SARS-CoV-2 Antibody Prevalence in the Portuguese Municipality of Vila Nova de Gaia after the First Wave of the Pandemic.

INTRODUCTION: Assessment of SARS-CoV-2 seroprevalence may detect the real spread of the virus because antibody data can provide a long-lasting measure of infection. Existing serological studies in Portugal have tested new serology methods, albeit with small sample sizes and a lack the focus on geographical regions with a high rate of infection cases. The aim of this study was to estimate the serological prevalence of SARS-CoV-2 in Vila Nova de Gaia, the most populous municipality in the north of Portugal and one of those most affected during the first pandemic wave. MATERIAL AND METHODS: A cross-sectional observational study was conducted between June 23rd and July 17th, 2020. Included in the cohort were 18- to 74-year-old men and women living in the municipality of Vila Nova de Gaia, who were sampled through a nonprobabilistic quota-based approach. Cases with a previous RT-PCR diagnosis of COVID-19 were excluded. Sociodemographic and clinical information was collected using a self-administered, written questionnaire. Blood samples were collected for serological laboratory analysis to detect and quantify SARS-CoV-2 anti-IgG antibodies. RESULTS: We tested 2754 participants. Our results show a SARS-CoV-2 seroprevalence of 3.03% (95% confidence interval: 2.37% - 3.87%). Being a smoker (odds ratio: 0.382, 95% confidence interval: 0.147 - 0.99) and having symptoms of COVID-19 (odds ratio: 2.480, 95% confidence interval: 1.360 - 4.522) were consistently associated with lower and higher odds of SARS-CoV-2 antibody presence, respectively, regardless of the analytic design. Moreover, without adjusting for any variables, having had contact with an infected person within the household was associated with increased odds of a positive test (odds ratio: 9.684, 95% confidence interval: 4.06 - 23.101); after adjusting, having self-reported chronic diseases (odds ratio: 0.448, 95% confidence interval: 0.213 - 0.941) was associated with decreased odds. CONCLUSION: This was the first study to estimate the serological prevalence of SARS-CoV-2 in one of the most populous municipalities in Portugal, representing the first step in the development of an epidemiological surveillance system in Portugal, which can help to improve the diagnosis of COVID-19.

Persistence of IgG COVID-19 antibodies: A longitudinal analysis.

Background and aim: The kinetics of antibody production in response to coronavirus disease 2019 (COVID-19) infection is not well-defined yet. This study aimed to evaluate the antibody responses to SARS-CoV-2 and its dynamics during 9-months in a cohort of patients infected during the first phase of the pandemic. As a secondary aim, it was intended to evaluate the factors associated with different concentrations of IgG antibodies. Methods: A prospective cohort study was conducted from June 2020 to January 2021. This study recruited a convenience sample of adult individuals who where recently diagnosed with COVID-19 and were living in mainland Portugal. A total of 1,695 blood samples were collected from 585 recovered COVID-19 patients up to 9 months after SARS-CoV-2 acute infection. A blood sample was collected at baseline and three, 6 and 9 months after SARS-CoV-2 acute infection to assess the concentration of IgG antibody against SARS-CoV-2. Results: The positivity rate of IgG reached 77.7% in the first 3 months after symptom onset. The IgG persists at all subsequent follow-up time-points, which was 87.7 and 89.2% in the 6th and 9th months after symptom onset, respectively. Three distinct kinetics of antibody response were found within the 9 months after infection. Kinetic 1 (K1) was characterized by a constant low IgG antibody concentration kinetic (group size: 65.2%); kinetic 2 (K2), composed by constant moderate IgG kinetic (group size: 27.5%) and kinetic 3 (K3) characterized by higher IgG kinetic (group size: 7.3%). People with ≥56 years old (OR: 3.33; CI 95%: [1.64; 6.67]; p-value: 0.001) and symptomatic COVID-19 (OR: 2.08; CI 95%: [1.08; 4.00]; p-value: 0.031) had higher odds of a "Moderate IgG kinetic." No significant association were found regarding the "Higher IgG kinetic." Conclusion: Our results demonstrate a lasting anti-spike (anti-S) IgG antibody response at least 9 months after infection in the majority of patients with COVID-19. Younger participants with asymptomatic disease have lower IgG antibody positivity and possibly more susceptible to reinfection. This information contributes to expanding knowledge of SARS-CoV-2 immune response and has direct implications in the adoption of preventive strategies and public health policies.

[The Epidemiology of Dementia and Alzheimer Disease in Portugal: Estimations of Prevalence and Treatment-Costs]. / Epidemiologia da Demência e da Doença de Alzheimer em Portugal: Estimativas da Prevalência e dos Encargos Financeiros com a Medicação.

INTRODUCTION: The incidence and prevalence of global dementia and Alzheimer's disease (AD) increase with age, almost doubling every five years after the sixth decade of life. Demographic aging is a reality in Portugal, being expectable that the number of dementia cases also increases. Even so, dementia-epidemiological data in Portugal is scarce and cost-of-illness studies are almost inexistent. Our aims were to obtain up-to-date information about the prevalence of dementia/ Alzheimer's disease in Portugal, to estimate the number of cases effectively diagnosed as Alzheimer's disease and to determine illness-costs with specific dementia treatment. MATERIAL AND METHODS: The numbers of age-adjusted prevalence of dementia obtained for Occidental Europe (Alzheimer's Disease International study), where applied to the resident population in Portugal (2013). Estimations related to diagnosis and treatment-costs were based in data provided by the Intercontinental Marketing Services Health (IMSH)-2013. RESULTS: The estimated number of Portuguese people with dementia among those aged ≥60 years, is 160,287, representing 5.91% of this population-stratum. Knowing Alzheimer's disease is responsible for 50-70% of all cases, we might conclude there are between 80,144 and 112,201 patients. According to IMSH-data, 76250 receive anti-dementia drugs and the costs of this kind of medication is 37 M€¬/year. CONCLUSIONS: As a consequence of the demographic aging, also the number of dementia cases increases. Apparently, not all Alzheimer's disease patients receive the recommended medication, suggesting this condition is still under-diagnosed. However, figures indicate a positive progression with an increment of treated cases and a reduction of medication-costs.

Introdução: A incidência e prevalência de demência e de Doença de Alzheimer aumentam com a idade, duplicando a cada cinco anos após a sexta década de vida. Portugal é um país envelhecido, previsivelmente com um número crescente de casos de demência. No entanto, os dados epidemiológicos são escassos e os estudos sobre os custos da doença praticamente inexistentes. Propomo-nos apresentar uma estimativa actualizada da prevalência de demência/ Doença de Alzheimer em Portugal e inferir, a partir da prescrição específica para demência, o número de diagnósticos efectivos e os encargos financeiros com esses medicamentos.Material e Métodos: ÃÄ população residente em Portugal (2013), aplicámos os valores de prevalência de demência para a Europa Ocidental (estudo da AlzheimerâÄôs Disease International). A estimativa dos diagnósticos efectivos de Doença de Alzheimer e dos encargos financeiros com medicação específica baseou-se nas informações do Intercontinental Marketing Services Health (IMSH) âÄì 2013.Resultados: O número estimado de Portugueses com mais de 60 anos e com demência foi 160287, o que corresponde a 5,91% deste universo populacional. Sabendo que a Doença de Alzheimer representa 50-70% dos casos, inferimos que existirão entre 80144 e 112201 doentes. Por outro lado, os dados da IMSH indicam que estarão diagnosticados e a receceber anti-demenciais 76250 doentes, representando um encargo financeiro de 37 MâǬ/ano.Conclusão: O envelhecimento da população incrementa o número de casos de demência. Aparentemente, nem todos os doentes com Doença de Alzheimer recebem a medicação aconselhada, sugerindo que esta condição ainda está sub-diagnosticada. A evolução tem sido positiva, com incremento do número de doentes tratados e redução dos custos com fármacos específicos.

Peacock bass mortality associated with catch-and-release sport fishing in the Negro River, Amazonas State, Brazil / Mortalidade de tucunaré associada à pesca esportiva do pesque e solte no rio Negro, Amazonas, Brasil

Sport fishing for peacock bass Cichla spp. in the Brazilian Amazon has increased in popularity and attracts anglers who generate significant economic benefits in rural regions. The sustainability of this fishery is partly dependent on the survival of fish caught through catch-and-release fishing. The objective of this work was to investigate, hooking mortality of Cichla spp., including speckled peacock bass (C. temensis Humbolt), butterfly peacock bass (C. orinocensis Humbolt), and popoca peacock bass (C. monoculus Agassiz) in the basin of the Negro River, the largest tributary of the Amazon River. Fish were caught at two different sites using artificial lures, transported to pens anchored in the river and monitored for 72 hours. A total of 162 individual peacock bass were captured and hooking mortality (mean % ± 95% confidence intervals) was calculated. Mean mortality was 3.5% (± 5.0), 2.3% (± 3.5) and 5.2% (± 10.2) for speckled peacock bass, butterfly peacock bass, and popoca peacock bass, respectively. Lengths of captured fish ranged from 26 to 79 cm (standard length), however, only fish under 42 cm died. This research suggests that catch-and-release sport fishing of peacock bass does not result in substantial mortality in the Negro River basin.

A pesca esportiva de tucunarés Cichla spp., na Amazônia brasileira, aumentou em popularidade nos últimos anos e tem atraído pescadores esportivos que geram benefícios econômicos para essa região. Entretanto, a sustentabilidade dessa pescaria depende em parte da sobrevivência dos peixes capturados por meio da prática do pesque e solte. O objetivo deste trabalho foi avaliar a mortalidade de Cichla spp., incluindo o tucunaré paca (C. temensis Humbolt), o borboleta (C. orinocensis Humbolt) e o popoca (C. monoculus Agassiz) em dois locais na bacia do rio Negro, o maior tributário do rio Amazonas. Os peixes foram capturados por variados tipos de iscas artificiais e posteriormente monitorados em viveiros construídos no próprio rio por 72 horas. Um total de 162 tucunarés foi capturado, e as mortalidades (% ± intervalo de confiança 95%) foram calculadas. A mortalidade foi 3,5% (± 5,0), 2,3% (± 3,2) e 5,2% (±10,2) para o paca, o borboleta e o popoca, respectivamente. O comprimento padrão dos peixes capturados variou de 26 a 79 cm, mas apenas os peixes menores até 42 cm morreram. A pesquisa sugere que a pesca esportiva não causou substancial mortalidade na população de Cichla spp. na bacia do rio Negro.

Functionalization of polydimethylsiloxane membranes to be used in the production of voice prostheses.

The voice is produced by the vibration of vocal cords which are located in the larynx. Therefore, one of the major consequences for patients subjected to laryngectomy is losing their voice. In these cases, a synthetic one-way valve set (voice prosthesis) can be implanted in order to allow restoration of speech. Most voice prostheses are produced with silicone-based materials such as polydimethylsiloxane (PDMS). This material has excellent properties, such as optical transparency, chemical and biological inertness, non-toxicity, permeability to gases and excellent mechanical resistance that are fundamental for its application in the biomedical field. However, PDMS is very hydrophobic and this property causes protein adsorption which is followed by microbial adhesion and biofilm formation. To overcome these problems, surface modification of materials has been proposed in this study. A commercial silicone elastomer, SylgardTM 184 was used to prepare membranes whose surface was modified by grafting 2-hydroxyethylmethacrylate and methacrylic acid by low-pressure plasma treatment. The hydrophilicity, hydrophobic recovery and surface energy of the produced materials were determined. Furthermore, the cytotoxicity and antibacterial activity of the materials were also assessed. The results obtained revealed that the PDMS surface modification performed did not affect the material's biocompatibility, but decreased their hydrophobic character and bacterial adhesion and growth on its surface.

Depression in patients with myocardial infarction.

The role of depression in cardiovascular disease is increasingly emphasized. Whether it precedes or follows coronary events, it is an obstacle to adherence to preventive measures and physical recovery. Between January and November 2005, we interviewed 82 patients admitted to a central hospital, with a discharge diagnosis of acute myocardial infarction (MI), and assessed them on a depression scale as outpatients. The characteristics of the sample were as expected in terms of known and revised risk factors. We also observed gender differences. We found moderate depression (significantly correlated with known psychosocial risk factors and depressive symptoms) in 36% of the subjects, and severe depression in 14% (positively and significantly associated with family conflict, anger-in, restlessness, type A personality, social isolation and sedentarism). The predictors of high scores on the scale were female gender, sedentarism, social isolation, sleep disturbances, family conflict, and low socioeconomic status.

[Psychotropic drugs and sudden death]. / Psicofármacos e morte súbita.

Sudden death associated with psychotropic drugs is an issue in clinical practice which is currently debated worldwide in the literature. The objective of this work is to review recent literature on the issue (up to the end of 2004). The literature focuses mainly on the association between unexplained sudden death and antipsychotics and, to a lesser degree, tricyclic antidepressants; there are few references to other classes of psychotropic drugs. Over the last few decades various causal mechanisms have been proposed. However, recent literature refers mostly to sudden cardiac death induced by arrhythmias, and discusses, as a possible mechanism, the prolongation of the QTc interval due to the inhibition of potassium channels, leading to the risk of developing torsade de pointes which can result in sudden death. Although these cases of sudden death are rare, associated risk factors are also discussed because it is believed that a combination of several of these factors may increase the risk. We go on to consider recommendations to diminish the risk of sudden death. Finally, we review sudden death cases that have occurred in the last 5 years in the Acute Psychiatric Ward of S. Francisco Xavier Hospital (January 1999 to December 2004).

Chromium-induced toxic hepatitis.

A clinical case of acute hepatitis in a patient undergoing an alternative medicine weight-reduction regimen is reported. Chromium polynicotinate had been ingested in combination with vegetable extracts over a 5-month period. Liver biopsy was compatible with toxic hepatitis and greatly elevated hepatic chromium levels were found (>10x normal). The clinical picture regressed following suspension of the medication.

Inquérito tuberculínico: estudo realizado em portadores de uveítes, esclerites e episclerites de causa endógena / Tuberculin inquiry: study performed in patients with uveitis, scleritis and episscleritis due to endogenous cause

Foi realizada a prova tuberculínica (PPD Rt 23-2 UT - Mantoux) em 180 portadores de lesöes uveais, esclerais, episclerais de causa endógena, com finalidade de avaliar a hiperergia dos indivíduos (39) portadores de lesöes sugestivas de etiologías tuberculosa em relaçäo aos portadores (141) de lesöes devidas a outras etiologias, agrupadas segundo criteriosa avaliaçäo clínica. Os primeiros apresentaram resultados com mínimo de 15mm, máximo 30mm, média 21mm, desvio-padräo 4mm; os restantes com mínimo de zero, máximo 20mm, média 6mm, desvio-padräo 7mm. A mesma prova foi realizada em 180 indivíduos sadios resultado mínimo de zero, máximo 21mm, média 6mm, desvio-padräo 7mm. Indivíduos adultos (média 35 anos), melanodérmicos, com relato de contato com doente tuberculoso foram variáveis com influência nos resultados da prova. Esses parâmetros, verificados pela pesquisa, associada aos já clássicos na literatura determinam a estruturaçäo clínica do raciocínio-diagnóstico de tuberculose ocular em nosso meio

Controvérsias nas uvéites tuberculosas / Controversy in tuberculous uveitis

Neste trabalho, os autores pretendem mostrar, através de dados epidermiológicos, da clínica dos exames laboratoriais, da anatomia patológica e tratamento específico, a grande importância da tuberculose como uma das etiologias da uveíte em nosso meio. Deste modo, foi apresentado um estudo de pacientes (132) com tuberculose, dentro de um Sanatório, comparado com pacientes (150) normais; estudo do teste tuberculínico em um grupo de pacientes com lesöes oculares sugestivas de tuberculose; um grupo de pacientes com lesöes näo sugestivas de tuberculose e um grupo controle; e por fim, estudou-se 1 caso de tuberculose pulmonar ativa; 1 caso de tuberculose pulmonar cicatrizada; 1 caso de tuberculose miliar; 1 caso de tuberculose ganglionar e 1 caso de tuberculose cicatrizada com BAAR positiva no olho centralateral enucleado. Todos os casos apresentavam envolvimento inflamatório uveal ativo e em todos eles o tratamento tuberculostático teve pleno êxito