Childhood social adversity and clustering of health risk behaviours during early adolescence in a population-based birth cohort.

OBJECTIVES: This study aimed to prospectively explore the association between early lifetime exposure to psychosocial adversity and engagement in health risk behaviours (HRBs) during early adolescence. STUDY DESIGN: This was a prospective study. METHODS: This study used data from the baseline (2005-2006), third (2016-2017) and fourth waves (2018-2020) of the Generation XXI birth cohort. Socio-economic circumstances (SECs) at baseline, adverse childhood experiences (ACEs; e.g. abuse, neglect, household dysfunction) at age 10 years and HRBs (i.e. alcohol consumption, smoking, physical exercise level, sedentary behaviours, sleep duration and eating behaviours) at age 13 years were measured. Patterns of HRBs were obtained using latent class analysis. Latent class regression analysis was used to estimate the likelihood of being engaged in HRBs according to the extent of exposure to ACEs (i.e. 0 ACEs, 1-3 ACEs, 4-5 ACEs and ≥6 ACEs) and negative family SECs. RESULTS: Adolescents whose mothers had a low level of education (adjusted odds ratio [aOR] = 2.72 [95% confidence interval {CI}, 2.33-3.18]), low occupational status (aOR = 3.21 [95% CI, 2.68-3.85]) and low income (aOR = 2.70 [95% CI, 2.23-3.28]) were more likely to be engaged in HRBs than their peers with higher SECs. Adolescents who experienced more ACEs were at a significantly increased risk of involvement in HRBs (aOR = 1.86 [95% CI, 1.33-2.63] for 4-5 ACEs vs aOR 2.41 [95% CI, 1.72-3.43] for ≥6 ACEs). No significant gender differences were observed. CONCLUSIONS: Adolescents from families with low SECs were more likely than their more affluent counterparts to be engaged in HRBs. Furthermore, more ACEs contributed to widening health inequalities.

Abuse among Portuguese older people at a time of economic crisis recovery: findings from the Harmed study.

This study aimed to assess the prevalence of abuse against Portuguese older people after an economic crisis and to assess how it has influenced health. A cross-sectional study was carried out including 677 older adults (≥60 years) during 2017. Results show that overall, 23.9% of older people reported being a victim of abuse in the last 12 months. The prevalence of psychological abuse was 19.9%, financial abuse 5.8%, physical abuse 2.5% and sexual abuse 1.9%. Older people who report abuse were more likely to have perceived insufficient income and low social support. The abuse was also significantly associated with poor health status and depressive symptoms. Even in an auspicious period, more than a fifth of older people experiences abuse which is associated with social and health vulnerabilities. These results support that an investment should be made in terms of policies toward an age-friendly environment.

Characterizing the Chemical Profile of Incidental Ultrafine Particles for Toxicity Assessment Using an Aerosol Concentrator.

Incidental ultrafine particles (UFPs) constitute a key pollutant in industrial workplaces. However, characterizing their chemical properties for exposure and toxicity assessments still remains a challenge. In this work, the performance of an aerosol concentrator (Versatile Aerosol Concentration Enrichment System, VACES) was assessed to simultaneously sample UFPs on filter substrates (for chemical analysis) and as liquid suspensions (for toxicity assessment), in a high UFP concentration scenario. An industrial case study was selected where metal-containing UFPs were emitted during thermal spraying of ceramic coatings. Results evidenced the comparability of the VACES system with online monitors in terms of UFP particle mass (for concentrations up to 95 µg UFP/m3) and between filters and liquid suspensions, in terms of particle composition (for concentrations up to 1000 µg/m3). This supports the applicability of this tool for UFP collection in view of chemical and toxicological characterization for incidental UFPs. In the industrial setting evaluated, results showed that the spraying temperature was a driver of fractionation of metals between UF (<0.2 µm) and fine (0.2-2.5 µm) particles. Potentially health hazardous metals (Ni, Cr) were enriched in UFPs and depleted in the fine particle fraction. Metals vaporized at high temperatures and concentrated in the UF fraction through nucleation processes. Results evidenced the need to understand incidental particle formation mechanisms due to their direct implications on particle composition and, thus, exposure. It is advisable that personal exposure and subsequent risk assessments in occupational settings should include dedicated metrics to monitor UFPs (especially, incidental).

Characterization of organic compounds and drugs in sewage sludge aiming for agricultural recycling.

The application of sewage sludge in soils can bring benefits to agricultural productivity, however, the risks arising from this application must be measured and carefully evaluated. Persistent organics compounds and drugs can be present in the sewage sludge and if applied to the soil, they can cause severe risks to the soil biota and contamination of groundwater. This work determined 174 persistent organic compounds and drugs in sludge samples from a wastewater treatment plant using chromatographic methods. The drugs ciprofloxacin, enrofloxacin and diclofenac were quantified, and values varied according to sampling period. For persistent organic compounds, cresols were the most abundant compounds in sewage sludge. With the analyses made of both the elutriate and the filtrate, it was possible to verify the potential for soil retention or leaching that each compound can present with the application of sewage sludge in the agriculture.

Automatização em nutrição parentérica: controlo de qualidade antes e após a sua implementação / Automation in parenteral nutrition: quality control of the process before and after it`s implementation

A nutrição parentérica (NP) desempenha um papel vital em doentes críticos, sendo muitas vezes necessária a sua preparação personalizada, ajustada às necessidades de doentes com carências específicas. A manipulação de NP poderá ser realizada de forma manual ou automatizada, requerendo sempre condições asséticas e pessoal treinado. A implementação de um sistema automatizado requer uma análise cuidada da sua necessidade/justificação, de forma a que, baseado em fundamentação adequada, se estruture um plano exequível. A monitorização do desempenho do sistema automatizado é um processo fundamental de validação farmacêutica. Nos Serviços Farmacêuticos (SF) do Centro Hospitalar e Universitário de São João (CHUSJ), elaborou-se um estudo de controlo de qualidade gravimétrico antes e após implementação do sistema automatizado, no sentido de monitorizar a precisão dos resultados obtidos para este ensaio de verificação. Como resultados estatísticos, o método de enchimento automatizado relacionou-se com a menor média para o desvio ao peso teórico, assim como menor desvio padrão, corroborando uma menor percentagem de erro e também uma menor dispersão dos resultados. Da análise dos resultados obtidos concluiu-se que a implementação da automatização se traduziu em melhorias a nível de precisão de resultados para o controlo gravimétrico das bolsas nutritivas, aumentando a segurança das misturas produzidas e, consequentemente, a qualidade dos cuidados prestados ao doente. É de elevada importância que se implementem procedimentos de validação do desempenho do sistema automatizado, como foi o caso, sendo que deverão ser complementados com outro tipo de avaliações, preferencialmente realizadas por entidades externas à instituição em causa. (AU)

Parenteral nutrition (PN) plays a vital role in critically ill patients and custom preparation is often necessary, adjusted to the needs of patients with specific needs. Compounding PN handling can be performed manually or automated, always requiring aseptic conditions and trained personnel. The implementation of an automated system requires a careful analysis of its need/ justification, so that, based on adequate rationale, a feasible execution plan may be structured. Monitoring the performance of the automated system is a key process which requires of pharmaceutical validation. In the Pharmaceutical Service of the Centro Hospitalar e Universitário de São João (CHUSJ), a study of gravimetric quality control was carried out before and after the implementation of the automated system, in order to monitor the accuracy of the results obtained for this verification test. As statistical results, the automated filling method was related to the lower average for the deviation to the theoretical weight, as well as lower standard deviation, corroborating a lower percentage of error but also a smaller dispersion of the results with this method. From the analysis of the results obtained, it was concluded that the implementation of automation resulted in improvements in the accuracy of results for the gravimetric control of nutritional bags, increasing the safety of the mixtures produced and, consequently, the quality of care provided to the patient. It is of highly importance that procedures for validating the performance of the automated system are implemented, as was the case, and these should be complemented by other types of evaluations, preferably performed by external entities to the institution in question. (AU)

Socioeconomic position and quality of life among older people: The mediating role of social support.

Social support can obscure social gradients in health, but its role as a mediator between socioeconomic position (SEP) and quality of life (QoL) in older populations remains unknown. We aimed to examine to what extent social support mediates the association between SEP and overall QoL among older adults (aged 60-84 years). We studied a population-based cohort of 585 noninstitutionalized adults in Porto, Portugal, who were evaluated in 2009. Education, occupation, and perceived income adequacy were used as SEP indicators. The WHOQOL-OLD was used to determine overall QoL. Social support was assessed using the Multidimensional Scale of Perceived Social Support. Path analysis was conducted to quantify direct, indirect, and total effects of SEP on QoL. There was a positive total effect of education on QoL (ß = 0.28; 95% CI: 0.05-0.48). In this model, we found an indirect effect through social support (ß = 0.15; 95% CI: 0.05-0.26), explaining 54% of the pathway between education and QoL. A similar pattern was identified for the association between occupation and QoL. Perceived income adequacy had a total effect of 2.74 (95% CI: 1.68-3.93) on QoL. Although an indirect effect through social support was found (ß = 0.98; 95% CI: 0.42-1.55), a direct effect from this variable remained (ß = 1.76; 95% CI: 0.65-2.90). Social support can be a mechanism through which SEP impacts the QoL of older people. Strengthening social support ties may attenuate the impact of social inequalities and improve the QoL of this population.

Manifestación atípica de sarcoidosis: calcificaciones pulmonares / Atypical presentation of sarcoidosis: pulmonary calcifica

Varón de 53 años, exfumador, diagnosticado de EPOC y sarcoidosis sistémica en tratamiento (afectación ganglionar múltiple, cutánea y renal) que presentó un infiltrado parenquimatoso en lóbulo superior izquierdo como hallazgo casual en radiografía de tórax. En TC realizada dada su persistencia, se observó afectación en vidrio deslustrado en campos medios y superiores, aparentemente secundaria a sarcoidosis. Dado el contexto de estabilidad clínica, se decidió realizar un control radiográfico en 6 meses, objetivándose un claro empeoramiento. La nueva TC mostró zonas de consolidación sobre las áreas que previamente presentaban mayor afectación en vidrio deslustrado, mostrando ahora valores de atenuación tan elevados que únicamente podrían corresponder a calcio. La aparición de las calcificaciones sobre tejido pulmonar previamente alterado, así como la ausencia de datos clínicos y analíticos de infección y/o desestabilización del metabolismo del calcio, apoyan que la sarcoidosis sea la causa de estas calcificaciones, lo cual es excepcional

53-year-old man, former smoker, with COPD and systemic sarcoidosis under treatment (multiple lymph nodes, skin and kidney affection). A chest x-ray showed a parenchyma infiltrate in upper left lobe. Chest CT demonstrated areas of ground-glass opacification at middle and upper areas of both lungs. As the patient was clinically stable, we decided to do an X-ray control 6 months later. The new chest X-ray image showed a clear worsening, with more severe infiltrates in middle and upper areas of both lungs. At this time, chest CT demonstrated pulmonary calcifications at the same areas that had been shown affected in the previous CT. These dystrophic calcifications were probably secondary to sarcoidosis. This is further supported by the clinical and analytical stability of the patient during this period, without developing signs of infectious processes or decompensation of calcium metabolic disorders

EEG data collection using visual evoked, steady state visual evoked and motor image task, designed to brain computer interfaces (BCI) development.

A set of electroencephalogram (EEG) data from 29 subjects obtained from a study, in which the subjects performed a set of tests based on visual stimuli and motor images of the hands is presented. Three types of data are provided in this article: (1) Signals based on visual events (VEP), (2) signals based on steady state visual events (SSVEP) and (3) signals based upon Motor Imagery (MI). Several research projects have used this data to test the detection of visual stimuli, classification and selection of characteristics of brain signals, EEG preprocessing and for optimization processes based on heuristic algorithms and algorithms based upon collective animal intelligence. The data was acquired using an Emotiv Epoc + portable EEG with 14 data channels and two reference channels.

MALDI-TOF MS in Anaerobiospirillum succiniciproducens bacteremia: A report of 4 cases in different hosts.

Anaerobiospirillum succiniciproducens is known as an uncommon cause of diarrhea and bacteremia in humans, usually in immunocompromised hosts. We report four cases of A. succiniciproducens bloodstream infection in different hosts, including a previously healthy man. We describe clinical features, antibiotics susceptibility profile, treatment and outcomes. Strains were identified by 16S rRNA gene sequences which contributed to the extension of our MALDI-TOF MS database.

Thermal degradation kinetics of anthocyanins extracted from juçara (Euterpe edulis Martius) and "Italia" grapes (Vitis vinifera L.), and the effect of heating on the antioxidant capacity.

The effect of temperature on the degradation of anthocyanins in juçara and "Italia" grape extracts was determined between 50 and 90°C. For both species, thermal degradation followed a first-order kinetic model. The decimal reduction time decreased with increasing temperature, and dependence on the thermodegradable factor was lower at higher temperatures. The anthocyanins from juçara degraded more slowly than those extracted from "Italia" grapes. The activation enthalpy and free energy of inactivation indicated an endothermic reaction, not spontaneous degradation, whereas the activation entropy suggested that the transition state has less structural freedom than that of the reactants. The antioxidant capacity of the extracts was reduced when subjected to 90°C heat treatment, however, significant quantities of this bioactive compound still remained.

CAD/CAM machining Vs pre-sintering in-lab fabrication techniques of Y-TZP ceramic specimens: Effects on their mechanical fatigue behavior.

This study evaluated the effects of different pre-sintering fabrication processing techniques of Y-TZP ceramic (CAD/CAM Vs. in-lab), considering surface characteristics and mechanical performance outcomes. Pre-sintered discs of Y-TZP ceramic (IPS e.max ZirCAD, Ivoclar Vivadent) were produced using different pre-sintering fabrication processing techniques: Machined- milling with a CAD/CAM system; Polished- fabrication using a cutting device followed by polishing (600 and 1200 SiC papers); Xfine- fabrication using a cutting machine followed by grinding with extra-fine diamond bur (grit size 30 µm); Fine- fabrication using a cutting machine followed by grinding with fine diamond bur (grit size 46 µm); SiC- fabrication using a cutting machine followed by grinding with 220 SiC paper. Afterwards, the discs were sintered and submitted to roughness (n=35), surface topography (n=2), phase transformation (n=2), biaxial flexural strength (n=20), and biaxial flexural fatigue strength (fatigue limit) (n=15) analyses. No monoclinic-phase content was observed in all processing techniques. It can be observed that obtaining a surface with similar characteristics to CAD/CAM milling is essential for the observation of similar mechanical performance. On this sense, grinding with fine diamond bur before sintering (Fine group) was the best mimic protocol in comparison to the CAD/CAM milling.

Grado de satisfacción de los cuidadores principales de pacientes seguidos por los equipos de cuidados paliativos / Satisfaction of principal caregivers of patients followed-up by palliative care teams

Objetivo. Conocer el grado de satisfacción o insatisfacción de los cuidadores principales de pacientes fallecidos atendidos por equipos de cuidados paliativos. Método. Búsqueda bibliográfica en bases de datos electrónicas -PubMed y MEDES- utilizando «Palliative Care» y «patient satisfaction» como descriptores principales, y «Family», «Professional-Family Relations», «Quality of Health Care» y «Quality Assurance, Health Care» como descriptores secundarios. Se incluyeron los estudios realizados en inglés y en español. Resultados. Perfil del cuidador principal: sexo femenino, rango de edad desde la segunda mitad de los 40 a la segunda mitad de los 50, parentesco más frecuente hijo/a y nivel de estudios primarios. Aspectos mejor valorados: amabilidad en el trato, poder plantear preguntas sobre problemas durante la evolución, delicadeza en la explicación, información recibida, control del dolor, tiempo para responder preguntas, interés por los problemas emocionales, información sobre el tratamiento. Aspectos peor valorados: control de síntomas, falta de ayuda psicológica después del fallecimiento, preparación para la muerte de un familiar, contacto después del fallecimiento, ayuda para resolver temas pendientes, ayuda durante el duelo. La gran mayoría de los equipos de cuidados paliativos obtienen excelentes resultados en el apartado de valoración global. Conclusión. A pesar de los buenos resultados de las encuestas de satisfacción de los usuarios (cuidadores) con respecto a las unidades de cuidados paliativos, se hace imprescindible mejorar la formación científico-técnica (tanto desde el punto de vista médico como psicológico) y las habilidades de comunicación de los profesionales que trabajan en cuidados paliativos (AU)

Objective. To determine the satisfaction of main caregivers of deceased patients followed-up by palliative care teams. Method. Web research on electronic data bases: PubMed and MEDES, using 'Palliative Care' and 'Patient Satisfaction' as main descriptors, and 'Family', 'Professional-Family Relations', 'Quality of Health Care' and 'Quality Assurance, Health Care' as secondary descriptors. Studies written in Spanish and English were included. Results. Profile of principal caregiver: a woman between her mid-forties and her mid-fifties, usually related with the patient as a daughter, and of primary educational level. The items that the main caregivers valued the most were: a kind manner, feeling free to ask questions about problems during the process, tactful explanations, receiving information, pain management, time for answering questions, interest for emotional problems, and information about treatment. The worse valued items were: symptoms control, lack of psychological support after death, preparation for a death of a relative, keeping in touch after death, help to resolve outstanding issues, and help during grief. In general, a great majority of palliative care teams achieved excellent results. Conclusion. In spite of the good results obtained in satisfaction surveys from caregivers with regard to palliative care teams, it is essential to improve the quality of scientific-technical training (both from the medical and the psychological point of view), as well as to improve communicational skills among palliative care staff (AU)

The effect of grinding on the mechanical behavior of Y-TZP ceramics: A systematic review and meta-analyses.

The aim of this study was to systematically review the literature to assess the effect of grinding on the mechanical properties, structural stability and superficial characteristics of Y-TZP ceramics. The MEDLINE via PubMed and Web of Science (ISI - Web of Knowledge) electronic databases were searched with included peer-reviewed publications in English language and with no publication year limit. From 342 potentially eligible studies, 73 were selected for full-text analysis, 30 were included in the systematic review with 20 considered in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Statistical analyses were performed using RevMan 5.1, with random effects model, at a significance level of 0.05. A descriptive analysis considering phase transformation, Y-TZP grain size, Vickers hardness, residual stress and aging of all included studies were executed. Four outcomes were considered in the meta-analyses (factor: grinding x as-sintered) in global and subgroups analyses (grinding tool, grit-size and cooling) for flexural strength and roughness (Ra) data. A significant difference (p<0.05) was observed in the global analysis for strength, favoring as-sintered; subgroup analyses revealed that different parameters lead to different effects on strength. In the global analysis for roughness, a significant difference (p<0.05) was observed between conditions, favoring grinding; subgroup analyses revealed that different parameters also lead to different effects on roughness. High heterogeneity was found in some comparisons. Generally grinding promotes decrease in strength and increase in roughness of Y-TZP ceramics. However, the use of a grinding tool that allows greater accuracy of the movement (i.e. contra angle hand-pieces coupled to slowspeed turbines), small grit size (<50µm) and the use of plenty coolant seem to be the main factors to decrease the defect introduction and allow the occurrence of the toughening transformation mechanism, decreasing the risk of deleterious impact on Y-TZP mechanical properties.

The efficacy and safety of teneligliptin added to ongoing metformin monotherapy in patients with type 2 diabetes: a randomized study with open label extension.

OBJECTIVE: The study investigated the efficacy and tolerability of teneligliptin co-administered to patients with type 2 diabetes mellitus (T2DM) who were inadequately controlled by stable metformin monotherapy ≥ 1000 mg/day. METHODS: A total of 447 patients from 55 European centers who completed a 14-day screening and 14-day run-in phase, received randomized double-blind treatment with 5, 10, 20 or 40 mg teneligliptin or placebo once daily, for 24 weeks. 364 patients continued treatment in a 28-week open label extension during which they received teneligliptin 20 mg once daily. RESULTS: Co-administration of teneligliptin (5 to 40 mg) with metformin demonstrated dose-related and statistically significant reductions in HbA1c after 24 weeks (-0.30 to -0.63% placebo adjusted) of double-blind treatment. The greatest reduction in HbA1c was seen with teneligliptin at 40 mg (-0.63%) at Week 24. There was also a dose-dependent increase in proportion of responders achieving HbA1c < 7.0% at this endpoint. Responses were maintained throughout 28 weeks open label treatment with 20 mg teneligliptin. Treatment was well tolerated to Week 52 and the overall incidence of hypoglycemia during 52 weeks was 2.3%. CONCLUSIONS: Teneligliptin co-administered with metformin produced significant reductions in HbA1c in patients with T2DM without increasing the risk of hypoglycemia.

[Satisfaction of principal caregivers of patients followed-up by palliative care teams]. / Grado de satisfacción de los cuidadores principales de pacientes seguidos por los equipos de cuidados paliativos.

OBJECTIVE: To determine the satisfaction of main caregivers of deceased patients followed-up by palliative care teams. METHOD: Web research on electronic data bases: PubMed and MEDES, using "Palliative Care" and "Patient Satisfaction" as main descriptors, and "Family", "Professional-Family Relations", "Quality of Health Care" and "Quality Assurance, Health Care" as secondary descriptors. Studies written in Spanish and English were included. RESULTS: Profile of principal caregiver: a woman between her mid-forties and her mid-fifties, usually related with the patient as a daughter, and of primary educational level. The items that the main caregivers valued the most were: a kind manner, feeling free to ask questions about problems during the process, tactful explanations, receiving information, pain management, time for answering questions, interest for emotional problems, and information about treatment. The worse valued items were: symptoms control, lack of psychological support after death, preparation for a death of a relative, keeping in touch after death, help to resolve outstanding issues, and help during grief. In general, a great majority of palliative care teams achieved excellent results. CONCLUSION: In spite of the good results obtained in satisfaction surveys from caregivers with regard to palliative care teams, it is essential to improve the quality of scientific-technical training (both from the medical and the psychological point of view), as well as to improve communicational skills among palliative care staff.

Are posts necessary for the restoration of root filled teeth with limited tissue loss? A structured review of laboratory and clinical studies.

Guidelines for post placement are lacking in respect of the amount of tooth structure, particularly in cases in which ≥50% of coronal structure is preserved. The aim of this review was to provide evidence-based principles for the use of posts in the restoration of root filled teeth with limited tissue loss. A literature search of laboratory and clinical studies published between 2000 and 2014 was conducted in PubMed. Included studies contained at least one study group with root filled teeth restored without a post, presented at least one group with root filled teeth with limited tissue loss, and, in the case of laboratory studies, performed mechanical cycling prior to a fracture resistance test. Based on the evidence from laboratory studies, root filled premolars and molars with limited tissue loss can be restored without posts, particularly when total coverage is planned. However, when no cusp protection is provided, post placement appears to be beneficial in premolars. Evidence regarding the best restoration option for root filled incisors with limited tissue loss remains controversial. When total coverage is intended, reconstruction seems to be successfully performed by restoration with composite. However, some reports consider that post insertion increases fracture loads. The review of clinical studies demonstrated that survival of teeth with substantial tooth tissue is not influenced by the use of posts. Exceptions were found when only premolars were investigated; in these cases, post placement was associated with greater survival rates in crowned teeth and fewer root fractures in teeth without cusp protection.

Role of H(2)O(2) in hypertension, renin-angiotensin system activation and renal medullary disfunction caused by angiotensin II.

BACKGROUND AND PURPOSE: Activation of the intrarenal renin-angiotensin system (RAS) and increased renal medullary hydrogen peroxide (H(2) O(2) ) contribute to hypertension. We examined whether H(2) O(2) mediated hypertension and intrarenal RAS activation induced by angiotensin II (Ang II). EXPERIMENTAL APPROACH: Ang II (200 ng·kg(-1) ·min(-1) ) or saline were infused in Sprague Dawley rats from day 0 to day 14. Polyethylene glycol (PEG)-catalase (10 000 U·kg(-1) ·day(-1) ) was given to Ang II-treated rats, from day 7 to day 14. Systolic blood pressure was measured throughout the study. H(2) O(2) , angiotensin AT(1) receptor and Nox4 expression and nuclear factor-κB (NF-κB) activation were evaluated in the kidney. Plasma and urinary H(2) O(2) and angiotensinogen were also measured. KEY RESULTS: Ang II increased H(2) O(2) , AT(1) receptor and Nox4 expression and NF-κB activation in the renal medulla, but not in the cortex. Ang II raised plasma and urinary H(2) O(2) levels, increased urinary angiotensinogen but reduced plasma angiotensinogen. PEG-catalase had a short-term antihypertensive effect and transiently suppressed urinary angiotensinogen. PEG-catalase decreased renal medullary expression of AT(1) receptors and Nox4 in Ang II-infused rats. Renal medullary NF-κB activation was correlated with local H(2) O(2) levels and urinary angiotensinogen excretion. Loss of antihypertensive efficacy was associated with an eightfold increase of plasma angiotensinogen. CONCLUSIONS AND IMPLICATIONS: The renal medulla is a major target for Ang II-induced redox dysfunction. H(2) O(2) appears to be the key mediator enhancing intrarenal RAS activation and decreasing systemic RAS activity. The specific control of renal medullary H(2) O(2) levels may provide future grounds for the treatment of hypertension.

Development of temporomandibular joint ankylosis in rats using stem cells and bone graft.

64 male Wistar rats were used: 24 for the removal of stem cells, 4 as a control group, and 36 for the experiment, in which either stem cells or bone graft was used. The rats were divided into groups according to the type of procedure and time span (15, 30 or 60 days). The joints were submitted to histological study in order to score the ankylosis. The mean differences between initial and final maximal mouth opening (MMO) were gradually increased from 15 to 60 days, for all times of evaluation for both groups, being statistically significant at 15 days (p=0.045) in the bone-graft group. When both groups were compared, the mean differences between initial and final MMO were statistically significant at 15 days (p=0.018) and 30 days (p=0.029). In relation to the histological scores, in the bone-graft group almost all animals had intra-articular fibrosis at all times of evaluation (n=17). In the stem-cell group, there was new bone at 15 days (n=4), 30 days (n=3) and 60 days (n=4). The study model permitted the development of fibrous ankylosis in the majority of animals for both groups and no bony bridge was observed.

Alcohol use among 13-year-old adolescents: associated factors and perceptions.

OBJECTIVE: To describe the frequency and determinants of alcohol use in a representative sample of 13 years old adolescents, and to analyse qualitatively how adolescents perceive this issue. STUDY DESIGN: Cross-sectional study with quantitative and qualitative components. METHODS: Two thousand and thirty-six adolescents attending schools in a city in Portugal were surveyed using a self-reported, structured questionnaire. The qualitative component of the study included 30 semi-structured interviews that intended to assess the reasons for and consequences of drinking as perceived by adolescents, and also the preventive strategies they suggested. RESULTS: Overall, 50.0% of girls and 44.9% of boys reported that they had experimented with alcohol, and 4.7% of girls and 6.6% of boys drink alcohol at least once per month. Most adolescents recognised that drinking alcohol is harmful and an addiction which is difficult to treat, but this perception was not associated with their own behaviour. Adolescents only identified minor and temporary consequences of drinking alcohol, usually related to very high and acute consumption. In order to prevent alcohol abuse and its consequences, adolescents proposed measures based on strict control, legal restrictions and economic measures, some of which are already in place in Portugal. CONCLUSION: A high proportion of adolescents had experimented with alcohol by 13 years of age, showing the importance of starting prevention at an early life stage. The results also reflect the importance of reviewing prevention programmes in schools, highlighting the importance of families.