Perfil clínico de pacientes con urticaria crónica en el Hospital Militar Principal, Guinea-Bisáu / Clinical profile of patients with chronic urticaria at the Main Military Hospital, Guinea-Bissau / Perfil clínico dos doentes com urticária crónica no Hospital Militar Principal, Guiné-Bissau

RESUMEN Introducción: La urticaria crónica es una enfermedad heterogénea delimitada de la piel caracterizada por el desarrollo de ronchas o habones. Objetivo: Determinar las características clínicas y el tratamiento farmacológico indicado en pacientes con diagnóstico de urticaria crónica. Método: Se realizó un estudio cuantitativo, prospectivo, observacional y descriptivo en un universo de 48 pacientes con diagnóstico de urticaria crónica, Hospital Militar Principal, Guinea-Bisáu, 2018-2020. Se midieron las variables: edad, sexo, tipo de urticaria, tiempo de evolución, comorbilidad y tratamiento utilizado en la primera y última consulta registrada, así como la actividad de la enfermedad. Resultados: La edad media fue de 38,52 años con predomino del sexo femenino. El tiempo medio de evolución de la enfermedad fue de 4,67 años y el 70,83 % no presentó angioedema. La urticaria crónica espontánea fue el tipo predominante. La ciproheptadina fue el tratamiento más indicado al inicio del tratamiento y al término del seguimiento su uso se incrementó. El montelukast fue el otro medicamento que incremento su uso al término del seguimiento. La actividad de la enfermedad se redujo con el tratamiento a índices reconocidos como urticaria crónica espontánea controlada. Conclusiones: La urticaria crónica en Guinea-Bisáu tiene una prevalencia y manifestaciones clínicas acorde a lo reportado a nivel mundial con esquemas de tratamiento susceptibles de modificaciones según el inicio del uso de medicamentos recomendados como ciclosporina u omalizumab.

ABSTRACT Introduction: Chronic urticaria is a heterogeneous demarcated skin disease characterized by the development of wheals or hives. Objective: Determination of the clinical characteristics and the pharmacological treatment indicated in patients diagnosed with chronic urticaria. Method: A quantitative, prospective, observational and descriptive study was conducted in a total of 48 patients (the universe) diagnosed with chronic urticaria, Main Military Hospital, Guinea-Bissau, 2018-2020. The following variables were used: age, sex, type of urticaria, time of evolution, comorbidity and treatment used in the first and last recorded consultation, as well as disease activity. Results: The mean age was 38.52 years with a female predominance. The mean time of evolution of the disease was 4.67 years and 70.83% did not present angioedema. Chronic spontaneous urticaria was the predominant type. cyproheptadine was the treatment most indicated to be used at baseline and at the end of treatment follow-up its use increased. montelukast was the other drug that increased its use at the end of follow-up. With the treatment used disease activity was reduced up to rates recognized as controlled chronic spontaneous urticaria. Conclusions: Chronic urticaria in Guinea-Bissau has prevalence and clinical manifestations in line with those reported worldwide, with treatment regimens susceptible to modifications depending on the early use of recommended drugs such as cyclosporine or omalizumab.

RESUMO Introdução: A urticária crônica é uma doença heterogênea delimitada da pele caracterizada pelo desenvolvimento de urticária ou urticária. Objetivo: Determinar as características clínicas e o tratamento farmacológico indicado em pacientes com diagnóstico de urticária crônica. Método: Estudo quantitativo, prospectivo, observacional e descritivo realizado em um universo de 48 pacientes com diagnóstico de urticária crônica, Hospital Militar Principal, Guiné-Bissau, 2018-2020. As variáveis foram mensuradas: idade, sexo, tipo de urticária, tempo de evolução, comorbidade e tratamento utilizado na primeira e última consulta registrada, bem como a atividade da doença. Resultados: A média de idade foi de 38,52 anos com predomínio do sexo feminino. O tempo médio de evolução da doença foi de 4,67 anos e 70,83% não apresentavam angioedema. A urticária crônica espontânea foi o tipo predominante. A ciproeptadina foi o tratamento mais indicado no início do tratamento e ao final do seguimento seu uso aumentou. O montelucaste foi a outra droga que aumentou seu uso ao final do seguimento. A atividade da doença foi reduzida com o tratamento para taxas reconhecidas como urticária crônica espontânea controlada. Conclusões: A urticária crônica na Guiné-Bissau tem prevalência e manifestações clínicas compatíveis com a relatada mundialmente, com esquemas de tratamento que podem ser modificados dependendo do início do uso de medicamentos recomendados como ciclosporina ou omalizumabe.

Prevalencia de rinitis alérgica y factores asociados en estudiantes de Guinea Bissau

RESUMEN Introducción: la rinitis alérgica es una enfermedad inflamatoria crónica de la mucosa nasal, alérgeno-específica, con participación de diversas células. Objetivo: determinar la prevalencia de rinitis alérgica y sus factores de riesgo en estudiantes en dos regiones de Guinea Bissau. Materiales y Métodos: se realizó un estudio cuantitativo, transversal y analítico en un universo de 2 008 estudiantes de 7ª a 12ª clase, en las regiones de Gabú y Bafatá, en Guinea Bissau, entre 2019 y 2020. Se utilizó el Cuestionario diagnóstico de rinitis alérgica para estudios epidemiológicos y el Cuestionario para identificar los factores de riesgo en rinitis alérgica. Los datos del estudio propuestos a medir fueron extraídos de las encuestas. Se solicitó autorización de las autoridades de las instituciones. Resultados: la prevalencia de rinitis alérgica fue del 17,77 %. La media de edad fue mayor en la región de Bafatá (17,34 años), con predominio del sexo femenino en ambas regiones (51,71 % vs. 51,97 %). Resultaron factores de riesgo en ambas regiones -con alto nivel de significación estadística- el sexo femenino (OR: 1,92 / 1,64), el antecedente familiar de la enfermedad (OR: 9,68 / 10,82) y el antecedente de enfermedad recurrente de vías respiratorias superiores (OR: 6,43 / 5,33). Factores como la humedad no resultaron de riesgo (OR: 0,71 / 0,93). Conclusiones: la rinitis alérgica es una condición frecuente en población joven en Guinea Bissau. El antecedente familiar de atopia y el antecedente personal de enfermedad recurrente de vías respiratorias superiores resultaron de un nivel de significación estadística muy alto.

ABSTRACT Introduction: allergic rhinitis is a chronic, allergen-specific, inflammatory disease of the nasal mucosa, involving various cells. Objective: to determine the prevalence of allergic rhinitis and its risk factors in students in two regions of Guinea Bissau. Materials and methods: a quantitative, cross-sectional and analytic study was carried out in a universe of 2,008 students from 7th to 12th class, in the regions of Gabú y Bafatá, in Guinea Bissau, between 2019 and 2020. The Diagnostic Questionnaire of Allergic Rhinitis for Epidemiologic Studies and the Questionnaire to Identify the Risk Factors in Allergic Rhinitis were used. The study data proposed to be measured were drawn from the surveys. It was asked authorization from the authorities of the institutions. Results: the prevalence of allergic rhinitis was 17.77 %. The mean age was higher in Bafatá region (17.34 years), with female predominance in both regions (51.71 % vs. 51.97 %). Risk factors found in both regions-with a high level of statistical significance-were female sex (OR: 1.92 / 1.64), family history of disease (OR: 9.68 / 10.82), and history of recurrent upper respiratory disease (OR: 6.43 / 5.33). Factors like humidity were not found risky (OR: 0.71 / 0.93). Conclusions: allergic rhinitis is a common condition among the young population in Guinea Bissau. The family history of atopy and the personal history of recurrent upper respiratory disease resulted in a very high level of statistical significance.

Reacciones anafilácticas y alérgicas durante procedimientos médicos o quirúrgicos en dos hospitales de Guinea Bissau

RESUMEN Introducción: la seguridad durante los procedimientos médicos o quirúrgicos se ve amenazada por la anafilaxia. Objetivo: evaluar el cuadro clínico, método de estudio y eventual resultado de la reexposición en pacientes con reacciones anafilácticas y alérgicas durante procedimientos médicos o quirúrgicos. Materiales y métodos: se realizó un estudio cuantitativo, observacional y descriptivo en 11 pacientes con diagnóstico de anafilaxia en el curso de una intervención quirúrgica o proceder médico, en los hospitales Militar Principal y Nacional Simão Méndes, de Guinea Bissau, entre 2018 y 2020. Se evaluaron las variables: edad, sexo, procedimiento, método anestésico, antecedentes alérgicos, gravedad de la anafilaxia y agente causal. Resultados: de los 11 pacientes estudiados, 10 tuvieron reacciones en procedimientos quirúrgicos. La media de edad fue de 46,09 años, con una relación por sexo de 0,57 casos masculinos por cada caso femenino. Cinco pacientes (45,45 %) desarrollaron el grado máximo de severidad de la anafilaxia. Los agentes anestésicos fueron la causa de la anafilaxia en dos de los cuatro pacientes sometidos al método de anestesia general y en dos de los cinco sometidos al método de anestesia regional. Por su parte, el látex resultó ser el agente causal en el 45,45 % de los pacientes. Conclusiones: la apropiada identificación de las reacciones anafilácticas durante su aparición, constituye la piedra angular de la actuación médica. En cualquier caso, conllevará estudios alergoanestésicos posteriores que definan el agente causal.

ABSTRACT Introduction: safety during medical or surgical procedures is threatened by anaphylaxis. Objective: to evaluate the clinical characteristics, study method and eventual outcome of re-exposure in patients with anaphylactic and allergic reactions during medical or surgical procedures. Materials and methods: a quantitative, observational and descriptive study was carried out in 11 patients with a diagnosis of anaphylaxis in the course of a surgical intervention or medical procedure, in the Main Military Hospital and the National Hospital Simão Méndes, of Guinea Bissau between 2018 and 2020. The evaluated variables were: age, sex, procedure, anesthetic method, allergic history, severity of anaphylaxis and causal agent. Results: of the 11 patients studied, 10 had reactions in surgical procedures. The mean age was 46.09 years with a sex ratio of 0.57 male cases for each female case. Five patients (45.45 %) developed the maximum degree of anaphylaxis severity. Anesthetic agents were the cause of anaphylaxis in two of the four patients who underwent the general anesthesia method, and in two of the five who underwent the regional anesthesia method. Latex was found to be the causal agent in 45.45 % of the patients. Conclusions: the proper identification of anaphylactic reactions during their appearance is the cornerstone of medical action. In any case, subsequent allergo-anesthetic studies would be needed to define the causative agent.

A clinical-pathological and survival study of oral squamous cell carcinomas from a population of the North of Portugal.

OBJECTIVES: Our aim was to analyze the clinical, pathological, and outcome characteristics of oral squamous cell carcinomas (OSCC) from a population of the North of Portugal. MATERIAL AND METHODS: We conducted a descriptive study of 128 OSCC diagnosed between the years of 2000 and 2010 in the Centro Hospitalar do Porto. Through of the review of the clinical records we studied several clinical, pathological, and outcome variables. The overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier method and log-rank test. Cox regression method was used for multivariate analysis. RESULTS: Of 128 patients with OSCC, 83 (64.8%) were male and 45 (35.2%) were female, (mean age of 62.13±15.57 years). The most affected location was the tongue (n=52; 40.6%). The most common cause of reference was a non-healing ulcer (n=35; 28.9%) followed by oral pain (n=27; 22.3%). Sixty (60.6%) patients were tobacco consumers and 55 (57.3%) alcohol consumers. The cumulative 3-years OS rate was 58.6% and DFS was 55.4%. In multivariable analysis for OS, we found an adverse independent prognostic value for advanced tumour size (p<0.001) and for the presence of perineural permeation (p=0.012). For DFS, advanced stage tumours presented adverse independent prognostic value (p<0.001). CONCLUSION: OSCC occurred most frequently in males, in older patients, and in patients with tobacco and/or alcohol habits. TNM and tumour stage additionally to the perineural permeation were the most important prognostic factor for the survival of these patients, contributing to identify high-risk subgroups and to guide therapy.

Behavioral analysis of Wistar rats fed with a flaxseed based diet added to an environmental enrichment / Análisis del comportamiento de ratas Wistar alimentadas con una dieta a base de linaza añadidos a un enriquecimiento ambiental

Flaxseed has a high content of n-3 fatty acids and its in take associated with an environmental enrichment may promote distinct behavioral results upon habituation and animal behavior. This work aimed to evaluating animal behavior under the use of these two tools in the Open Field Test. Thirty-six male Wistar rats were divided into 6 groups (n = 6): FEEG, receiving chow made up off lax seed and kept in enriched environment; FSEG, receiving flaxseed based diet and kept in a standard environment; CEEG, receiving casein based diet and kept in enriched environment; CSEG, receiving case in based chow and kept in standard environment; MCEEG, receiving chow made up of case in but modified so as to provide the same content of fibers and lipids found in flaxseed diet and kept in enriched environment; MCSEG, receiving modified case in based diet and kept in standard environment. All animals were kept under controlled temperature, collective cages and dark/light cycle, receiving chow and water ad libitum, except for MCEEG and MCSEG, which were pair fed with FEEG and FSEG, respectively. Chow intake and animal body weight were evaluated twice in a week. Animals were maintained in these groups from the first until the second month of life, by the time when 3 day tests in Open Field Test began. Finishing the tests, animals were sacrificed and their brains were obtained in order to calculate the relative brain weight. Our results show an interplay between flaxseed and environmental enrichment in habituation to a new environment, making the animals more manage able and less stressed (AU)

La linaza posee una gran cantidad de ácidos grasos n-3 y su consumo asociado a ambiente enriquecido, puede promover diferentes resultados comportamentales sobre el animal y su habituación. Este trabajo tubo por objetivo evaluar el comportamiento animal utilizando dos herramientas en el Open Field Test. Treinta y seis ratón Wistar fueron divididos en 6 grupos (n=6): FEEG, que recibió dieta a base de linaza y fue mantenido en ambiente enriquecido; FSEG, que recibió dieta a base de linaza y fue mantenido en ambiente padrón; CEEG, que recibió dieta a base de caseína y fue mantenido en ambiente enriquecido; CSEG, que recibió dieta a base de caseína y fue mantenido en ambiente padrón; MCEEG, que recibió dieta a base de caseína con modificaciones de modo a proporcionar el mismo contenido de fibras y grasa encontrados en la dieta a base de linaza, y mantenido en ambiente enriquecido; MCSEG, que recibió dieta a base de caseína modificada y fue mantenido en ambiente padrón. Todos los animales tuvieron temperatura ambiente controlada, jaulas colectivas (n = 3) y ciclo claro/oscuro (12 h), recibiendo agua y ración ad libitum, excepto los grupos MCEEG y MCSEG que fueron sometidos a sistema pair feeding con los grupos FEEG y FSEG, respectivamente. El consumo y peso corporal de los animales fue medido dos veces por semana. Los animales fueron mantenidos en sus respectivos grupos a partir del primer mes de vida y hasta el segundo, cuando se inició un período de pruebas en el Open Field Test. Al término de las pruebas se sacrificaron los animales y se retiraron sus cerebros para calcular el peso relativo. Nuestros resultados muestran una interacción entre la linaza y el enriquecimiento ambiental en la habituación a un nuevo ambiente, haciendo que los animales sean mas manipulables y menos nerviosos (AU)

Trophic position of bottom-feeding fish in the Upper Paraná River floodplain

The 15N composition of bottom-feeding fish (iliophagous = Apareiodon affinis, Cyphocharax nagelii, Prochilodus lineatus, Steindachnerina brevipinna and S. insculpta; detritivorous = Loricariichthys platymetopon and Liposarcus anisitsi; benthophagous = Satanoperca pappaterra and Hoplosternum littorale) and their primary food sources were investigated in the upper Paraná River floodplain during rainy seasons in different environments (lotic and lentic). Two hypotheses were tested: i) that the trophic position and isotopic values of the investigated organisms (fish and food resources) vary spatially; and ii) that trophic position and isotopic compositions differ among iliophagous, detritivorous and benthophagous fish. C4 macrophytes, periphyton and phytoplankton were isotopically different in sites analyzed. Significant isotopic differences occurred in the species of each trophic category. Spatial differences were observed in the isotopic composition of P. lineatus and L. platymetopon, whose values were more enriched in the Paraná River and Pau Véio Lake. Significant spatial differences in trophic position were observed for L. platymetopon and H. littorale, which presented the highest values in the Paraná and Baía rivers, respectively. Trophic positions were significantly different among the species that composed each trophic category. These findings demonstrate that in energy-flow studies in detrital food chains generalizations concerning the grouping of fish into trophic categories and/or habitats should only be carried out after careful investigations of the local/specific trophic dynamics of the organisms.

A composição de 15N de peixes exploradores de fundo (iliófagos = Apareiodon affinis, Cyphocharax nagelii, Prochilodus lineatus, Steindachnerina brevipinna e S. insculpta; detritívoros = Loricariichthys platymetopon e Liposarcus anisitsi; e bentófagos = Satanoperca pappaterra e Hoplosternum littorale) e suas fontes alimentares foram investigadas na planície de inundação do alto rio Paraná durante a estação de chuvas em ambientes lóticos e lênticos. Duas hipóteses foram testadas: i) que a posição trófica e os valores isotópicos dos organismos investigados (peixes e fontes alimentares) variam espacialmente; e ii) que a posição trófica e a composição isotópica diferem entre os peixes iliófagos, detritívoros e bentófagos. Macrofitas C4, perifíton e fitoplâncton foram isotopicamente diferentes entre os locais analisados. Diferenças isotópicas ocorreram entre as espécies de cada categoria trófica. Diferenças espaciais foram observadas na composição isotópica de P. lineatus e L. platymetopon, as quais tiveram valores mais enriquecidos no rio Paraná e ressaco do Pau Véio. Diferenças espaciais significativas nas posições tróficas foram verificadas para L. platymetopon e H. littorale, as quais apresentaram os maiores valores nos rios Paraná e Baía, respectivamente. As posições tróficas foram significativamente diferentes entre as espécies que compuseram cada categoria trófica. Estes resultados demonstram que em estudos de fluxo de energia em cadeias alimentares detritais generalizações a respeito do agrupamento de peixes em categorias tróficas e/ ou habitats devem ser conduzidos somente após investigações criteriosas da dinâmica trófica local/ específica dos organismos.