RESUMO Contexto: Carcinoma hepatocelular (CHC) é o tipo mais comum de câncer de fígado. Os fatores de risco para CHC incluem infecção pelo vírus da hepatite C (VHC) e B (VHB), cirrose alcoólica e alterações genéticas que podem afetar diversas vias celulares. Objetivo: Este estudo teve como objetivo analisar a expressão gênica e proteica sérica de VEGF, AFP, CSTB, β-catenina e GPC3 em grupos com CHC, cirrose ou VHC e controles, e sua relação com o estadiamento clínico nos grupos CHC e cirrose, bem como sua valores de sensibilidade e especificidade. Métodos: Duzentos e trinta indivíduos foram distribuídos no Grupo 1 (G1) - 80 pacientes com CHC; Grupo 2 (G2) - 76 pacientes com cirrose de qualquer etiologia; Grupo 3 (G3) - 33 pacientes com VHC; Grupo 4 (G4 - Controles) - 41 indivíduos sem sinais clínicos ou bioquímicos de qualquer doença hepática. A expressão gênica foi analisada por qRT-PCR e as proteínas séricas foram realizadas pelo método ELISA. Resultados: Aumento da expressão de VEGF e AFP pode ser observado em pacientes BCLC estágio D em comparação com pacientes estágio B, e pacientes estágio C apresentaram maior expressão de CTNNB1, em comparação com pacientes estágio B (P<0,05). Para VEGF e GPC3, foi observado poder discriminatório entre pacientes com CHC e controles (AUC = 0,71; 0,82, respectivamente). O CSTB mostrou poder discriminatório na comparação entre pacientes com VHC e controles (AUC =0,74). Conclusão: O presente estudo confirma a sensibilidade do CSTB sérico no diagnóstico da hepatite C, e a expressão gênica de VEGF e GPC3 sérica conferem sensibilidade e especificidade para o diagnóstico de CHC.

ABSTRACT Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Risk factors for HCC include hepatitis C (HCV) and B (HBV) virus infection, alcoholic cirrhosis and genetic alterations that can affect several cellular pathways. Objective: This study purposed to analyze the gene and serum protein expression of vascular endothelial growth factor (VEGF), angiogenesis, alpha fetoprotein, cystatin B (CSTB), β-catenin and glypican-3 (GPC3) in groups with HCC, cirrhosis or HCV and controls, and their relation with clinical staging in the HCC and cirrhosis groups, as well its sensitivity and specificity values. Methods: A total of 230 individuals were distributed in Group 1 (G1) - 80 patients with HCC; Group 2 (G2) - 76 patients with cirrhosis due to any etiology; Group 3 (G3) - 33 patients with HCV; Group 4 (G4 - controls) - 41 individuals without clinical or biochemical signs of any liver disease. Gene expression was analyzed by qRT-PCR and serum proteins were performed using the ELISA method. Results: Increased VEGF and angiogenesis, alpha fetoprotein expression could be observed in BCLC stage-D patients compared to stage-B patients, and stage-C patients showed higher expression of β-catenin, compared to stage-B patients (P<0.05). For VEGF and GPC3, discriminatory power was observed between HCC patients and controls (AUC =0.71; 0.82, respectively). CSTB showed discriminatory power in the comparison between patients with HCV and controls (AUC =0.74). Conclusion The present study confirms the sensitivity of serum CSTB in the diagnosis of hepatitis C, and gene expression of VEGF and serum GPC3, confer both sensitivity and specificity for the diagnosis of HCC.

Na última década em Portugal assistimos à explosão do número de estudos acerca dos fatores psicológicos e contextuais que antecedem a eficácia das equipas em ambientes de trabalho complexos e extremos. Esta investigação tem-se centrado em torno dos aspetos comportamentais (e.g. coordenação, liderança), cognitivos (e.g. modelos mentais partilhados, sistemas de memória transitiva) e afetivos (e.g. coesão, teamwork engagement) que nos ajudam a explicar por que razão algumas equipas têm um desempenho melhor, estão mais satisfeitas com o seu trabalho e acreditam que são mais viáveis (mesmo as que trabalham em condições adversas). Ao longo deste artigo, fazemos não só uma revisão da investigação feita sobre o tema do trabalho em equipa nos últimos dez anos em Portugal, como estabelecemos pontes com outros trabalhos internacionais e apresentamos algumas sugestões para o futuro da investigação desta área na próxima década.

In the last decade in Portugal, we have witnessed the explosion of the number of studies about the antecedents of the effectiveness of work teams in complex and extreme work environments. Research has focused on behavioral (e.g. coordination, leadership), cognitive (e.g. shared mental models, transactive memory systems) and affective (e.g. team work engagement) factors that help us explaining why some teams perform better, are more satisfied with their work, and believe that they are more viable (even the ones that work in adverse conditions). Throughout this article, we review team studies conducted in Portugal over the last ten years, we establish bridges with other international contributions, and present suggestions for the future of teamwork research in the next decade.

Resumo A radiação electromagnética é amplamente usada na medicina quer para diagóstico quer para terapêutica. A utilização em terapêutica pressupõe a existência de efeitos biológicos nocivos os quais são criteriosamente selecionados para causar dano onde é necessário (e.g. células cancerigenas) e proteger o restante organismo. Em diagnóstico o possível dano causado pela radiação é minimizado podendo ser usada em segurança quer para os doentes quer para os profissionais de saúde. Tendo em conta esta dicotomia do bem e do mal apresentam-se as principais caracteristicas da radiação e o seu uso na cliníca.

Abstract Electromagnetic radiation is widely used in medicine for both diagnosis and therapy. Its use in therapy assumes the existence of deleterious biological effects which are carefully selected to cause damage where it is necessary (e.g. cancer cells) and to protect the remaining organism. In diagnosis the possible damage caused by radiation is minimized and can be safely used for both patients and health professionals. Taking into account this dichotomy of good and evil the main characteristics of radiation and its use in the clinic are presented.

Abstract Objectives Since most of the studies evaluates diabetics on multiple daily injections therapy and continuous subcutaneous insulin infusion may help gain better metabolic control and prevent complications, the objective of this study was to evaluate the prevalence of dental caries, the unstimulated salivary flow rate and the total bacteria load, Streptococcus spp. levels and Lactobacillus spp. levels in saliva and supragingival dental biofilm of type 1 diabetics on insulin pump. Material and Methods Sixty patients with type 1 diabetes on insulin pump and 60 nondiabetic individuals were included. The dental caries evaluation was performed using ICDAS and the oral hygiene was assessed according to Greene and Vermillion Simplified Oral Hygiene Index. Unstimulated saliva and supragingival dental biofilm were collected. Total bacteria, Streptococcus spp. and Lactobacillus spp. was quantified by qPCR. Results Patients with type 1 diabetes had a higher prevalence of dental caries and filled and missing teeth when compared with the control group. These patients were associated with more risk factors for the development of dental caries, namely a lower unstimulated salivary flow rate and a higher bacterial load in saliva and dental biofilm. Conclusion Some risk factors related to dental caries were associated with type 1 diabetics. An early diagnosis combined with the evaluation of the risk profile of the diabetic patient is imperative, allowing the dental caries to be analyzed through a perspective of prevention and the patient to be integrated into an individualized oral health program.

Abstract Purpose: To investigate the inflammatory and redox responses to teduglutide on an animal model of laparotomy and intestinal anastomosis. Methods: Wistar rats (n=62) were allocated into four groups: “Ileal Resection and Anastomosis” vs. “Laparotomy”, each one split into “Postoperative Teduglutide Administration” vs. “No Treatment”; and euthanized at the third or the seventh day. Ileal and blood samples were recovered at the baseline and at the euthanasia. Flow cytometry was used to study the inflammatory response (IL-1α, MCP-1, TNF-α, IFN-γ and IL-4 levels), oxidative stress (cytosolic peroxides, mitochondrial reactive species, intracellular glutathione and mitochondrial membrane potential) and cellular viability and death (annexin V/propidium iodide double staining). Results: Postoperative teduglutide treatment was associated with higher cellular viability index and lower early apoptosis ratio at the seventh day; higher cytosolic peroxides level at the third day and mitochondrial overgeneration of reactive species at the seventh day; higher tissue concentration of IL-4 and lower local pro-to-anti-inflammatory cytokines ratio at the seventh day. Conclusion: Those findings suggest an intestinal pro-oxidative and anti-inflammatory influence of teduglutide on the peri-operative context with a potential interference in the intestinal anastomotic healing.

A parotidite bacteriana neonatal é uma situação rara, de diagnóstico essencialmente clínico e prognóstico excelente, quando tratada precoce e adequadamente. Descrevemos um caso clínico de parotidite bacteriana bilateral numa prematura, com dez dias de vida, sob aleitamento materno exclusivo. Foi admitida no serviço de urgência por prostração, tumefação pré-auricular bilateral e perda ponderal. A drenagem de pus pelos canais de Sténon, para a cavidade oral, confirmou o diagnóstico de parotidite. O Staphylococcus aureus foi isolado no exame bacteriológico do pus, na hemocultura e na cultura do leite materno, tendo sido a mãe considerada a fonte de infeção. Foi iniciada antibioticoterapia empírica endovenosa com ampicilina e gentamicina, substituída por flucloxacilina de acordo com o antibiograma dos locais de colheita. Não se verificaram complicações ou recorrências. Apesar de rara, a parotidite deve ser considerada no diagnóstico diferencial de tumefação da região parotídea no recém-nascido, permitindo o tratamento precoce e prevenindo as complicações.

Neonatal suppurative parotitis is a rare condition. Early diagnosis is essential to improve prognosis in these cases. We describe a ten-day-old preterm breastfed girl who developed bilateral suppurative parotitis. She was admitted to the hospital with general malaise, weight loss and bilateral preauricular swelling. Purulent drainage from both Sténon ducts into the mouth confirmed the diagnosis. Staphylococcus aureus was isolated from the purulent exudate and blood. Furthermore, Staphylococcus aureus was also found at the breast milk and, consequently, the mother was considered to be the source of the infection. Empiric antibiotic therapy was started with intravenous ampicilin and gentamicin. It was later changed to flucloxacilin, according to the antibiotic resistance profile. There were no complications or recurrences. Although rare, neonatal suppurative parotitis should be suspected in newborns presenting with parotid swelling, in order to provide early treatment and prevent complications.

PURPOSE: To investigate the impact of selective hepatic artery clamping (SHAC) in hepatocellular function. METHODS: Three groups of Wistar male rats were subjected to SHAC ischemia period of 60min: Group A continuous SHAC were subjected to SHAC ischemia period of 60min, Group B intermittent SHAC of 30min with 5min of reperfusion and Group C intermittent SHAC of 15min with 5min of reperfusion. Animals without SHAC were included-Group D. To evaluate hepatocellular function blood markers and hepatic extraction function (HEF) using 99mTc-mebrofenin were performed before and after surgery. Flow cytometry was used to analyze oxidative stress and cell viability. RESULTS: A mortality rate of 7.6% in Group A was observed. HEF maintained normal values between the groups. Flow cytometry demonstrated no significant differences between the groups in viability, type of cell death as well as in the production of reactive oxygen species. CONCLUSIONS: The selective hepatic artery clamping compared to other clamping techniques results on increased cell viability and decreased hepatocyte death. The SHAC is a potential alternative to decrease per-operative bleeding while maintaining hepatocellular function.

Os nemátodes-das-galhas-radiculares (NGR), Meloidogyne spp., são fitoparasitas com uma grande distribuição e economicamente importantes, causando reduções significativas na quantidade e qualidade da produção agrícola. O seu controlo é difícil e muitos dos métodos utilizados são ineficazes. Algumas plantas libertam fitoquímicos naturais com propriedades nematodicidas e os exsudatos radiculares podem actuar como estimuladores ou inibidores da eclosão de jovens do segundo estádio (J2). O objectivo deste trabalho foi avaliar o efeito dos exsudatos radiculares de Solanum sisiymbriifolium (cvs Sharp, Pion, Sis 4004 e Domino) na eclosão de J2 de cinco isolados de Meloidogyne (M. arenaria, M. chitwoodi, M. hapla, M. hispanica e M. javanica), contribuindo para o desenvolvimento de estratégias de protecção alternativas à utilização de nematodicidas. Os exsudatos radiculares obtidos através da lixiviação sucessiva do solo foram testados, com contagens diárias, durante o período de 15 dias. O exsudato de tomateiro (S. lycopersicum cv. Easypeel) e a água destilada foram utilizados como testemunhas.

Root-knot nematodes (RKN), Meloidogyne spp., are widespread and economically important plant-parasitic nematodes, causing significant reduction on quantity and quality of agricultural production. Its control is difficult and many methods are inefficient. Some plants release natural phytochemicals that have been identified and proved to have nematicides properties. The root exudates may act as stimulants or inhibitors of second-stage juveniles (J2) hatching. The goal of this research was to evaluate the hatching effect of root exudates from Solanum sisiymbriifolium (cvs Sharp, Pion, Sis 4004 e Domino) on five Meloidogyne isolates (M. arenaria, M. chitwoodi, M. hapla, M. hispanica and M. javanica) and to contribute for the development of an alternative strategy to the use of the nematicides. The root exudates, obtained by successive soil leaching, were tested, with daily counts, for a period of 15 days. The exsudate from tomato (S. lycopersicum cv. Easypeel) and distilled water were used as controls.

OBJETIVO: Apresentar novo modelo de adenocarcinoma distal em camundongos atímicos. MÉTODOS: Foram utilizados sete camundongos atímicos. Desvio do cólon distal e fístula foram feitas. Células de adenocarcinoma foram inoculadas na submucosa da fístula. O crescimento do tumor foi monitorado diariamente. Cintilografia com 99mTc-MIBI foi realizada para identificar o tumor. RESULTADOS: O modelo de câncer de cólon distal é viável. Detecção do tumor foi possível macroscopicamente e por imagem molecular. Todas as ressecções demonstraram tumores pouco diferenciados. Obstrução do cólon ocorreu em um caso, de forma semelhante à evolução em tumores humanos do cólon distal. CONCLUSÃO: O modelo de câncer do cólon distal proposto é viável, permite a monitorização fácil do crescimento tumoral macroscopicamente e por imagem molecular, sendo adequado para o estudo da evolução de tumor com aplicação de terapia citotóxica in vivo.

PURPOSE: The present a novel adenocarcinoma model in athymic mice. METHODS: Seven athymic mice were used. Colon diversion and distal fistula were made. Adenocarcinoma cells were inoculated in the submucosa of fistula. Tumor growth was monitored daily. Scintigraphy with 99mTc-MIBI was performed to identify the tumor. RESULTS: The model of distal colon cancer is feasible. Tumor detection was possible by both, macroscopically and molecular imaging. All resections demonstrated poorly differentiated tumors. Colon obstruction occurred in one case, similarly to evolution in human tumors of distal colon. CONCLUSION: The proposed model of distal colon cancer is feasible, allows for easy monitoring of tumoral growth by both, macroscopically and molecular imaging, and is suitable for studying the evolution of tumor with implementation of cytotoxic therapy in vivo.