Resumo Introdução: O nosso objetivo foi avaliar se os doentes seguidos em consulta de Medicina Interna são elegíveis para a estratégia do estudo COMPASS (dose baixa de rivaroxabano bidiária e ácido acetilsalicílico diário), detalhar os seus critérios de inclusão e de exclusão e definir a frequência de doentes que já se encontravam sob esta estratégia terapêutica. Métodos: Estudo observacional, retrospetivo e transversal realizado num departamento de medicina interna de um hospital universitário e terciário. Durante um período de um mês, consultámos todos os registos médicos eletrónicos das consultas de Medicina Interna para avaliar quais os doentes que apresentavam critérios de inclusão e exclusão do estudo COMPASS. Resultados: Dos 228 doentes, 40 (17,5%) preenchiam os critérios de inclusão do estudo COMPASS. Doze (30,0%) tinham doença arterial coronária, 21 (52,5%) tinham doença arterial periférica e 6 (1,5%) tinham ambas. Um doente já se encontrava sob a estratégia. Dos que preenchiam os critérios de inclusão, 70,0% (n = 28) apresentavam, pelo menos, um critério de exclusão. O mais frequente era a anticoagulação oral (principalmente para o tratamento da fibrilhação atrial), seguido pela terapêutica antiplaquetária sem ácido acetilsalicílico. Conclusão: O número de doentes seguido em consulta de Medicina Interna elegíveis para beneficiar da estraté-gia do estudo COMPASS é relevante. Os internistas devem estar despertos para os critérios de inclusão e exclusão desta nova estratégia de prevenção para aplicá-la prontamente na prática clínica.

Abstract: Introduction: We sought to evaluate if internal medicine outpatients are candidates to COMPASS trial strategy (low dose rivaroxaban twice a day plus daily acetylsalicylic acid), to detail the inclusion and exclusion criteria of COMPASS trial presented by internal medicine patients and to evaluate the frequency of patients already under the strategy. Methods: Observational, retrospective, and transversal study in an internal medicine department of a tertiary university hospital. During a one-month period, we consulted all electronic medical records of internal medicine appointments to assess which patients presented inclusion and exclusion criteria of the COMPASS trial. Results: Of 228 patients, 40 (17.5%) met inclusion criteria for COMPASS trial. Twelve (30.0%) had coronary artery disease, 21 (52.5%) had peripheral artery disease, and 6 (1.5%) had both. One patient was already on the COMPASS trial strategy. Of those who met inclusion criteria, 70.0% (n = 28) presented at least one exclusion criteria. The most frequent was the use of oral anticoagulation (mostly due to atrial fibrillation), followed by the users of non-acetylsalicylic acid antiplatelet therapy. Conclusion: The number of internal medicine patients who are eligible to benefit from the COMPASS strategy is relevant. Internal medicine physicians must be aware of inclusion and exclusion criteria of this new prevention strategy to promptly apply it in clinical practice.

ABSTRACT Background: This article aims to provide information on the diameter distribution of naturally regenerated forests of Taurus cedar (Cedrus libani A. Rich), a tree species endemic in the mountains of the Eastern Mediterranean basin and assess their prediction ability with the Johnson SB distribution. Previous research attested to the flexibility of Johnson family distributions to mimic empirical diameter data for a large set of tree species, justifying its use for the case study. A set of 134 plots (400 m2) were sampled in the most represented areas of the distribution of the species in Türkiye and diameter at breast height was measured in all the living trees. The cedar forests displayed heterogeneous diameter structures with diameters range from 10 to 116 cm and irregular shapes (e.g. unimodal, bell-shaped, left- and right-skewed, and non-uniform). Over three-quarters of the empirical diameter distributions (104 sample plots) were classified as SB distribution. The remaining were classified as bounded at the lower end, SL (16) or unbounded, SU (14). The authors essayed the 3-parameter and 4-parameter recovery methods after Parresol and Fonseca and other´s fundamental studies. The 3-parameter recovery method outperformed the 4-parameter method in the convergence criterion and error index (EI) expressed in the basal area. Results: Results show that the Johnson SB distribution can adequately reproduce the high variability in diameter for most of the distributions observed in these natural forests, providing reliable estimates which can serve as a basis for decision support systems. Conclusion: The SB distribution can represent the diameter distributions of natural cedar forests, even if the empirical distributions are not in the region covered by this distribution.

Resumo Existem múltiplos fatores que podem contribuir para uma má qualidade de sono no doente idoso hospitalizado. Os clínicos têm à disposição várias intervenções não farmacológicas e farmacológicas. O presente artigo pretende fazer uma revisão narrativa das diferentes opções terapêuticas. No tratamento da insónia do doente idoso hospitalizado deve ser dada primazia às medidas não farmacológicas que irão melhorar a qualidade do sono e consequentemente melhorar o bem-estar e a sua recuperação. Algumas medidas podem ser aplicadas durante o dia sendo disso exemplo minimizar sestas diurnas, prevenir e tratar delirium bem como pesquisar e tratar doenças do sono que não estejam diagnosticadas. Relativamente às medidas farmacológicas, mais do que salientar os fármacos com menos efeitos prejudiciais, pretendemos reforçar a evicção de alguns fármacos, pelos seus efeitos adversos e impacto nas outras comorbilidades destes doentes, como as benzodiazepinas com semivida longa e os anti-histamínicos. Outros fármacos a considerar na prática clínica são os não-benzodiazepinicos como o zolpidem e antidepressivos com efeito sedativo como a mirtazapina e a trazodona.

Abstract There are several factors that can contribute to poor sleep quality in hospitalized elderly patients. Clinicians have a variety of non-pharmacological and pharmacological in-terventions available. This article aims to review the different therapeutic options. In the treatment of insomnia in hospitalized elderly patients, priority should be given to non-pharmacological mea-sures that will improve sleep quality and improve well-being and health recovery. Some measures can be applied during the day, such as minimizing daytime naps, preventing and treating delirium as well as looking for and treat undiagnosed sleeping disorders. Regarding the pharmacological measures, more than emphasize the less harmful medicines, we intend to reinforce medicines to be avoided due to side effects and impact on patients’ comorbidities, like benzodiazepines with a long half-life and antihistamines. Other drugs to consider in clinical practice are non-benzodiazepine drugs such as zolpidem and antidepressants with sedative effects such as mirtazapine and trazodone.

Abstract Introduction: To assess the association of neutrophil-to-lymphocyte ratio (NLR) with post-stroke pneumonia (PSP) incidence, stroke subtype, severity, and prognosis. Material and Methods: Prospective observational study over a 42-month period in a Stroke Unit of a tertiary University Hospital. All patients with acute ischaemic stroke (AIS) were sequentially included. NLR was obtained at admission. Pa-tient characteristics such as stroke subtype, severity and PSP diagnosis were ascertained. Score A2DS2 was used as clinical predictor of PSP. Results: 521 patients with AIS were identified. The mean age was 76.17 ± 10.16 years years, 46.9% were men. Association was found between NLR and type and severity of stroke (p < 0.01), persisting in stratified analysis after excluding concomitant infection. Patients with higher ratio presented severer neurological deficits at admission, higher mortality, and dependency on discharge (p < 0.01). A logistic regression was performed to ascertain the predictive capacity of NLR (≥3) and A2DS2 (≥6) on the likelihood of developing PSP (p < 0.005). The model explained 17.1% (Nagelkerke R2) of the variance in pneumonia diagnoses, correctly classifying 77.0% of patients with 96.3% specificity. Patients with A2DS2 ≥6 were likelier to develop pneumonia (OR 8.36, p < 0.01). Moreover, patients with NLR ≥3 had higher odds of developing pneumonia (OR 2.35, p < 0.01). Conclusion: NLR appears to be related to severity in AIS, possibly as surrogate of neuroimmune mediation. Advances in the understanding of the immunobiological effects of ischemia in the brain may lead to future therapeutic developments. Presently, as a relatively inexpensive biomarker, there may be a potential role for NLR in improving PSP prediction scores.

Resumo Introdução: Avaliar a associação da relação neutrófilo-linfócito (NLR) e a incidência de pneumonia pós-acidente vascular cerebral (PSP), subtipo de acidente vascular cerebral (AVC), gravidade e prognóstico. Material e Métodos: Foi realizado um estudo prospetivo observacional durante um período de 42 meses numa Unidade de AVC de um hospital terciário. Todos os doentes com AVC isquémico agudo (AIS) foram sequencialmente incluídos. O valor de NLR foi calculado na admissão. As características dos doentes como subtipo de AVC, gravidade e diagnóstico de PSP foram obtidos. A escala A2DS2 foi utilizada como preditor clínico de PSP. Resultados: Foram identificados 521 doentes com AIS. A idade média foi 76,17 ± 10,16 anos, 46,9% eram homens. Verificou-se uma associação entre NLR, tipo e gravidade de AVC (p <0,01), persistindo em análise estratificada após exclu-são de infeção concomitante. Doentes com NLR mais elevado apresentavam défice neurológico mais grave na admissão, maior mortalidade e maior grau de dependência na alta (p < 0,01). Foi realizada uma regressão logística para caracterizar a capacidade preditiva da NLR (≥3) e do A2DS2 (≥6) na probabilidade de desenvolver PSP (p < 0,005). O modelo explicou 17,1% (Nagelkerke R2) da variância nos diagnósticos de pneumonia, classificando corretamente 77,0% dos doentes com uma especificidade de 96,3%. Doentes com A2DS2 ≥6 (OR 8,36, p < 0,01) e doentes com NLR ≥3 (OR 2,35, p < 0,01) apresentaram um maior risco de desenvolver pneumonia. Conclusão: NLR parece estar relacioando com a gravidade dos AIS, possivelmente como marcador de ativação neuroimune. Avanços na compreensão dos efeitos imunobiológicos da isquemia no cérebro poderão levar a desenvolvimentos terapêuticos futuros. Atualmente, sendo um biomarcador relativamente pouco dispendioso, talvez exista um papel da NLR na melhoria das escalas preditoras de PSP.

Resumo Os processos políticos do reinado de D. Miguel referentes aos detidos na cidade de Lisboa pelo delito referido como «Cantigas subversivas» permitem-nos conhecer um pouco da época em que decorreram sob duas vertentes: a política e a social. No âmbito da primeira, confirmam-nos o ambiente persecutório e intimidatório característico deste reinado. No plano social, mostram-nos uma Lisboa popular, barulhenta e alegre, que cantava e dançava de dia e principalmente à noite. As casas de bebidas eram os locais de convívio mais frequentes, onde se comia, bebia e jogava. Também se convivia em casa e na via pública. A ingestão excessiva de álcool era vulgar entre o povo, sendo frequente encontrar homens embriagados e até algumas mulheres. Eles permitem-nos ainda conhecer a origem geográfica e algumas das atividades económicas do povo trabalhador, bem como os locais mais movimentados desta Lisboa popular.

Abstract The political processes of D. Miguel’s reign regarding prisoners in the city of Lisbon for the crime referred to as «Subversive songs» allow us to know a little about the time in which they took place in two aspects: political and social. In the first, they confirm the persecutory and intimidating atmosphere characteristic of this reign. On the social level, they show us a noisy and cheerful popular Lisbon, which sang and danced during the day and especially at night. The liquor stores were the most frequent socializing places, where people ate, drank and played. They also used to get together at home and on the public road. Excessive alcohol intake was common among the people, and drunken men and even some women were frequently seen. They also allow us to know the geographical origin and some of the economic activities of the working people, as well as the busiest places in this popular Lisbon.

ABSTRACT In Portugal, chestnut wood demand has increased in the last decades. Since chestnut plantations are usually established in low fertility soils, addition of N, P and K as fertilizers usually have a benefic effect in increasing wood productivity. The study aims to evaluate the effects of fertilization on growth of chestnut tree (Castanea sativa Mill.) cultivated for wood purposes. An experimental essay was established in a 3-year old chestnut tree stand with a planting spacing of 3.5 × 3.0 m. Four treatments were applied to randomized blocks with three repetitions: control (C), addition of phosphorus (P), addition of phosphorus and potassium (PK) and addition of nitrogen, phosphorus, and potassium (NPK). The chemical properties of the soil and the concentration of nutrients in the leaves were evaluated after the treatment, and measurements of tree diameter and stem height were made for a monitoring period of 4 years. Treatments did not affect soil properties or leaf nutrient concentrations. On the counterpart, the effect of the fertilizers was noticed for tree dimensions and growth. Gains of NPK in relation to the control were observed for the height variable, over the years. Seven years after application of the treatments, differences were also noticed for the diameter and the volume index variables. The NPK treatment has presented a significant effect on tree growth compared to the control, with noticeable gains in the stem height.

Abstract The authors present a proposal of a partnership between the Sociedade Brasileira de Oncologia Pediátrica (SOBOPE) and the International Society of Pediatric Oncology (SIOP) to promote the standardization and improvement of nutritional care of kids under cancer treatment in Brazil. The results of the first meeting in Brazil as well as plans for future meetings are described.

Children born later in the year of competition have lower chances of promotion due to their low degree of physical, mental and emotional maturity. This phenomenon is known as Relative Age Effect or RAE. The objective of this study is to determine if the date of birth (month of birth) is a factor in the configuration of the professional teams of Spanish football. As for the methodology, we determined the months of birth of the players of the first and second division of Spanish football. A total of 42 professional teams were analyzed. The data were arranged in semesters and quarters. The results show that there is a strong tendency for the selection of professional players born in the first quarters of the year compared to those born in the later ones. In conclusion, in Spain there is a predominance of professional football players depending on the month of birth.

Los niños nacidos más tarde dentro del año de competición sufren de menores posibilidades de promoción, debido a su menor grado de madurez física, mental y emocional. Este fenómeno, es conocido como Efecto Relativo de la Edad o RAE. Objetivos: determinar si la fecha de nacimiento (mes de nacimiento) es un factor que interviene en la configuración de los equipos profesionales del fútbol español. Método: Se determinan los meses de nacimiento de los jugadores de la primera y segunda división del fútbol española. Un total de 42 equipos profesionales fueron analizados. Los datos se dispusieron en semestres y trimestres. Resultado: Hay una fuerte tendencia a la selección de los jugadores profesionales nacidos en los primeros trimestres del año frente a los nacidos en los últimos. Como conclusión en España hay un predominio de jugadores de fútbol profesionales en función del mes de nacimiento.

ABSTRACT Background: Acute myeloid leukemia presenting the MYST3-CREBBP fusion gene is a rare subgroup associated with hemophagocytosis in early infancy and monocytic differentiation. The aim of this study was to define the relevant molecular cytogenetic characteristics of a unique series of early infancy acute myeloid leukemia cases (≤24 months old), based on the presence of hemophagocytosis by blast cells at diagnosis. Methods: A series of 266 infant cases of acute myeloid leukemia was the reference cohort for the present analysis. Acute myeloid leukemia cases with hemophagocytosis by blast cells were reviewed to investigate the presence of the MYST3-CREBBP fusion gene by fluorescence in situ hybridization (FISH) and reverse transcription polymerase chain reaction. Results: Eleven cases with hemophagocytosis were identified with hemophagocytic lymphohistiocytosis being ruled out. Six cases were classified as myelomonocytic leukemia, three as AML-M7 and two as AML-M2. In five cases, the presence of the MYST3-CREBBP fusion gene identified by molecular cytogenetics was confirmed by fluorescence in situ hybridization. All patients received treatment according to the Berlin-Frankfürt-Münster acute myeloid leukemia protocols and only one out of the five patients with the MYST3-CREBBP fusion gene is still alive. Conclusions: Our findings demonstrate that the presence of hemophagocytosis in acute myeloid leukemia was not exclusively associated to the MYST3-CREBBP fusion gene. Improvements in molecular cytogenetics may help to elucidate more complex chromosomal rearrangements in infants with acute myeloid leukemia and hemophagocytosis.

O objetivo deste estudo foi analisar o efeito de fatores de ordem biológica, sociocultural e motora na prestação da habilidade motora fundamental lançamento, em crianças de 10 e 11 anos de idade. Tratou-se de um estudo transversal envolvendo 96 crianças, 49 rapazes e 47 raparigas (idade decimal, 10.94 ± 0.52). Foi avaliado o produto (distância) e processo (padrão motor) do lançamento. A comparação entre grupos no que respeita à distância do lançamento foi realizada com o t-teste enquanto no que se refere ao padrão de lançamento envolveu os testes de U Mann-Whitney e Kruskal-Wallis Recorreu-se à correlação de Pearson para analisar as associações entre as variáveis experimentais. A análise do efeito dos fatores na prestação da habilidade de lançamento envolveu o Modelo Geral Linear. As crianças situadas no estádio maduro de todos os componentes do lançamento tiveram o melhor desempenho (p<0.001). Verificou-se um efeito de elevada dimensão do número de assoalhadas da habitação (h p² = 0.995; p= 0.043), tempo despendido com jogos eletrónicos ao sábado (h p² = 0.995; p= 0.044), estatura (h p² = 0.995; p= 0.045) e sexo do companheiro de brincadeira (h p² = 0.996; p= 0.040) na prestação do lançamento. Conclui-se que em idades pré-pubertárias, para além das variáveis de natureza biológica, as variáveis socioculturais parecem desempenhar um papel fundamental na prestação da habilidade manipulativa lançamento.

The aim of this study was to analyse the effect of the biological, sociocultural and motor variables in the performance of the fundamental motor skill throwing in children aged between 10-11 years old. This was a cross sectional study involving 96 children, 49 boys and 47 girls (10.94 ± 0.52 years). It was evaluated the product (distance) and process (motor pattern) of throwing. To analyse the differences between groups in the throwing distance an analysis of variance (ANOVA) and a t-test were used. To analyse the differences between groups in terms of the distance of throw we used t-test while U de Mann-Whitney and Kruskal-Wallis tests were used to depict differences in the patterns of throw. The Pearson correlation was used to analyse the associations between experimental variables. The evaluation of the effects of the factors on the performance of throw was performed using the General Linear Model. The children situated at the mature stage of all the throwing components had the best performance (p< 0.001). There was a high-sized effect of the number of rooms of the house (h p²= 0.995; p= 0.043), time spent playing electronic games on Saturday (h p²= 0.995; p= 0.044), height (h p²= 0.995; p= 0.045), and sex of the friend whom the child plays with (h p²= 0.996; p= 0.040) on the throwing performance. We can conclude that beside a biological influence, the performance of the manipulative skill throwing in pre-pubertal ages appears to be relevantly influenced by socio-cultural variables.

Neste artigo analisámos as consequências da política reformista do marquês de Pombal na atividade económica da Feitoria Britânica de Lisboa. Procedemos em primeiro lugar à caraterização socioeconómica dos membros da Feitoria. Mencionámos os privilégios por estes adquiridos ao longo de séculos em Portugal e o modo abusivo como eram utilizados. Explicámos de que maneira o ministro de D. José e a Câmara de Lisboa procuraram combater tais abusos, no contexto da política de poder absoluto esclarecido. E descrevemos a reação dos britânicos a tais medidas.

In this article we analyze the consequences of the Marquis of Pombal reformist politics in the economical activity of the British Factory of Lisbon. In the first place, we proceed to the socioeconomic characterization of the British Factory members. Next, we refer to theirs advantages in Portugal, acquired along of centuries, and the abusive way as they were used. We explain how the king Joseph’s prime minister and the Lisbon Municipal Council tried to reverse those advantages and overuses in the context of the enlightened absolutism politics. We also intend to elucidate the reactions of the British businessmen to the Portuguese initiatives.