Acute Complications of Sickle Cell Disease in Children Under 5 Years at a Level II Hospital.

The aim of this study was to characterize the acute complications that required hospitalization in children under 5 years with Sickle Cell Disease. The population included 70 patients, 64% of African ascendency and 95.7% homozygotic for the HbS. We analyzed data from 337 hospitalizations. The first hospitalization occurred before 12 months in 38.6% and the average hospital admission per child was 3.92. The mean duration per hospitalization was 5.36 days. The most common diagnosis was vaso-occlusive crisis (36.8%) followed by fever, upper airway infections, bacterial pneumonia and splenic sequestration. Hemoglobin values at admission were between 6 and 7 g/dL in 22.3%, with 44.2% requiring at least 1 blood transfusion. There are several acute complications of SCD, being vaso-occlusive crisis the most common. Splenic sequestration generally occurs during the first 2 years and is associated with the need of transfusion. They represent a significant burden, with each child spending approximately 3 weeks hospitalized.

A methodology to empower citizens towards a low-carbon economy. The potential of schools and sustainability indicators.

Environmental empowering to control resource consumption and environmental impacts is critical to engage citizens to adopt more sustainable habits. This study demonstrates the potential benefits of innovative approaches based on sustainability indicators towards a low-carbon economy. A methodology to measure and promote sustainability in schools has been proposed and evaluated, aiming at showing the environmental performance and informing of potential environmental savings. The methodology, titled ClimACT, has two main purposes: measuring the environmental performance of schools through a school sustainability index based on measurable indicators in the areas of transport, procurement, green spaces, indoor air quality, energy, water and waste; and encouraging students, teachers and families towards an energy-efficient and low-carbon pathway through a structural procedure based on roles, activities and progress evaluation. The approach, applied to 39 pilot schools from Portugal, Spain, France and Gibraltar, achieved promising and encouraging results. All schools deployed the methodology successfully, achieving measurable environmental benefits in 95% of cases, with an average improvement of 10% in the global performance of schools after one year. Moreover, the 5112 surveys applied to school communities, before and after the methodology implementation, highlighted how the sustainable indicators had a significant influence on the daily lives of families, leading to improvements of their behaviour, with an average increase of 20% in indicators regarding good practices in transport, energy, water, waste and citizenship. The environmental empowering through measurable indicators is a step forward a low-carbon economy. This methodology is open and adaptable to all sectors and requirements.

Bioburden in sleeping environments from Portuguese dwellings.

A wider characterization of indoor air quality during sleep is still lacking in the literature. This study intends to assess bioburden before and after sleeping periods in Portuguese dwellings through active methods (air sampling) coupled with passive methods, such as electrostatic dust cloths (EDC); and investigate associations between before and after sleeping and bioburden. In addition, and driven by the lack of information regarding fungi azole-resistance in Portuguese dwellings, a screening with supplemented media was also performed. The most prevalent genera of airborne bacteria identified in the indoor air of the bedrooms were Micrococcus (41%), Staphylococcus (15%) and Neisseria (9%). The major indoor bacterial species isolated in all ten studied bedrooms were Micrococcus luteus (30%), Staphylococcus aureus (13%) and Micrococcus varians (11%). Our results highlight that our bodies are the source of the majority of the bacteria found in the indoor air of our homes. Regarding air fungal contamination, Chrysosporium spp. presented the highest prevalence both in after the sleeping period (40.8%) and before the sleeping period (28.8%) followed by Penicillium spp. (23.47% morning; 23.6% night) and Chrysonilia spp. (12.4% morning; 20.3% night). Several Aspergillus sections were identified in air and EDC samples. However, none of the fungal species/strains (Aspergillus sections Fumigati, Flavi, Nidulantes and Circumdati) were amplified by qPCR in the analyzed EDC. The correlations observed suggest reduced susceptibility to antifungal drugs of some fungal species found in sleeping environments. Toxigenic fungal species and indicators of harmful fungal contamination were observed in sleeping environments.

Compliance of indoor air quality during sleep with legislation and guidelines - A case study of Lisbon dwellings.

This study aimed to provide a comprehensive characterisation of the indoor air quality during the sleeping period of 10 couples at Lisbon dwellings, using a multi-pollutant approach, and to understand how the compliance with legislation and guidelines was to assure a good indoor air quality. The assessment of indoor air quality was conducted in the cold season using real time monitors during the sleeping period for comfort parameters (temperature and relative humidity) and air pollutants (carbon dioxide - CO2, carbon monoxide - CO, formaldehyde - CH2O, total volatile organic compounds - VOCs, and particulate matter - PM2.5 and PM10), together with active sampling of bioaerosols (fungi and bacteria) before and after the sleeping period. Lower compliance (less than 50% of the cases) with the Portuguese legislation was found for temperature, CO2 (3440 ± 1610 mg m-3), VOCs (1.79 ± 0.99 mg m-3) and both bioaerosol types. In 70% of the cases, PM2.5 (15.3 ± 9.1 µg m-3) exceeded the WHO guideline of 10 µg m-3. All bedrooms presented air change rates above the recommended minimum value of 0.7 h-1, highlighting that a good indoor air quality during sleep is not guaranteed.

Comparison of indoor air quality during sleep in smokers and non-smokers' bedrooms: A preliminary study.

People spend one third of their life sleeping, but the bedroom, as a specific micro-environment, is often neglected when assessing human exposure to air pollutants. However, exposure during sleep may be significant in the long-term to the integrated individual exposure. This study aimed to assess the exposure during sleep, focusing on a multi-pollutant approach (comfort parameters, carbon dioxide - CO2, carbon monoxide - CO, formaldehyde (CH2O), total volatile organic compounds (VOCs), particulate matter - PM2.5 and PM10 - and ultrafine particles, particle number concentrations - PNC - and lung deposited surface area - LDSA). For that, the air quality during sleep (in real conditions) was monitored using real-time devices in 12 bedrooms of urban (Lisbon and Vila Franca de Xira) and rural (Ponte de Sor) areas of Portugal for one night. Volunteers were smokers and non-smokers. Considering the Portuguese legislation for indoor air quality (IAQ), 67% of the bedrooms registered CO2 levels above the limit value, while CH2O, VOC, PM10 and PM2.5 thresholds were exceeded in 30, 100, 36, and 45% of cases, respectively. Regarding ultrafine parameters, LDSA and PNC ranged from 7.3 to 95.2 µm2/cm3 and from 0.6 to 4.8 × 103/cm3, respectively. Even with no smoking indoors, smokers' bedrooms were found to have significant higher levels of CO, CH2O, PM2.5, PM10 and LDSA than non-smokers' bedrooms, showing the effect of thirdhand smoke, exhalation of pollutants after smoking and infiltration on the degradation of the air quality in the bedroom. A recent new model of real-time monitor was also used for a wide set of IAQ parameters. Its performance to measure PM2.5 and CO2 was assessed, showing its applicability in real conditions. Although often neglected, these micro-environments should be considered in the integrated individual exposure to air pollutants and further studied. MAIN FINDINGS OF THE WORK: Several pollutants (CO2, PM, VOCs and CH2O) exceeded the guidelines during sleep; smokers are exposed to higher levels of CO, CH2O, PM, and LDSA than non-smokers while sleeping.

Integration of biomonitoring and instrumental techniques to assess the air quality in an industrial area located in the coastal of central Asturias, Spain.

Throughout the world, epidemiological studies were established to examine the relationship between air pollution and mortality rates and adverse respiratory health effects. However, despite the years of discussion the correlation between adverse health effects and atmospheric pollution remains controversial, partly because these studies are frequently restricted to small and well-monitored areas. Monitoring air pollution is complex due to the large spatial and temporal variations of pollution phenomena, the high costs of recording instruments, and the low sampling density of a purely instrumental approach. Therefore, together with the traditional instrumental monitoring, bioindication techniques allow for the mapping of pollution effects over wide areas with a high sampling density. In this study, instrumental and biomonitoring techniques were integrated to support an epidemiological study that will be developed in an industrial area located in Gijon in the coastal of central Asturias, Spain. Three main objectives were proposed to (i) analyze temporal patterns of PM10 concentrations in order to apportion emissions sources, (ii) investigate spatial patterns of lichen conductivity to identify the impact of the studied industrial area in air quality, and (iii) establish relationships amongst lichen conductivity with some site-specific characteristics. Samples of the epiphytic lichen Parmelia sulcata were transplanted in a grid of 18 by 20 km with an industrial area in the center. Lichens were exposed for a 5-mo period starting in April 2010. After exposure, lichen samples were soaked in 18-MΩ water aimed at determination of water electrical conductivity and, consequently, lichen vitality and cell damage. A marked decreasing gradient of lichens conductivity relative to distance from the emitting sources was observed. Transplants from a sampling site proximal to the industrial area reached values 10-fold higher than levels far from it. This finding showed that lichens reacted physiologically in the polluted industrial area as evidenced by increased conductivity correlated to contamination level. The integration of temporal PM10 measurements and analysis of wind direction corroborated the importance of this industrialized region for air quality measurements and identified the relevance of traffic for the urban area.