus do tipo B apesar de detetados em número bastante mais reduzido comparativamente com o subtipo A(H1)pdm09, foram na sua maioria da linhagem Victoria que antigenicamente se distinguem da estirpe vacinal de 2015/2016 (B/Phuket/3073/2013). Esta situação foi igualmente verificada nos restantes países da Europa, Estados Unidos da América e Canadá. Os vírus do subtipo A(H3) assemelham-se antigenicamente à estirpe selecionada para a vacina de 2016/2017 (A/Hong Kong/4801/2014). Geneticamente a maioria dos vírus caraterizados pertencem ao grupo 3C.2a, e são semelhantes à estirpe vacinal para a época de 2016/2017. A avaliação da resistência aos antivirais inibidores da neuraminidase, não revelou a circulação de estirpes com diminuição da suscetibilidade aos inibidores da neuraminidase (oseltamivir e zanamivir). A situação verificada em Portugal é semelhante à observada a nível europeu. A percentagem mais elevada de casos de gripe foi verificada nos indivíduos com idade inferior a 45 anos. A febre, as cefaleias, o mal-estar geral, as mialgias, a tosse e os calafrios mostraram apresentar uma forte associação à confirmação laboratorial de um caso de gripe. Foi nos doentes com imunodeficiência congénita ou adquirida que a proporção de casos de gripe foi mais elevada, seguidos dos doentes com diabetes e obesidade. A percentagem total de casos de gripe em mulheres grávidas foi semelhante à observada nas mulheres em idade fértil não grávidas. No entanto, o vírus da gripe do tipo A(H1)pdm09 foi detetado em maior proporção nas mulheres grávidas quando comparado as mulheres não grávidas. A vacina como a principal forma de prevenção da gripe é especialmente recomendada em indivíduos com idade igual ou superior a 65 anos, doentes crónicos e imunodeprimidos, grávidas e profissionais de saúde. A vacinação antigripal foi referida em 13% dos casos notificados. A deteção do vírus da gripe ocorreu em 25% dos casos vacinados e sujeitos a diagnóstico laboratorial estando essencialmente associados ao vírus da gripe A(H1)pdm09, o predominante na época de 2015/2016. Esta situação foi mais frequentemente verificada em indivíduos com idade compreendida entre os 15 e 45 anos. A confirmação de gripe em indivíduos vacinados poderá estar relacionada com uma moderada efetividade da vacina antigripal na população em geral. A informação relativa à terapêutica antiviral foi indicada em 67% casos de SG notificados, proporção superior ao verificado em anos anteriores. Os antivirais foram prescritos a um número reduzido de doentes (9,0%) dos quais 45.0% referiam pelo menos a presença de uma doença crónica ou gravidez. O antiviral mais prescrito foi o oseltamivir. A pesquisa de outros vírus respiratórios nos casos de SG negativos para o vírus da gripe, veio revelar a circulação e o envolvimento de outros agentes virais respiratórios em casos de SG. Os vírus respiratórios foram detetados durante todo o período de vigilância da gripe, entre a semana 40/2015 e a semana 20/2016. O hRV, o hCoV e o RSV foram os agentes mais frequentemente detetados, para além do vírus da gripe, estando o RSV essencialmente associado a crianças com idade inferior a 4 anos de idade e o hRV e o hCoV aos adultos e população mais idosa (≥ 65 anos). A Rede Portuguesa de Laboratórios para o Diagnóstico da Gripe, efetuou o diagnóstico da gripe em 7443 casos de infeção respiratória sendo o vírus da gripe detetado em 1458 destes casos. Em 71% dos casos de gripe foi detetado o vírus da gripe A(H1)pdm09. Os vírus da gripe do tipo A(H3) foram detetados esporadicamente e em número muito reduzido (2%), e em 11% o vírus da gripe A (não subtipado). O vírus da gripe do tipo B foi detetado em 16% dos casos. A frequência de cada tipo e subtipo do vírus da gripe identificados na Rede Hospitalar assemelha-se ao observado nos cuidados de saúde primários (Rede Médicos-Sentinela e Serviços de Urgência). Foi nos indivíduos adultos, entre os 45-64 anos, que o vírus A(H1)pdm09 representou uma maior proporção dos casos de gripe incluindo igualmente a maior proporção de doentes que necessitaram de internamento hospitalar em unidades de cuidados intensivos. O vírus da gripe do tipo B esteve associado a casos de gripe confirmados nas crianças entre os 5 e 14 anos. Outros vírus respiratórios foram igualmente detetados sendo o RSV e os picornavírus (hRV, hEV e picornavírus) os mais frequentes e em co circulação com o vírus da gripe. Durante a época de vigilância da gripe, 2015/2016, não se observaram excessos de mortalidade semanais. Nas UCI verificou-se uma franca dominância do vírus da gripe A(H1)pdm09 (90%) e a circulação simultânea do vírus da gripe B (3%). A taxa de admissão em UCI oscilou entre 5,8% e 4,7% entre as semanas 53 e 12 tendo o valor máximo sido registado na semana 8 de 2016 (8,1%). Cerca de metade dos doentes tinha entre 45 e 64 anos. Os mais idosos (65+ anos) foram apenas 20% dos casos, o que não será de estranhar, considerando que o vírus da gripe A(H1)pdm09 circulou como vírus dominante. Aproximadamente 70% dos doentes tinham doença crónica subjacente, tendo a obesidade sido a mais frequente (37%). Comparativamente com a pandemia, em que circulou também o A(H1)pdm09, a obesidade, em 2015/2016, foi cerca de 4 vezes mais frequente (9,8%). Apenas 8% dos doentes tinha feito a vacina contra a gripe sazonal, apesar de mais de 70% ter doença crónica subjacente e de haver recomendações da DGS nesse sentido. A taxa de letalidade foi estimada em 29,3%, mais elevada do que na época anterior (23,7%). Cerca de 80% dos óbitos ocorreram em indivíduos com doença crónica subjacente que poderá ter agravado o quadro e contribuído para o óbito. Salienta-se a ausência de dados históricos publicados sobre letalidade em UCI, para comparação. Note-se que esta estimativa se refere a óbitos ocorridos apenas durante a hospitalização na UCI e que poderão ter ocorrido mais óbitos após a alta da UCI para outros serviços/enfermarias. Este sistema de vigilância da gripe sazonal em UCI poderá ser aperfeiçoado nas próximas épocas reduzindo a subnotificação e melhorando o preenchimento dos campos necessários ao estudo da doença. A época de vigilância da gripe 2015/2016 foi em muitas caraterísticas comparável ao descrito na maioria dos países europeus. A situação em Portugal destacou-se pela baixa intensidade da atividade gripal, pelo predomínio do vírus da gripe do subtipo A(H1)pdm09 acompanhada pela deteção de vírus do tipo B (linhagem Victoria) essencialmente no final da época gripal. A mortalidade por todas as causas durante a epidemia da gripe manteve-se dentro do esperado, não tendo sido observados excessos de mortalidade. Os vírus da gripe do subtipo predominante na época 2015/2016, A(H1)pdm09, revelaram-se antigénicamente semelhantes à estirpe vacinal. Os vírus da gripe do tipo B detetados distinguem-se da estirpe vacinal de 2015/2016. Este facto conduziu à atualização da composição da vacina antigripal para a época 2016/2017. A monitorização contínua da epidemia da gripe a nível nacional e mundial permite a cada inverno avaliar o impacto da gripe na saúde da população, monitorizar a evolução dos vírus da gripe e atuar de forma a prevenir e implementar medidas eficazes de tratamento da doença, especialmente quando esta se apresenta acompanhada de complicações graves.

2016 Recommended Immunizations for Adults: By Age

These charts show which vaccinations you should have at what ages and by what health condition.

2016-vacunas recomendadas para adultos según la edad

These charts show which vaccinations you should have at what ages and by what health condition.