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Summary: Background. Vespula spp. and Polistes spp. are relevant species in South Europe, with Vespa velutina nigrithorax (VVN) being considered a public health problem. We aimed to characterize a cohort of Portuguese patients referred for large local reaction (LLR) and/or systemic reaction (SR) to vespids. In patients treated with venom immunotherapy (VIT), induction protocol and frequency of adverse reactions were evaluated. Methods. Retrospective study including patients with LLR and SR to vespids referred to our Immunoallergology Department (2008-2022). Results. A total of 129 patients were evaluated, the majority were male adults (n = 77, 59.7%), from rural areas. From these, 51 patients had SR (Mueller classification: 7.8% grade I, 19.6% grade II, 37.3% grade III, 35.3% grade IV). We found no differences regarding the levels of total serum IgE, basal serum tryptase value, sIgE levels to the eliciting venom or their molecular components, regarding the severity of the SR that motivated the referral to our clinic. In the SR group, previous LLR Hymenoptera sting were reported in 15.7%. Thirty-eight patients (74.5%) initiated VIT: 22 with wasp venom, 14 with paper wasp venom and 2 with Vespa velutina venom. There was one mild systemic reaction, not requiring adrenaline and 4 LLR. Re-stings after VIT occurred in 16 patients, without any systemic or local reactions. Currently, eleven patients remain under VIT. Conclusions. Most vespid-venom allergic patients are male adults from rural areas. Sensitization to wasp venom was present in 52.9%, paper wasp in 33.3% and Vespa velutina in 13.7%. The frequency of adverse reactions during both induction and maintenance phases appears to be low. Despite a reduced sample size, our experience with VVN VIT, suggests its safety.
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Summary: Background. Grass and olive pollens have overlapping pollination periods and are common allergens in the Iberian Peninsula. The objective is to determine the sensitization pattern to major Phleum pratense and Olea europaea pollens in the Portuguese population with pollen allergic rhinitis (AR) using molecular allergen diagnosis (MAD). Methods. Seasonal AR patients (≥ 12 years), with positive skin prick tests (SPT) to Phleum and Olea were recruited from 16 centers. Using ALEX2, specific IgE to Phl p1, Phl p2, Phl p5, Phl p6, Phl p7, Phl p 12, Ole e1, Ole e7 and Ole e9 were determined. Immunoblotting of Olea allergic patients was performed. Results. Included 175 patients (55.4% female; mean age 31.6 ± 13.3 years; 85.7% adults; 40% asthmatic, Coast 28%/Inland 72% and North 29.1%/Centre 20.6%/South 50.3%). Considering Phleum MAD, 85.7% were sensitized to Phl p1, 45.7% to Phl p2, 50.3% to Phl p5, 45.7%, to Phl p6, 10.9% to Phl p7 and 22.9% to Phl p12. Sensitization to Ole e1 was found in 56.6%, to Ole e7 in 1.7% and Ole e9 in 3.4% patients. Sensitization to Phl p7 was more frequent in asthmatics (17.4% vs 6.6%; p = 0.044). Sensitization to Phl p5, Phl p6, Phl p12 and Ole e1 was more frequent in inland. Regarding sensitization patterns: 53.1% patients were sensitized to both species genuine´ sIgE, 38.3% to Phleum and 3.4% only to Olea species' sIgE. Immunoblotting of Olea allergic patients showed a high intensity band that may correspond to Ole e12. Conclusions. MAD showed "genuine" Grass and Olea sensitization in approximately 50% of our patients.
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In this study, we discuss the removal of fluoride from water through column adsorption methods using Al(OH)3@AC as a functional granular activated carbon. The height of the bed, fluoride concentration, and flow rate are the experimental factors used to obtain the breakthrough curves. As the flow rate increased, the breakthrough and saturation times decreased. The analysis of simplified column models, such as the Adams-Bohart, Thomas, and Yoon-Nelson models, revealed that the Clark model best described the adsorption process when fitting the experimental data. The obtained breakthrough curves agreed with the corresponding experimental data. The highest capacity for adsorption obtained during the column procedure was found to be 41.84 mg g-1 with a bed height of 3 cm, an initial fluoride concentration of 10 mg L-1 and a flow rate of 7.5 mL min-1.
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Summary: Background. Non-steroidal anti-inflammatory drugs (NSAID)/analgesics (paracetamol) are among the most common causes of drug hypersensitivity reactions in children, with a reported prevalence of around 0.3% in the pediatric population. Paracetamol and ibuprofen are the most commonly reported culprits in the pediatric population. Our objective was to describe the allergy workup to NSAID/paracetamol of a pediatric population monitored in an allergy outpatient clinic. Methods. Retrospective observational study by consulting the medical records of patients evaluated in a pediatric outpatient clinic with history of NSAID/paracetamol, between January 2016 to August 2022. Results. A total of 43 patients have been evaluated for NSAID/paracetamol suspected allergy: 53.5% females, mean age of 9.8 ± 5.1 years, 47.7% atopic. The drugs reported as culprits were: ibuprofen (75.6%), paracetamol (17.8%), metamizole (4.4%) and naproxen (2.2%) and clinical manifestations were mainly urticaria/angioedema and maculopapular exanthema. Skin tests were performed in 7 patients: paracetamol (n = 5) and metamizole (n = 2), which were all negative. Fourty-six drug provocation tests were performed: 28 with the culprit drug and 18 with an alternative one; only 2 were positive (ibuprofen - culprit NSAID group): one immediate periorbital angioedema and one delayed lip edema with oropharyngeal tightness. Conclusions. The investigation of allergy to NSAID/paracetamol in children remains a challenge. In our population, ibuprofen was the most common NSAID reported. There were only 2 (4.3%) mild reactions on DPT. We could allow the use of the culprit NSAID/analgesic in 11 patients and an alternative one in 9 patients. This study highlights the importance of DPT in children for a correct diagnosis of NSAID hypersensitivity and selection of an alternative drug.
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Venenos de Artrópodes , Hipersensibilidade , Vespas , Animais , Humanos , Portugal/epidemiologia , Venenos de VespasRESUMO
Summary: Hereditary angioedema (HAE) poses a high burden of disease, being its epidemiological and clinical data heterogeneous among countries, with no recent published studies concerning Portuguese patients. Therefore, we aimed to raise awareness of HAE and to contribute to clinical knowledge. An observational, descriptive, retrospective, and cross-sectional study was performed, that included a cohort of 126 patients followed in a single Portuguese Center. We observed a high prevalence of HAE-C1-INH type II (45.2% of patients). Most HAE patients (67.4%) presented the initial manifestations of the disease before adulthood, at a mean age of 12.6 ± 8.4 years. However, we found a long delay in HAE diagnosis, especially in those without family history (mean 20.7 ± 17.3 years). Stress was the most common trigger, followed by trauma and infection. Symptoms involving different systems were increasingly reported with increased disease duration. Cutaneous symptoms (95.0%) were more frequent, followed by gastrointestinal (80.7%), and respiratory symptoms (50.4%). HAE symptoms led to abdominal surgery in 22 (17.5%) patients and induced laryngeal edema requiring intubation/tracheostomy in 8 (6.3%) patients. Most patients were under long-term prophylaxis, mainly with attenuated androgens (62.7% of patients).The correct distinction between HAE and other common causes of angioedema is critical, allowing reduction of diagnostic delay, improvement of adequate management, and ultimately improving outcomes and quality of life of HAE patients.
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During 2019-2020, the Virgin Islands Department of Health investigated potential animal reservoirs of Leptospira spp., the bacteria that cause leptospirosis. In this cross-sectional study, we investigated Leptospira spp. exposure and carriage in the small Indian mongoose (Urva auropunctata, syn: Herpestes auropunctatus), an invasive animal species. This study was conducted across the three main islands of the U.S. Virgin Islands (USVI), which are St. Croix, St. Thomas, and St. John. We used the microscopic agglutination test (MAT), fluorescent antibody test (FAT), real-time polymerase chain reaction (lipl32 rt-PCR), and bacterial culture to evaluate serum and kidney specimens and compared the sensitivity, specificity, positive predictive value, and negative predictive value of these laboratory methods. Mongooses (n = 274) were live-trapped at 31 field sites in ten regions across USVI and humanely euthanized for Leptospira spp. testing. Bacterial isolates were sequenced and evaluated for species and phylogenetic analysis using the ppk gene. Anti-Leptospira spp. antibodies were detected in 34% (87/256) of mongooses. Reactions were observed with the following serogroups: Sejroe, Icterohaemorrhagiae, Pyrogenes, Mini, Cynopteri, Australis, Hebdomadis, Autumnalis, Mankarso, Pomona, and Ballum. Of the kidney specimens examined, 5.8% (16/270) were FAT-positive, 10% (27/274) were culture-positive, and 12.4% (34/274) were positive by rt-PCR. Of the Leptospira spp. isolated from mongooses, 25 were L. borgpetersenii, one was L. interrogans, and one was L. kirschneri. Positive predictive values of FAT and rt-PCR testing for predicting successful isolation of Leptospira by culture were 88% and 65%, respectively. The isolation and identification of Leptospira spp. in mongooses highlights the potential role of mongooses as a wildlife reservoir of leptospirosis; mongooses could be a source of Leptospira spp. infections for other wildlife, domestic animals, and humans.
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Reservatórios de Doenças/microbiologia , Herpestidae/microbiologia , Leptospira/isolamento & purificação , Testes de Aglutinação , Animais , Estudos Transversais , Herpestidae/fisiologia , Humanos , Espécies Introduzidas/estatística & dados numéricos , Rim/microbiologia , Leptospira/genética , Leptospira/imunologia , Leptospirose/microbiologia , Leptospirose/transmissão , Filogenia , Ilhas Virgens AmericanasRESUMO
Mongooses, a nonnative species, are a known reservoir of rabies virus in the Caribbean region. A cross-sectional study of mongooses at 41 field sites on the US Virgin Islands of St. Croix, St. John, and St. Thomas captured 312 mongooses (32% capture rate). We determined the absence of rabies virus by antigen testing and rabies virus exposure by antibody testing in mongoose populations on all three islands. USVI is the first Caribbean state to determine freedom-from-rabies for its mongoose populations with a scientifically-led robust cross-sectional study. Ongoing surveillance activities will determine if other domestic and wildlife populations in USVI are rabies-free.
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Animais Selvagens/virologia , Reservatórios de Doenças/virologia , Herpestidae/virologia , Vírus da Raiva/isolamento & purificação , Animais , Estudos Transversais , Vírus da Raiva/classificação , Vírus da Raiva/genética , Ilhas Virgens AmericanasRESUMO
This paper presents the results of research on the initial teacher training in Spain. The aim is to verify whether the development of a training program for teachers based on methodological and epistemological aspects has a positive repercussion on the learning of secondary school pupils. We evaluated to what degree this training was reflected in secondary education pupils (n = 467, Mage = 14.74, SD = 1.97) taught by the participating trainee teachers during their period of teaching practice. A pretest and a postest were employed to obtain data on the methodology and the motivation and perceived learning on the part of the pupils. A confirmatory factor analysis was carried out to verify the validity and internal consistency of the tools and, later, the longitudinal invariance in each of the dimensions analyzed. The results confirm the internal consistency and validity of the tools employed and the improvement in the pupils' evaluation regarding methodology, motivation, and learning.
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BACKGROUND AND OBJECTIVES: To analyze component-resolved diagnosis of sensitization to Dermatophagoides pteronyssinus (Der p) in patients with respiratory allergy and the association between diagnostic findings and clinical severity in different geographical areas. METHODS: The study population comprised 217 patients (mean age, 25.85 [12.7] years; 51.16% female) selected from 13 centers in Portugal (5 from the North, n=65). All had allergic rhinitis with or without asthma and positive skin prick test results to at least 1 dust mite. Specific IgE (sIgE) to Der p, Dermatophagoides farinae, Lepidoglyphus destructor, Der p 1, Der p 2, Der p 10, and Der p 23 was determined using ImmunoCAP. The Mann-Whitney test was applied for the following comparisons: rhinitis vs rhinitis and asthma; mild vs moderate-to-severe rhinitis; North vs South. RESULTS: The prevalence of sensitization was 98.2% for Der p, and 72.4%, 89.4%, 9.7%, and 77% for Der p 1, Der p 2, Der p 10, and Der p 23, respectively. The corresponding median sIgE levels were 8.56, 17.7, 0.01, and 3.95 kUA/L. sIgE to all allergens was higher in patients with moderate-to-severe rhinitis and rhinitis with asthma (nonsignficant). Concentrations of sIgE to Der p 2 were significantly higher in the South than in the North (P=.0496). CONCLUSION: The most common sensitization in Portugal was to Der p. The highest prevalence and median sIgE level were observed for Der p 2. All sIgE values for molecular components were higher in more symptomatic patients (nonsignificant). Concentrations of sIgE to Der p 2 were higher in the South, probably because of the warmer temperature and/or the larger sample size.
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Antígenos de Dermatophagoides , Dermatophagoides pteronyssinus , Adulto , Alérgenos , Animais , Poeira , Feminino , Humanos , Imunoglobulina E , Masculino , Portugal/epidemiologia , Testes Cutâneos/métodosRESUMO
The main objective of this article is to analyze the cognitive level of the activities in History textbooks in Spain, England, and Portugal in the transition stage from Primary to Secondary Education (11-13 years), according to the country of origin, typology, and the concepts and disciplinary contents included. The design of this research is quantitative, descriptive, and cross-sectional. The non-probabilistic sample consists of 6,561 activities contained in 27 school textbooks from Spain, England, and Portugal. Descriptive and contrast analyses have been carried out using parametric tests. The results indicate that textbooks from Spain and Portugal mainly include activities situated between a basic and intermediate cognitive level while in England, the cognitive level of activities is medium or high. The ANOVA and Tukey B tests show significant differences between the cognitive level required in the activities and the typology of exercises, the concepts, and historical contents worked on. The activities with higher cognitive level correspond to those of creation and essays, the exercises that work on empathy and historical relevance, and that contain activities of social and economic history. In contrast, the activities with the lowest cognitive level are short questions and objective tests, those that work on first-order concepts (data and concrete facts), and those on the History of Art. The conclusion is that there is a need for a balanced presence of first-order content and historical thinking skills, the application in the classroom of a more active student-centered methodology, and the teachers' conception of history teaching that prioritizes historical skills.
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The distribution of Burkholderia pseudomallei in the Caribbean is poorly understood. We isolated B. pseudomallei from US Virgin Islands soil. The soil isolate was genetically similar to other isolates from the Caribbean, suggesting that B. pseudomallei might have been introduced to the islands multiple times through severe weather events.
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Burkholderia pseudomallei , Melioidose , Microbiologia do Solo , Burkholderia pseudomallei/genética , Humanos , Ilhas , Melioidose/epidemiologia , Filogenia , Ilhas Virgens AmericanasRESUMO
[This corrects the article DOI: 10.1371/journal.pone.0236083.].
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Recent years have witnessed the arrival of new methodological horizons in teacher training. Technological resources and mobile connections play a major role in these studies. At the same time, there is a focus on play to increase commitment and motivation. It is in this context that gamification and flipped-classroom strategies have arisen. This paper presents the results of a training program with future Primary Education teachers using gamification and flipped-classroom strategies and techniques. The aim was that teachers in training acquire competences in proposing innovative teaching units. The learning achieved through the program was evaluated by collecting perceptions via a questionnaire and using an observation scale of the didactic units designed. The program was implemented in four classroom groups (N = 210) at the University of Murcia (Spain). Descriptive statistics are shown; mean tests (t of Student and ANOVA of one factor); non-parametric tests (U-Mann Whitney test); and Pearson correlations between subscales. The data show a very positive assessment of the learning achieved and the strategies applied in the training program. The learning outcomes were satisfactory, although lower than perceived. Some differences between class groups and gender are discussed, and some weaknesses of the program are pointed out.
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Avaliação de Resultados em Cuidados de Saúde , Percepção , Capacitação de Professores/métodos , Humanos , Análise Multivariada , Análise de RegressãoRESUMO
We report 2 cases of melioidosis in women with diabetes admitted to an emergency department in the US Virgin Islands during October 2017. These cases emerged after Hurricanes Irma and Maria and did not have a definitively identified source. Poor outcomes were observed when septicemia and pulmonary involvement were present.
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Tempestades Ciclônicas , Melioidose/epidemiologia , Desastres Naturais , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Burkholderia pseudomallei/efeitos dos fármacos , Feminino , Humanos , Melioidose/diagnóstico , Melioidose/tratamento farmacológico , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Ilhas Virgens Americanas/epidemiologiaRESUMO
SUMMARY: Background. Ultra-rush (UR) are induction protocols used in venom immunotherapy (VIT). Objectives: To evaluate the adverse reactions during a 210-minutes UR and determine possible risk factors. Methods: Retrospective study of 129 patients submitted to UR with VIT in the last 20 years. Results: In 114 (88.4%) patients the 101.1 µg maintenance dose was reached in 210 minutes. Systemic reactions (SR) occurred in 22% of patients (71% mild). There were no severe SR, late reactions or fatalities. Adrenaline was administered in 10% of all UR. The SR were more frequent with honey bee VIT and had greater severity in the patients with a previous severe systemic sting reaction. No significant difference in the risk of SR was found with other demographic, clinical or laboratory factors. There were 5% of large local reactions (LLR), these being more frequent in females. Conclusion: Most SR during UR were mild with no need for adrenaline treatment. The honey bee venom and the severity of the anaphylaxis during the field sting were the only SR´s risk factors for systemic adverse reactions during the UR.
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Cytochromes P450 (CYPs) play an important role in the oxidative metabolism of xenobiotics. Three-dimensional structures of CYPs are needed to study structure-function relationships in their molecules and interaction with partner proteins. Experimental determination of eucaryotic CYPs 3D structures is difficult because of hydrophobic membrane anchors and surface hydrophobic regions that prevent their crystallization. Replacement of surface hydrophobic amino acids by hydrophilic residues without any changes in protein structure and function can help to solve this problem. Such modification can be proposed using the analysis of 3D model of protein. In this work computer aided 3D structure of microsomal P450 2B4 (CYP2B4) was modeled for the further prediction of surface mutations for hydrophilization of the protein surface. The model of 3D structure of CYP2B4 was constructed by homology with CYP2C5 Model optimization was made by energy minimization and molecular dynamics simulation of protein molecule in water environment. The model was verified by using special statistic software and by comparison with the experimental data on the substrate recognition site, redox-partner binding sites and chemical modification of the protein surface.
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Hidrocarboneto de Aril Hidroxilases/química , Simulação por Computador , Sequência de Aminoácidos , Sistema Enzimático do Citocromo P-450/química , Família 2 do Citocromo P450 , Modelos Moleculares , Dados de Sequência Molecular , Estrutura Secundária de Proteína , Alinhamento de Sequência , Esteroide 21-Hidroxilase/químicaRESUMO
Many applications dealing with electric load forecasting in buildings require temperature prediction. A new method for short-term temperature forecasting based on a Radial Basis Functions Neural Network, initialized by a Regression Tree, is presented. In this method, each terminal node of the tree contributes one hidden unit to the RBF network. The forecaster uses the current coded hour and the temperature as inputs, and predicts the next hour temperature. The results demonstrate this predictor can be used for load forecasting.