ABSTRACT Objectives: Congenital hypothyroidism (CH) can be permanent (PCH) or transient (TCH). While the importance of thyroxine in myelination of the brain is undisputed, the benefits to neurodevelopmental outcomes of TCH treatment are controversial. Our objectives were to determine predictive factors for PCH and verify its prevalence changes over time. Subjects and methods: A total of 165 children were evaluated at 3 years of age to verify the diagnosis of PCH. 130 were submitted to a two-step cluster analysis, with the aim of grouping them into homogeneous clusters. The mean incidence of PCH and TCH was calculated from 2004 to 2010 and 2011 to 2015. Results: Sixty-six children were diagnosed with PCH, and 99 were diagnosed with TCH. Eighty-one percent of PCH children and all TCH children with thyroid imaging had glands in situ. Eighty children (61.5%) were in Cluster 1, 8 children (6.2%) were in Cluster 2 and 42 children (32.3%) were in Cluster 3. No children had PCH in Cluster 1, while 87.5% of children in Cluster 2 and all children in Cluster 3 had PCH. The most important predictor for PCH was the initial serum TSH, which was marginally higher in importance than the blood spot TSH, followed by the initial serum free T4. The mean incidence of PCH (odds ratio: 1.95, 95% CI 1.36 to 2.95, p < 0.0001) and TCH (odds ratio 1.33, 95%, CI 1.02 to 1.77, p = 0,038) increased over time. Conclusions: The most important PCH predictors are the initial serum TSH and the blood spot TSH. The mean incidence of both PCH and TCH in our series increased.

RESUMO Objetivo descrever os principais métodos quantitativos utilizados para análise morfométrica do trato vocal em cantores, suas aplicações e os principais segmentos estudados. Estratégia de pesquisa trata-se de uma revisão integrativa guiada pela pergunta condutora: “Quais os principais métodos quantitativos utilizados para análise morfométrica do trato vocal, suas aplicações e os principais segmentos estudados em cantores?”. Foram utilizadas as bases eletrônicas PubMed, Scopus e BVS, por meio da chave de busca Vocal tract OR Oropharynx AND Morphology OR Geometry AND Evaluation OR Diagnosis AND voice, sem restrições de ano de publicação, sendo incluídos artigos em três idiomas: português, inglês e espanhol. Critérios de seleção: a seleção se deu de forma independente, por meio da leitura por pares e posterior aplicação dos critérios de exclusão e inclusão. Resultados dos 380 estudos, foram excluídos 30 duplicados. A partir da leitura dos resumos, aplicando-se os critérios de seleção, foram selecionados 18 estudos para leitura na íntegra, dos quais, 12 foram incluídos nesta revisão. A ressonância magnética foi o principal instrumento utilizado e os segmentos analisados incluíram desde o comprimento e volume do trato vocal, como segmentos isolados e suas particularidades morfológicas. Conclusão os métodos de quantificação morfológica do trato vocal integram instrumentos importantes para a avaliação instrumental do trato vocal e de seus segmentos, colaborando na atualização tecnológica em voz para melhor compreensão e intervenções fonoaudiológicas na voz cantada

ABSTRACT Purpose To describe the main quantitative methods used for morphometric analysis of the vocal tract in singers, their applications and the main segments studied. Research strategy This is an integrative review guided by the guiding question “What are the main quantitative methods used for morphometric analysis of the vocal tract, their applications and the main segments studied in singers?”. The electronic databases PubMed, Scopus and VHL were used through the search key (Vocal tract OR Oropharynx) AND (Morphology OR Geometry) AND (Evaluation OR Diagnosis) AND (voice), without restriction of years of publication, including articles in three languages: Portuguese, English and Spanish. Selection criteria The selection took place independently through reading by pairs and subsequent application of exclusion and inclusion criteria. Results Of the 380 studies, 30 duplicates were excluded. After reading the abstracts, applying the selection criteria, 18 studies were selected for full reading, of which 12 were included in this review. Magnetic resonance imaging was the main instrument used and the analyzed segments ranged from the length and volume of the vocal tract to isolated segments and their morphological particularities. Conclusion Vocal tract morphological quantification methods are important for the instrumental evaluation of the vocal tract and its segments, a technological update leading to better understanding of singers’ voice and therapeutical intervention.

Abstract We evaluate how the concentrations of inorganic nutrients and chlorophyll a vary in a heterogeneous area (Equatorial SW Atlantic), covering a gradient from stations closer to the coast to others more distant associated or not with turbid-zone reefs. Vertical temperature (27.9 ± 0.10 °C; mean ± standard deviation) and salinity (36.2 ± 0.14) profles showed that the water column is well mixed (0-30 m depth). The oligotrophic condition was marked by low concentrations of phosphate (0.30 ± 0.22 µM) and dissolved inorganic nitrogen (0.64 ± 0.74 µM). Moreover, dissolved reactive silicon (DSi) was low in most samples (< 2.0 µM), but higher (>10 µM) in nearshore stations, probably related to continental runoff and/or resuspension of the bottom sediments. The pelagic phytoplankton biomass indicated that chlorophyll a (0.25 ± 0.08 µg L-1) was low, positively correlated with light and negatively correlated with nutrients, indicating possible phytoplankton uptake. Chlorophyll a concentrations were lower in stations closer to the coast and higher in some stations near the reefs, indicating that the latter could be more prone to phytoplankton development and depletion of nutrients, especially DSi. Therefore, although oligotrophy is present along this coast, we found some unexpected heterogeneity of nutrient and chlorophyll a distributions, which were probably infuenced by benthic-pelagic coupling due to the presence of extensive reefs, sponge gardens (18-30 m depth), and the proximity to the coast. These results highlight the importance of understanding the heterogeneity of ocean productivity, especially in lesser known low-latitude areas, which showed distinct nutrient and chlorophyll a levels related to the occurrence of tropical reefs that are capable of supporting important fsh stocks and unique biological communities.

RESUMO Objetivo: Descrever e comparar as variáveis da aptidão física de acordo com o cumprimento da recomendação de atividade física, medida por acelerometria. Métodos: A amostra foi composta de 120 escolares, sendo 57 meninos e 63 meninas, de 9 a 11 anos de idade. As variáveis analisadas foram: peso, estatura, índice de massa corpórea (IMC), dobras cutâneas, circunferências, agilidade, flexibilidade, velocidade e força de membros superiores, inferiores e abdominal. A atividade física foi mensurada de forma objetiva por meio de acelerômetro. Os escolares foram divididos em dois grupos: “cumpre a recomendação” (≥60min/dia) e “não cumpre a recomendação” (<60min/dia). Para verificar a normalidade dos dados, foi utilizado o teste de Kolmogorov-Smirnov. A comparação dos valores médios dos escolares que cumprem ou não a recomendação de atividade física foi feita pelos testes t de Student e U de Mann-Whitney. O nível de significância adotado foi de p<0,05. Resultados: Os escolares que cumpriram a recomendação, comparados com os que não cumpriram, apresentaram valores significativamente menores para adiposidade (somatória das sete dobras cutâneas), peso corporal, IMC e força abdominal. Não foram encontradas diferenças significativas nas variáveis de velocidade e agilidade; quanto à força de membros superiores (MMSS), constatou-se que ela foi maior em quem não cumpriu a recomendação. Conclusões: Crianças que cumpriram a recomendação de atividade física apresentaram melhor composição corporal e força abdominal que as crianças que não cumpriram.

Abstract Objective: To describe and compare physical fitness variables according to compliance with the recommendations of physical activity, measured by accelerometry. Methods: The sample gathered 120 students, 57 boys and 63 girls aged 9 to 11 years. The variables analyzed were: weight, stature, BMI, skinfolds, waist circumference, agility, flexibility, speed and strength of upper and lower limbs, and abdominal strength. Physical activity was measured objectively using an accelerometer. The students were divided into two groups: “complies with recommendations” (≥60min/day) and “does not comply with recommendations” (<60min/day). To verify the normality of the data, the Kolmogorov-Smirnov test was used. The mean values of students who do or do not comply with the physical activity recommendation were compared using Student's t and U-Mann Whitney tests. The level of significance was set at p<0.05. Results: The students who followed the recommendation showed significantly lower values compared to those who did not for adiposity (sum of 7 skinfolds); body weight; body mass index (BMI) and abdominal strength. No significant differences were found in the variables of speed and agility, and the upper limbs’ strength was greater in subjects who did not comply with recommendations. Conclusions: Students who complied with physical activity recommendations had better body composition and more abdominal strength than those who did not.

Abstract This study evaluated the bioactive potential of a macro-porous chitosan scaffold incorporated with calcium hydroxide (CH-Ca) and functionalized with bioactive doses of simvastatin (SV) for bone tissue regeneration. Initially, the bioactive dose of SV in osteoblastic cells (SAOS-2) was determined. For the direct contact experiment, SAOS-2 cells were plated on scaffolds to assess cell viability and osteogenic differentiation. The second assay was performed at a distance using extracts from scaffolds incubated in culture medium to assess the effect of conditioned medium on viability and osteogenic differentiation. The initial screening showed that 1 μM SV presented the best biostimulating effects, and this dose was selected for incorporation into the CH-Ca and pure chitosan (CH) scaffolds. The cells remained viable throughout the direct contact experiment, with the greatest cell density in the CH-Ca and CH-Ca-SV scaffolds because of their higher porosity. The CH-Ca-SV scaffold showed the most intense bio-stimulating effect in assays in the presence and absence of osteogenic medium, leading to an increased deposition of mineralized matrix. There was an increase in the viability of cells exposed to the extracts for CH-Ca, CH-SV, and CH-Ca-SV during the one-day period. There was an increase in ALP activity in the CH-Ca and CH-Ca-SV; however, the CH-Ca-SV scaffold resulted in an intense increase in the deposition of mineralized nodules, approximately 56.4% at 7 days and 117% at 14 days, compared with CH (control). In conclusion, functionalization of the CH-Ca scaffold with SV promoted an increase in bioactivity, presenting a promising option for bone tissue regeneration.

Abstract Knowledge about the prevalence of concussion in combat sports is important information to keep athletes’ and practitioners’ physical integrity in different modalities such as Brazilian jiu-jitsu (BJJ). Therefore, this study aimed to compare concussions incidence in BJJ between men and women practitioners. A randomized sample of 779 (689 men and 90 women) BJJ practitioners (age: 32.4± 9.8 years, training-time: 57.3± 54.4 months, training frequency: 3.4± 1.3 times/week). The injury analysis was done using a questionnaire with demographic data and a survey about concussions. The main results showed that women had a significantly higher frequency of concussions in training than men [38 (41%) women vs 147 men (20,5%); p ≤ 0.001]. Furthermore, women had a significantly higher frequency of loss of consciousness than men [13 (8.8%) men vs 4 (11%) women; p = 0.009], among the symptoms resulting from a concussion, headache, dizziness, and loss of balance, represented the most common symptoms in those affected by concussion, regardless of gender. The results of this study may be helpful to athletes, coaches, and federations to prevent this type of injury, mainly in women.

Abstract Obstetric violence is a gender violence, which has racism as an overlay, making Black women more vulnerable. In Portugal, this reality remains silenced behind the myth of social equality disseminated post-colonial period. The bodies of these women in the obstetric scenario in the country, bring us the need to address issues of body-race-health articulated with the feminist and Black movements. This article is based on a theoretical approach sustained in post-colonial and feminist studies, with a sociological perspective. For its methodology, this article shares the actions of a collective of antiracist women acting from an intersectional perspective, using the methodological technique of the experience report. The main results of this study point to the pertinence of developing intersectional sociological research on the reproductive health experiences of racialized women in Portugal and the importance of social movements to conduct such work. The collective Saúde das Mães Negras (SaMaNe) through four fronts brings to social, political, and academic debate the experiences of pregnancy, childbirth and postpartum of black and afro-descendant women in Portugal. In conclusion, there is a need to deepen the debate on oppression and racial inequalities in obstetric care, and this article also intends to break the silence around the theme and transform it into action.

Resumo A violência obstétrica é uma violência de gênero, que tem o racismo como sobreposição, tornando as mulheres negras mais vulneráveis. Em Portugal, esta realidade continua silenciada por detrás do mito da igualdade social difundido no pós-período colonial. Os corpos destas mulheres no cenário obstétrico no país trazem-nos a necessidade de abordar questões de corpo-raça-saúde articuladas com os movimentos feministas e negros. Este artigo parte de uma abordagem teórica sustentada nos estudos pós-coloniais e feministas, com uma perspectiva sociológica. Em termos metodológicos, o texto compartilha as atividades de um coletivo de mulheres antirracistas sob uma perspectiva interseccional, utilizando a técnica metodológica do relato de experiência. Os principais resultados deste estudo apontam para a pertinência de se desenvolver uma investigação sociológica transversal sobre as experiências de saúde reprodutiva das mulheres racializadas em Portugal e a importância dos movimentos sociais para a realização desses trabalhos. O coletivo Saúde das Mães Negras (SaMaNe), através de quatro frentes de atuação, traz para o debate social, político e académico as experiências de gravidez, parto e pós-parto de mulheres negras e afrodescendentes em Portugal. Concluiu-se que há necessidade de aprofundar o debate sobre as opressões e desigualdades raciais nos cuidados obstétricos, pelo que este artigo pretende também romper com o silêncio em torno do tema e transformá-lo em ação.

Abstract Institutional racism is prevalent in the health services in Brazil and is based on concrete power relations that subjugate, dominate and exclude blacks from having adequate access to health care and health institutions. This critical essay analyzes the importance of expanding the debate, and the production of knowledge about the health of the black population (HBP), focusing on two points: the role of the National Policy for the Integral Health of the Black Population (PNSIPN) and the importance of including the skin color item in the health information systems; and the need for a process of permanent training of professionals, including contents related to the understanding of racism as an element of the social determination of health/disease and heir effects. To demonstrate how structural and institutional racism have affected the black population, we bring also examples of the quilombola populations in the context of the Covid-19 pandemic in the country since 2020. It is concluded that the promotion of care, the reduction of inequities and the quality of health care need to undergo changes in several dimensions, such as the strengthening of the SUS, the daily fight against structural and institutional racism, among others.

Resumo O racismo institucional impera nos serviços de saúde no Brasil, fundados em relações concretas de poder que subjugam, dominam e excluem negros/as do adequado acesso aos serviços e instituições de saúde. Este ensaio crítico analisa a importância da ampliação do debate e da produção do conhecimento sobre a saúde da população negra (SPN), focando dois pontos: o papel da Política Nacional de Saúde Integral da População Negra (PNSIPN) e a importância da inserção do quesito cor nos sistemas de informação em saúde; e a necessidade de um processo de formação permanente dos/as profissionais, inserindo conteúdos relacionados à compreensão do racismo como um dos elementos de determinação social de saúde/doença e seus efeitos. Para demonstrar como o racismo estrutural e institucional tem afetado a população negra, trazemos também exemplos das populações quilombolas no contexto da pandemia de COVID-19 no país a partir de 2020. Conclui-se que a promoção do cuidado, a redução das iniquidades e a qualidade da atenção à saúde precisam passar por mudanças em várias dimensões, como o fortalecimento do SUS e o combate cotidiano ao racismo estrutural e institucional.

ABSTRACT Coronary artery fistula draining into the coronary sinus is a rare vascular malformation, and its diagnosis and clinical manifestations usually occur late. We describe the case of a 72-year-old female patient with dyspnea on exertion (New York Heart Association Class III) associated with palpitations. The transthoracic echocardiogram showed significant tricuspid insufficiency. Cardiac catheterization showed aneurysm of the circumflex coronary artery and fistula of this artery draining into the coronary sinus. The patient underwent fistula ligation and tricuspid valve repair, with excellent surgical results.

Resumo O racismo institucional impera nos serviços de saúde no Brasil, fundados em relações concretas de poder que subjugam, dominam e excluem negros/as do adequado acesso aos serviços e instituições de saúde. Este ensaio crítico analisa a importância da ampliação do debate e da produção do conhecimento sobre a saúde da população negra (SPN), focando dois pontos: o papel da Política Nacional de Saúde Integral da População Negra (PNSIPN) e a importância da inserção do quesito cor nos sistemas de informação em saúde; e a necessidade de um processo de formação permanente dos/as profissionais, inserindo conteúdos relacionados à compreensão do racismo como um dos elementos de determinação social de saúde/doença e seus efeitos. Para demonstrar como o racismo estrutural e institucional tem afetado a população negra, trazemos também exemplos das populações quilombolas no contexto da pandemia de COVID-19 no país a partir de 2020. Conclui-se que a promoção do cuidado, a redução das iniquidades e a qualidade da atenção à saúde precisam passar por mudanças em várias dimensões, como o fortalecimento do SUS e o combate cotidiano ao racismo estrutural e institucional.

Abstract Institutional racism is prevalent in the health services in Brazil and is based on concrete power relations that subjugate, dominate and exclude blacks from having adequate access to health care and health institutions. This critical essay analyzes the importance of expanding the debate, and the production of knowledge about the health of the black population (HBP), focusing on two points: the role of the National Policy for the Integral Health of the Black Population (PNSIPN) and the importance of including the skin color item in the health information systems; and the need for a process of permanent training of professionals, including contents related to the understanding of racism as an element of the social determination of health/disease and heir effects. To demonstrate how structural and institutional racism have affected the black population, we bring also examples of the quilombola populations in the context of the Covid-19 pandemic in the country since 2020. It is concluded that the promotion of care, the reduction of inequities and the quality of health care need to undergo changes in several dimensions, such as the strengthening of the SUS, the daily fight against structural and institutional racism, among others.

Resumo Este trabalho teve como objetivo avaliar a influência da interface de uma restauração adesiva na difusão do peróxido de hidrogênio (H2O2), toxicidade indireta e expressão de mediadores pró-inflamatórios por células odontoblastóides, após clareamento dental em consultório. Cavidades dentárias preparadas em discos de esmalte / dentina foram restauradas com adesivo e submetidas ou não à degradação hidrolítica (HD). Um gel clareador com 35% H2O2 (WG) foi aplicado por 45 min em discos restaurados e não restaurados adaptados às câmaras pulpares artificiais dando origem aos grupos: SD- discos intactos (controle); SD / HP - Discos intactos clareados; RT / HP - discos restaurados e clareados; e RT / HD / HP - discos restaurados, clareados e submetidos a HD. Os extratos (meio de cultura + componentes WG difundidos através da interface esmalte/dentina/restauração) foram coletados e aplicados em células odontoblastóides MDPC-23. Foi avaliada a quantidade de H2O2 nos extratos, bem como a viabilidade (CV), morfologia (CM) e expressão gênica de mediadores inflamatórios (TNF-α e COX-2) pelas células pulpares expostas aos extratos (ANOVA e testes de Tukey; 5% de significância). Todos os grupos clareados apresentaram menor CV do que SD (controle; p <0,05). A maior redução CV e expressão gênica de TNF-α e COX-2 foi observada no grupo RT / HD / HP em comparação com SD / HP e RT / HP (controle; p <0,05). Alterações na CM ocorreram em todos os grupos clareados. A intensidade desses efeitos celulares teve relação direta com a quantidade de H2O2 nos extratos. Concluímos que a presença de uma cavidade contendo restauração adesiva aumenta a difusão de H2O2 após o clareamento em consultório, o que, por sua vez, aumenta a toxicidade indireta dessa terapia e desencadeia a expressão de mediadores pró-inflamatórios pelas células pulpares MDPC-23.

Abstract This paper aimed to assess the influence of adhesive restoration interface on the diffusion of hydrogen peroxide (H2O2), indirect toxicity, and pro-inflammatory mediators expression by odontoblast-like cells, after in-office tooth whitening. Dental cavities prepared in bovine enamel/dentin discs were adhesively restored and subjected or not to hydrolytic degradation (HD). A whitening gel with 35% H2O2 (WG) was applied for 45 min onto restored and non-restored specimens adapted to artificial pulp chambers giving rise to the groups: SD- intact discs (control); SD/HP- whitened intact discs; RT/HP- restored and whitened discs; and RT/HD/HP- restored and whitened discs subjected to HD. The extracts (culture medium + WG components diffused through enamel/dentin/restoration interface) were collected and applied to odontoblast-like MDPC-23 cells. The study evaluated the amount of H2O2 in the extracts, as well as the cell viability (CV), cell morphology (CM), and gene expression of inflammatory mediators (TNF-α and COX-2) by the pulp cells exposed to the extracts (ANOVA and Tukey tests; 5% significance). All whitened groups presented lower CV than SD (control; p<0.05). The highest CV reduction and gene expression of TNF-α and COX-2 was observed in the RT/HD/HP group in comparison with SD/HP and RT/HP (control; p<0.05). CM alterations occurred in all whitened groups. The intensity of these cell side effects was directly related with the amount of H2O2 in the extracts. We concluded that adhesive restoration of dental cavity increases the H2O2 diffusion after in-office whitening, enhancing the indirect toxicity of this therapy and trigger pro-inflammatory overexpression by MDPC-23 cells.

ABSTRACT Objectives: Evaluate the celiac disease (CD) markers, within the scope of its screening, in a pediatric population with diagnosis of type 1 diabetes (T1D) at Hospital de Braga (HB) and determine the prevalence of CD in the sample. Reflect on CD screening algorithm applied in this pediatric population. Subjects and methods: Retrospective observational study with 94 patients diagnosed with T1D at age 10 years or younger, followed up at the HB Outpatient Diabetology Consultation, including those referred from other hospitals. Record of clinical information, IgA anti-transglutaminase and anti-endomysium and HLA DQ2/DQ8 haplotypes. Results: We obtained positive serological test for CD in 4 patients. This test had 100% sensitivity and specificity. The prevalence of CD was 4.3% (n = 4). Positive HLA screening in 84.6% of patients, with both sensitivity and negative predictive value of 100% and specificity of 16.67%. Diagnosis of CD was made on average 3.40 ± 3.32 years after the diagnosis of TD1. All cases of CD registered non-gastrointestinal manifestations, none had gastrointestinal symptoms. Conclusion: This study proved that there is a higher prevalence of CD in pediatric population with TD1, when compared to general population, and clarified the importance of CD screening. Furthermore, it was observed that serological screening for CD antibodies is an excellent screening test and HLA typing, although not the most suitable first line test, can be useful in excluding the possibility of patients with T1D developing CD.

Resumo Introdução: A alergia ao ovo representa uma das alergias alimentares mais frequentes na infância. A administração da vacina anti-sarampo, parotidite e rubéola (VASPR) é recomendada em idade pediátrica. Apesar da presença de vestígios de ovalbumina na composição da vacina, a literatura recomenda a sua administração independentemente da história de alergia, advertindo para os casos em que a mesma deve ocorrer em ambiente hospitalar. Objetivo: Caracterizar a população pediátrica referenciada para a consulta de Imunoalergologia do Centro Hospitalar Universitário do Porto para administração da VASPR, bem como a segurança da mesma em crianças com alergia ou sensibilização ao ovo. Métodos: Estudo observacional retrospetivo dos processos clínicos de crianças referenciadas para a consulta de Imunoalergologia para administração da VASPR com alergia suspeita ou confirmado a ovo entre 1 de janeiro de 2013 e 31 de dezembro de 2019. Resultados: Das 60 crianças estudadas, 90% apresentaram sintomas mediante ingestão de ovo, predominantemente cutâneos (67%) mas também anafilaxia em quatro casos. Alergia à proteína do leite de vaca (55%), seguida da alergia a outros alimentos (45%) foram os antecedentes pessoais de doença alérgica mais frequentes. Foi identificada asma em 10% dos casos, encontrando-se controlada em todos. Das crianças referenciadas para administração de reforço vacinal, uma tinha apresentado reação à dose prévia da VASPR. Três crianças desenvolveram reação cutânea local tardia e uma desenvolveu reação sistémica tardia após administração da VASPR. Todas tiveram prova de provocação oral negativa. Conclusão: A administração da VASPR é segura e a sua recomendação mantém-se mesmo em crianças com alergia ao ovo. Contudo, a inoculação deve ser realizada em ambiente hospitalar em crianças com reação anafilática ao ovo, reação anafilática a uma dose prévia da vacina ou seus componentes, asma não controlada e alergia ao ovo, ou asma não controlada e alergia a uma dose prévia da vacina.

Abstract Introduction: Egg allergy is one of the most common food allergies in childhood. Administration of the measles, mumps, and rubella (MMR) vaccine is recommended in pediatric age. Despite the presence of traces of egg protein in its composition, the literature recommends MMR vaccine administration regardless of the patient’s past egg allergy history, identifying cases in which the administration should occur in hospital setting. Purpose: To characterize the pediatric population referred to the Allergy and Clinical Immunology Department of Centro Hospitalar Universitário do Porto for MMR vaccine administration and investigate vaccination safety in children with egg allergy or sensitization. Methods: This was a retrospective observational study of clinical records of children with confirmed or suspected egg allergy referred to the Allergy and Clinical Immunology Department for administration of the MMR vaccine between January 1, 2013 and December 31, 2019. Results: Among 60 children studied, 90% presented symptoms upon egg intake, with cutaneous reactions being the most prevalent (67%) and four reported cases of anaphylaxis. Allergy to cow’s milk protein (55%), followed by allergy to other foods (45%) were the most frequent personal histories of allergic diseases. Asthma was identified in 10% of patients and was controlled in all cases. Among children referred for vaccination booster dose, one had had a reaction to the previous MMR vaccine dose. Three children developed late local skin reactions, and one had a late systemic reaction after vaccination. All children had negative oral food challenge. Conclusion: MMR vaccine administration is safe and recommended in pediatric age, regardless of egg allergy history. However, immunization should be performed in hospital setting in children with a history of anaphylaxis due to egg allergy, previous anaphylactic reaction to MMR vaccine or one of its constituents, uncontrolled asthma with documented egg allergy, and uncontrolled asthma with allergy to a previous MMR vaccine dose.

ABSTRACT Objectives: Evaluate the celiac disease (CD) markers, within the scope of its screening, in a pediatric population with diagnosis of type 1 diabetes (T1D) at Hospital de Braga (HB) and determine the prevalence of CD in the sample. Reflect on CD screening algorithm applied in this pediatric population. Subjects and methods: Retrospective observational study with 94 patients diagnosed with T1D at age 10 years or younger, followed up at the HB Outpatient Diabetology Consultation, including those referred from other hospitals. Record of clinical information, IgA anti-transglutaminase and anti-endomysium and HLA DQ2/DQ8 haplotypes. Results: We obtained positive serological test for CD in 4 patients. This test had 100% sensitivity and specificity. The prevalence of CD was 4.3% (n = 4). Positive HLA screening in 84.6% of patients, with both sensitivity and negative predictive value of 100% and specificity of 16.67%. Diagnosis of CD was made on average 3.40 ± 3.32 years after the diagnosis of TD1. All cases of CD registered non-gastrointestinal manifestations, none had gastrointestinal symptoms. Conclusion: This study proved that there is a higher prevalence of CD in pediatric population with TD1, when compared to general population, and clarified the importance of CD screening. Furthermore, it was observed that serological screening for CD antibodies is an excellent screening test and HLA typing, although not the most suitable first line test, can be useful in excluding the possibility of patients with T1D developing CD.