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Introduction: Multiple sclerosis (MS), a chronic inflammatory immune-mediated disease of the central nervous system (CNS), is a common condition in young adults, but it can also affect children. The aim of this study was to construct radiomic models of lesions based on magnetic resonance imaging (MRI, T2-weighted-Fluid-Attenuated Inversion Recovery), to understand the correlation between extracted radiomic features, brain and lesion volumetry, demographic, clinical and laboratorial data., Methods: The neuroimaging data extracted from eleven scans of pediatric MS patients were analyzed. A total of 60 radiomic features based on MR T2-FLAIR images were extracted and used to calculate gray level co-occurrence matrix (GLCM). The principal component analysis and ROC analysis were performed to select the radiomic features, respectively. The realized classification task by the logistic regression models was performed according to these radiomic features., Results: Ten most relevant features were selected from data extracted. The logistic regression applied to T2-FLAIR radiomic features revealed significant predictor for multiple sclerosis (MS) lesion detection. Only the variable "contrast" was statistically significant, indicating that only this variable played a significant role in the model. This approach enhances the classification of lesions from normal tissue., Discussion and Conclusion: Our exploratory results suggest that the radiomic models based on MR imaging (T2-FLAIR) may have a potential contribution to characterization of brain tissues and classification of lesions in pediatric MS., Competing Interests: The reviewer PS declared a shared affiliation with the author RF to the handling editor at the time of review. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Faustino, Lopes, Jantarada, Mendonça, Raposo, Ferrão, Freitas, Mateus, Pinto, Almeida, Gomes, Marques and Palavra.)

Background: Mozambique's community health programme has a disproportionate number of male community health workers (known as Agentes Polivalentes Elementares (APEs)). The Government of Mozambique is aiming to increase the proportion of females to constitute 60% to improve maternal and child health outcomes. To understand the imbalance, this study explored the current recruitment processes for APEs and how these are shaped by gender norms, roles and relations, as well as how they influence the experience and retention of APEs in Maputo Province, Mozambique., Methods: We employed qualitative methods with APEs, APE supervisors, community leaders and a government official in two districts within Maputo Province. Interviews were recorded, transcribed and translated. A coding framework was developed in accordance with thematic analysis to synthesise the findings., Findings: In-depth interviews (n = 30), key informant interviews (n = 1) and focus group discussions (n = 3) captured experiences and perceptions of employment processes. Intra-household decision-making structures mean women may experience additional barriers to join the APE programme, often requiring their husband's consent. Training programmes outside of the community were viewed positively as an opportunity to build a cohort. However, women reported difficulty leaving family responsibilities behind, and men reported challenges in providing for their families during training as other income-generating opportunities were not available to them. These dynamics were particularly acute in the case of single mothers, serving both a provider and primary carer role. Differences in attrition by gender were reported: women are likely to leave the programme when they marry, whereas men tend to leave when offered another job with a higher salary. Age and geographic location were also important intersecting factors: younger male and female APEs seek employment opportunities in neighbouring South Africa, whereas older APEs are more content to remain., Conclusion: Gender norms, roles and power dynamics intersect with other axes of inequity such as marital status, age and geographic location to impact recruitment and retention of APEs in Maputo Province, Mozambique. Responsive policies to support gender equity within APE recruitment processes are required to support and retain a gender-equitable APE cadre.

Purpose: To evaluate long-term outcomes among a population of very old patients (≥80years) after nonelective intensive care unit (ICU) admission., Methods: A retrospective study of very old patients admitted to a mixed ICU between 2006 and 2012 was conducted. A detailed description was made; functional status was assessed through the modified Rankin Scale and quality of life through EQ-5D-3L. Follow-up results are compared between 3 groups: very old with "old" (66-79 years) and "non-old" (≤65years) patients., Results: A total of 278 very old patients were admitted into the ICU representing 10.3% of admissions. The mean (SD) Simplified Acute Physiology Score II was 61 (16) predicting a hospital mortality of 70%, and the observed hospital mortality was 53%. Two-year survival rate was 38%. Of the 158 patients who survived in the ICU, 51 were evaluated in the outpatient clinic, and of those, 25 (51%) had already resumed previous functional activity. Evaluation through the modified Rankin Scale showed that 29 (60%) remained independent in their daily activities. When comparing the 3 groups, several differences were observed between theme, with the oldest groups (>80years) reporting more problems in motility, self-care, and usual activities. The respondent's self-rated health through the median visual analog scale score on the day of the outpatient clinic appointment decreased with age., Conclusions: For those who survive, return to previous functional activity was likely. Long-term survival and quality of life achieved afterward were translated in more than a year of perfect health status gained., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Introduction: Behçet's disease (BD) is a multisystem inflammatory disease of unknown etiology that may affect the CNS - Neuro-Behçet (NB). Our aim was to evaluate the frequency of neurological involvement and characterize a cohort of our NB patients., Methods: We retrospectively revised the clinical, laboratory and imaging data of a cohort of BD patients, followed in our hospital outpatient clinic., Results: We identified 138 BD patients. Twenty-five out of 138 had NB (15 female). Four patients presented with neurological symptoms. We identified a total of 37 attacks. Twenty-one attacks were classified as parenchymatous, four non-parenchymatous and 12 as other syndromes. Seventeen patients had CSF analysis performed (20 samples). Five samples were normal, 15 showed CSF pleocytosis. The most frequent finding on MRI performed in the acute phase was extensive lesions involving the brainstem. Two patients died due to the neurological involvement of BD., Conclusion: We found 18.1% prevalence of NB and a higher female-to-male ratio in our group than in other series. Gastrointestinal and vascular involvement was more frequent in the NB group. The fact that neurological involvement may be the first manifestation of BD with therapeutic implications and associated morbidity points out the relevance of an early diagnosis., (© 2015 S. Karger AG, Basel.)

Objective: To determine whether race is a factor of blood pressure levels in school-age children of similar social status, and to investigate other potential determinants of the levels of blood pressure., Design: Inquiry in schools of the suburbs of Lisbon., Setting: Three schools, four medical observers (general practitioners with school-health functions)., Subjects: Three hundred ninety seven children, aged 6-14 years, both sexes, 296 being white and 101 non-white., Interventions: Inquiry to the following individual characteristics--sex, age, race, birthplace, type of housing, house availability of water, electricity and waste water, type of transportation to school, number of cohabitans, family income, school marks. Individual determination of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), weight and height., Measurements and Main Results: Blood pressure values were cross-analyzed with all the determined variables, and the virtual correlations were checked. Main results as follows: Race does not influence either SBP or DBP. In this age group, sex does not influence blood pressure values. The used markers of socioeconomical status have equally no influence on blood pressure. Age has only a significant repercussion on SBP. No significant correlation was found between height and blood pressure. Body weight, however, influence either SBP or DBP. SBP was found to be lower in the second of two successive measurements, and the difference increases with age., Conclusions: In this school-aged biracial population, body weight seems to be the major factor of blood pressure levels, in the sense-bigger weight, higher SBP and DBP.