Evaluation of patients' satisfaction with domiciliary biological treatment in severe asthma: a Portuguese survey.

Dear Editor, According to GINA, severe asthma is defined as uncontrolled asthma, despite therapy adherence with an optimized high dose of inhaled corticosteroid plus long-acting ß2-agonist coupled with management of modifiable factors/comorbidities, that worsens when this treatment is decreased. It affects a significant portion of asthmatic patients and imposes a high risk of exacerbations and mortality, which are associated with significant healthcare costs and psychosocial impact...

The Clinical Spectrum of Adrenoleukodystrophy at a Portuguese Tertiary Hospital: Case Series and Review of Literature.

Adrenoleukodystrophy, a rare genetic disease associated with the X chromosome (X-ALD - X-linked adrenoleukodystrophy), predominantly affects males and stems from mutations in the ABCD1 gene, responsible for transporting very long chain fatty acids (VLCFA) into peroxisomes. It leads to adrenal insufficiency (AI) and axonal demyelination. In males, the phenotype varies from isolated adrenocortical insufficiency and progressive myelopathy to cerebral adrenoleukodystrophy (CALD). The aim of this case series is to characterize patients with different clinical presentations of X-ALD with follow-up at a tertiary Portuguese hospital. All four patients were males, and the median age at the diagnosis was 5 years. Three patients were diagnosed through family screening, with the oldest already displaying hyperpigmentation. Two distinct forms were identified: adolescent CALD (25%) and isolated primary adrenal insufficiency (75%). Analytical studies revealed elevated plasma VLCFA levels in all cases, and genetic analysis demonstrated two different mutations in the ABCD1 gene. This disorder requires early diagnosis for improved prognosis. Screening male children with primary AIfor X-ALD using a VLCFA panel should be considered, particularly after ruling out the most common causes or when learning difficulties are evident. Genetic confirmation of the diagnosis is essential, enabling genetic counseling, family planning, and preimplantation genetic diagnosis.

Harnessing online digital data in biodiversity monitoring.

Online digital data from media platforms have the potential to complement biodiversity monitoring efforts. We propose a strategy for integrating these data into current biodiversity datasets in light of the Kunming-Montreal Global Biodiversity Framework.

Exploring the relationship between emotion regulation, inhibitory control, and eating psychopathology in a non-clinical sample.

OBJECTIVE: The present study aimed to explore the relationship between difficulties in emotion regulation and deficits in inhibitory control, and the role of these processes in eating psychopathology in a non-clinical sample. We also explored the specificity in which deficits in inhibitory control may underlie eating psychopathology, namely whether they can be conceptualised as context specific or more extensive in nature. METHOD: Participants were 107 healthy individuals recruited at a major Portuguese university, aged between 18 and 43 years-old (M = 21.23, SD = 4.79). Two computerised neuropsychological tasks (i.e., emotional go/no-go and food go/no-go tasks) were used to assess response inhibition in the presence of general versus context-specific stimuli. A set of self-report measures was used to assess variables of interest such as emotion regulation and eating psychopathology. RESULTS: Results indicated higher response inhibition deficits among participants with higher difficulties in emotion regulation comparing to those with lower difficulties in emotion regulation, particularly in the context of food-related stimuli. In addition, the relationship between difficulties in emotion regulation and eating psychopathology was moderated by inhibitory control deficits in both the context of food and pleasant stimuli. CONCLUSIONS: The present findings highlight inhibitory control as an important process underlying the relationship between difficulties in emotion regulation and eating psychopathology in non-clinical samples. Findings have important implications for clinical practice and the prevention of eating psychopathology in healthy individuals and individuals with eating disorders.

Brown-Séquard Syndrome Following a Thoracic Spine Stab Wound: A Case Report.

Nonmissile penetrating spine injury represents a small percentage of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. This paper presents a detailed case report of a 28-year-old man with a history of substance use who suffered multiple injuries following a violent incident. The patient was found with a knife embedded in his thoracic spine, prompting immediate medical intervention. Computed tomography and postoperative magnetic resonance imaging revealed the extent of spinal cord and anatomical involvement. A thorough physical medicine and rehabilitation evaluation was conducted post-surgery, leading to a diagnosis of Brown-Séquard syndrome with associated sensorimotor deficits. This paper highlights the challenges posed by penetrating SCIs while reviewing the literature.

Corrigendum: Severe and enduring' stage in anorexia nervosa: comparing eating attitudes, impairment and associated psychopathology.

[This corrects the article DOI: 10.3389/fnut.2022.867401.].

Standardized approach for extubation during extracorporeal membrane oxygenation in severe acute respiratory distress syndrome: a prospective observational study.

BACKGROUND: Extubation during extracorporeal oxygenation (ECMO) in severe acute respiratory distress syndrome (ARDS) has not been well studied. Despite the potential benefits of this strategy, weaning from ECMO before liberation from invasive mechanical ventilation remains the most frequent approach. Our aim was to evaluate the safety and feasibility of a standardized approach for extubation during ECMO in patients with severe ARDS. RESULTS: We conducted a prospective observational study to assess the safety and feasibility of a standardized approach for extubation during ECMO in severe ARDS among 254 adult patients across 4 intensive care units (ICU) from 2 tertiary ECMO centers over 6 years. This consisted of a daily assessment of clinical and gas exchange criteria based on an Extracorporeal Life Support Organization guideline, with extubation during ECMO after validation by a dedicated intensive care medicine specialist. Fifty-four (21%) patients were extubated during ECMO, 167 (66%) did not reach the clinical criteria, and in 33 (13%) patients, gas exchange precluded extubation during ECMO. At ECMO initiation, there were fewer extrapulmonary organ dysfunctions (lower SOFA score [OR, 0.88; 95% CI, 0.79-0.98; P = .02] with similar PaO2/FiO2) when compared with patients not extubated during ECMO. Extubation during ECMO associated with shorter duration of invasive mechanical ventilation (7 (4-18) vs. 32 (18-54) days; P < .01) and of ECMO (12 (7-25) vs. 19 (10-41) days; P = .01). This was accompanied by a lower incidence of hemorrhagic shock (2 vs. 11%; P = .05), but more cannula-associated deep vein thrombosis (49 vs. 31%; P = .02) and failed extubation (20 vs. 6%; P < .01). There were no increased major adverse events. Extubation during ECMO is associated with a lower risk of all-cause death, independently of measured confounding (adjusted logistic regression OR 0.23; 95% confidence interval 0.08-0.69, P = .008). CONCLUSIONS: A standardized approach was safe and feasible allowing extubation during ECMO in 21% of patients with severe ARDS, selecting patients who will have a shorter duration of invasive mechanical ventilation, ECMO course, and ICU stay, as well as fewer infectious complications, and high hospital survival.

Postural stability computerized evaluation in total knee arthroplasty.

PURPOSE: To evaluate the balance in patients with total knee arthroplasty (TKA) and knee osteoarthrosis (KOA), measured by postural stability computerized evaluation (PSCE), and to evaluate the effect of post-TKA patients' characteristics in their performance on PSCE. MATERIALS AND METHODS: An observational cross-sectional study was conducted in two sets of patients: (A) patients with KOA and primary TKA surgery scheduled and (B) patients who underwent primary TKA >9 months. Sociodemographic, radiographic, clinical and PSCE parameters (using the Biodex Balance System) were assessed. RESULTS: Post-TKA patients placed more load on the replaced knee than the contralateral osteoarthritic knee (p = 0.027). They had less imbalance on the balance tests performed with the eyes open, on stable (p = 0.032), and unstable platforms (p = 0.022). These patients also showed better postural stability in monopodalic stance, both standing on the TKA (p = 0.010) and contralateral knee (p = 0.017). Age, weight, pain on the operated knee, extension deficit on the operated knee, and Berg Balance Scale scores on post-TKA patients were significantly associated with their performance on PSCE tests. CONCLUSIONS: PSCE can be useful to quantify the balance of post-TKA and KOA patients.

Total knee arthroplasty is the definitive treatment for knee osteoarthrosis and it has several benefits, but its effect on balance is still unknown.Postural stability computerized evaluation is used to evaluate balance on vestibular diseases and it has been recently studied on musculoskeletal conditions.Postural stability computerized evaluation may be useful to evaluate patients' balance before and after total knee arthroplasty.

Surviving critical COVID-19: How functionality, physical, mental and cognitive outcomes evolve?

PURPOSE: To analyze the long-term consequences of critical COVID-19, regarding physical, mental, cognitive and functional impairments, and to describe its evolution through time. METHODS: Prospective cohort study, with consecutive inclusion of patients admitted due to SARS-CoV-2 to intensive care units(ICU) of a tertiary-care center, between May/2020 and September/2021. All included patients were included in Physical and Rehabilitation Medicine(PRM) inpatient programs during ICU stay. Eligible patients were evaluated on PRM appointments 6 and 12 months after ICU discharge. In each visit, physical examination and a predefined set of scales were applied, aiming to comprehensively evaluate the three domains (physical, mental and cognitive) of post-intensive care syndrome and the patients' functionality. Statistical analysis encompassed descriptive and univariate analysis. RESULTS: A total of 42 patients were included: 66.7% males, mean age of 62 yo. In the physical domain, 6 months after ICU discharge, there was a significant reduction in quality of life (p-value = 0.034), muscle strength (p-value = 0.002), gait ability (p-value<0.001) and balance (p-values<0.001) and increased fatigue levels (p-value = 0.009), in comparison with reference values. Yet, a significative positive evolution was observed in all referred subdomains (p-values<0.05). Nevertheless, 12 months after discharge, muscle strength (p-value = 0.001), gait (p-value<0.001) and balance (p-value<0.001) were still significantly compromised. Regarding the mental domain, both at 6 and 12 months after discharge, the levels of anxiety and depression were significantly increased (p-values<0.001). Nonetheless, a positive evolution was also found (p-values<0.02). Cognitive performance was significantly impaired in comparison with reference values, both at 6 and 12 months (p-value<0.001). Yet, a global improvement was also depicted (p-value = 0.003). Six months after ICU discharge, 54.8% were autonomous in activities of daily living, a value that improved to 74.0% in the subsequent 6 months (p-value = 0.002). CONCLUSION: Critical COVID-19 survivors present significant physical, mental and cognitive impairments 6 and 12 months after ICU discharge, despite their positive evolution through time.

Short and long-term temperature variations drive recruitment variability in marine and estuarine juvenile fishes.

Understanding the long-term effects of climatic factors on key species' recruitment is crucial to species management and conservation. Here, we analysed the recruitment variability of key species (Dicentrarchus labrax, Platichthys flesus, Solea solea, Pomatoschistus microps and Pomatoschistus minutus) in an estuary between 2003 and 2019, and related it with the prevailing local and large-scale environmental factors. Using a dynamic factor analysis (DFA), juvenile abundance data were grouped into three common trends linked to different habitat uses and life cycle characteristics, with significant effect of temperature-related variables on fish recruitment: Sea surface temperature and the Atlantic Multidecadal Oscillation. In 2010, a regime shift in the North Atlantic coincided with a shift in the common trends, particularly a decline in P. flesus and S. solea trend. This work highlights the thermophilic character of fish recruitment and the necessity to investigate key biological processes in the context of species-specific responses to climate change.

Stability and Bioaccessibility of Phenolic Compounds in Rosehip Extracts during In Vitro Digestion.

Rosehips, particularly dog rose fruits (Rosa canina L.), are a great source of antioxidant compounds, mainly phenolics. However, their health benefits directly depend on the bioaccessibility of these compounds affected by gastrointestinal digestion. Thus, the purpose of this research was to study the impact of gastrointestinal and colonic in vitro digestions on the concentration of total and individual bioaccessible phenolic compounds from a hydroalcoholic extract of rosehips (Rosa canina) and also their antioxidant capacity. A total of 34 phenolic compounds were detected in the extracts using UPLC-MS/MS. Ellagic acid, taxifolin, and catechin were the most abundant compounds in the free fraction, while gallic and p-coumaric acids were the main compounds in the bound phenolic fraction. Gastric digestion negatively affected the content of free phenolic compounds and the antioxidant activity measured using the DPPH radical method. However, there was an enhancement of antioxidant properties in terms of phenolic content and antioxidant activity (DPPH (2,2-diphenyl-1-picrylhydrazyl): 18.01 ± 4.22 mmol Trolox Equivalent (TE)/g; FRAP (Ferric Reducing Antioxidant Power): 7.84 ± 1.83 mmol TE/g) after the intestinal stage. The most bioaccessible phenolic compounds were flavonols (73.3%) and flavan-3-ols (71.4%). However, the bioaccessibility of phenolic acids was 3%, probably indicating that most of the phenolic acids were still bound to other components of the extract. Ellagic acid is an exception since it presented a high bioaccessibility (93%) as it was mainly found in the free fraction of the extract. Total phenolic content decreased after in vitro colonic digestion, probably due to chemical transformations of the phenolic compounds by gut microbiota. These results demonstrated that rosehip extracts have a great potential to be used as a functional ingredient.

Interannual variability in early life phenology is driven by climate and oceanic processes in two NE Atlantic flatfishes.

Early life phenology is a crucial factor for population dynamics in a climate change scenario. As such, understanding how the early life cycle of marine fishes is influenced by key oceanic and climate drivers is of chief importance for sustainable fisheries. This study documents interannual changes in early life phenology of two commercial flatfishes: European flounder (Platichthys flesus) and common sole (Solea solea) from 2010 to 2015 based on otolith microstructure. Using GAMs, we looked for correlations of the North Atlantic Oscillation (NAO), Eastern Atlantic pattern (EA), sea surface temperature (SST), chlorophyl a concentration (Chla) and upwelling (Ui) variation with the onset of hatch, metamorphosis, and benthic settlement day. We concluded that higher SST, more intensive upwelling, and EA were coincident with a later the onset of each stage, while increasing NAO induces an earlier onset of each stage. Although similar to S. solea, P. flesus showed a more complex interaction with the environmental drivers, most possibly because it is at its southern limit of its distribution. Our results highlight the complexity of the relationship between climate conditions and fish early life history, particularly those with complex life cycles that include migrations between coastal areas and estuaries.