Exploring Lifestyle Factors and Treatment Adherence among Older Adults with Hypertension Attending a Mobile Health Unit (MHU) in a Rural Area of Central Portugal.

This cross-sectional and analytical study aimed to characterize a sample of hypertensive older adults attending a Mobile Health Unit (MHU) in a rural area of central Portugal according to their lifestyle and to analyze the impact of lifestyles on treatment adherence. The sample comprised 235 Portuguese hypertense patients, mainly females (63.8%) with a mean age of 75 years (±8.14 years) and low level of education. The data collection was carried out through a questionnaire consisting of sociodemographic questions, dietary variables, an Alcohol Dependence Questionnaire, an International Physical Activity Questionnaire (Short Version), a Nutrition Health Determination Questionnaire, a Self-Care with Hypertension Scale, and an Adherence to Treatments Measurement Scale. Only 34.5% of the hypertensive patients have controlled blood pressure values (28.2% men and 38% women). However, more than half (56.2%) of the hypertensive patients are classified as adherent to therapeutic measures. The hypertensive individuals, who present higher levels of adherence to the treatment, do not present alcohol dependence, are frequent consumers of aromatic herbs, sporadically consume salt, present good nutritional health, and practice moderate physical activity. The predictor variables for treatment adherence are the self-care dimensions general dietary (p = 0.001), specific dietary (p = 0.034), physical activity (p = 0.031), and antihypertensive medication intake (p < 0.001). Hypertensive patients with healthier lifestyles present better levels of treatment adherence. Therefore, promoting physical activity and healthy dietary practices is necessary to improve treatment adherence and increase antihypertensive treatment's effectiveness.

Fatores associados aos Níveis de Ansiedade nas Puérperas em internamento em serviço de obstetrícia / Factors associated with levels of anxiety in postpartum women hospitalized in an obstetrics service

A Ansiedade Puerperal é um fenómeno frequente, uma vez que o puerpério é o período de maior risco para o surgimento ou agravamento de ansiedade. Geralmente manifesta-se por irritabilidade, fadiga, dificuldades de concentração, tensão e perturbações do sono. Pode provocar consequências tanto na mulher como na sua relação com o bebé e com o companheiro, interferindo na qualidade de vida e no futuro da família. Objetivo: identificar os fatores que se relacionam com os níveis de ansiedade das puérperas, durante o internamento num serviço de obstetrícia. Metodologia: trata-se de um estudo quantitativo descritivo-correlacional e analítico, com a aplicação da Escala de Autoavaliação de Ansiedade de Zung, da Escala de Perceção do Design de Suporte do Ambiente Hospitalar e da Escala de Autoperceção Materna das Competências Cuidativas neonatais. Participaram 85 puérperas que se encontravam internadas no serviço de obstetrícia, num hospital da região norte de Portugal. Resultados: A maioria das puérperas (51,8%) apresentou ausência de ansiedade, 11,8% manifestou ansiedade não patológica e 36,5% apresentou ansiedade patológica. Dos fatores de ansiedade estudados, estabeleceu-se relação, de forma global, entre o nível de ansiedade puerperal e a perceção das competências cuidativas neonatais (p=0,00). Conclusão: As puérperas apresentaram maior ansiedade na dimensão Sistema Nervoso Central (SNC). A melhor perceção do suporte social no ambiente hospitalar reduz os níveis de ansiedade materna nas diferentes vertentes. Quanto maior a autoperceção materna das competências no cuidar do bebé, menor o nível de ansiedade puerperal.

Postpartum Anxiety is a frequent phenomenon, since the puerperium is the period of greatest risk for the onset or worsening of anxiety. It is usually manifested by irritability, fatigue, concentration difficulties, tension and sleep disturbances. It can have consequences both for the woman and for her relationship with the baby and her partner, interfering with the quality of life and the future of the family. Objective: to identify the factors that relate to the anxiety levels of postpartum women during hospitalization in an obstetrics service. Methodology: this is a descriptive, correlational and analytical quantitative study, with the application of the Zung Self-Rating Anxiety Scale, the Supportive Hospital Environment Design Scale and the Maternal Self-Perceived Scale of Neonatal Care Skills. Participants were 85 postpartum women who were hospitalized in the obstetrics service, in a hospital in the northern region of Portugal. Results: Most mothers (51.8%) had no anxiety, 11.8% had non-pathological anxiety and 36.5% had pathological anxiety. Of the anxiety factors studied, a global relationship was established between the level of postpartum anxiety and the perception of neonatal care skills (p=0.00). Conclusion: The postpartum women showed greater anxiety in the Central Nervous System (CNS) dimension. A better perception of social support in the hospital environment reduces levels of maternal anxiety in different aspects. The higher the maternal self-perception of skills in caring for the baby, the lower the level of postpartum anxiety.

Assessment of a New Copper-Based Formulation to Control Esca Disease in Field and Study of Its Impact on the Vine Microbiome, Vine Physiology and Enological Parameters of the Juice.

Copper-based preparations have been used for more than 100 years in viticulture to control downy mildew caused by Plasmopara viticola. LC2017, and a new low-copper-based formulation, has been developed to control grapevine trunk diseases (GTDs). Previous greenhouse studies showed the potential of LC2017 to control GTDs by both fungistatic and plant defense elicitor effects. Here, we further characterize the effects of LC2017 in the field determining its impact on: (i) incidence of Esca, (ii) the vine microbiome, (iii) the vine physiology and (iv) enological parameters of juices. We observed a progressive decrease of cumulate Esca incidence in treated vines over the years with annual fluctuation related to the known erratic emergence of GTD symptoms. Neither harmful effects of LC2017 on the vine microbiota, nor on vine physiology were observed (at both transcriptomic and metabolomic levels). Similarly, no impact of LC2017 was observed on the enological properties of berries except for sugar content in juice from esca-diseased vines. The most important result concerns the transcriptomic profiles: that of diseased and LC2017 treated vines differs from that of disease untreated ones, showing a treatment effect. Moreover, the transcriptomic profile of diseased and LC2017-treated vines is similar to that of untreated asymptomatic vines, suggesting control of the disease.

Contributo das TIC para a enfermagem na pandemia por COVID-19: Perceção dos enfermeiros gestores / Contribution of ICT to nursing in the pandemic by covid-19: Perception of managing nurses

Atualmente, a humanidade vive um cenário de desconhecimento e incerteza em torno da doença COVID-19, causada pelo coronavírus SARS-CoV-2, que "transformou o mundo laboral e trouxe profundas e rápidas mudanças no mercado de trabalho, nos modelos de negócio e na organização e gestão do trabalho" (Direção Geral de Saúde, 2020c, p.5). Este estudo teve por objetivo analisar a utilização das Tecnologias da Informação e Comunicação (TICs) pelos enfermeiros gestores na gestão dos cuidados em contexto pandémico. Foi desenvolvido um estudo qualitativo, descritivo e exploratório. A amostra foi constituída por seis enfermeiros gestores, de vários serviços, de um hospital privado da Região Norte de Portugal. A técnica de recolha de dados utilizada foi o Focus group. A análise e o tratamento de dados foram realizadas através da análise de conteúdo, segundo Bardin (2002). Os enfermeiros gestores identificaram a utilização de várias ferramentas e estratégias digitais em tempo de pandemia, nomeadamente, o WhatsApp®, a plataforma Teams®, email e intranet. A sua utilização teve um papel fundamental na formação dos enfermeiros, na partilha de informações entre equipas, na gestão de recursos, na consulta de documentação e na comunicação interprofissional, inclusive entre os hospitais da rede. Salienta-se, ainda, a relevância que estas estratégias tiveram na comunicação com os utentes no geral e entre os clientes internados e a família. Concluímos que a pandemia foi um vetor de aceleração para o processo natural da implementação e adaptação às TICs, aditando vantagens para a tomada de decisão e processos de trabalho. Podemos, ainda, concluir que a utilização das TICs demonstrou uma significativa eficácia a nível da comunicação entre o enfermeiro gestor e as equipas de enfermagem e na gestão dos cuidados

Currently, humanity lives a scenario of ignorance and uncertainty surrounding the disease COVID-19, caused by the coronavirus SARS-CoV-2, which "transformed the world of work and brought about profound and rapid changes in the labor market, in business models and in the organization and management of work "( Direção Geral de Saúde, 2020c, p.5). This study aims to analyze the use of Information and Communication Technologies (ICT) by nurse managers in the management of care in a pandemic context. A qualitative, descriptive and exploratory study was developed. The sample was consisted of six nurse managers, from various services, of a private hospital in the Northern Region of Portugal participated in the investigation. The data collection technique used was the focus group. Data analysis and treatment were performed through content analysis, according to Bardin (2002). The nurse managers identified the use of several digital tools and strategies in a pandemic time, namely, WhatsApp®, the Teams® platform, email and intranet. Its use had a fundamental role in the training of nurses, in the sharing of information between teams, in the management of resources, in the consultation of documentation and in interprofessional communication, including between hospitals in the network. It is also emphasized the relevance that these strategies had in the communication with the users in general and between hospitalized users and the family. The pandemic was a vector for accelerating the natural process of ICT implementation and adaptation, adding advantages to decision-making and work processes. We can also conclude that the use of ICT has demonstrated a significant efficiency in terms of communication between the nurse manager and the nursing teams and in the management of care

Trunk Surgery as a Tool to Reduce Foliar Symptoms in Diseases of the Esca Complex and Its Influence on Vine Wood Microbiota.

In the last few years, trunk surgery has gained increasing attention as a method to reduce foliar symptoms typical of some of the Esca complex diseases. The technique relies on the mechanical removal of decayed wood by a chainsaw. A study on a 14-year-old Cabernet Sauvignon vineyard was carried out to validate the efficacy of trunk surgery and explore possible explanations behind it. Three levels of treatment were applied to three of the most characteristic symptoms associated with some diseases of the Esca complex, such as leaf stripe symptoms (LS), wilted shoots (WS) and apoplexy (APP). The most promising results were obtained by complete trunk surgery, where the larger decay removal allowed lower symptom re-expression. According to the wood types analyzed (decay, medium and sound wood), different changes in microbiota were observed. Alpha-diversity generally decreased for bacteria and increased for fungi. More specifically, main changes were observed for Fomitiporia mediterranea abundance that decreased considerably after trunk surgery. A possible explanation for LS symptom reduction after trunk surgery could be the microbiota shifting caused by the technique itself affecting a microbic-shared biochemical pathway involved in symptom expression.

Draft genome sequence of Bacillus amyloliquefaciens subsp. plantarum strain Fito_F321, an endophyte microorganism from Vitis vinifera with biocontrol potential.

Bacillus amyloliquefaciens subsp. plantarum strain Fito_F321 is a naturally occurring strain in vineyard, with the ability to colonise grapevine and which unveils a naturally antagonistic potential against phytopathogens of grapevine, including those responsible for the Botryosphaeria dieback, a GTD disease. Herein we report the draft genome sequence of B. amyloliquefaciens subsp. plantarum Fito_F321, isolated from the leaf of Vitis vinifera cv. Merlot at Bairrada appellation (Cantanhede, Portugal). The genome size is 3,856,229 bp, with a GC content of 46.54% that contains 3697 protein-coding genes, 86 tRNA coding genes and 5 rRNA genes. The draft genome of strain Fito_F321 allowed to predict a set of bioactive compounds as bacillaene, difficidin, macrolactin, surfactin and fengycin that due to their antimicrobial activity are hypothesized to be of utmost importance for biocontrol of grapevine diseases.

Deep neural models for ICD-10 coding of death certificates and autopsy reports in free-text.

We address the assignment of ICD-10 codes for causes of death by analyzing free-text descriptions in death certificates, together with the associated autopsy reports and clinical bulletins, from the Portuguese Ministry of Health. We leverage a deep neural network that combines word embeddings, recurrent units, and neural attention, for the generation of intermediate representations of the textual contents. The neural network also explores the hierarchical nature of the input data, by building representations from the sequences of words within individual fields, which are then combined according to the sequences of fields that compose the inputs. Moreover, we explore innovative mechanisms for initializing the weights of the final nodes of the network, leveraging co-occurrences between classes together with the hierarchical structure of ICD-10. Experimental results attest to the contribution of the different neural network components. Our best model achieves accuracy scores over 89%, 81%, and 76%, respectively for ICD-10 chapters, blocks, and full-codes. Through examples, we also show that our method can produce interpretable results, useful for public health surveillance.

Understand the Potential Role of Aureobasidium pullulans, a Resident Microorganism From Grapevine, to Prevent the Infection Caused by Diplodia seriata.

Grapevine trunk diseases (GTDs) are one of the major concern amongst grapevine diseases, responsible for the decline of vineyards and for several economical losses. Since grapevine is naturally colonized by resident microorganisms such as Aureobasidium pullulans, the present challenge is to understand their biocontrol potential and how such microorganisms can be successfully integrated in the control of GTDs. In this context, the first priority consists to exploit the plant-beneficial-phytopathogen interactions in plant model systems, to identify the most prevalent equilibrium limiting expression of GTDs. In the current study, we deep characterized the interaction of a resident and abundant microorganism from grapevine - Aureobasidium pullulans strain Fito_F278 - against D. seriata F98.1, a Botryosphaeria dieback agent, and with plant (cv Chardonnay). Results revealed that A. pullulans strain Fito_F278 was able to reduce significantly the mycelium growth of D. seriata F98.1 at 33.41 ± 0.55%, under in vitro conditions, though this reduction is possibly dependent on a direct interaction between strain Fito_F278 and pathogen. Furthermore, strain Fito_F278 was able to promote an induction of some plant defense responses in cutting plants, 1 week after the D. seriata F98.1 infection. Results evidenced that strain Fito_F278 colonized efficiently grapevine at both epiphyte and endophyte level, could persist on plant roots for long-periods (up to 2 months after its inoculation) and grow at different pH and high salinity conditions. Moreover, a significant decrease of the microbial load from soil and rhizosphere was observed in plants treated with the strain Fito_F278, suggesting its competitivity potential in a microbial ecosystem. Altogether, the present study gives the first insights about the interaction of A. pullulans strain Fito_F278, a resident microorganism, with grapevine, its potential role against a Botryosphaeria dieback agent, and highlights its importance to toward more resilient grapevine.

Grapevine Trunk Diseases: A Review of Fifteen Years of Trials for Their Control with Chemicals and Biocontrol Agents.

Grapevine trunk diseases (GTDs) represent one of the most important problems for viticulture worldwide. Beyond the original causes of this outbreak in some countries like France, the lack of efficient control protocols and the prohibition of using active ingredients such as sodium arsenite and benzimidazoles, until recently used to reduce the impact of some GTDs but deleterious for humans and the environment, have probably worsened the impact of the diseases, leading to increasing economic losses. Since 1990, searches have been made to find efficient tools to control GTDs, testing a wide range of active ingredients and biocontrol agents. This review provides readers with an overview of the results reported in the scientific literature over the last 15 years. In particular, the review focuses on the trials carried out applying chemicals or microorganisms to control Esca complex diseases, Botryosphaeria dieback, and Eutypa dieback, the most widespread GTDs.

Mortality Information System in Portugal: transition to e-death certification.

Inability to invest in and develop mortality information systems has been considered the single most critical failure in health information systems and there is a recognized urgent need to improve mortality statistics and cause of death information. Although there have been major developments in information technology with the potential to improve public health information systems, mortality data collection has largely remained unchanged in most countries, mainly due to legal and operational barriers. Electronic registration and certification of death certificates has the potential to improve the quality and timeliness of mortality statistics. The Mortality Information System in Portugal has, since 1950, been a paper-form death certification model. The Portuguese Directorate-General of Health recently implemented electronic death certification as the basis of a new mortality information system. A strategic multistep approach, defined by geographic areas of the country, was planned for implementation of the system. National implementation was completed in December of 2013 and 100% e-death certification was achieved beginning January 2014. This article reports the implementation process and describes the newly established mortality information system.

Evaluation of Cytotoxicity and Cell Death Induced In Vitro by Saxitoxin in Mammalian Cells.

Since the cyanotoxin saxitoxin (STX) is a neurotoxin and induces ecological changes in aquatic environments, a potential risk to public and environmental health exists. However, data on STX-mediated cytotoxic and genotoxic effects are still scare. In order to gain a better understanding of the effects of this toxin, the cytotoxic and genotoxic potential of STX was examined in two mammalian cell lines. Neuro 2A (N2A), a neuroblastoma mouse cell line, and Vero cell line, derived from Vero green monkey kidney cells, were exposed to several concentrations of STX ranging from 0.5 to 64 nM to determine cell viability, induction of apoptosis (DNA fragmentation assay), and formation of micronuclei (MN) (cytokinesis-block micronucleus assay; CBMN) following 24 h of incubation. The half maximal effective concentration (EC50) values for STX calculated in cell viability tests were 1.01 nM for N2A and 0.82 nM for Vero cells. With increasing STX concentration there was evidence of DNA fragmentation indicating apoptosis induction in Vero cells with a 50% increase in DNA fragmentation compared to control at the highest STX concentration tested (3 nM). The results demonstrated no significant changes in the frequency of micronucleated binucleated cells in N2A and Vero cells exposed to STX, indicating the absence of genotoxicity under these test conditions. There was no apparent cellular necrosis as evidenced by a lack of formation of multinucleated cells. In conclusion, data reported herein demonstrate that STX produced death of both cell types tested through an apoptotic process.

Wine fermentation microbiome: a landscape from different Portuguese wine appellations.

Grapes and wine musts harbor a complex microbiome, which plays a crucial role in wine fermentation as it impacts on wine flavour and, consequently, on its final quality and value. Unveiling the microbiome and its dynamics, and understanding the ecological factors that explain such biodiversity, has been a challenge to oenology. In this work, we tackle this using a metagenomics approach to describe the natural microbial communities, both fungal and bacterial microorganisms, associated with spontaneous wine fermentations. For this, the wine microbiome, from six Portuguese wine appellations, was fully characterized as regards to three stages of fermentation - Initial Musts (IM), and Start and End of alcoholic fermentations (SF and EF, respectively). The wine fermentation process revealed a higher impact on fungal populations when compared with bacterial communities, and the fermentation evolution clearly caused a loss of the environmental microorganisms. Furthermore, significant differences (p < 0.05) were found in the fungal populations between IM, SF, and EF, and in the bacterial population between IM and SF. Fungal communities were characterized by either the presence of environmental microorganisms and phytopathogens in the IM, or yeasts associated with alcoholic fermentations in wine must samples as Saccharomyces and non-Saccharomyces yeasts (as Lachancea, Metschnikowia, Hanseniaspora, Hyphopichia, Sporothrix, Candida, and Schizosaccharomyces). Among bacterial communities, the most abundant family was Enterobacteriaceae; though families of species associated with the production of lactic acid (Lactobacillaceae, Leuconostocaceae) and acetic acid (Acetobacteriaceae) were also detected. Interestingly, a biogeographical correlation for both fungal and bacterial communities was identified between wine appellations at IM suggesting that each wine region contains specific and embedded microbial communities which may contribute to the uniqueness of regional wines.

Unravelling the diversity of grapevine microbiome.

Vitis vinifera is one of the most widely cultivated fruit crops with a great economic impact on the global industry. As a plant, it is naturally colonised by a wide variety of both prokaryotic and eukaryotic microorganisms that interact with grapevine, having either beneficial or phytopathogenic effects, who play a major role in fruit yield, grape quality and, ultimately, in the evolution of grape fermentation and wine production. Therefore, the objective of this study was to extensively characterize the natural microbiome of grapevine. Considering that the majority of microorganisms are uncultivable, we have deeply studied the microflora of grapevine leaves using massive parallel rDNA sequencing, along its vegetative cycle. Among eukaryotic population the most abundant microorganisms belonged to the early diverging fungi lineages and Ascomycota phylum, whereas the Basidiomycota were the least abundant. Regarding prokaryotes, a high diversity of Proteobacteria, Firmicutes and Actinobacteria was unveiled. Indeed, the microbial communities present in the vineyard during its vegetative cycle were shown to be highly structured and dynamic. In all cases, the major abundant microorganisms were the yeast-like fungus Aureobasidium and the prokaryotic Enterobacteriaceae. Herein, we report the first complete microbiome landscape of the vineyard, through a metagenomic approach, and highlight the analysis of the microbial interactions within the vineyard and its importance for the equilibrium of the microecosystem of grapevines.

Establishing the yeast Kluyveromyces lactis as an expression host for production of the saposin-like domain of the aspartic protease cirsin.

Typical plant aspartic protease zymogens comprise a characteristic and plant-specific insert (PSI). PSI domains can interact with membranes, and a role as a defensive weapon against pathogens has been proposed. However, the potential of PSIs as antimicrobial agents has not been fully investigated and explored yet due to problems in producing sufficient amounts of these domains in bacteria. Here, we report the development of an expression platform for the production of the PSI domain of cirsin in the generally regarded as safe (GRAS) yeast Kluyveromyces lactis. We successfully generated K. lactis transformants expressing and secreting significant amounts of correctly processed and glycosylated PSI, as well as its nonglycosylated mutant. A purification protocol with protein yields of ∼4.0 mg/liter was established for both wild-type and nonglycosylated PSIs, which represents the highest reported yield for a nontagged PSI domain. Subsequent bioactivity assays targeting phytopathogenic fungi indicated that the PSI of cirsin is produced in a biologically active form in K. lactis and provided clear evidence for its antifungal activity. This yeast expression system thereby emerges as a promising production platform for further exploring the biotechnological potential of these plant saposin-like proteins.

Trends in influenza vaccination coverage in Portugal from 1998 to 2010: effect of major pandemic threats.

BACKGROUND: Vaccination is the key measure available for prevention of the public health burden of annual influenza epidemics. This article describes national trends in seasonal influenza vaccine (IV) coverage in Portugal from 1998/99 to 2010/11, analyzes progress towards meeting WHO 2010 coverage goals, and addresses the effect of major public health threats of the last 12 years (SARS in 2003/04, influenza A (H5N1) in 2005/06, and the influenza A (H1N1)2009 pandemic) on vaccination trends. METHODS: The National Institute of Health surveyed (12 times) a random sample of Portuguese families. IV coverage was estimated and was adjusted for age distribution and country region. Independence of age and sex coverage distribution was tested using a modified F-statistic with a 5% significance level. The effect of SARS, A (H5N1), and the A (H1N1)2009 pandemic was tested using a meta-regression model. The model was adjusted for IV coverage in the general population and in the age groups. RESULTS: Between 1998/99 and 2010/11 IV, coverage in the general population varied between 14.2% (CI(95%): 11.6%-16.8%) and 17.5% (CI(95%): 17.6%-21.6%). There was no trend in coverage (p = 0.097). In the younger age group (<15 years) a declining trend was identified until 2008/09 (p = 0.005). This trend reversed in 2009/10. There was also a gradual and significant increase in seasonal IV coverage in the elderly (p for trend < 0.001). After 2006/07, IV coverage remained near 50%. Adjusting for baseline trends, there was significantly higher coverage in the general population in 2003/04 (p = 0.032) and 2005/06 (p = 0.018). The high coverage observed in the <15-year age group in season 2009/10 was also significant (p = 0.015). CONCLUSIONS: IV coverage in the elderly population displayed an increasing trend, but the 75% WHO 2010 target was not met. This result indicates that influenza vaccination strategy should be improved to meet the ambitious WHO coverage goals. The major pandemic threats of the past decade had a modest but significant effect on seasonal influenza vaccination. There was an increase in vaccine uptake proportion in the general population in 2003/04 and in 2005/06, and in individuals <15 years old in 2009/10.

Pediatric versus adult drug trials for conditions with high pediatric disease burden.

BACKGROUND AND OBJECTIVE: Optimal treatment decisions in children require sufficient evidence on the safety and efficacy of pharmaceuticals in pediatric patients. However, there is concern that not enough trials are conducted in children and that pediatric trials differ from those performed in adults. Our objective was to measure the prevalence of pediatric studies among clinical drug trials and compare trial characteristics and quality indicators between pediatric and adult drug trials. METHODS: For conditions representing a high burden of pediatric disease, we identified all drug trials registered in ClinicalTrials.gov with start dates between 2006 and 2011 and tracked the resulting publications. We measured the proportion of pediatric trials and subjects for each condition and compared pediatric and adult trial characteristics and quality indicators. RESULTS: For the conditions selected, 59.9% of the disease burden was attributable to children, but only 12.0% (292/2440) of trials were pediatric (P < .001). Among pediatric trials, 58.6% were conducted without industry funding compared with 35.0% of adult trials (P < .001). Fewer pediatric compared with adult randomized trials examined safety outcomes (10.1% vs 16.9%, P = .008). Pediatric randomized trials were slightly more likely to be appropriately registered before study start (46.9% vs 39.3%, P = .04) and had a modestly higher probability of publication in the examined time frame (32.8% vs 23.2%, P = .04). CONCLUSIONS: There is substantial discrepancy between pediatric burden of disease and the amount of clinical trial research devoted to pediatric populations. This may be related in part to trial funding, with pediatric trials relying primarily on government and nonprofit organizations.

Investigation of animal and algal bioassays for reliable saxitoxin ecotoxicity and cytotoxicity risk evaluation.

Contamination of water bodies by saxitoxin can result in various toxic effects in aquatic organisms. Saxitoxin contamination has also been shown to be a threat to human health in several reported cases, even resulting in death. In this study, we evaluated the sensitivity of animal (Neuro-2A) and algal (Chlamydomonas reinhardtii) bioassays to saxitoxin effect. Neuro-2A cells were found to be sensitive to saxitoxin, as shown by a 24 h EC50 value of 1.5 nM, which was obtained using a cell viability assay. Conversely, no saxitoxin effect was found in any of the algal biomarkers evaluated, for the concentration range tested (2-128 nM). These results indicate that saxitoxin may induce toxic effects in animal and human populations at concentrations where phytoplankton communities are not affected. Therefore, when evaluating STX risk of toxicity, algal bioassays do not appear to be reliable indicators and should always be conducted in combination with animal bioassays.

Removal of coloured compounds from textile industry effluents by UV/H2O2 advanced oxidation and toxicity evaluation.

This study has investigated the reduction in coloured substances and toxic compounds present in textile industry effluent by the use of an advanced oxidation process using hydrogen peroxide (H2O2) as oxidant, activated by ultraviolet radiation. The investigation was carried out on industrial effluents, both raw and after biological treatment, using different concentrations of H2O2 in a photochemical reactor equipped with a 250 W high-pressure mercury vapour lamp. The results showed that after 60 minutes of ultraviolet irradiation a H2O2 concentration of 500 mg L(-1) was able to remove approximately 73% of the coloured compounds present in raw effluent and 96% of those present in biologically treated effluent. Additionally, post-treatment toxicity tests performed using the microcrustacean Daphnia magna showed a significant effective reduction in the acute toxicity of the raw effluent. In tests carried out with treatment at a concentration of 750 and 1000 mg L(-1) H2O2, analysis of the frequency ofmicronuclei in erythrocytes of Tilapia cf rendalli exposed to treated effluent samples confirmed that there were no mutagenic effects on the fish. Together, these results indicate that the oxidation process offers a good alternative for the removal of colour and toxicity from textile industry effluent.

Decontamination of poultry carcasses using steam or hot water in combination with rapid cooling, chilling or freezing of carcass surfaces.

The effects of the application of steam at atmospheric pressure for times up to 20 s on the numbers of inoculated Campylobacter jejuni and Escherichia coli on whole chicken carcasses were investigated in a pilot steam cabinet. Steam treatments reduced the numbers of C. jejuni AR6 by ca. 1.8, 2.6 and 3.3 log(10) cfu cm(-2) in 10, 12 and 20 s, respectively. Corresponding reductions in numbers of E. coli K12 were 1.7, 2.3 and 2.8 log(10) cfu cm(-2). However, such treatments caused the skin to shrink and change colour. The optimum treatment for maximum reductions of C. jejuni and E. coli, least skin shrinkage and change of colour was concluded to be <12 s. Further work was carried out to determine whether a modified air chilling system in combination with steam or hot water decontamination treatments could be used to reduce numbers of pathogens, particularly campylobacters, on the surface of poultry carcasses. Whole chicken carcasses inoculated with C. jejuni and E. coli were either not treated, treated with steam at atmospheric pressure for up to 10 s or treated with hot water at 80 degrees C for up to 20 s, then either chilled by crust freezing, chilled at 0 degrees C, or chilled at 15 degrees C, in a pilot chilling chamber. The optimum combination was treatment with water at 80 degrees C for 20 s followed by crust freezing, which reduced the numbers of C. jejuni and E. coli by ca. 2.9 and 3.2 log(10) cfu cm(-2), respectively, without extensive degradation of carcass appearance.

Ressecçäo transuretral de próstata com anestesia loco-regional: nota prévia sobre quatro casos / Transurethral resection of the prostate with local anesthesia: previous note on 4 cases

Apresenta-se o uso de anestesia loco-regional na ressecçäo transuretral de próstata. O método foi utilizado em quatro pacientes, onde a infiltraçäo peri e intraprostática (bupivacaína e/ou lidocaína) possibilitou, com o uso concomitante de sedaçäo (benzodiazepínico intravenoso) a ressecçäo transuretral da próstata. Descreve-se a técnica e discute-se a indicaçäo deste procedimento em pacientes com risco cirúrgico elevado por doenças cardiopulmonares. Nos quatro casos, o procedimento mostrou-se eficaz, seguro e bem tolerado pelos pacientes