The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups.

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.

When residents die in Portuguese care facilities: The experiences and practices of care facility directors before and during the COVID-19 pandemic.

This qualitative exploratory study aimed to describe the experiences and practices of care facility directors regarding residents dying in Portuguese residential care facilities (RCFs) before and during the COVID-19 pandemic. Data was obtained from 17 care director facilities who participated in focus groups. The data analysis followed the interpretative phenomenological approach. Participants stated that practices surrounding the death of the residents in Portuguese RCFs changed significantly from before to during the pandemic, regarding both those who died from COVID-19 infection and from other conditions. Four themes emerged that illustrated the situation during the peaks of the pandemic. During the pandemic, practices and experiences quite different from the usual ones have emerged. These results support the importance of a good death, and dying with dignity in RCFs, and the need for policies, practices, and training on the death of residents in RCFs in Portugal.

A veterinary cerumenomic assay for bovine laminitis identification.

Bovine laminitis disorder results in animal welfare and economic concerns in dairy and beef farms worldwide. However, the affected metabolic pathways, pathophysiologic characteristics, and inflammatory mechanisms remain unclear, hampering the development of new diagnostics. Using cerumen (earwax) as a source of volatile metabolites (cerumenomic) that carry valuable biological information has interesting implications for veterinary medicine. Nonetheless, up to now, no applications of veterinary cerumenomic assays have been made to identify bovine laminitis. This work aims to develop a veterinary cerumenomic assay for bovine laminitis identification that is non-invasive, robust, accurate, and sensitive to detecting the metabolic disturbances in bovine volatile metabolome. Twenty earwax samples (10 from healthy/control calves and 10 from laminitis calves) were collected from Nellore cattle, followed by Headspace/Gas Chromatography-Mass Spectrometry (HS/GC-MS) analysis and biomarker selection in two multivariate approaches: semiquantitative (intensity data) and semiqualitative (binary data). Following the analysis, cerumen volatile metabolites were indicated as candidate biomarkers for identifying bovine laminitis by monitoring their intensity or occurrence. In the semiquantitative strategy, the p-cresol presented the highest diagnostic figures of merit (area under the curve: 0.845, sensitivity: 0.700, and specificity: 0.900). Regarding the binary approach, a panel combining eight variables/volatiles, with formamide being the most prominent one, showed an area under the curve, sensitivity, and specificity of 0.97, 0.81, and 0.90, respectively. In summary, this work describes the first veterinary cerumenomic assay for bovine laminitis that indicates new metabolites altered during the inflammatory condition, paving the way for developing laminitis early diagnosis by monitoring the cerumen metabolites.

Surgical management of a giant parotid gland pleomorphic adenoma in Northern Sri Lanka: A case report.

INTRODUCTION: Pleomorphic adenoma is the most common benign tumour of the parotid gland. It is commonly observed in middle-aged women. Usually, pleomorphic adenomas are asymptomatic with a slow-progressing tendency. There is a substantial risk of malignant transformation if left untreated. Imaging modalities and fine needle aspiration cytology are highly valuable preoperative diagnostic tools and aid in selecting therapeutic interventions. Surgical technique is chosen based on clinical grounds. PRESENTATION OF CASE: A 48-year-old woman presented with a painless extensive mass in the left-sided face. A provisional diagnosis of the benign parotid tumour was made based on clinical evaluation. Imaging studies and cytological assessment suggested pleomorphic adenoma of the left parotid gland, and left-sided total parotidectomy with facial nerve dissection was performed. DISCUSSION: Pleomorphic adenoma involving the deep lobe of the parotid gland is rare. It typically grows slowly. If left untreated, it can present as a giant mass, as in our case. The extensive tumour mass can also involve adjacent structures, including facial nerve. Therefore, surgical dissection must be involved facial nerve and adjacent muscles. CONCLUSION: Surgical dissection of giant pleomorphic adenoma is challenging and often leads to significant deformities postoperatively. Early intervention will improve surgical outcomes and quality of life.

Na+/K+ carrier ionophore antibiotics valinomycin and monensin enhance the antibacterial activity of fluoride.

Fluoride is routinely used as a highly effective antibacterial agent that interferes with bacterial metabolism through fundamentally different mechanisms. One of the major bacterial evasion mechanisms against fluoride is the impermeability of cell envelope to the anion that limits its cellular uptake. Therefore, translating such compounds to clinical settings requires novel mechanisms to facilitate the uptake of membrane-impermeant molecules. Published data have indicated antibiotic synergy between fluoride and membrane destabilizing agents that induce strong fluoride toxicity in bacteria via enhancing the permeability of bacterial membranes to fluoride. Here, we report a similar mechanism of antibiotic synergy between fluoride and potassium ion carriers, valinomycin and monensin against Gram-positive bacteria, B. subtilis and S. aureus. Molecular dynamics simulations were performed to understand the effect of potassium on the binding affinity of fluoride to monensin and valinomycin. The trajectory results strongly indicated that the monensin molecules transport fluoride ions across the cell membrane via formation of ion-pair between the monensin-K+ complex and a fluoride. This study provides new insights to design novel compounds to enhance the uptake of small toxic anions via synergistic interactions and thus exert strong antibacterial activity against a wide variety of pathogens.

Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal.

OBJECTIVES: The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. STUDY DESIGN: Cross-sectional study. METHODS: This study used data from a Portuguese community-based survey entitled 'COVID-19 Barometer: Social Opinion'. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. RESULTS: Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. CONCLUSIONS: Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.

Oral health-related quality of life in portuguese pre-school children: a cross-sectional study.

PURPOSE: To study Oral Health related Quality of Life (OHRQoL) of pre-school children and its associated factors. METHODS: Cross-sectional study with sample data collected through an on-line questionnaire to a non-probabilistic sample. The questionnaire included the Portuguese version of the Early Childhood Oral Health Impact Scale (ECOHIS) and questions about sociodemographic characteristics, oral health behaviours, and reported oral health of the child. Data analyses included descriptive statistics, Mann-Whitney and Kruskal-Wallis tests and Linear regression (α = 0.05). RESULTS: The sample consisted of 1475 parents of pre-school children (3-5 years-old), residing in Portugal. The mean ECOHIS total score was 1.5 (sd = 3.4). In the bivariate analysis the child's age, starting toothbrushing after one year of age, frequent intake of sugary food and drinks, previous appointment with an oral health professional, all reported of oral health problems, and a negative perception of oral health were negatively associated with OHRQoL (p < 0,05). In the regression model the factors that most contributed to a worse quality of life were dental caries and abscess, contributing to an ECOHIS average increase of 2.56 and 3.34, respectively. CONCLUSIONS: The studied population presented a good OHRQoL, with the item related to pain being the most relevant for the ECOHIS score. Worst OHRQoL was found in older children, whose parents negatively rated the children's oral health and with reported dental caries, trauma, and abscess.

Tuberculosis infection in HIV vs. non-HIV patients.

OBJECTIVES: Tuberculosis (TB) is the most common opportunistic infection and cause of mortality among people living with HIV, and it is possible that it may also influence the evolution of the HIV infection. We assessed the differences between HIV-positive and -negative people infected with TB. METHODS: The present study is a cross-sectional retrospective study by electronic record revision. We included patients admitted to a tertiary hospital with a diagnosis of TB between 2011 and 2016, comparing those with HIV coinfection with non-HIV patients, according to demographic and clinical characteristics. RESULTS: This study included 591 patients, of whom 32% were HIV-coinfected. HIV-TB patients were younger, with a predominance of male gender. Considering TB risk factors, there was a higher prevalence of homelessness and intravenous drug use in the HIV group. In the non-HIV group, direct contact with other patients with TB and immunosuppression were more prevalent. Relative to TB characteristics, the HIV-coinfected group presents with a higher prevalence of disseminated disease and a higher occurrence of previous TB infection. Cancer was the most frequent cause of immunosuppression in the HIV group and the number testing positive for TB via microbiological culture was lower. Assessment of microbiological resistance and in-hospital mortality showed similar numbers in both groups. CONCLUSIONS: There are few papers comparing clinical course of TB between HIV-infected and non-infected patients. Our study differs from others in the literature as we focused on a country with middling incidence of TB and further characterized the differences between HIV-infected and non-infected patients which can contribute to the management of these patients.

Identifying and managing patient–ventilator asynchrony: An international survey / Identificación y manejo de la asincronía paciente-ventilador: encuesta internacional

Objective To describe the main factors associated with proper recognition and management of patient–ventilator asynchrony (PVA). Design An analytical cross-sectional study was carried out. Setting An international study conducted in 20 countries through an online survey. Participants Physicians, respiratory therapists, nurses and physiotherapists currently working in the Intensive Care Unit (ICU). Main variables of interest Univariate and multivariate logistic regression models were used to establish associations between all variables (profession, training in mechanical ventilation, type of training program, years of experience and ICU characteristics) and the ability of HCPs to correctly identify and manage 6 PVA. Results A total of 431 healthcare professionals answered a validated survey. The main factors associated to proper recognition of PVA were: specific training program in mechanical ventilation (MV) (OR 2.27; 95%CI 1.14–4.52; p=0.019), courses with more than 100h completed (OR 2.28; 95%CI 1.29–4.03; p=0.005), and the number of ICU beds (OR 1.037; 95%CI 1.01–1.06; p=0.005). The main factor influencing the management of PVA was the correct recognition of 6 PVAs (OR 118.98; 95%CI 35.25–401.58; p<0.001). Conclusion Identifying and managing PVA using ventilator waveform analysis is influenced by many factors, including specific training programs in MV, the number of ICU beds, and the number of recognized PVAs. (AU)

Objetivo Describir los factores asociados al correcto reconocimiento y manejo de la asincronía paciente-ventilador (APV). Diseño Estudio analítico transversal. Ámbito Estudio internacional realizado en 20 países mediante una encuesta a través de Internet. Participantes Médicos, terapeutas respiratorios, enfermeras/os y fisioterapeutas que trabajan actualmente en unidades de cuidados intensivos (UCI). Principales variables de interés Se utilizó un análisis uni y multivariado para describir la asociación entre todas las variables (profesión, formación en ventilación mecánica, tipo de programa de formación, años de experiencia y características de la UCI en la cual trabajan los profesionales) con la correcta identificación y manejo de 6 APV. Resultados Un total de 431 profesionales respondieron una encuesta validada previamente. Los factores asociados a una correcta identificación de 6 APV fueron: haber completado un programa de formación específico sobre ventilación mecánica (OR: 2,27; IC 95%: 1,14-4,52; p=0,019), programa de formación con más de 100h (OR: 2,28; IC 95%: 1,29-4,03; p=0,005) y el número de camas de UCI (OR: 1,037; IC 95%: 1,01-1,06; p=0,005). El principal factor asociado a un adecuado manejo de la APV fue la correcta identificación de 6 APV (OR: 118,98; IC 95%: 35,25-401,58; p<0,001). Conclusiones La identificación y el manejo de la asincronía paciente-ventilador, mediante el análisis de las curvas del ventilador está influenciada por programas de formación, específicos sobre ventilación mecánica, el número de camas de la UCI y el número de asincronías identificadas. (AU)

Influence of different periods of pre-slaughter fasting on microbiological quality of bullfrog carcasses (Lithobates catesbeianus) / [Influência de diferentes períodos de jejum pré-abate na qualidade microbiológica de carcaças de rã-touro (Lithobates catesbeianus)]

The aim of this study was to evaluate the influence of different periods of pre-slaughter fasting (F1: 2 to 24 hours and F2: 48 to 72 hours) on the counts of hygiene indicator microorganisms and the presence of Salmonella spp. in carcasses of bullfrogs. Two different stages of the slaughter process were analyzed: after bleeding (A) and after the final carcasses cleaning (B). Samples from each fasting period were analyzed to count hygiene indicator microorganisms (n=30) and Salmonella spp. (n=140). For aerobic mesophilic microorganisms, the variation in fasting periods caused a reduction of 0.69 log10 CFU / g (P<0.05) in F2 when compared to F1 at point B of the slaughter. Coliforms at 35º C and Escherichia coli showed no differences (P >0.05) between the fasting analyzed periods. Considering the presence of E. coli, it was observed that F2 resulted in a reduction of 30% (P<0.05) positivity on point B. For Salmonella spp., the results showed that F2 contributed to an 11.5% reduction in the presence of this bacteria at point B. (P<0.05). Therefore, it is concluded that 48 to 72 hours of pre-slaughter fasting resulted in a positive impact on the microbiological quality of bullfrog carcasses.(AU)

O objetivo deste estudo foi avaliar a influência de diferentes períodos de jejum pré-abate (F1: duas a 24 horas e F2: 48 a 72 horas) nas contagens de micro-organismos indicadores de higiene e na presença de Salmonella spp. em carcaças de rãs-touro. Foram analisadas duas etapas do processo de abate: após a sangria (A) e após a toalete final da carcaça (B). As amostras de cada período de jejum foram utilizadas para contagem de indicadores de higiene (n = 30) e Salmonella spp. (n = 140). Para aeróbios mesófilos, a variação no tempo de jejum causou uma redução de 0,69 log10 UFC/g (P<0,05) em F2 quando comparado a F1 na etapa B do abate. Os coliformes a 35ºC e Escherichia coli não apresentaram diferenças (P>0,05) entre os dois períodos de jejum analisados. Considerando a presença de E. coli, F2 resultou em uma redução de 30% (P<0,05) de positividade na etapa B. Para Salmonella spp., os resultados mostraram que F2 contribuiu para uma redução de 11,5% na presença desse micro-organismo na etapa B. Portanto, conclui-se que 48 a 72 horas de jejum pré-abate tiveram um impacto positivo na qualidade microbiológica das carcaças de rã-touro.(AU)

Trajectories of depressive symptoms through adolescence and young adulthood: social and health outcomes.

Depressive symptoms display heterogeneous trajectories across adolescence, which can lead to different consequences. This study aimed to identify trajectories of depressive symptoms from adolescence to young adulthood, assessing the association with social and health outcomes at young adulthood. Adolescents born in 1990, enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) completed the Beck Depression Inventory II (BDI-II) at 13, 17 and 21 years. Mixed models and model-based clustering were used to describe the trajectories in the BDI-II score (n = 2010). Outcomes were assessed at age 21 years with self-administered questionnaires and face-to-face interviews (n = 1594). Odds ratios or regression coefficients, with 95% confidence intervals, were estimated using logistic and linear regression. Three trajectory classes of depressive symptoms were identified, similar in shape in both sexes: High (8.4%), Moderate (31.3%) and Low (60.2%). Participants in High or Moderate classes were more likely to describe lower scores of community involvement, more medical appointments during the last year, higher levels of pain and had higher probability of self-rating health as "good" or "fair or poor". Females in the High and Moderate classes were more likely to be current smokers, to describe ever using drugs and to report more sexual partners, emergency room visits and the use of antidepressants. The risk of depressive symptoms in adulthood is likely to be early determined in adolescence. The trajectory classes with higher levels of symptoms were associated with worse social and health outcomes.

Identifying and managing patient-ventilator asynchrony: An international survey.

OBJECTIVE: To describe the main factors associated with proper recognition and management of patient-ventilator asynchrony (PVA). DESIGN: An analytical cross-sectional study was carried out. SETTING: An international study conducted in 20 countries through an online survey. PARTICIPANTS: Physicians, respiratory therapists, nurses and physiotherapists currently working in the Intensive Care Unit (ICU). MAIN VARIABLES OF INTEREST: Univariate and multivariate logistic regression models were used to establish associations between all variables (profession, training in mechanical ventilation, type of training program, years of experience and ICU characteristics) and the ability of HCPs to correctly identify and manage 6 PVA. RESULTS: A total of 431 healthcare professionals answered a validated survey. The main factors associated to proper recognition of PVA were: specific training program in mechanical ventilation (MV) (OR 2.27; 95%CI 1.14-4.52; p=0.019), courses with more than 100h completed (OR 2.28; 95%CI 1.29-4.03; p=0.005), and the number of ICU beds (OR 1.037; 95%CI 1.01-1.06; p=0.005). The main factor influencing the management of PVA was the correct recognition of 6 PVAs (OR 118.98; 95%CI 35.25-401.58; p<0.001). CONCLUSION: Identifying and managing PVA using ventilator waveform analysis is influenced by many factors, including specific training programs in MV, the number of ICU beds, and the number of recognized PVAs.

Validation of an in vitro system to trigger changes in the gene expression of effectors of Sclerotinia sclerotiorum.

AIMS: Sclerotinia sclerotiorum, the causal agent of white mold, can infect several host species, including economically important crops. In this study, we propose and validate a new in vitro system able to mimic the conditions of interaction with the host and promote the induction of S. sclerotiorum effectors. METHODS AND RESULTS: For culture media production, we selected three plant species, common bean (Phaseolus vulgaris L, cv. Requinte.), maize (Zea mays, cv. BRS1030) and beggarticks (Bidens pilosa). To validate this system as an in vitro inducer of effectors, the qRT-PCR technique was used to investigate the expression profile of some S. sclerotiorum effector genes in each growth medium at different times after inoculation. CONCLUSION: The results obtained in this study provide a validation of a new method to study S. sclerotiorum during mimetic interaction with different hosts. Although leaf extract does not fully represent the plant environment, the presence of plant components in the culture medium seems to induce effector genes, mimicking in planta conditions. The use of MEVM is simpler than in planta growth, bypasses problems such as the amount of mycelium produced, as well as contamination of host cells during transcriptomic and proteomic analyses. SIGNIFICANCE AND IMPACT OF THE STUDY: We have devised MEVM media as a model mimicking the interaction of S. sclerotiorum and its hosts and used it to evaluate in vitro expression of effectors normally expressed only in planta.

Eficácia da suplementação oral com 1, 3-1, 6 betaglucano proveniente de Saccharomyces cerevisiae no controle da mastite bovina / [Efficiency of oral supplementation of 1. 3-1. 6 beta-glucan from saccharomyces cerevisiae on the control of bovine mastitis]

A mastite bovina, uma das principais doenças do rebanho leiteiro, caracteriza-se por um processo inflamatório no úbere. A inviabilidade econômica, o impacto ambiental negativo e os resíduos antimicrobianos têm estimulado a pesquisa de outros tratamentos alternativos para a prevenção e o tratamento de doenças na bovinocultura leiteira. O betaglucano é um agente imunomodulador com potencial ação preventiva para doenças infecciosas, inclusive a mastite. Este estudo teve como objetivo avaliar a eficácia do uso do betaglucano, por meio de administração oral, em animais em lactação. Foram utilizadas 20 vacas lactantes, distribuídas em dois grupos, um controle e um tratamento, com 10 animais em cada grupo. O grupo tratamento recebeu 5g/dia, durante 60 dias, de 1,3-1,6 betaglucano isolado da parede celular de Saccharomyces cerevisiae diluído em ração após a ordenha, enquanto o grupo controle recebia somente a ração. Foram realizados os testes de California Mastitis Test (CMT), contagem de células somáticas (CCS), produção de leite e percentual de gordura e proteína no leite. Não houve diferença estatisticamente significativa entre os grupos quanto à CCS, ao CMT, à composição do leite ou produção. Não se observou, portanto, eficácia do uso do betaglucano purificado, administrado por via oral, no controle e na prevenção da mastite em vacas leiteiras, quando comparadas com o grupo controle. Atribuem-se esses resultados, principalmente, à degradação ruminal do produto testado. Sugerem-se, portanto, mais pesquisas utilizando o 1,3-1,6 betaglucano purificado de parede de S. cerevisiae por outras vias de administração, tais como intramamária e subcutânea.(AU)

Bovine mastitis, one of the main diseases of dairy herds, is characterized by an inflammatory process in the udder. The economic and environmental impacts, as well as the residues of antimicrobial drugs have stimulated the research of novel alternative treatments for the prevention and treatment of diseases in dairy production cows. The beta-glucan is an immunomodulator agent, with potential preventive action for infectious diseases, including mastitis. This study aimed to assess the effectiveness of orally administered beta-glucan in lactating cows. 20 lactating cows were used, distributed into two groups, one control and one treatment, with 10 cows in each group. The treatment group received 5g of 1.3-1.6 betaglucan daily for 60 days, isolated from the cell-wall of Saccharomyces cerevisiae diluted into a grain meal, whereas the animals in the control group received only the ration. The California Mastitis Test (CMT), Somatic Cells Counting (SCC), daily production and assessments of fat and protein content in milk were done. There was no statistically significant difference between the groups concerning subclinical mastitis detected by CMT, SCC, milk production and composition regarding protein and fat content. It was not observed, therefore, the effectiveness of the use of purified beta-glucan orally administered on the control or prevention of mastitis in dairy cows. The results are attributed to the ruminal degradation of the product tested. It is, therefore, suggested that more research should be conducted using the 1.3-1.6 beta-glucan purified from the cell wall of S. cerevisiae by other administration means and ruminal protection technologies for the isolated beta-glucan.(AU)

Metástase de seminoma em região orbital em cão - relato de caso / Metastatic seminoma in the orbital region in a dog - case report

O seminoma é uma neoformação testicular originária de células germinativas de ocorrência comum em cães, com maior prevalência em animais senis. Em geral, o comportamento biológico do seminoma canino é benigno. Relata-se neste trabalho um caso de seminoma com metástase em região orbital em um cão com 14 anos de idade. O animal foi atendido com queixa de aumento de volume em órbita esquerda, com posterior detecção de nódulo testicular. A punção aspirativa por agulha fina da massa orbital sugeriu tratar-se de linfoma de alto grau, contudo o diagnóstico definitivo de seminoma difuso foi estabelecido pela avaliação histopatológica, a qual revelou tratar-se de neoplasia maligna pouco diferenciada, sendo o diagnóstico de seminoma difuso confirmado pelo exame imunoistoquímico. Relatos de seminomas metastáticos em cães são incomuns. Objetivou-se com este trabalho relatar um caso de seminoma anaplásico difuso em cão cujo foco principal de metástase ocorreu em região orbital, além de descrever e discutir as dificuldades diagnósticas encontradas.(AU)

Seminoma is a testicular neoformation originating from germ cells, commonly occurring in dogs. With higher prevalence in senile animals, the biological behavior of canine seminomas generally benign. This case reports seminoma with mestastasis in the orbital region in a 14-year-old dog. The animal was treated with a complaint of increased volume in the left orbit, and later a nodule in the testicle was discovered. Fine-needle aspiration of the orbit mass initially indicated a high-grade lymphoma. The definitive diagnosis of diffused seminoma was established by histopathological examination, resulting in poorly differentiated malignant neoplasia. Finally, the diagnosis was confirmed through immunohistochemistry, being the result compatible with diffused seminoma. Metastatic seminomas reported in dogs are quite uncommon. In this work we report a case of diffused anaplastic seminoma in dogs, where the main focus of metastasis was observed in the orbital region, and we also describe and discuss the difficulties encountered in the diagnostic.(AU)

Preventing HIV under financial constraints: The 2011-12 reform of the Portuguese HIV/AIDS Programme.

The national HIV/AIDS Programme has been a core health programme in Portugal, and has led the country's response to the HIV epidemics since the 1980s. In 2011, the Portuguese Government reorganised central services and reformed all vertical programmes, including the HIV/AIDS Programme. This paper describes the main features of that reform and analyses selected outcomes, as well as how those financial constraints affected the response to HIV/AIDS. Despite some transitory cuts in spending, the National Programme for HIV/AIDS Infection was able to successfully expand testing and prevention interventions. Strategic partnerships with non-governmental and community-based organisations were crucial to continue delivering adequate HIV testing services and reaching most-at-risk groups. Scaling-up access to pre-exposure prophylaxis (PrEP), improving access and adherence to antiretroviral therapy, and continuously promoting access to HIV testing services and HIV self-testing are the main challenges that the National Programme for HIV/AIDS Infection will face in the upcoming years.

Primary surgical management of anterior pelvic organ prolapse: a systematic review, network meta-analysis and cost-effectiveness analysis.

BACKGROUND: Anterior compartment prolapse is the most common pelvic organ prolapse (POP) with a range of surgical treatment options available. OBJECTIVES: To compare the clinical effectiveness and cost-effectiveness of surgical treatments for the repair of anterior POP. METHODS: We conducted a systematic review of randomised controlled trials comparing surgical treatments for women with POP. Network meta-analysis was possible for anterior POP, same-site recurrence outcome. A Markov model was used to compare the cost-utility of surgical treatments for the primary repair of anterior POP from a UK National Health Service perspective. MAIN RESULTS: We identified 27 eligible trials for the network meta-analysis involving eight surgical treatments tested on 3194 women. Synthetic mesh was the most effective in preventing recurrence at the same site. There was no evidence to suggest a difference between synthetic non-absorbable mesh, synthetic partially absorbable mesh, and biological mesh. The cost-utility analysis, which incorporated effectiveness, complications and cost data, found non-mesh repair to have the highest probability of being cost-effective. The conclusions were robust to model inputs including effectiveness, costs and utility values. CONCLUSIONS: Anterior colporrhaphy augmented with mesh appeared to be cost-ineffective in women requiring primary repair of anterior POP. There is a need for further research on long-term effectiveness and the safety of mesh products to establish their relative cost-effectiveness with a greater certainty. TWEETABLE ABSTRACT: New study finds mesh cost-ineffective in women with anterior pelvic organ prolapse.

Factors related to condomless anal intercourse between men who have sex with men: results from a European bio-behavioural survey.

BACKGROUND: Relationship status is an important factor associated with condomless anal intercourse (CAI) amongst men who have sex with men (MSM). METHODS: A multi-centre bio-behavioural survey with MSM was conducted in 13 European cities (n = 4901) exploring factors associated with CAI via bivariate and multivariate multilevel logistic regression analyses. RESULTS: Likelihood of CAI with casual partners was associated with being 'out' to a majority (AOR = 1.19;95% CI 1,1.42); knowing their HIV status (AOR = 1.86; 95% CI 1.25,2.76); using substances (1-2 AOR = 1.39; 95% CI 1.16,1.63, 2+ AOR = 1.81; 95% CI 1.35,2.42); being older (AOR = 0.98; 95% CI 0.97,0.99); successful sero-communication (AOR = 0.79; 95% CI 0.67,0.94); and, not having a recent HIV test (AOR = 0.78; 95% CI 0.66,0.92). CAI with steady partners was associated with successful sero-communication (AOR = 2.72; 95% CI 2.72,3.66); not having a recent HIV test (AOR = 1.26; 95% CI 1.09,1.46), and; being older (AOR = 0.99; 95% CI 0.98,0.99). CONCLUSIONS: Understandings of partner type and/or relationship status in relation to CAI amongst MSM can potentially play an important role in the development of culturally appropriate HIV/STI prevention and risk-reduction efforts targeting at-risk MSM. Our results speak to the need to consider segmented and tailored public health and health promotion initiatives for MSM with differing CAI behaviours and relationship profiles.