Laser Monotherapy in Plantar Fasciitis

Introdução: A fasceíte plantar (FP) constitui a causa mais frequente de dor no retropé. Está recomendada uma prova terapêutica inicial conservadora. Objetivos: Caraterizar fatores demográficos e sintomáticos, terapêutica prévia e resultados de monoterapia com laser. Material e Métodos: Estudo observacional retrospetivo (12 meses). O tratamento aplicado foi laser infravermelho (AsGa 904nm; densidade de energia 20J/cm2; potência de pico 200mW). Fez-se análise estatística descritiva e comparativa (nível de significância de 0,05). Resultados: Seguiram-se 32 doentes com FP, com idade média de 54,28 anos (24–86; DP 13,95), 66% mulheres, Índice de Massa Corporal (IMC) médio de 30,18Kg/m2 (17,91-41,13; DP 5,19), 75% unilaterais, tempo médio de evolução de 6,28 meses (0,2-24; DP 6,82), 21 tinham feito previamente farmacoterapia e 12 outros tratamentos de MFR. O nível de dor inicial (END) médio foi 7,31 (5-10; DP 1,38). Dos 26 doentes tratados (6 perdas), 24 (92,3%) reportaram melhoria. O número médio de sessões foi 28,5 (11– 60; DP 14,01). O nível médio de dor final foi 0,75 (0-5; DP 2,37), com melhoria média de 89,7% (28,6%-100%; DP 0,16) do nível de dor. A intensidade de dor inicial foi maior em doentes com IMC superior (p=0,002). Não se encontraram outras relações estatisticamente significativas. Conclusões: A FP caraterizou-se por um nível de dor significativo (moderado a grave). A obesidade pareceu ser um fator de risco. A taxa de melhoria com o tratamento com laser foi muito satisfatória. A terapia com laser de baixa intensidade IV constitui uma boa opção terapêutica, a justificar avaliação suplementar por ensaios prospetivos controlados e randomizados

Perfeccionismo no transtorno obsessivo-compulsivo e nos transtornos alimentares

OBJETIVO: Este estudo tem dois objetivos principais. Primeiro, avaliar as dimensões do perfeccionismo no transtorno obsessivo-compulsivo e nos transtornos alimentares em comparação com duas amostras controle: psiquiátrica (depressão/ansiedade) e não clínica. Segundo, avaliar se o perfeccionismo é um traço de personalidade especificamente relacionado com estas diferentes condições clínicas. MÉTODO: 39 pacientes com transtorno obsessivo-compulsivo, 24 com transtornos alimentares, 65 com um diagnóstico de depressão e/ou ansiedade (todos estes pacientes encontravam-se em regime de ambulatório) e 70 controles não clínicos completaram a versão portuguesa da Multidimensional Perfectionism Scale. RESULTADOS: Comparativamente à amostra não clínica, todas as amostras clínicas apresentaram níveis significativamente mais elevados na Multidimensional Perfectionism Scale total, no Perfeccionismo Auto-Orientado e no Perfeccionismo-Socialmente-Prescrito. Não houve diferenças estatisticamente significativas no Perfeccionismo-Auto-Orientado e na Multidimensional Perfectionism Scale total nas três amostras clínicas. No entanto, a amostra com transtornos alimentares apresentou níveis significativamente mais elevados de Perfeccionismo-Socialmente-Prescrito, comparativamente à transtornos alimentares e à amostra psiquiátrica (depressão/ansiedade). CONCLUSÃO: O perfeccionismo revelou estar associado a uma grande variedade de condições psicopatológicas. Contudo, as diferenças encontradas entre a amostra de transtornos alimentares, de transtorno obsessivo-compulsivo e a psiquiátrica no Perfeccionismo-Socialmente-Prescrito necessitam de investigação subsequente no sentido de clarificar a especificidade desta dimensão com os transtornos alimentares

Short-term versus long-term changes in the benthic communities of a small coastal lagoon: implications for ecological status assessment

The characteristic high variability and low predictability of coastal lagoons, due to strong changes in marine and freshwater inputs, make these ecosystems an interesting casestudy. The small Melides landlocked coastal lagoon in SW Portugal is a paradigmatic example, with a biological community highly stressed by these phenomena. Benthic macroinvertebrate samples were collected in 1998/99 and 2009 and each year, in different seasons and addressing different environmental conditions influenced by the connection to the sea and rainfall regime. Major spatial and temporal patterns in benthic communities were investigated using some invertebrate attributes (e.g. community composition, density, species richness and diversity). A very low taxonomic species richness and diversity was found in the Melides lagoon and only a much reduced number of species occurred along all sampling periods and in both sampling campaigns. Although the colonization events play a crucial role, the persistence of the observed species was mainly associated to abiotic factors, such as salinity, temperature and dissolved oxygen. Despite the potential reduction in anthropogenic pressure, by the construction of a sewage treatment plant and a reduction of urban occupation, the ecological status did not improve and the high level of natural environmental variably in the lagoon seems to be the dominant stressor influencing benthic invertebrate communitie

Cognitive performance in healthy older adults relates to spontaneous switching between states of functional connectivity during rest

Growing evidence has shown that brain activity at rest slowly wanders through a repertoire of different states, where whole-brain functional connectivity (FC) temporarily settles into distinct FC patterns. Nevertheless, the functional role of resting-state activity remains unclear. Here, we investigate how the switching behavior of resting-state FC relates with cognitive performance in healthy older adults. We analyse resting-state fMRI data from 98 healthy adults previously categorized as being among the best or among the worst performers in a cohort study of >1000 subjects aged 50+ who underwent neuropsychological assessment. We use a novel approach focusing on the dominant FC pattern captured by the leading eigenvector of dynamic FC matrices. Recurrent FC patterns - or states - are detected and characterized in terms of lifetime, probability of occurrence and switching profiles. We find that poorer cognitive performance is associated with weaker FC temporal similarity together with altered switching between FC states. These results provide new evidence linking the switching dynamics of FC during rest with cognitive performance in later life, reinforcing the functional role of resting-state activity for effective cognitive processing.This project was financed by the Fundação Calouste Gulbenkian (Portugal) (Contract grant number: P-139977; project “Better mental health during ageing based on temporal prediction of individual brain ageing trajectories (TEMPO)”), co-financed by Portuguese North Regional Operational Program (ON.2) under the National Strategic Reference Framework (QREN), through the European Regional Development Fund (FEDER) as well as the Projecto Estratégico co-funded by FCT (PEst-C/SAU/LA0026-/2013) and the European Regional Development Fund COMPETE (FCOMP-01-0124-FEDER-037298) and under the scope of the project NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020) under the Portugal 2020 Partnership Agreement through the European Regional Development Fundinfo:eu-repo/semantics/publishedVersio

Risk assessment for the spread of Serratia marcescens within dental-unit waterline systems using Vermamoeba vermiformis

Vermamoeba vermiformis is associated with the biofilm ecology of dental-unit waterlines (DUWLs). This study investigated whether V. vermiformis is able to act as a vector for potentially pathogenic bacteria and so aid their dispersal within DUWL systems. Clinical dental water was initially examined for Legionella species by inoculating it onto Legionella selective-medium plates. The molecular identity/profile of the glassy colonies obtained indicated none of these isolates were Legionella species. During this work bacterial colonies were identified as a non-pigmented Serratia marcescens. As the water was from a clinical DUWL which had been treated with Alpron™ this prompted the question as to whether S. marcescens had developed resistance to the biocide. Exposure to Alpron™ indicated that this dental biocide was effective, under laboratory conditions, against S. marcescens at up to 1x108 colony forming units/millilitre (cfu/ml). V. vermiformis was cultured for eight weeks on cells of S. marcescens and Escherichia coli. Subsequent electron microscopy showed that V. vermiformis grew equally well on S. marcescens and E. coli (p = 0.0001). Failure to detect the presence of S. marcescens within the encysted amoebae suggests that V. vermiformis is unlikely to act as a vector supporting the growth of this newly isolated, nosocomial bacterium

Reprodução na juventude: perfis sociodemográficos, comportamentais e reprodutivos na PNDS 2006

OBJETIVO: Analizar características sociodemográficas y de conductas sexual y reproductiva de mujeres jóvenes. MÉTODOS: Estudio poblacional transversal con representatividad nacional sobre el comportamiento sexual, anticonceptivo y reproductivo de 2.991 mujeres de 15 a 20 años en la Investigación Nacional de Demografía y Salud del Niño y de la Mujer (PNDS) 2006. Las jóvenes se clasificaron en tres grupos: iniciaron la vida sexual y se embarazaron antes de los 20 años (grupo A); iniciaron la vida sexual y no se embarazaron antes de los 20 (grupo B) y no iniciaron la vida sexual (grupo C). Mujeres de hasta 25 años se consideraron para el estudio de las tasas de embarazo y de sus consecuencias en la vida. Los análisis estadísticos consideraron los pesos y la planificación del muestreo complejo. La asociación entre dos variables categóricas fue evaluada por la prueba Chi-cuadrado. Para las conductuales, se utilizó el modelo linear global. RESULTADOS: Mujeres del grupo A eran principalmente negras, más pobres y con menor escolaridad. Tuvieron la primera relación sexual más precozmente, comportamiento anticonceptivo más desprotegido y menor conocimiento de la fisiología de la reproducción con relación al grupo B; las jóvenes del grupo C se caracterizaron por frecuentar más la escuela, y la preservación de la virginidad para el matrimonio fue relatada por 1/3 del grupo. En las mujeres con hasta 25 años, el embarazo antes de los 20 fue percibido con más consecuencias positivas que negativas en la vida amorosa, conyugal, social y autoestima. CONCLUSIONES: Hay asociación significativa entre embarazo antes de los 20 años con mayor pobreza y menor escolaridad. En ausencia de mejores condiciones de vida y de oportunidades, el embarazo, aunque no sea previsto, se establece como "proyecto de vida" en comparación con su inexistencia.OBJECTIVE: Analyze the sociodemographic characteristics and the sexual and reproductive behavior of young women. METHODS: A cross-sectional nationally representative study was performed about sexual, contraceptive and reproductive behavior with 2,991 women age 15 to 20 years in the National Survey on Demography and Health of Women and Children, 2006. The women were classified into three groups: sexual initiation and pregnancy before the age of 20 (group A); sexual initiation but no pregnancy before the age of 20 (group B) and no sexual initiation (group C). Women until age 25 years were included in the study about reasons for becoming pregnant and the implications for their lives. Statistical analysis considered survey weights and the complex sample design. The association between two categorical variables was assessed by chi-square test. The behavior variables were assessed using a global linear model. RESULTS: Women in group A were mainly black, poorer and with lower education level. These women had an early sexual initiation, less safe contraceptive behavior and less knowledge of reproduction physiology in comparison with group B; young women in group C were characterized by greater attendance at school and 1/3 of this group claimed to maintain their virginity until marriage. For women up to the age of 25, pregnancy before 20 years was perceived as having more positive than negative impacts upon their love life, spousal relationships, social lives and self-esteem. CONCLUSIONS: There is a significant association between pregnancy before the age of 20 and higher poverty and lower educational level. In the absence of better living conditions and opportunities, pregnancy, although unplanned, becomes "a plan for life", and is not seen as a lack of life planning.OBJETIVO: Analisar características sociodemográficas e do comportamento sexual e reprodutivo de mulheres jovens. MÉTODOS: Estudo populacional transversal com representatividade nacional sobre o comportamento sexual, contraceptivo e reprodutivo de 2.991 mulheres de 15 a 20 anos na Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher 2006. As jovens foram classificadas em três grupos: iniciaram a vida sexual e engravidaram antes dos 20 anos (grupo A); iniciaram a vida sexual e não engravidaram antes dos 20 (grupo B) e não iniciaram a vida sexual (grupo C). Mulheres de até 25 anos foram consideradas para o estudo das razões da gravidez e de suas implicações na vida. As análises estatísticas consideraram os pesos e o planejamento amostral complexo. A associação entre duas variáveis categóricas foi avaliada pelo teste tipo qui-quadrado. Quanto às comportamentais, utilizou-se modelo linear global. RESULTADOS: Mulheres do grupo A eram principalmente negras, mais pobres e com menor escolaridade. Tiveram a primeira relação sexual mais precocemente, comportamento contraceptivo mais desprotegido e menor conhecimento da fisiologia da reprodução em relação ao grupo B; as jovens do grupo C caracterizaram-se por maior frequência à escola e a preservação da virgindade para o casamento foi alegada por um 1/3 desse grupo. Para as mulheres com até 25 anos, a gravidez antes dos 20 foi percebida como tendo implicações mais positivas que negativas na vida amorosa, conjugal, social e autoestima. CONCLUSÕES: Há associação significativa entre gravidez antes dos 20 anos com maior pobreza e menor escolaridade. Na ausência de melhores condições de vida e de oportunidades, a gravidez, embora não prevista, configura-se como "projeto de vida" e não sua mera ausência

Approaches in biotechnological applications of natural polymers

Natural polymers, such as gums and mucilage, are biocompatible, cheap, easily available and non-toxic materials of native origin. These polymers are increasingly preferred over synthetic materials for industrial applications due to their intrinsic properties, as well as they are considered alternative sources of raw materials since they present characteristics of sustainability, biodegradability and biosafety. As definition, gums and mucilages are polysaccharides or complex carbohydrates consisting of one or more monosaccharides or their derivatives linked in bewildering variety of linkages and structures. Natural gums are considered polysaccharides naturally occurring in varieties of plant seeds and exudates, tree or shrub exudates, seaweed extracts, fungi, bacteria, and animal sources. Water-soluble gums, also known as hydrocolloids, are considered exudates and are pathological products; therefore, they do not form a part of cell wall. On the other hand, mucilages are part of cell and physiological products. It is important to highlight that gums represent the largest amounts of polymer materials derived from plants. Gums have enormously large and broad applications in both food and non-food industries, being commonly used as thickening, binding, emulsifying, suspending, stabilizing agents and matrices for drug release in pharmaceutical and cosmetic industries. In the food industry, their gelling properties and the ability to mold edible films and coatings are extensively studied. The use of gums depends on the intrinsic properties that they provide, often at costs below those of synthetic polymers. For upgrading the value of gums, they are being processed into various forms, including the most recent nanomaterials, for various biotechnological applications. Thus, the main natural polymers including galactomannans, cellulose, chitin, agar, carrageenan, alginate, cashew gum, pectin and starch, in addition to the current researches about them are reviewed in this article.. }To the Conselho Nacional de Desenvolvimento Cientfíico e Tecnológico (CNPq) for fellowships (LCBBC and MGCC) and the Coordenação de Aperfeiçoamento de Pessoal de Nvíel Superior (CAPES) (PBSA). This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2013 unit, the Project RECI/BBB-EBI/0179/2012 (FCOMP-01-0124-FEDER-027462) and COMPETE 2020 (POCI-01-0145-FEDER-006684) (JAT)

Outbreak by serratia marcescens producing carbapenemases in an adult intensive care unit

Serratia marcescens (SM) es un bacilo Gram-negativo perteneciente a la familia Enterobacteriaceae, reconocido como patógeno oportunista asociado a brotes nosocomiales. Es naturalmente resistente a tetraciclina, amoxicilina, amoxicilina-clavulánico, cefalotina y colistin. En los últimos años existe preocupación por la gran dispersión de los bacilos gramnegativos resistentes a los carbapenémicos (KPC), también causantes de brotes nosocomiales; éstas aumentan la morbimortalidad, los costos hospitalarios y prolon-gan la internación. En nuestro hospital en la Unidad de Cuidados Intensivos (UCI) en el año 2012 tuvimos el primer caso de Infección por SM KPC, constituyéndose un gran desafío médico y de control de infecciones en cuanto al tratamiento, y medidas de control

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Autoimmune thyroiditis in antinuclear antibody positive children without rheumatologic disease

<p>Abstract</p> <p>Background</p> <p>Children are commonly referred to a pediatric rheumatology center for the laboratory finding of an Anti-nuclear antibody (ANA) of undetermined significance. Previous studies regarding adult rheumatology patients have supported an association between ANA and anti-thyroid antibodies, with the prevalence of thyroid antibodies being significantly higher in patients referred to a rheumatology center for an ANA without evidence of connective tissue disease compared to the general population. The purpose of the present study was to determine the frequency of thyroid antibodies in children referred to a pediatric rheumatology center for a positive ANA without evidence of a connective tissue disease.</p> <p>Methods</p> <p>A retrospective chart review was performed on children who were referred to our pediatric rheumatology center between August 2003 and March 2007 for positive ANA with concurrent thyroid antibody and thyroid function tests performed who did not fulfill criteria for a specific connective tissue disease. Laboratory and clinical features were recorded and analyzed. Mean and standard deviation were used to describe continuous data. Chi-square or Fisher's exact tests were used to compare proportions between variables.</p> <p>Results</p> <p>One-hundred and four ANA-positive patients with concurrent thyroid studies were evaluated (88% female, 93% Caucasian, mean age 11.9 ± 4.0 years). Half of patients had an ANA titer ≥ 1:320. The ANA pattern was speckled in 60% of the patients. Thyroid antibodies were detected in 30% of the patients. Anti-Thyroglobulin (ATG) was detected in 29% and Anti-thyroid peroxidase (ATPO) in 21% of the patients; of these children, 14% had hypothyroidism. ANA pattern and titer were not associated with anti-thyroid antibody positivity.</p> <p>Conclusion</p> <p>Thyroid antibodies associated with chronic lymphocytic thyroiditis, ATG and ATPO, were detected significantly higher in ANA-positive children without a rheumatologic condition (30%) as compared to the general pediatric population (1.3 - 3.4%). ANA titer and pattern did not help predict the presence or absence of thyroid antibodies. Given the high frequency of thyroid antibodies and increased risk of developing hypothyroidism over time, routine evaluation of ATG and ATPO with thyroid function tests in ANA-positive children is recommended.</p