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1.
Sci Total Environ ; 901: 165836, 2023 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-37517729

RESUMO

Beach sand harbors a diverse group of microbial organisms that may be of public health concern. Nonetheless, little is known about the presence and distribution of viruses in beach sand. In this study, the first objective was to evaluate the presence of seven viruses (Aichi virus, enterovirus, hepatitis A virus, human adenovirus, norovirus, rotavirus, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) in sands collected at public beaches. The second objective was to assess the spatial distribution of enteric viruses in beach sand. To that end, 27 beach sand samples from different beaches in Portugal were collected between November 2018 and August 2020 and analyzed for the presence of viruses. At seven beaches, samples were collected in the supratidal and intertidal zones. Results show that viruses were detected in 89 % (24/27) of the sand samples. Aichi virus was the most prevalent (74 %). Noroviruses were present in 19 % of the samples (norovirus GI - 15 %, norovirus GII - 4 %). Human adenovirus and enterovirus were detected in 48 % and 22 % of the samples, respectively. Hepatitis A virus and rotavirus were not detected. Similarly, SARS-CoV-2 in beach sand collected during the initial stages of the pandemic was also not detected. The detection of three or more viruses occurred in 15 % of the samples. Concentrations of viruses were as high as 7.2 log copies (cp)/g of sand. Enteric viruses were found in higher prevalence in sand collected from the supratidal zone compared to the intertidal zone. Human adenovirus was detected in 43 % of the supratidal and 14 % in the intertidal samples and Aichi virus in 57 % and 86 % of the intertidal and supratidal areas, respectively. Our findings suggest that beach sand can be a reservoir of enteric viruses, suggesting that it might be a vehicle for disease transmission, particularly for children, the elderly, and immunocompromised users.


Assuntos
Adenovírus Humanos , COVID-19 , Enterovirus , Norovirus , Rotavirus , Criança , Humanos , Idoso , SARS-CoV-2 , Areia , COVID-19/epidemiologia
2.
Sci Total Environ ; 859(Pt 1): 160132, 2023 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-36400291

RESUMO

The present study employed data collected during the Mycosands survey to investigate the environmental factors influencing yeasts and molds distribution along European shores applying a species distribution modelling approach. Occurrence data were compared to climatic datasets (temperature, precipitation, and solar radiation), soil datasets (chemical and physical properties), and water datasets (temperature, salinity, and chlorophyll-a concentration) downloaded from web databases. Analyses were performed by MaxEnt software. Results suggested a different probability of distribution of yeasts and molds along European shores. Yeasts seem to tolerate low temperatures better during winter than molds and this reflects a higher suitability for the Northern European coasts. This difference is more evident considering suitability in waters. Both distributions of molds and yeasts are influenced by basic soil pH, probably because acidic soils are more favorable to bacterial growth. Soils with high nitrogen concentrations are not suitable for fungal growth, which, in contrast, are optimal for plant growth, favored by this environment. Finally, molds show affinity with soil rich in nickel and yeasts with soils rich in cadmium resulting in a distribution mainly at the mouths of European rivers or lagoons, where these metals accumulate in river sediments.


Assuntos
Rios , Poluentes do Solo , Rios/química , Solo/química , Cádmio/análise , Poluentes do Solo/análise , Metais/análise , Leveduras , Monitoramento Ambiental
3.
J Small Anim Pract ; 63(12): 863-872, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35843599

RESUMO

OBJECTIVES: Formularies are intended to simplify clinical decision-making by collecting evidence-based information on drugs and their dosages. This study assessed the characteristics of sources used to support drug dosages and reference intervals for mammals in a specific exotic animal formulary, and how the sources had changed over five editions. METHODS: Each reference supporting drug dosages and reference intervals in the sections for ferrets, rabbits, rodents, hedgehogs and miniature pigs in all five editions of the formulary was evaluated and classified by two independent investigators in terms of the type of source cited. Univariable and multi-variable logistic regression models were built to evaluate changes between editions and sections. RESULTS: In total, 1338 references supporting drug dosages and 180 references supporting reference intervals were included from all editions of the formulary. Primary sources were cited by 525 (39.2%) and 39 (21.7%) of the drug and reference interval references, respectively. For drug dosages, the current edition of the formulary (2018) cited a higher proportion of primary rather than secondary sources compared with the first edition (odds ratios 3.4, 95% confidence interval 2.1 to 5.6), while for reference intervals there were no significant changes between editions. In the current edition of the formulary, the 168 secondary sources cited for drug dosages included 78 (46.4%) textbooks, 63 (37.5%) reviews, 14 (8.3%) personal communications and 7 (4.2%) other formularies. CLINICAL SIGNIFICANCE: A large proportion of references supporting drug dosages and reference intervals in the evaluated sections cited secondary sources. Although modest improvements have been observed over time, practitioners should be aware that the evidence supporting several drugs and dosages was limited, and assess the information within the formulary critically.


Assuntos
Animais Exóticos , Cálculos da Dosagem de Medicamento , Animais , Coelhos , Furões , Suínos , Cálculos da Dosagem de Medicamento/história
4.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(2): 102-104, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35168918

RESUMO

INTRODUCTION: The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anaesthesia. CLINICAL CASE: A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anaesthesia with a serratus plane block (SPB) and transversus thoracic muscle plane block (TTPB) with administration of Mepivacaine and Ropivacaine. S-ICD placement was achieved under regional anaesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain. DISCUSSION: The implantation of the ICD occurs in fragile patients, with high anaesthetic risk. In this case, the association of SPB and TTPB was an effective anaesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.


Assuntos
Anestesia por Condução , Bloqueio Nervoso , Humanos , Masculino , Músculo Esquelético , Bloqueio Nervoso/métodos , Tela Subcutânea
5.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34127280

RESUMO

INTRODUCTION: The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anesthesia. CLINICAL CASE: A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anesthesia with a serratus plane block and transversus thoracic muscle plane block with administration of mepivacaine and ropivacaine. S-ICD placement was achieved under regional anesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain. DISCUSSION: The implantation of the ICD occurs in fragile patients, with high anesthetic risk. In this case, the association of serratus plane block and transversus thoracic muscle plane block was an effective anesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.

6.
Sci Total Environ ; 781: 146598, 2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-33812107

RESUMO

The goal of most studies published on sand contaminants is to gather and discuss knowledge to avoid faecal contamination of water by run-offs and tide-retractions. Other life forms in the sand, however, are seldom studied but always pointed out as relevant. The Mycosands initiative was created to generate data on fungi in beach sands and waters, of both coastal and freshwater inland bathing sites. A team of medical mycologists and water quality specialists explored the sand culturable mycobiota of 91 bathing sites, and water of 67 of these, spanning from the Atlantic to the Eastern Mediterranean coasts, including the Italian lakes and the Adriatic, Baltic, and Black Seas. Sydney (Australia) was also included in the study. Thirteen countries took part in the initiative. The present study considered several fungal parameters (all fungi, several species of the genus Aspergillus and Candida and the genera themselves, plus other yeasts, allergenic fungi, dematiaceous fungi and dermatophytes). The study considered four variables that the team expected would influence the results of the analytical parameters, such as coast or inland location, urban and non-urban sites, period of the year, geographical proximity and type of sediment. The genera most frequently found were Aspergillus spp., Candida spp., Fusarium spp. and Cryptococcus spp. both in sand and in water. A site-blind median was found to be 89 Colony-Forming Units (CFU) of fungi per gram of sand in coastal and inland freshwaters, with variability between 0 and 6400 CFU/g. For freshwater sites, that number was 201.7 CFU/g (0, 6400 CFU/g (p = 0.01)) and for coastal sites was 76.7 CFU/g (0, 3497.5 CFU/g). For coastal waters and all waters, the median was 0 CFU/ml (0, 1592 CFU/ml) and for freshwaters 6.7 (0, 310.0) CFU/ml (p < 0.001). The results advocate that beaches should be monitored for fungi for safer use and better management.


Assuntos
Praias , Areia , Austrália , Mar Negro , Fungos , Humanos , Itália , Microbiologia da Água
7.
Sci Total Environ ; 740: 140237, 2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-32927553

RESUMO

Thirty people (mostly children) experienced an episode of skin rash days after a sand sifting beach operation at Porto Pim Beach in Faial, Azores during June 2019. An environmental and epidemiologic investigation was conducted to identify the cause of the outbreak of skin rash. The epidemiologic investigation found that some of the patients experiencing symptoms had never entered the beach water. During the pollution period and throughout the epidemiologic investigation, faecal indicator bacteria levels (94 CFU/100 ml for intestinal enterococci and 61 CFU/100 ml for Escherichia coli) in water remained under the limits used for the ninety-five percentile calculation of an Excellent coastal and transitional bathing water defined in the Portuguese Legislation (100 CFU/100 ml for intestinal enterococci and 250 CFU/100 ml for Escherichia coli). Thus sand contact was considered as a likely primary exposure route. Sand microbiological analysis for faecal indicator organisms and electron microscopy strongly suggested faecal contamination. Chemical analysis of the sand also revealed a concomitant substance compatible with sodium-hypochlorite as analysed using gas chromatography and subsequently confirmed by free chlorine analysis. Inspection of the toilet facilities and sewage disposal system revealed a leaking sewage distribution box. Collectively, results suggest that the cause of the outbreak was the leaking underground sewage distribution box that serviced the beach toilet facilities (40 m from beach), where sodium-hypochlorite was used for cleaning and disinfection. This sewage then contaminated the surficial sands to which beach goers were exposed. Chlorine being an irritant substance, was believed to have been the cause of the symptoms given the sudden presentation and dissipation of skin rashes. No gastro-intestinal illness was reported during this episode and during the following 30 days. Like water, beach sand should also be monitored for safety, especially for areas serviced by aged infrastructure.


Assuntos
Praias , Esgotos , Açores , Criança , Monitoramento Ambiental , Fezes , Humanos , Areia , Microbiologia da Água
8.
Int Endod J ; 53(8): 1131-1139, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32294253

RESUMO

AIM: To evaluate the effect of the addition of surfactants to sodium hypochlorite (NaOCl) on the removal of accumulated hard tissue debris (AHTD), before and after final irrigation with 17% EDTA, from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis. METHODOLOGY: Thirty moderately curved mandibular mesial roots with Vertucci type II canal configuration were selected and scanned in a micro-CT device at an isotropic resolution of 22.9 µm. The specimens were assigned to three groups (n = 10) with respect to the root length, degree of curvature of the mesial root, volume and 3D anatomy of the root canals according to the irrigating solution used during root canal preparation: 2.5% NaOCl and 0.1% Benzalkonium Chloride, 2.5% NaOCl and 0.1% Tween 80 and 2.5% NaOCl without additives. The root canals were instrumented up to Reciproc R25 instrument. Then, the specimens were scanned again after canal preparation and after final irrigation with 17% EDTA, and the registered data sets were examined to evaluate the percentage of AHTD. For comparison between the different groups before and after using 17% EDTA, the Kruskal-Wallis test was used with a significance level of 5%. For comparison between the same groups before and after using 17% EDTA, the Wilcoxon test was used with a significance level of 5%. RESULTS: None of the irrigant solutions tested was able to completely eliminate hard tissue debris from mesial canals of mandibular molars. There were no significant differences in the percentage of AHTD amongst the different irrigation solutions (P > 0.05). Final irrigation with 17% EDTA significantly reduced the percentage of AHTD (P < 0.05), without differences amongst the groups (P > 0.05). CONCLUSIONS: The addition of surfactants to NaOCl did not affect the removal of AHTD from mesial canals of extracted mandibular molars. Final irrigation with 17% EDTA significantly improved AHTD removal.


Assuntos
Irrigantes do Canal Radicular , Hipoclorito de Sódio , Cavidade Pulpar , Ácido Edético , Preparo de Canal Radicular , Tensoativos , Irrigação Terapêutica
10.
Hernia ; 23(6): 1065-1069, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31494807

RESUMO

PURPOSE: To analyze pain scores after surgery in a group of patients submitted to inguinal hernia repair under peripheral nerve block with local or spinal anesthesia. METHODS: Fifty patients were divided into two groups (both with 25 patients each). In the first group the patients were submitted to herniorrhaphy under peripheral block and local anesthesia (LG) and in the other group the patients were submitted to the same procedure under spinal anesthesia (RG). The pain was assessed using the international visual analog pain scale at four different moments. The analysis cost of the procedure was performed using the hospital's average final cost, without including medical expenses. RESULTS: The groups were homogeneous in relation to the epidemiological and clinical features. There was no significant difference between the pain in the intraoperative period and in the return visit for both groups (p = 0.17 and p = 0.18). In the immediate postoperative period, both groups reported no pain at all. In general, the RG reported a greater pain score (16% for RG and 12% for LG). Complications were more frequent in patients submitted to spinal anesthesia (40% versus 8%) (p = 0.008). The surgical time was higher in the LG (39.3 ± 9.2 min) versus (28.7 ± 7.5 min) (p = 0.01). The average final cost of the procedure was US$ 100.98 for the LG and US$ 166.19 for the RG (p = 0.00). CONCLUSION: The inguinal hernioplastia under local anesthesia plus sedation is a safe method, with a low incidence of complications, great acceptance by patients and less expensive.


Assuntos
Anestesia Local , Raquianestesia , Hérnia Inguinal/cirurgia , Herniorrafia , Bloqueio Nervoso , Dor Pós-Operatória/prevenção & controle , Adulto , Idoso , Sedação Consciente , Feminino , Virilha/cirurgia , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Período Pós-Operatório
11.
Ann Vasc Surg ; 60: 95-102, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31075455

RESUMO

BACKGROUND: Ruptured abdominal aortic aneurysm (rAAA) remains a critical life-threatening condition. We aimed to evaluate rAAA management in our center focusing on predictors of mortality at 48 hr of intensive care unit (ICU) and to develop a new mortality prediction score considering data at 48 hr postprocedure. External validation of the modified score with patient data from independent vascular surgery centers was subsequently pursued. METHODS: Clinical data of all patients admitted in our center from January 2010 to December 2017 with the diagnosis of rAAA were retrospectively reviewed for the development of the mortality prediction score. Subsequently, clinical data from patients admitted at independent centers from January 2010 to December 2017 were reviewed for external validation of the score. Statistical analysis was performed with SPSS Version 25. RESULTS: A total of 78 patients were included in the first part of the study: 21 endovascular aneurysm repairs (EVARs), 56 open repairs (ORs), and 1 case of conservative management. Intraoperative mortality in EVAR and OR groups was 0% vs. 24.6%, respectively (P = 0.012). Thirty-day mortality reached 50% and 33% in the OR and EVAR groups. For patients alive at 48 hr, 30-day mortality diminished to 27.6%. Several preoperative predictors of outcome were identified: smoking (P = 0.004), hemodynamic instability(P = 0.004), and elevated international normalized ratio (P < 0.0001). Dutch Aneurysm Score and Vascular Study Group of New England Score (VSGNE) were also significant predictors of outcome (area under the receiver operating characteristic curve [ROC AUC] 0.89 and 0.79, respectively; P < 0.0001). At 48 hr of ICU stay, high lactate level, high Sequential Organ Failure Assessment score, need for hemodyalitic technique, and hemodynamic instability were significant risk predictors for 30-day mortality (P < 0.05). VSGNE score was modified with the inclusion of 2 variables: hemodynamic instability and lactate level at 48 hr and a new score was attained-Postoperative Aneurysm Score (PAS). Comparing AUC for VSGNE and PAS for patients alive at 48 hr, the latter was significantly better (AUC 0.775 vs. 0.852, P = 0.039). The PAS was applied and validated in 3 independent vascular surgery centers (AUC VSGNE 0.782 vs. AUC PAS 0.820, P = 0.027). CONCLUSIONS: Despite recent evidence on preoperative predictors of survival in an era when both EVAR and OR are available, emergent decision to withhold life-saving treatment will always be extremely difficult. Therefore, the policy in our department is to try surgical repair in all cases. It remains important, however, to identify whether late deaths can be predicted, so that unnecessary prolonged treatment can be avoided. A PAS was delineated predicting 30-day mortality significantly better in patients alive at 48 hr. The score was externally applied and validated in independent centers, corroborating the score's usefulness.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/cirurgia , Cuidados Críticos , Técnicas de Apoio para a Decisão , Procedimentos Cirúrgicos Vasculares , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/mortalidade , Ruptura Aórtica/diagnóstico por imagem , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Procedimentos Cirúrgicos Vasculares/mortalidade
12.
Sci Rep ; 9(1): 4144, 2019 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-30858450

RESUMO

Magnetic skyrmions are promising candidates for the next generation of spintronic devices due to their small size and topologically protected structure. One challenge for using these magnetic states in applications lies on controlling the nucleation process and stabilization that usually requires an external force. Here, we report on the evidence of skyrmions in unpatterned symmetric Pd/Co/Pd multilayers at room temperature without prior application of neither electric current nor magnetic field. Decreasing the ferromagnetic interlayer thickness, the tuning of the physical properties across the ferromagnetic/non-magnetic interface gives rise to a transition from worm like domains patterns to isolated skyrmions as demonstrated by magnetic force microscopy. On the direct comparison of the measured and simulated skyrmions size, the interfacial Dzyaloshinskii-Moriya interaction (iDMI) was estimated, reveling that isolated skyrmions are just stabilized at zero magnetic field taking into account non-null values of iDMI. Our findings provide new insights towards the use of stabilized skyrmions for room temperature devices in nominally symmetric multilayers.

13.
Rev Esp Anestesiol Reanim (Engl Ed) ; 66(3): 167-171, 2019 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30522818

RESUMO

We report the successful clinical case of a patient scheduled for lumbar spine surgery in which we performed a bilateral single-shot erector spinae plane block as part of a multimodal analgesic strategy for pain control. Performing the block preoperatively dismissed the need for extra intraoperative opioids other than those for intubation, and enabled the use of paracetamol for analgesia only. Further, there was no need for hypotensive techniques, as the block provided satisfactory sympathetic blockade and regional vasodilation with a clear surgical field. Postoperatively, the patient had minor opioid consumption and was able to freely move without any motor impairment or pain from early on in the Post Anaesthesia Care Unit. The use of single-shot erector spinae plane block at the lumbar level for lumbar spine surgery analgesia emphasises its wide application and analgesic efficacy.


Assuntos
Dor Aguda/terapia , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Dor Pós-Operatória/terapia , Idoso , Feminino , Humanos , Músculos Paraespinais , Indução de Remissão
14.
Sci Rep ; 7(1): 4569, 2017 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-28676685

RESUMO

Heavy metal layers, exemplified by Pt, are known to play a significant role in the magnetization behaviour of thin-film ferromagnets by three distinct mechanisms that can each contribute to the reversal process. These include modifying the local magnetization state via an interfacial Dzyaloshinskii-Moriya interaction (IDMI), enhancement of the damping, via d-d hybridisation and spin-pumping across the interface, and the mediation of the magnetization switching, with the flow of current through a system, via the spin-Hall effect. Here we show for a system with weak interfacial DMI (NiFe/Pt) that the measurement of magnetic field-driven magnetization reversal, mediated by domain wall (DW) motion, is dominated by the enhanced intrinsic damping contribution as a function of the Pt capping layer thickness. But, we also show micromagnetically that the IDMI and damping also combine to modify the domain wall velocity behaviour when the damping is larger. It is also noted that Walker breakdown occurs at lower fields and peak DW velocity decreases in the presence of IDMI. These results highlight the significance of the relative contributions of the damping and the IDMI from the heavy metal layer on the magnetization reversal and provide a route to controlling the DW behaviour in nanoscale device structures.

15.
Eur J Clin Microbiol Infect Dis ; 36(7): 1345-1352, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28188492

RESUMO

There is a lack of knowledge on the epidemiology of fungal infections worldwide because there are no reporting obligations. The aim of this study was to estimate the burden of fungal disease in Portugal as part of a global fungal burden project. Most published epidemiology papers reporting fungal infection rates from Portugal were identified. Where no data existed, specific populations at risk and fungal infection frequencies in those populations were used in order to estimate national incidence or prevalence, depending on the condition. An estimated 1,510,391 persons develop a skin or nail fungal infection each year. The second most common fungal infection in Portugal is recurrent vulvovaginal candidiasis, with an estimated 150,700 women (15-50 years of age) suffering from it every year. In human immunodeficiency virus (HIV)-infected people, oral or oesophageal candidiasis rates were estimated to be 19.5 and 16.8/100,000, respectively. Candidaemia affects 2.19/100,000 patients, in a total of 231 cases nationally. Invasive aspergillosis is less common than in other countries as chronic obstructive pulmonary disease (COPD) is uncommon in Portugal, a total of 240 cases annually. The estimated prevalence of chronic pulmonary aspergillosis after tuberculosis (TB) is 194 cases, whereas its prevalence for all underlying pulmonary conditions was 776 patients. Asthma is common (10% in adults) and we estimate 16,614 and 12,600 people with severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis, respectively. Sixty-five patients develop Pneumocystis pneumonia in acquired immune deficiency syndrome (AIDS) and 13 develop cryptococcosis. Overall, we estimate a total number of 1,695,514 fungal infections starting each year in Portugal.


Assuntos
Micoses/epidemiologia , Micoses/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Portugal/epidemiologia , Prevalência , Adulto Jovem
16.
Anaesth Crit Care Pain Med ; 36(1): 39-42, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27436451

RESUMO

BACKGROUND: Catecholamines and/or levosimendan have been proposed for haemodynamic restoration during cardiogenic shock (CS). In CS induced by post-partum cardiomyopathy (PPCM), levosimendan might be particularly favourable. The aim of this study was to evaluate the haemodynamic and echocardiographic effects of levosimendan in patients with CS, in particular in patients with PPCM-induced CS. METHODS: Twenty-eight patients with refractory CS were retrospectively included in the study. Among them, a cohort of 8 women with PPCM-induced CS was included. All patients were treated with levosimendan (loading dose followed by a continuous infusion for 24 h) and were invasively monitored, including a pulmonary artery catheter, for 48hours. Echocardiographic measurements were performed at baseline and during follow-up. RESULTS: Significant improvements in haemodynamic parameters were observed 48 h after starting levosimendan. The cardiac index increased (+1.2±0.6L/min, P<0.001) and filling pressures decreased (pulmonary artery occlusion pressure, PAOP: -11.2±4.3mmHg, P<0.001; right-atrial pressure, RAP: -6.1±4.9mmHg, P<0.001). The left ventricular ejection fraction was significantly higher at 48 h compared to baseline (38% [34-46%] versus 27% [22-30%], P<0.001). Despite similar characteristics at baseline, in the subgroup of patients with PPCM, more profound decongestive effects at 48hours were observed: PAOP (13±2 versus 17±4mmHg, P=0.007) and RAP (12±4 versus 17±4mmHg, P=0.006) were significantly lower in the PPCM subgroup compared to the non-PPCM subgroup. CONCLUSIONS: Haemodynamics and left-ventricular ejection fraction rapidly improved after treatment with levosimendan. In patients with PPCM-induced CS, a more profound reduction of congestion was observed.


Assuntos
Cardiomiopatias/complicações , Cardiotônicos/uso terapêutico , Hidrazonas/uso terapêutico , Período Pós-Parto , Piridazinas/uso terapêutico , Choque Cardiogênico/tratamento farmacológico , Choque Cardiogênico/etiologia , Adulto , Idoso , Função do Átrio Direito/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Cardiomiopatias/diagnóstico por imagem , Cateterismo , Ecocardiografia , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/fisiopatologia , Estudos Retrospectivos , Simendana , Volume Sistólico/efeitos dos fármacos
17.
Sci Total Environ ; 472: 1062-9, 2014 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-24355396

RESUMO

Beaches worldwide provide recreational opportunities to hundreds of millions of people and serve as important components of coastal economies. Beach water is often monitored for microbiological quality to detect the presence of indicators of human sewage contamination so as to prevent public health outbreaks associated with water contact. However, growing evidence suggests that beach sand can harbor microbes harmful to human health, often in concentrations greater than the beach water. Currently, there are no standards for monitoring, sampling, analyzing, or managing beach sand quality. In addition to indicator microbes, growing evidence has identified pathogenic bacteria, viruses, and fungi in a variety of beach sands worldwide. The public health threat associated with these populations through direct and indirect contact is unknown because so little research has been conducted relating to health outcomes associated with sand quality. In this manuscript, we present the consensus findings of a workshop of experts convened in Lisbon, Portugal to discuss the current state of knowledge on beach sand microbiological quality and to develop suggestions for standardizing the evaluation of sand at coastal beaches. The expert group at the "Microareias 2012" workshop recommends that 1) beach sand should be screened for a variety of pathogens harmful to human health, and sand monitoring should then be initiated alongside regular water monitoring; 2) sampling and analysis protocols should be standardized to allow proper comparisons among beach locations; and 3) further studies are needed to estimate human health risk with exposure to contaminated beach sand. Much of the manuscript is focused on research specific to Portugal, but similar results have been found elsewhere, and the findings have worldwide implications.


Assuntos
Praias , Monitoramento Ambiental/métodos , Sedimentos Geológicos/microbiologia , Água do Mar/microbiologia , Monitoramento Ambiental/normas , Política Ambiental , Política de Saúde , Humanos , Portugal , Saúde Pública , Medição de Risco , Microbiologia da Água
18.
J Toxicol Environ Health A ; 75(22-23): 1359-70, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23095154

RESUMO

Indoor air quality recently entered legislation in Portugal. Several parameters must be evaluated and kept within limits in order to obtain a certification for air quality and energy consumption. Certification parameters were analyzed in two Portuguese archives in order to assess indoor air quality both for people attending or working on these premises and for maintenance of a written heritage that must be retained for future generations. Carbon monoxide (CO) and carbon dioxide (CO2), formaldehyde, and fungal counts were kept within stipulated limits. Relative humidity (RH), volatile organic compounds (VOC), particulate matter (PM10), and ozone (O3) showed values above legislated levels and justified the implementation of corrective measures. In terms of conservation, studies on the limit values are still needed, but according to the available international guidelines, some of the analyzed parameters such as PM10, O3, and RH were also above desirable values. Corrective measures were proposed to these institutions. Although this study was only of a short duration, it proved valuable in assessing potential eventual problems and constitutes the first Portuguese indoor air quality assessment taking into consideration both aspects of an archive such as human health and heritage safekeeping.


Assuntos
Poluição do Ar em Ambientes Fechados , Arquivos , Exposição Ambiental , Exposição por Inalação , Microbiologia do Ar , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Poluição do Ar em Ambientes Fechados/prevenção & controle , Certificação , Contagem de Colônia Microbiana , Exposição Ambiental/efeitos adversos , Exposição Ambiental/prevenção & controle , Monitoramento Ambiental , Fungos/isolamento & purificação , Guias como Assunto , Humanos , Ciência da Informação , Exposição por Inalação/efeitos adversos , Exposição por Inalação/prevenção & controle , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/prevenção & controle , Ozônio/administração & dosagem , Ozônio/análise , Ozônio/toxicidade , Material Particulado/administração & dosagem , Material Particulado/análise , Material Particulado/toxicidade , Portugal , Medição de Risco , Estações do Ano , Compostos Orgânicos Voláteis/administração & dosagem , Compostos Orgânicos Voláteis/análise , Compostos Orgânicos Voláteis/toxicidade , Recursos Humanos
19.
Vet Comp Oncol ; 10(2): 82-94, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22487188

RESUMO

An overall median survival time (MST) and prognostic factors in rabbits with thymomas treated with megavoltage radiation therapy (RT) were determined in this multi-institutional retrospective case analysis. Medical records for 19 rabbits with suspected or confirmed thymomas treated with RT were evaluated for data including signalment, haematological and serum biochemistry abnormalities, presence of pleural effusion, radiation plan, body weight, total radiation dose and institution administering RT. Statistical significance of these factors related to overall survival was assessed. An overall MST for all 19 rabbits was 313 days; exclusion of 3 rabbits that died acutely during the first 14 days of RT yielded a MST of 727 days. The only factor associated with a significantly decreased survival time was having a body weight lower than mean body weight of 1.57 kg. Radiation treatment-associated complications were infrequent and included radiation-induced myocardial failure, radiation pneumonitis and alopecia.


Assuntos
Coelhos , Radioterapia de Alta Energia/veterinária , Timoma/veterinária , Neoplasias do Timo/veterinária , Animais , Cálcio/sangue , Feminino , Masculino , Prognóstico , Radioterapia de Alta Energia/efeitos adversos , Estudos Retrospectivos , Taxa de Sobrevida , Timoma/mortalidade , Timoma/radioterapia , Neoplasias do Timo/mortalidade , Neoplasias do Timo/radioterapia , Resultado do Tratamento
20.
Work ; 41 Suppl 1: 5652-4, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22317641

RESUMO

This study evaluated the influence an abdominal support attached to a traditional stool, of those used by dentists, has on the body's distribution of the electrical activity of the superior trapezius and the longissimus thoracic muscles of dental students during the execution of a clinical procedure. The results showed no significant difference in the body's distribution in the seat and backrest, but did reveal there was a weight discharge of 3.1 ± 1.9% of dentist's body weight in the abdominal support. The 9 o'clock position proved to be the best position to perform clinical procedures. It was also observed that the position was closer to the body's axis.


Assuntos
Equipamentos Odontológicos , Odontologia , Músculos Superficiais do Dorso/fisiologia , Abdome , Adulto , Eletromiografia , Feminino , Humanos , Postura/fisiologia , Adulto Jovem
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