RESUMEN
A novel strain, MA3_2.13T, was isolated from deep-sea sediment of Madeira Archipelago, Portugal, and characterized using a polyphasic approach. This strain produced dark brown soluble pigments, bronwish black substrate mycelia and an aerial mycelium with yellowish white spores, when grown on GYM 50SW agar. The main respiratory quinones were MK-10(H4), MK-10(H6) and MK-10(H8). Diphosphatidylglycerol, phosphatidylethanolamine, three unidentified phospholipids and two glycophospholipids were identified as the main phospholipids. The major cellular fatty acids were iso-C16â:â1, iso-C16â:â0, anteiso-C17â:â1 and anteiso-C17â:â0. Phylogenetic analyses based on 16S rRNA gene showed that strain MA3_2.13T is a member of the genus Streptomyces and was most closely related to Streptomyces triticirhizae NEAU-YY642T (NR_180032.1; 16S rRNA gene similarity 97.9â%), Streptomyces sedi YIM 65188T (NR_044582.1; 16S rRNA gene similarity 97.4â%), Streptomyces mimosae 3MP-10T (NR_170412.1; 16S rRNA gene similarity 97.3â%) and Streptomyces zhaozhouensis NEAU-LZS-5T (NR_133874.1; 16S rRNA gene similarity 97.0â%). Genome pairwise comparisons with closest related type strains retrieved values below the threshold for species delineation suggesting that strain MA3_2.13T represents a new branch within the genus Streptomyces. Based on these results, strain MA3_2.13T (=DSM 115980T=LMG 33094T) is proposed as the type strain of a novel species of the genus Streptomyces, for which the name Streptomyces profundus sp. nov. is proposed.
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Ácidos Grasos , Streptomyces , Ácidos Grasos/química , Análisis de Secuencia de ADN , Filogenia , ARN Ribosómico 16S/genética , Portugal , Microbiología del Suelo , ADN Bacteriano/genética , Técnicas de Tipificación Bacteriana , Composición de Base , Fosfolípidos/químicaRESUMEN
Climate change will pose a challenge for the winemaking sector worldwide, bringing progressively drier and warmer conditions and increasing the frequency and intensity of weather extremes. The short-term adaptation strategy of applying biostimulants through foliar application serves as a crucial measure in mitigating the detrimental effects of environmental stresses on grapevine yield and berry quality. The aim of this study was to evaluate the effect of foliar application of a seaweed-based biostimulant (A. nodosum-ANE) and glycine betaine (GB) on berry quality, phenolic compounds, and antioxidant activity and to elucidate their action on the secondary metabolism. A trial was installed in a commercial vineyard (cv. "Touriga Franca") in the Cima Corgo (Upper Corgo) sub-region of the Douro Demarcated Region, Portugal. A total of four foliar sprayings were performed during the growing season: at flowering, pea size, bunch closer, and veraison. There was a positive effect of GB in the berry quality traits. Both ANE and GB increased the synthesis of anthocyanins and other phenolics in berries and influenced the expression of genes related to the synthesis and transport of anthocyanins (CHS, F3H, UFGT, and GST). So, they have the potential to act as elicitors of the secondary metabolism, leading to improved grape quality, and also to set the foundation for sustainable agricultural practices in the long run.
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Antioxidantes , Betaína , Frutas , Regulación de la Expresión Génica de las Plantas , Fenoles , Algas Marinas , Vitis , Vitis/efectos de los fármacos , Vitis/genética , Vitis/metabolismo , Antioxidantes/farmacología , Antioxidantes/metabolismo , Betaína/farmacología , Frutas/efectos de los fármacos , Frutas/metabolismo , Frutas/química , Frutas/genética , Fenoles/metabolismo , Regulación de la Expresión Génica de las Plantas/efectos de los fármacos , Algas Marinas/metabolismo , Antocianinas/biosíntesisRESUMEN
BACKGROUND: Plant-based extracts have been recently used as sustainable tools to improve biotic and abiotic stress tolerance and increase grape (Vitis vinifera L.) quality. However, knowledge about the effect of these extracts on secondary metabolism compounds, that are fundamental for grape and wine quality, is still scarce. In this study, a trial was installed in an experimental vineyard with the variety Touriga Franca located at University of Trás-os-Montes e Alto Douro, Baixo Corgo sub-region of the Douro Demarcated Region, Portugal in two growing seasons: 2019 and 2020. The aim was to evaluate the effect of foliar application of nettle (Urtica spp.) extract (NE) and Japanese knotweed (Reynoutria japonica) extract (JKE) on grapevines leaves and berries bioactive compounds contents and antioxidant activity, at veraison and harvest. RESULTS: The application of NE increased the total carotenoids in leaves and the total phenolics content and the antioxidant activity (ferric reducing antioxidant power, FRAP) in berries while JKE increased flavonoids content in leaves and the antioxidant activity (2,2-diphenyl-1-picrylhydrazyl, DPPH) in berries. CONCLUSION: These extracts seem to have a stimulatory effect on grapevine, enhancing bioactive compounds contents and antioxidant capacity and, consequently, the physiological performance of the plant and the quality of the berries. © 2024 Society of Chemical Industry.
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Fallopia japonica , Vitis , Vino , Vitis/química , Antioxidantes/análisis , Fallopia japonica/metabolismo , Antocianinas/análisis , Metabolismo Secundario , Vino/análisis , Extractos Vegetales/química , Frutas/químicaRESUMEN
The deep-sea constitutes a true unexplored frontier and a potential source of innovative drug scaffolds. Here, we present the genome sequence of two novel marine actinobacterial strains, MA3_2.13 and S07_1.15, isolated from deep-sea samples (sediments and sponge) and collected at Madeira archipelago (NE Atlantic Ocean; Portugal). The de novo assembly of both genomes was achieved using a hybrid strategy that combines short-reads (Illumina) and long-reads (PacBio) sequencing data. Phylogenetic analyses showed that strain MA3_2.13 is a new species of the Streptomyces genus, whereas strain S07_1.15 is closely related to the type strain of Streptomyces xinghaiensis. In silico analysis revealed that the total length of predicted biosynthetic gene clusters (BGCs) accounted for a high percentage of the MA3_2.13 genome, with several potential new metabolites identified. Strain S07_1.15 had, with a few exceptions, a predicted metabolic profile similar to S. xinghaiensis. In this work, we implemented a straightforward approach for generating high-quality genomes of new bacterial isolates and analyse in silico their potential to produce novel NPs. The inclusion of these in silico dereplication steps allows to minimize the rediscovery rates of traditional natural products screening methodologies and expedite the drug discovery process.
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Sedimentos Geológicos , Poríferos , Streptomyces , Animales , Organismos Acuáticos , Océano Atlántico , Descubrimiento de Drogas , Genoma Bacteriano , Portugal , Secuenciación Completa del GenomaRESUMEN
AIM: Mortality in end-stage renal disease (ESRD) remains high, particularly among elderly, who represents the most rapidly growing segment of the ESRD population in wealthier countries. We developed and validated a risk score in elderly patients to predict 6-month mortality after dialysis initiation. METHODS: We used data from a cohort of 421 patients, aged 65 years and over who started dialysis between 2009 and 2016, in our Nephrology department. The predictive score was developed using a multivariable logistic regression analysis. A bootstrapping technique was used for internal validation. RESULTS: The overall mortality within 6 months was 14.0%. Five independent predictors were identified, and a points system was constructed: age 75 years or older (2 points), coronary artery disease (2), cerebrovascular disease with hemiplegia (2), time of nephrology care before dialysis (<3.0 months [2]; ≥3 to <12 months [1]), and serum albumin levels (3.0-3.49 g/dL [1]; <3.0 g/dL [2]). A score of 6 identified patients with a 70% risk of 6-month mortality. Model performance was good in both discrimination (area under the curve of 0.793; [95% CI 0.73-0.86]) and validation (concordance statistics of 0.791 [95% CI 0.73-0.85]). CONCLUSIONS: We developed a simple prediction score based on readily available clinical and laboratory data that can be a practical and useful tool to assess short-term prognosis in elderly patients starting dialysis. It may help to inform patients and their families about ESRD treatment options and provide a more patient-centered overall approach to care.
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Diálisis/estadística & datos numéricos , Fallo Renal Crónico/mortalidad , Fallo Renal Crónico/terapia , Factores de Edad , Anciano , Estudios de Cohortes , Femenino , Humanos , Incidencia , Masculino , Mortalidad , Portugal/epidemiología , Pronóstico , Estudios Retrospectivos , RiesgoRESUMEN
BACKGROUND: Prenatal ethanol exposure has been shown to reduce nephron endowment in animal models, but the effect of alcohol during human pregnancy on postnatal kidney function has not been explored. We aim to investigate the potential association of maternal alcohol consumption during pregnancy with the offspring renal function, considering potential confounding by intrauterine growth and children's current nutritional status. METHODS: Prospective longitudinal study in a random sample of 1093 children from a population-based birth cohort. Anthropometrics and estimated glomerular filtration rate (eGFR) were assessed at 7 years of age. Multiple linear regression models were fitted, adjusting for child's gender, age, birthweight, and maternal age, education, prepregnancy nutritional status, and smoking. RESULTS: Thirteen percent of mothers consumed alcohol during pregnancy. At 7 years of age, eGFR was significantly lower in children with prenatal alcohol exposure (134 ± 17 vs.138 ± 16 mL/min/1.73m2, p = 0.014). The effect was dose dependent and only present in overweight and obese children, among whom adjusted eGFR was -6.6(-12.0 to -1.1)mL/min/1.73m2 and -11.1(-21.3 to -1.2)mL/min/1.73m2 in those exposed to ≤ 40 g and to > 40 g of alcohol per week, respectively, compared to no consumption (ptrend = 0.002). CONCLUSIONS: Prenatal alcohol exposure has a dose-dependent adverse effect on renal function at school age in overweight and obese children.
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Consumo de Bebidas Alcohólicas/epidemiología , Etanol/efectos adversos , Tasa de Filtración Glomerular/efectos de los fármacos , Obesidad Infantil/epidemiología , Efectos Tardíos de la Exposición Prenatal/epidemiología , Adulto , Niño , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Estudios Longitudinales , Masculino , Embarazo , Estudios ProspectivosRESUMEN
The involvement of aquaporins in rain-induced sweet cherry (Prunus avium L.) fruit cracking is an important research topic with potential agricultural applications. In the present study, we performed the functional characterization of PaPIP1;4, the most expressed aquaporin in sweet cherry fruit. Field experiments focused on the pre-harvest exogenous application to sweet cherry trees, cultivar Skeena, with a solution of 0.5% CaCl2, which is the most common treatment to prevent cracking. Results show that PaPIP1;4 was mostly expressed in the fruit peduncle, but its steady-state transcript levels were higher in fruits from CaCl2-treated plants than in controls. The transient expression of PaPIP1;4-GFP in tobacco epidermal cells and the overexpression of PaPIP1;4 in YSH1172 yeast mutation showed that PaPIP1;4 is a plasma membrane protein able to transport water and hydrogen peroxide. In this study, we characterized for the first time a plasma membrane sweet cherry aquaporin able to transport water and H2O2 that is upregulated by the pre-harvest exogenous application of CaCl2 supplements.
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Acuaporinas/genética , Acuaporinas/metabolismo , Calcio/metabolismo , Frutas/metabolismo , Prunus avium/fisiología , Secuencia de Aminoácidos , Clonación Molecular , Biología Computacional/métodos , Proteínas de Plantas/química , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Análisis de Secuencia de ADNRESUMEN
BACKGROUND: Cherry fruit cracking is a costly problem for cherry growers. The effect of repeated sprayings (gibberellic acid - GA3 ; abscisic acid - ABA; salicylic acid - SA; glycine betaine - GB, and Ascophyllum nodosum - AN) combined with CaCl2 , on 'Sweetheart' cherry fruit-cracking characteristics was investigated. Cracking was quantified in terms of cracking incidence, crack morphology, confocal scanning laser microscopy, cuticular wax content, cell-wall modification, and cuticular wax gene expression. RESULTS: All spray treatments reduced cracking compared with an untreated control (H2 O), with fewer cheek cracks. The least cracking incidence was observed for ABA + CaCl2 - and GB + CaCl2 -treated fruits, indicating an added benefit compared to spraying with CaCl2 alone. In addition, GB + CaCl2 -treated fruits showed higher fruit diameter. ABA + CaCl2 and GB + CaCl2 sprays showed higher wax content and higher cuticle and epidermal thickness compared with the control, including increased expression of wax synthase (ABA + CaCl2 ) and expansin 1 (GB + CaCl2 ). CONCLUSION: In general, factors that improve the cuticle thickness appear to be important at the fruit-coloring stage. At the fruit-ripening stage, larger cell sizes of the epidermis, hypodermis, and parenchyma cells lower cracking incidence, indicating the importance of flexibility and elasticity of the epidermis. © 2020 Society of Chemical Industry.
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Frutas/efectos de los fármacos , Reguladores del Crecimiento de las Plantas/farmacología , Prunus avium/efectos de los fármacos , Cloruro de Calcio/farmacología , Frutas/crecimiento & desarrollo , Regulación de la Expresión Génica de las Plantas , Epidermis de la Planta/efectos de los fármacos , Prunus avium/genética , Prunus avium/fisiologíaRESUMEN
BACKGROUND: Time-trend disparity in adverse pregnancy outcomes according to maternal nationality or immigration status has been well documented. In this study, we investigated time changes in individual-level risk factors for adverse pregnancy outcomes that have not been given the needed attention. OBJECTIVE: To compare 20-year trends in sociodemographic, obstetric, health care factors, and adverse pregnancy outcomes in Portuguese and non-Portuguese women. METHODS: We studied 2 105 497 livebirths from Portuguese national birth registry (1995-2014). We compared maternal sociodemographic characteristics (age, education, employment, and marital status), obstetric, and health care factors (parity, number of foetuses, place and type of delivery) in Portuguese and non-Portuguese at four periods (1995-1999, 2000-2004, 2005-09, and 2010-2014). Time-trend analysis using joinpoint regression method was performed to identify trends (joinpoints) and compare time changes in the prevalence of sociodemographic, obstetric, and health care factors expressed as annual percentage change (APC). RESULTS: The proportion of livebirths in non-Portuguese mothers increased between 1995 and 1999 (2.9%), 2000-2004 (6.3%), 2005-2009 (9.5%), and 2010-2014 (9.8%). The proportion of women aged ≥ 35 years among Portuguese mothers varied from 11.1% (1995-1999), 14.4% (2000-2004), 18.6% (2005-2009) to 25.5% (2010-2014); among non-Portuguese women, the corresponding proportions were 15.7% (1995-1999), 14.6% (2000-2004), 16.1% (2005-2009), and 19.0% (2010-2014), respectively. The rate of change in maternal age ≥ 35 years had 2 joinpoints in both Portuguese (APC = 6.5%, 95% confidence interval [CI] 6.2, 6.9; 2005-2014) and non-Portuguese (3.3%, 95% CI 2.5, 4.0; 2002-2014). Increase in caesarean rate was higher for non-Portuguese (24.0%-36.1%) than the Portuguese (30.6%-31.6%) between 1995 and 2014. CONCLUSIONS: Sociodemographic, obstetric, and health care factors have divergent time trends and rate of change for Portuguese and non-Portuguese.
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Cesárea/estadística & datos numéricos , Parto Obstétrico/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Servicios de Salud Materna/tendencias , Adulto , Femenino , Encuestas de Atención de la Salud , Humanos , Portugal/epidemiología , Embarazo , Resultado del Embarazo , Factores SocioeconómicosRESUMEN
Evidence on the association between mode of delivery and asthma at school age is inconclusive. We assessed the associations between specific modes of delivery and asthma in children from 9 European birth cohorts that enrolled participants between 1996 and 2006. Cohort-specific crude and adjusted risk ratios for asthma at ages 5-9 years were calculated using Poisson regression models and pooled. A sensitivity analysis was carried out in children born at term to reduce confounding due to perinatal factors. The study included 67,613 participants. Cohort-specific rates of cesarean delivery varied from 9.4% to 37.5%. Cesarean delivery, as opposed to vaginal delivery, was associated with an increased risk of asthma (adjusted risk ratio (aRR) = 1.22, 95% confidence interval (CI): 1.02, 1.46). Compared with spontaneous vaginal delivery, the adjusted risk ratio was 1.33 (95% CI: 1.02, 1.75) for elective cesarean delivery, 1.07 (95% CI: 0.94, 1.22) for emergency cesarean delivery, and 0.97 (95% CI: 0.84, 1.12) for operative vaginal delivery. In children born at term, the associations were strengthened only for elective cesarean delivery (aRR = 1.49, 95% CI: 1.13, 1.97). The large sample size allowed analysis of the associations between specific modes of delivery and asthma at school age. The increased risk of asthma associated with elective cesarean delivery, especially among children born at term, is relevant in counteracting the increasing use of this procedure, which is often performed without a clear medical indication.
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Asma/etiología , Cesárea/efectos adversos , Parto Obstétrico/métodos , Asma/epidemiología , Cesárea/estadística & datos numéricos , Niño , Preescolar , Estudios de Cohortes , Parto Obstétrico/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos/efectos adversos , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Europa (Continente)/epidemiología , Humanos , Distribución de Poisson , Prevalencia , Estudios Prospectivos , Nacimiento a TérminoRESUMEN
Highly prevalent and typically beginning in childhood, asthma is a burdensome disease, yet the risk factors for this condition are not clarified. To enhance understanding, this study assessed the cohort-specific and pooled risk of maternal education on asthma in children aged 3-8 across 10 European countries. Data on 47,099 children were obtained from prospective birth cohort studies across 10 European countries. We calculated cohort-specific prevalence difference in asthma outcomes using the relative index of inequality (RII) and slope index of inequality (SII). Results from all countries were pooled using random-effects meta-analysis procedures to obtain mean RII and SII scores at the European level. Final models were adjusted for child sex, smoking during pregnancy, parity, mother's age and ethnicity. The higher the score the greater the magnitude of relative (RII, reference 1) and absolute (SII, reference 0) inequity. The pooled RII estimate for asthma risk across all cohorts was 1.46 (95% CI 1.26, 1.71) and the pooled SII estimate was 1.90 (95% CI 0.26, 3.54). Of the countries examined, France, the United Kingdom and the Netherlands had the highest prevalence's of childhood asthma and the largest inequity in asthma risk. Smaller inverse associations were noted for all other countries except Italy, which presented contradictory scores, but with small effect sizes. Tests for heterogeneity yielded significant results for SII scores. Overall, offspring of mothers with a low level of education had an increased relative and absolute risk of asthma compared to offspring of high-educated mothers.
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Asma/epidemiología , Escolaridad , Madres , Asma/etiología , Niño , Preescolar , Comparación Transcultural , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Edad Materna , Madres/psicología , Madres/estadística & datos numéricos , Prevalencia , Factores de RiesgoRESUMEN
BACKGROUND: Comparable evidence on adiposity inequalities in early life is lacking across a range of European countries. This study investigates whether low maternal education is associated with overweight and obesity risk in children from distinct European settings during early childhood. METHODS: Prospective data of 45 413 children from 11 European cohorts were used. Children's height and weight obtained at ages 4-7 years were used to assess prevalent overweight and obesity according to the International Obesity Task Force definition. The Relative/Slope Indices of Inequality (RII/SII) were estimated within each cohort and by gender to investigate adiposity risk among children born to mothers with low education as compared to counterparts born to mothers with high education. Individual-data meta-analyses were conducted to obtain aggregate estimates and to assess heterogeneity between cohorts. RESULTS: Low maternal education yielded a substantial risk of early childhood adiposity across 11 European countries. Low maternal education yielded a mean risk ratio of 1.58 (95% confidence interval (CI) 1.34, 1.85) and a mean risk difference of 7.78% (5.34, 10.22) in early childhood overweight, respectively, measured by the RII and SII. Early childhood obesity risk by low maternal education was as substantial for all cohorts combined (RII = 2.61 (2.10, 3.23)) and (SII = 4.01% (3.14, 4.88)). Inequalities in early childhood adiposity were consistent among boys, but varied among girls in a few cohorts. CONCLUSIONS: Considerable inequalities in overweight and obesity are evident among European children in early life. Tackling early childhood adiposity is necessary to promote children's immediate health and well-being and throughout the life course.
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Escolaridad , Conducta Materna , Madres , Obesidad Infantil/etiología , Adulto , Preescolar , Comparación Transcultural , Europa (Continente)/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Conducta Materna/psicología , Madres/psicología , Madres/estadística & datos numéricos , Obesidad Infantil/epidemiología , Obesidad Infantil/prevención & control , Embarazo , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Factores SocioeconómicosRESUMEN
OBJECTIVE: We aimed to estimate the extent to which differences in small-for-gestational age (SGA) according to maternal socioeconomic position (SEP) and anthropometrics are accounted for childhood background. METHODS: Adult mothers of singletons (n=6893) recruited in 2005/2006 in Porto, Portugal self-reported data on socio-demographics. Grandparents' education and social class were used to characterise childhood social environment. Maternal education and marital status were used as adult SEP indicators. Height was categorised according to the 10th and 90th percentiles. The odds of SGA according to adult SEP and height were stratified by childhood conditions. RESULTS: SGA (14.5%) was less likely in taller [vs. 10th-90th percentiles: 0.62 (95% confidence interval (CI): 0.46-0.83)], more educated [vs. low: 0.77 (0.65-0.90)] and in married women [vs. single: 0.64 (0.47-0.86)]. No association was found between childhood social conditions and SGA. The protection provided by maternal education was found in women from deprived childhood backgrounds but not in those with more advantage conditions. Shorter women were more likely to deliver SGA babies but the effect was stronger (pinteraction<0.001) in those from least deprived childhood conditions. CONCLUSIONS: Sufficient increase in education seems to overcome disadvantage earlier in life. Other pathological processes might impact physical development beyond social influence, having long lasting effects on SGA.
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Recién Nacido Pequeño para la Edad Gestacional , Madres/estadística & datos numéricos , Clase Social , Medio Social , Adulto , Estatura , Estudios de Cohortes , Escolaridad , Femenino , Humanos , Recién Nacido , Entrevistas como Asunto , Masculino , Estado Civil , Registros Médicos/estadística & datos numéricos , Portugal , Tiempo , Adulto JovenRESUMEN
BACKGROUND: An association between education and preterm delivery has been observed in populations across Europe, but differences in methodology limit comparability. We performed a direct cross-cohort comparison of educational disparities in preterm delivery based on individual-level birth cohort data. METHODS: The study included data from 12 European cohorts from Denmark, England, France, Lithuania, the Netherlands, Norway, Italy, Portugal, and Spain. The cohorts included between 2434 and 99 655 pregnancies. The association between maternal education and preterm delivery (22-36 completed weeks of gestation) was reported as risk ratios, risk differences, and slope indexes of inequality with 95% confidence intervals (CIs). RESULTS: Singleton preterm live delivery proportion varied between 3.7% and 7.5%. There were large variations between the cohorts in the distribution of education and maternal characteristics. Nevertheless, there were similar educational differences in risk of preterm delivery in 8 of the 12 cohorts with slope index of inequality varying between 2.2 [95% CI 1.1, 3.3] and 4.0 [95% CI 1.4, 6.6] excess preterm deliveries per 100 singleton deliveries among the educationally most disadvantaged, and risk ratio between the lowest and highest education category varying from 1.4 [95% CI 1.1, 1.8] to 1.9 [95% CI 1.2, 3.1]. No associations were found in the last four cohorts. CONCLUSIONS: Educational disparities in preterm delivery were found all over Europe. Despite differences in the distributions of education and preterm delivery, the results were remarkably similar across the cohorts. For those few cohorts that did not follow the pattern, study and country characteristics did not explain the differences.
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Consumo de Bebidas Alcohólicas/epidemiología , Escolaridad , Nacimiento Prematuro/epidemiología , Fumar/epidemiología , Factores Socioeconómicos , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/prevención & control , Estudios de Cohortes , Europa (Continente)/epidemiología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Recién Nacido , Embarazo , Nacimiento Prematuro/etiología , Nacimiento Prematuro/prevención & control , Factores de Riesgo , Fumar/efectos adversos , Prevención del Hábito de FumarRESUMEN
INTRODUCTION: Using vital statistics, the Portuguese National Health Plan predicts that 14% of live births will be preterm in 2016. The prediction was based on a preterm birth rise from 5.9% in 2000 to 8.8% in 2009. However, the same source showed an actual decline from 2010 onwards. To assess the plausibility of national preterm birth trends, we aimed to compare the evolution of preterm birth and low birthweight rates between vital statistics and a hospital database. MATERIAL AND METHODS: A time-trend analysis (2004-2011) of preterm birth (<37 gestational weeks) and low birthweight (<2500 g) rates was conducted using data on singleton births from the national birth certificates (n = 801,783) and an electronic maternity unit database (n = 21,392). Annual prevalence estimates, ratios of preterm birth:low birthweight and adjusted prevalence ratios were estimated to compare data sources. RESULTS: Although the national prevalence of preterm birth increased from 2004 (5.4%), particularly between 2006 and 2009 (highest rate was 7.5% in 2007), and decreased after 2009 (5.7% in 2011), the prevalence at the maternity unit remained constant. Between 2006 and 2009, preterm birth was almost 1.4 times higher in the national statistics (using the national or the catchment region samples) than in the maternity unit, but no differences were found for low birthweight. CONCLUSION: Portuguese preterm birth prevalence seems biased between 2006 and 2009, suggesting that early term babies were misclassified as preterm. As civil registration systems are important to support public health decisions, monitoring strategies should be taken to assure good quality data.
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Nacimiento Prematuro/epidemiología , Adulto , Certificado de Nacimiento , Peso al Nacer , Bases de Datos Factuales , Femenino , Humanos , Recién Nacido , Portugal/epidemiología , Embarazo , Prevalencia , Estadísticas VitalesRESUMEN
To evaluate whether public and private prenatal care users experience similar outcomes, taking into consideration maternal pre-pregnancy social and clinical risk. We studied 7,325 women who delivered single newborns at five public maternity units in Porto, Portugal. Health behaviors and prenatal care were self-reported; pregnancy complications and delivery data were retrieved from medical files. The odds of inadequate weight gain, continuing to smoke, gestational hypertension, gestational diabetes, caesarean section, preterm birth, low birthweight, and small- and large-for-gestational-age were estimated for public and private providers using logistic regression, stratified by pre-pregnancy risk profile, adjusted for maternal characteristics. 38 % of women used private prenatal care. Among low-risk women, public care users were more likely to gain excessive weight (OR 1.26; 95 % CI 1.06-1.57) and be diagnosed with gestational diabetes (OR 1.37; 95 % CI 1.01-1.86). They were less likely to have a caesarean (OR 0.63; 95 % CI 0.51-0.78) and more likely to deliver small-for-gestational-age babies (OR 1.48; 95 % CI 1.19-1.83). Outcomes were similar in high-risk women although preterm and pre-labor caesarean were less frequent in public care users (OR 0.64 95 % CI 0.45-0.91; OR 0.69 95 % CI 0.49-0.97). The amount of care was not significantly related to risk profile in either case. Public care users experienced similar outcomes to those using private care, despite higher pre-pregnancy disadvantage. Low-risk women need further attention if narrowing inequalities in birth outcomes remains a priority.
Asunto(s)
Hospitales Privados , Hospitales Públicos , Servicios de Salud Materna/organización & administración , Evaluación de Resultado en la Atención de Salud , Resultado del Embarazo , Atención Prenatal/métodos , Adulto , Cesárea/estadística & datos numéricos , Diabetes Gestacional/epidemiología , Femenino , Edad Gestacional , Humanos , Hipertensión Inducida en el Embarazo/epidemiología , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Edad Materna , Portugal/epidemiología , Embarazo , Complicaciones del Embarazo , Atención Prenatal/estadística & datos numéricos , Factores de Riesgo , Aumento de PesoRESUMEN
BACKGROUND: Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. OBJECTIVES: We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). METHODS: First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age <37 weeks) and low birth weight (<2500 g) with childhood asthma outcomes. RESULTS: Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P < .05). The inverse associations of birth weight with childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27). CONCLUSION: Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth.
Asunto(s)
Asma , Peso al Nacer , Edad Gestacional , Nacimiento Prematuro , Aumento de Peso , Asma/epidemiología , Asma/patología , Asma/fisiopatología , Europa (Continente)/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/patología , Nacimiento Prematuro/fisiopatología , Factores de RiesgoRESUMEN
Septic arthritis of the temporomandibular joint (SATMJ), primarily caused by bacterial infections, is a rare condition with a diverse etiology that is inadequately documented in the literature, resulting in the absence of standardized treatment protocols. Its nonspecific clinical presentation often leads to misdiagnosis as other temporomandibular disorders, delaying diagnosis and treatment and potentially causing severe complications in the absence of established therapeutic guidelines. The main objective of this article is to report a case of a 61-year-old female with diabetes who was undergoing prolonged corticosteroid therapy and presented with pain, swelling in the right pre-auricular area, and progressive limitation in mouth opening, with no history of facial trauma, where the early diagnosis and isolation of Staphylococcus aureus after a single-port arthrocentesis prompted the timely adjustment of the treatment regimen, significantly influencing the outcome by mitigating the risk of complications. Additionally, this report includes a comprehensive literature review, highlighting the crucial importance of this prompt intervention to achieve a favorable clinical outcome.
RESUMEN
Capillary intraosseous hemangioma is a benign vascular neoplasm that affects bone tissue, yet its occurrence in the jaw bones has been seldom reported in the literature. We present a case of a capillary intraosseous hemangioma located in the mandibular symphysis of a 28-year-old male. Initially addressed by the patient's dentist as an infectious lesion of endodontic origin, the sudden worsening of the condition, marked by the development of a rapidly expanding exophytic mandibular lesion and tooth mobility, led to the consideration of various potential diagnoses. Subsequently, an incisional biopsy was performed, triggering multiple episodes of recurrent bleeding, leading to several visits to the emergency department, and prompting an urgent status upgrade for the patient. Upon the histological diagnosis of vascular neoplasm, the patient underwent the excision of the lesion, with a favorable and uneventful evolution, although with expected sequelae. As a result, a temporary prosthetic solution, comprising a Maryland Bridge, was implemented, with plans for guided bone regeneration and implant-supported fixed dental prostheses currently in progress. This case underscores the diagnostic and therapeutic challenges associated with this rare condition. Consequently, achieving the optimal outcome for the patient largely depends on a multidisciplinary approach, emphasizing the critical importance of thorough preoperative assessment, along with a well-devised treatment plan and rapid intervention.
RESUMEN
Gastric heterotopia is characterized by the presence of mature gastric tissue outside the stomach, yet its occurrence in the palate has not been previously documented. We describe a case of gastric heterotopia in the hard palate of an elderly female patient, presenting as a swollen mass with associated secretion. Given the patient's age and clinical symptoms, a presumptive diagnosis of a malignant tumor originating from the minor salivary glands was made. An incisional biopsy of the mass revealed gastric heterotopia. Subsequently, the extended excision of the lesion was performed, leading to the full resolution of the patient's symptoms. After a two-year follow-up period, no evidence of recurrence was observed. The importance of this case, underscored by the unprecedented location of gastric heterotopia, emphasizes the critical need for thorough evaluation to avert misdiagnosis, as well as the complete surgical excision of the lesion to prevent recurrence.