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Substituted phenethylamines including 2C (2,5-dimethoxyphenethylamines) and NBOMe (N-(2-methoxybenzyl)phenethylamines) drugs are potent psychoactive substances with little to no knowledge available on their toxicity. In the present in vitro study, we explored the mechanisms underlying the neurotoxicity of six substituted phenethylamines: 2C-T-2, 2C-T-4, 2C-T-7 and their corresponding NBOMes. These drugs were synthesized and chemically characterized, and their cytotoxicity (0–1000 μM) was evaluated in differentiated SH-SY5Y cells and primary rat cortical cultures, by the NR uptake and MTT reduction assays. In differentiated SH-SY5Y cells, mitochondrial membrane potential, intracellular ATP and calcium levels, reactive oxygen species production, and intracellular total glutathione levels were also evaluated. All the tested drugs exhibited concentration-dependent cytotoxic effects towards differentiated SH-SY5Y cells and primary rat cortical cultures. The NBOMe drugs presented higher cytotoxicity than their counterparts, which correlates with the drug’s lipophilicity. These cytotoxic effects were associated with mitochondrial dysfunction, evident through mitochondrial membrane depolarization and lowered intracellular ATP levels. Intracellular calcium imbalance was observed for 2C-T-7 and 25T7-NBOMe, implying a disrupted calcium regulation. Although reactive species levels remained unchanged, a reduction in intracellular total GSH content was observed. Overall, these findings contribute to a deeper understanding of these drugs, shedding light on the mechanisms underpinning their neurotoxicity.

Surface roughness is primarily determined by the inherent characteristics of a material, the specific polishing protocol and the manual operator’s dexterity. This research intends to conduct a comparative analysis between a conventional and mechanized polishing protocol concerning surface roughness and its impact on surface topography. Thirty samples were included in this in vitro study: six samples for each type of acrylic resin. All specimens underwent a polishing protocol by a conventional method and a mechanized approach with a controlled polishing tool (CPT). Profilometric measures were extracted: arithmetic mean height (Pa), skewness (Psk) and kurtosis (Pku). The Pa values acquired through both the mechanized and conventional polishing techniques are significantly lower compared to the control group. The mechanized polishing notably yielded higher roughness compared to the control group. Relatively consistent skewness and lower-to-moderate values of kurtosis were found across resin types. Differences in the dispersion and pattern for Pa were not detected between the polishing protocols. The CPT protocol reliably maintains consistent skewness and kurtosis values. The conventional protocol remains significant due to the variations observed in the Pa values obtained.

Healthcare-associated infections (HAIs) represent a major challenge in patient safety that affects services disproportionally. This paper aimed to assess how the HAI prevalence varies between hospital services and what contextual characteristics may explain such variance. A cross-sectional study was conducted on adult patients in Portuguese hospitals, using data from the European point prevalence survey of HAI prevalence. The study variables included patient, structural, and process variables, tested as risk factors, with patients clustered in hospitals. Variables with a p-value ≤ 0.2 in univariate analyses were retested in a multivariable model. A total of 18,261 patients from 119 hospitals were included: 736 from 56 intensive care units (ICUs), 3160 from 72 surgical departments, and 8081 from 90 medical departments. The HAI prevalence was 7.9%, 5.9%, and 1.7%, respectively. In ICUs, only the number of devices was associated with the HAI prevalence. In surgical departments, age, comorbidities, being a specialized hospital, and a higher ratio of infection prevention and control (IPC) personnel were associated with higher SSI. The safety climate was associated with lower SSI. In medical departments, age and devices were positively associated, whereas a larger ratio of IPC nurses was negatively associated. These results may help implement targeted interventions to achieve optimal results in each department.

Table of contents for Volume 12(i) of International Journal of Religious Tourism and Pilgrimage

Gender dysphoria is defined as a condition characterized by mental suffering associated with the incongruence between one’s experienced gender and their birth-assigned sex. Gender as a construct and gender dysphoria as a condition in need of multidisciplinary intervention have developed as swiftly as their visibility in society, making it mandatory to promote the literacy and education of all healthcare professionals in this area. This article aims to review information based on scientific evidence on people with gender dysphoria and its clinical approach, while contributing to a safe, inclusive, and non-discriminatory practice of healthcare.

Neurodegenerative diseases (NDs) are a set of progressive, chronic, and incurable diseases characterized by the gradual loss of neurons, culminating in the decline of cognitive and/or motor functions. Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the most common NDs and represent an enormous burden both in terms of human suffering and economic cost. The available therapies for AD and PD only provide symptomatic and palliative relief for a limited period and are unable to modify the diseases’ progression. Over the last decades, research efforts have been focused on developing new pharmacological treatments for these NDs. However, to date, no breakthrough treatment has been discovered. Hence, the development of disease-modifying drugs able to halt or reverse the progression of NDs remains an unmet clinical need. This review summarizes the major hallmarks of AD and PD and the drugs available for pharmacological treatment. It also sheds light on potential directions that can be pursued to develop new, disease-modifying drugs to treat AD and PD, describing as representative examples some advances in the development of drug candidates targeting oxidative stress and adenosine A2A receptors.

In this article, a preliminary exploratory study is undertaken to cover a lesser researched topic in the tourism literature concerning the conceptualisation of heritage-based routes. A route of less-known heritage that crosses a territory with varied cultures is proposed. It is intended that the route contributes to the practice of creating itineraries for tourists. The route extends from Central Europe to the Iberian Peninsula and is related to historical and mythical legacies of Elisabeth of Hungary (1207-1231); Landgrave of Thuringia and; Isabel (Elisabeth), Princess of Aragon (1270?-1336) and Queen of Portugal. In this research, we opt for a qualitative approach, using both primary and secondary sources of data collection. Documentary sources, namely cultural-historical-mythical, field observation undertaken over several years and visual material collected. Results led to defining a common theme, as they share the miracle that earned them immortality – the miracle of the roses. Secondly, heritage elements were obtained and information on their history was collected to highlight specificities of the territories and identify the cultural path and points along the route.

Polyetheretherketone is a high-performance thermoplastic polymer that can be used in 3D printing by fused deposition modeling, and is a promising material for dental applications. Some printing parameters are sensitive and can influence the properties of the printed object. Thus, this work aims to evaluate the influence of the print layer thickness on the surface roughness of polyetheretherketone before and after polishing and to verify the effectiveness of the polishing method used, as well as to compare it with the results obtained using polymethyl methacrylate as the control group. Specimens with different impression layer thicknesses were printed with polyetheretherketone (Group A—0.1 mm and Group B—0.3 mm). Additionally, a control group with polymethyl methacrylate specimens was milled. Roughness evaluation was conducted using a contact profilometer after the specimens had been printed (before polishing). Then, silicon carbide sandpaper was used to polish the surface, and the roughness was reassessed. Differences were observed between specimens regarding the print layer thickness and the roughness, with the 0.3 mm layer thickness showing the lowest roughness values. The results of this pilot study suggest that the surface roughness of fused deposition modeling printed polyetheretherketone is influenced by print layer thickness, with the lowest roughness seen at a thickness of 0.3 mm.

The increasing interest in utilizing psychedelics for therapeutic purposes demands the development of tools capable of efficiently monitoring and accurately identifying these substances, thereby supporting medical interventions. 4-Bromo-2,5-dimethoxyphenethylamine (2C-B) has gained significant popularity as one of the most widely used psychedelic compounds in non-medical settings. In this study, we aimed to create a material with selective recognition of 2C-B by synthesizing a series of molecularly imprinted polymers (MIP) using 2C-B as the template and varying ratios of methacrylic acid (MAA) as the functional monomer (1:2, 1:3, and 1:4). Both thermal and microwave-assisted polymerization processes were employed. The molar ratio between the template molecule (2C-B) and functional monomer (MAA) was 1:4, utilizing a microwave-assisted polymerization process. Isotherm studies revealed a Langmuir’s maximum absorption capacity (Bmax) value of 115.6 μmol·mg−1 and Kd values of 26.7 μM for this material. An imprint factor of 4.2 was determined for this material, against the corresponding non-imprinted polymer. The good selectivity against 14 other new psychoactive substances highlighted the material’s potential for applications requiring selective recognition. These findings can contribute to the development of tailored materials for the detection and analysis of 2C-B, supporting advancements in non-medical use monitoring and potential therapeutic models involving psychedelics.

O estudo teve por objetivo identificar a percepção dos Presidentes, Conselheiros de Administração e Auditores internos acerca das práticas de controle interno em cooperativas de crédito, baseando-se no framework do COSO ICIF 2013. Para tanto, utilizou-se um survey para capturar os contextos institucionais dos respondentes. Os dados foram analisados em conjunto e pelas médias dos grupos, por meio do teste não paramétrico de Kruskal Wallis. Os resultados indicam a existência de práticas de controle interno nas instituições, todavia, não há uniformização conceitual de controle interno. Além disso, as práticas relacionadas aos componentes: Ambiente de controle e atividades de controle, são mais evidentes, todavia, as práticas relacionadas aos demais componentes necessitam de reforço para garantirem o funcionamento constante do sistema de controle interno. No panorama geral, conclui-se que, apesar da divergência conceitual, as cooperativas possuem estruturas de controles internos, sendo corroboradas pela expressiva concordância acerca da implementação de práticas de controle interno.

(1) Introduction: Apart from the polishing method, conventional or mechanized, the arithmetic mean roughness (Ra) is the most common metric to evaluate the surface roughness of denture base acrylic resins. An overview of the constraints related to this roughness parameter is highlighted in this study. This research introduces new parameters for accessing a functional analysis of surface roughness. (2) Materials and Methods: Five samples of CAD/CAM 3D-printed acrylic resins were prepared. Two polishing techniques, manual and mechanical, were applied. Surface roughness parameters were extracted from a profilometer reading: arithmetic mean height (Ra and Pa), skewness (Rsk and Psk), and kurtosis (Rku and Pku). (3) Results: Significant differences (p < 0.001) were found in the Ra distribution among the study samples, in contrast with the lack of significance in Pa values. Surface roughness parameters revealed an increased coefficient of variance (CV) value due to mechanized polishing across the specimens analyzed. Skewness and kurtosis indicate a more pronounced distribution with the manual polishing technique. (4) Conclusion: This preliminary study exhibits the influence of different polishing protocols on surface roughness parameters. The primary profile, skewness, and kurtosis should be assessed for the surface characterization of acrylic resins.

Abstract The common pheasant, a game species widely introduced throughout the world, can be considered as an ideal model to study the effects of introduction events on local adaptations, biogeographic patterns, and genetic divergence processes. We aimed to assess the origin, spatial patterns of genetic variation, and demographic history of the introduced populations in the contact zone of Central and Southeast Europe, using mitochondrial DNA control region sequences and microsatellite loci. Both types of molecular markers indicated relatively low to moderate levels of genetic variation. The mtDNA analyses revealed that common pheasants across the study area are divided into two distinct clades: B (mongolicus group) and F (colchicus group). Analyses of the microsatellite data consistently suggested a differentiation between Hungary and Serbia, with the pheasant population in Hungary being much more genetically homogeneous, while that of Serbia has much more genetic mixture and admixture. This cryptic differentiation was not detected using a non-spatial Bayesian clustering model. The analyses also provided strong evidence for a recent population expansion. This fundamental information is essential for adequate and effective conservation management of populations of a game species of great economic and ecological importance in the studied geographical region.

A psicofarmacologia representa, cada vez mais, uma área de conhecimento com importantes implicações na atuação profissional dos psicólogos. Em vários países, tem-se assistido, ao longo dos últimos anos, a uma crescente importância dada à formação em psicofarmacologia para psicólogos. O objetivo deste trabalho foi realizar um levantamento dos planos curriculares de todas as instituições de Ensino Superior portuguesas que lecionam cursos de licenciatura e mestrado em psicologia de modo a verificar quais destes incluem unidades curriculares sobre psicofarmacologia. Para tal, foram recolhidos dados através do sítio da Direção Geral do Ensino Superior (DGES) e dos sítios oficiais das instituições de Ensino Superior durante o mês de julho de 2021. Os resultados observados indicam que a formação em psicofarmacologia, apesar de existir, é em número reduzido. Num total de 97 cursos de licenciatura e mestrado em psicologia analisados, apenas 11 unidades curriculares relacionadas com psicofarmacologia foram identificadas, sendo que três destas são ministradas na mesma instituição. No geral, estes dados sugerem que a formação em psicofarmacologia dada nas formações iniciais dos psicólogos, apesar de existir, é ainda residual. No final do artigo, são referidas as implicações dos resultados para os currículos da formação dos psicólogos bem como perspetivadas consequências para a prática profissional da psicologia.

Este trabalho objetivou acompanhar o comportamento das abelhas africanizadas (Apis mellifera L.), utilizando sensores de rádio frequência – RFID em Belém, Pará, Brasil. A metodologia empregada baseou-se na fixação de rastreadores às abelhas, passando a ser observadas por ondas eletromagnéticas, por meio de um condutor de metal ou carbono que funciona com antena, trocando informações com o sistema através de seus EPCs (Eletronic Product Code). A avaliação comportamental dessas abelhas com o uso da tecnologia RFID poderá trazer informações de grande importância para um melhor entendimento da biologia comportamental do inseto e suas relações com o bioma amazônico, as quais também poderão ser utilizadas na potencialização da polinização e da produção de mel para a geração de renda aos apicultores da região da Amazônia Oriental.

Mescaline derivative (2C phenethylamines) drugs have been modified by the introduction of a N-2-methoxybenzyl group to originate a new series of compounds with recognized and potent psychedelic effects, the NBOMe-drugs. Although they are prevalent in unregulated drug markets, their toxicity profile is still poorly understood, despite several reports highlighting cases of acute intoxication, with brain and liver toxicity. Thus, in this study, mescaline, 2C-N (insertion of a nitro in the para position of the 2C phenethylamines aromatic ring) and 2C-B (insertion of a bromide in the para position of the 2C phenethylamines aromatic ring) and their corresponding NBOMe counterparts, mescaline-NBOMe, 25N-NBOMe and 25B-NBOMe, were synthetized and the in vitro neuro- and hepatocytotoxicity evaluated in differentiated SH-SY5Y and HepG2 cell lines, respectively. Cytotoxicity, oxidative stress, metabolic and energetic studies were performed to evaluate the main pathways involved in their toxicity. Our results demonstrated that the presence of the N-2-methoxybenzyl group significantly increased the in vitro cytotoxicity of 2C phenethylamines drugs in both cell lines, with the NBOMe drugs presenting lower EC50 values when compared to their counterparts. Consistently, our data showed a correlation between the drug’s lipophilicity and the EC50 values, except for 2C-B. The 2C-B presented higher cytotoxic effects in both cell lines than mescaline-NBOMe, a result that can be explained by its higher passive permeability. All the NBOMe derivatives were able to cross the blood–brain barrier. Considering metabolic studies, the cytotoxicity of these drugs was shown to be influenced by inhibition of cytochrome P450 (CYP), which suggests a potential role of this enzyme complex, especially CYP3A4 and CYP2D6 isoenzymes in SH-SY5Y cells, in their detoxification or bioactivation. Furthermore, in differentiated SH-SY5Y cells, the drugs were able to induce mitochondrial membrane depolarization, and to disrupt GSH and ATP intracellular levels, these effects being concentration dependent and more pronounced for the NBOMe derivatives. No ROS overproduction was detected for any of the drugs in the tested experimental conditions. A correlation between a drug’s lipophilicity and the EC50 values in both cell lines, except for 2C-B, was also obtained. In summary, the introduction of a NBOMe moiety to the parent drugs significantly increases their lipophilicity, brain permeability and cytotoxic effects, with GSH and ATP homeostasis disruption. The inhibition of CYP3A4 and CYP2D6 emphasized that CYP-mediated metabolism impacts the toxicity of these drugs.

A 61-year-old man was diagnosed with an exudative pleural effusion with raised amylase and bilirubin levels. The patient had no previous history of acute pancreatitis or trauma and no clinical or radiological signs of chronic pancreatitis. On thoracoabdominal computed tomography, a pancreatic pseudocyst with a pancreaticopleural fistula was identified. Endoscopic retrograde cholangiopancreatography identified a ductal disruption site in the body of the pancreas. Pancreatic sphincterotomy and stent placement in the duct of Wirsung, combined with medical management, allowed fistula closure, pseudocyst reabsorption, and no relapse of the pleural effusion. The relevance of this case lies not only in its rarity but also as it highlights the importance of a multidisciplinary approach in such uncommon conditions. Optimal management of this condition is debatable due to the absence of prospective studies comparing medical, endoscopic, and surgical approaches.

Abstract Opicapone (2,5‐dichloro‐3‐(5‐(3,4‐dihydroxy‐5‐nitrophenyl)‐1,2,4‐oxadiazol‐3‐yl)‐4,6‐dimethylpyridine 1‐oxide) is a selective catechol‐O‐methyltransferase inhibitor that has been granted marketing authorization in Europe, Japan, and United States. The present work describes the metabolism and disposition of opicapone in the rat obtained in support to its development and regulatory filling. Plasma levels and elimination of total radioactivity were determined after oral and intravenous administration of [14C]‐opicapone. The maximum plasma concentrations of opicapone‐related radioactivity were reached at early time points followed by a gradual return to baseline with a biphasic elimination. Fecal excretion was the primary route of elimination of total radioactivity. Quantitative distribution of drug‐related radioactivity demonstrated that opicapone and related metabolites did not distribute to the central nervous system. Opicapone was extensively metabolized in rats resulting in more than 20 phase I and phase II metabolites. Although O‐glucuronidation, ‐sulfation, and ‐methylation of the nitrocatechol moiety were the principal metabolic pathways, small amount of the N‐acetyl derivative was detected, as a result of reduction of the nitro group and subsequent conjugation. Other metabolic transformations included N‐oxide reduction to the pyridine derivative and reductive cleavage of 1,2,4‐oxadiazole ring followed by further conjugative reactions. Reaction phenotyping studies suggested that SULT 1A1*1 and *2 and UGT1A7, UGT1A8, UGT1A9, and UGT1A10 may be involved in opicapone sulfation and glucuronidation, respectively. However, the reductive metabolic pathways mediated by gut microflora cannot be excluded. Opicapone, in the rat, was found to be rapidly absorbed, widely distributed to peripheric tissues, metabolized mainly via conjugative pathways at the nitro catechol ring, and primarily excreted via feces.

The aim of this study is to explore a holistic approach to assessing the level of development of a pilgrimage route using a model proposed by Ambrosio et al. (2019). In accordance with this model, a diagnosis matrix structures the surveying of predefined variables and enables the evaluation of pilgrimage routes. This tool allows an understanding of both, material and immaterial elements that comprise part of pilgrimage experiences, and of the respective routes as tourism products. The study takes as reference two Municipalities along the Portuguese Way to Santiago—one in the South, Vila Franca de Xira, and another in the North, Viana do Castelo. In our primary research, the criteria of the conceptual model were interpreted along a three-stage assessment methodology based on the diagnosis matrix to test the conceptual model—the physical structure of the route itself, the supporting services, and the availability and quality of the attractions. A visual methodology through photo elicitation was used to register data and generate discussion amongst stakeholders. Findings suggest that the same type of resources are being handled differently in the crossed municipalities, demonstrating a lack of coordinated development. Additionally, a general lack of knowledge of emerging consumer trends may be impeding innovations by businesses, raising doubt about the readiness of the pilgrimage route for the post-pandemic pilgrim.

Post-traumatic stress disorder (PTSD) is a common anxiety mental disorder and can be manifested after exposure to a real or perceived life-threatening event. Increased noradrenaline and adrenaline in plasma and urine have been documented in PTSD. Dopamine-β-hydroxylase (DBH) catalyzes the conversion of dopamine to noradrenaline and consequently, DBH inhibition reduces catecholamines. Our aim was to evaluate if nepicastat treatment decreases PTSD signs in an animal model. Wild-type (129x1/SvJ) female mice were submitted to PTSD induction protocol. DBH-inhibitor nepicastat (30 mg/kg) or vehicle (0.2% HPMC) were administered once daily since day 0 until day 7 or 12. The percentage of freezing was calculated on days 0, 1, 2, and 7, and behavioral tests were performed. Quantification of nepicastat in plasma and DBH activity in the adrenal gland was evaluated. Catecholamines were quantified by HPLC with electrochemical detection. mRNA expression of Npas4 and Bdnf in hippocampus was evaluated by qPCR.Mice in the PTSD-group and treated with nepicastat showed a decrease in freezing, and an increase in the time spent and entries in open arms in elevated plus maze test. In mice treated with nepicastat, adrenal gland DBH activity was decreased, and catecholamines were also decreased in plasma and tissues. On day 7, in mice treated with nepicastat, there was an increase of Npas4 and Bdnf mRNA expression in the hippocampus.In conclusion, DBH inhibitor nepicastat has an effect consistent with a decrease in the persistence of traumatic memories and anxiety-like behavior in this PTSD mice model. The disruption of traumatic memories through interference with the formation, consolidation, retrieval, and/or expression processes may be important to decrease PTSD symptoms and signs. The increase in Npas4 and Bdnf mRNA expression in the hippocampus may be important to develop a weaker traumatic contextual memory after nepicastat treatment.

The present study aimed to test, in vitro, the antimicrobial activity against Candida albicans and Streptococcus mutans and the surface roughness of a 3D-printed polymethylmethacrylate dental resin enhanced with graphene. A 3D-printed polymethylmethacrylate dental resin was reinforced with four different concentrations of graphene: 0.01, 0.1, 0.25 and 0.5 wt%. Neat resin was used as a control. The specimens were printed in a liquid crystal display printer. Disc specimens were used in antimicrobial evaluation, and bar-shaped specimens were used to measure surface roughness. The study of antimicrobial activity included the inhibition of the growth of C. albicans and S. mutans and their adhesion to the resin’s surface. Surface roughness increased with the increase in the graphene concentration. The growth inhibition of C. albicans was observed in the different concentrations of graphene after 24 h, with no recovery after 48 h. The specimens doped with graphene were capable of inactivating S. mutans after 48 h. The surface-adhesion studies showed that the density of microbial biofilms decreases in the case of specimens doped with graphene. Graphene, despite increasing the resin’s surface roughness, was effective in inhibiting the growth and the adhesion to the resin’s surface of the main inducers of prosthetic stomatitis.

Targeting antioxidants to mitochondria is considered a promising strategy to prevent cellular senescence and skin ageing. In this study, we investigate whether four hydroxybenzoic acid-based mitochondria-targeted antioxidants (MitoBENs, MB1-4) could be used as potential active ingredients to prevent senescence in skin cells. Firstly, we evaluated the chemical stability, cytotoxicity, genotoxicity and mitochondrial toxicity of all compounds. We followed this by testing the antioxidant protective capacity of the two less toxic compounds on human skin fibroblasts. We then assessed the effects of the best hit on senescence, inflammation and mitochondrial remodeling on a 3D skin cell model, while also testing its mutagenic potential. Cytotoxicity and mitochondrial toxicity rankings were produced: MB3 < MB4 ≃ MB1 < MB2 and MB3 < MB1 < MB4 < MB2, respectively. These results suggest that pyrogallol-based compounds (MB2 and MB4) have lower cytotoxicity. The pyrogallol derivative, MB2, containing a 6-carbon spacer, showed a more potent antioxidant protective activity against hydrogen peroxide cytotoxicity. In a 3D skin cell model, MB2 also decreased transcripts related to senescence. In sum, MB2’s biological safety profile, good chemical stability and lack of mutagenicity, combined with its anti-senescence effect, converts MB2 into a good candidate for further development as an active ingredient for skin anti-ageing products.

This investigation aims to determine the effect of the same polishing protocol on the surface roughness (Ra) of different resins obtained by different processing techniques. Acrylic resins obtained by CAD/CAM technology overcame the disadvantages identified in conventional materials. A total of thirty samples (six of each resin): self-cured, heat-polymerized, injection molded, CAD/CAM 3D-printed and CAD/CAM milled were prepared. JOTA® Kit 1877 DENTUR POLISH was used to polish the samples by two techniques: manual and mechanized, with a prototype for guided polishing exclusively developed for this investigation. The Ra was measured by a profilometer. The values were analyzed using ANOVA, Games–Howell post-hoc test and One-sample t-test, with p < 0.05. Manual polishing produces lower values of Ra compared to mechanized polishing, except for injected molded resins (p = 0.713). Manual polishing reveals significant differences between the resin pairs milling/3D-printing (p = 0.012) and thermopolymerizable/milling (p = 0.024). In the mechanized technique only, significant differences regarding the Ra values were found between the self-cured/3D-printed (p = 0.004) and self-cured/thermopolymerizable pair resins (p = 0.004). Differences in surface roughness values can be attributed to the inherent characteristics of the resin and the respective processing techniques.

We explore the role of restaurants and food events in promoting local and regional gastronomy in the Minho region in Northern Portugal. Interviews with restaurant owners and event organizers in this mainly rural region reveal that innovation is driven mainly by changing consumer tastes, but also constrained by consumer expectations of low prices. Restaurants maintain a family-run structure, also due to a lack of human resources. The main thrust of innovation lies in creating a convivial atmosphere, but there is less emphasis on locally produced food ingredients. In the long run this may undermine the regional food culture and its authenticity, despite the perceived importance of tradition.

Research has demonstrated that policing is a stressful occupation and that this stress has a negative impact on police officers’ mental and physical health, performance, and interactions with citizens. Mental health at the workplace has become a concern due to the costs of depression, anxiety, burnout, and even suicide, which is high among police officers. To ameliorate occupational health, it is therefore crucial to identify stress and burnout levels on a regular basis. However, the instruments frequently used to measure stress have not valorized the specificity of policing tasks. This study aims to: (i) conduct a literature review to identify questionnaires used to assess occupational stress and burnout among police officers; (ii) analyze the psychometric characteristics of a Portuguese version of Operational Police Stress Questionnaire (PSQ-Op); and, using the PSQ-Op and other questionnaires, (iii) to identify operational stress, burnout, and distress levels among Portuguese police officers. The literature review identified 108 studies which use a multiplicity of questionnaires to measure burnout or occupational stress among police officers, but few studies use specific police stress questionnaires. Sample sizes were mostly below 500 participants and studies were mainly developed in the last decade in the USA and Brazil, but also in another 24 countries, showing the extent of the interest in this topic. This study applied to 2057 police officers from the National Portuguese Police, a force policing urban centers, and used the PSQ-Op, as well the Spanish Burnout Inventory and the Kessler Psychological Distress Scale. The results show that the psychometric properties of the Portuguese version of PSQ-Op are adequate. Factorial analysis revealed two dimensions defined as social and work issues, which were associated with measures of distress and burnout. Fit indices suggested a second-order solution called operational police stress. Overall, and considering the scale range of each questionnaire, the results showed moderate values of operational stress, distress, and burnout. However, considering their cut-off points, 85% of the sample presented high operational stress levels, 11% critical values for burnout, and 28% high distress levels, with 55% of the sample at risk of a psychological disorder. These results reinforce the need to prevent stress and to invest in police officers’ occupational health.

Despite a recent decline, tuberculosis (TB) infection is still a frequent diagnosis in Portugal. Adenosine deaminase (ADA) measurement has become an important tool in the timely diagnosis of this infection. However, ADA elevation in bodily fluids is not pathognomonic of TB infection. We present the case of a 70-year-old woman, undergoing treatment for pleural TB, diagnosed based on elevated ADA levels in a pleural effusion. Due to worsening symptoms she was readmitted, and the previous diagnosis was reconsidered. Thoracocentesis was repeated and cytometry analysis of the fluid was performed, showing the presence of diffuse large B cell lymphoma (DLBCL). DLBCL is the most frequently occurring non-Hodgkin lymphoma (NHL). Pleural involvement is rare in the initial stages. ADA elevation >250 U/l should raise suspicion of malignancy, especially in association with markedly elevated LDH levels. The purpose of this case report is to highlight that in the absence of microbiologic or histologic confirmation, a presumptive TB diagnosis should not be lightly made, and alternative diagnoses should be systematically ruled out.

This paper presents a study about an autonomous photovoltaic system making use of the novel Lithium Iron Phosphate as a battery pack for isolated rural houses. More particularly, this paper examines the behavior and efficiency of a low-cost isolated photovoltaic system for typical rural houses near Luena in Angola. The proposed system (solar panel, batteries, controller, and inverter) has been projected having in mind the required household daily load of 1,300 Wh and available solar irradiance. The initial batteries charging revealed to be essential to not only ensure a long battery life but using a balanced pack it was possible to achieve more stored energy. On-site, the polycrystalline solar panels used showed a daily average efficiency of 10.8%, with the total system having 75% efficiency. This result was adjusted to the average temperature in Angola. This way, it was made an extrapolation to the monthly irradiation values in Angola. The results achieved showed good energy production during almost all year except January and December, which revealed critical production values of 1,356 Wh and 1,311 Wh, respectively. These values are too close to the daily consumed energy and indicate the addition of a 2nd alternative source of energy (wind generator, diesel generator, etc.) to be explored further.

Mitochondriotropic antioxidants (MC3, MC6.2, MC4 and MC7.2) based on dietary antioxidants and analogs (caffeic, hydrocaffeic, trihydroxyphenylpropanoic and trihydroxycinnamic acids) were developed. In this study, we evaluate and compare the cytotoxicity profile of novel mitochondria-targeted molecules (generally known as MitoCINs) on human HepG2 and differentiated SH-SY5Y cells with the quinone-based mitochondria-targeted antioxidants MitoQ and SkQ1 and with two non-targeted antioxidants, resveratrol and coenzyme Q10 (CoQ10). We further evaluate their effects on mitochondrial membrane potential, cellular oxygen consumption and extracellular acidification rates. Overall, MitoCINs derivatives reduced cell viability at concentrations about six times higher than those observed with MitoQ and SkQ1. A toxicity ranking for both cell lines was produced: MC4 < MC7.2 < MC3 < MC6.2. These results suggest that C-6 carbon linker and the presence of a pyrogallol group result in lower cytotoxicity. MC3 and MC6.2 affected the mitochondrial function more significantly relative to MitoQ, SkQ1, resveratrol and CoQ10, while MC4 and MC7.2 displayed around 100–1000 times less cytotoxicity than SkQ1 and MitoQ. Based on the mitochondrial and cytotoxicity cellular data, MC4 and MC7.2 are proposed as leads that can be optimized to develop safe drug candidates with therapeutic application in mitochondrial oxidative stress-related diseases.

A necessidade de avaliação e monitorização dos factores de risco de natureza psicossocial tem sido estabelecida como uma prioridade pelos organismos internacionais e definida como uma meta ao nível nacional no âmbito das políticas de Segurança e Saúde do Trabalho. Os modelos e métodos de avaliação são diversos e frequentemente multidimensionais. Em Portugal a adaptação e validação do COPSOQ II nas suas versões curta, média e longa tornou-o um instrumento cada vez mais usado nos processos de avaliação e monitorização dos factores de risco psicossociais, numa perspectiva de investigação e deprática quotidiana das organizações de trabalho.Com este artigo pretende-se fazer uma abordagem teórica às perspectivas de evolução do Copenhagen Psychosocial Questionnaire II (COPSOQ II), um instrumento de avaliação de riscos psicossociais adaptado e validado para Portugal.

A 55 years-old Caucasian male presented initially in the emergency room reporting myalgia, chills and fever. Physical exam and laboratory tests were unremarkable and he was discharged with symptomatic care. He returned to our ER two weeks later reporting dizziness, loss of balance, blurred vision, mild dysarthria and bilateral hand paresthesia. On examination he presented complete bilateral ophthalmoplegia, mild dysarthria, left finger-to-nose dysmetria, ataxia, areflexia and bilateral hand hypoesthesia without fever. Blood tests and head computed tomography were normal. The patient was admitted to the Internal Medicine department. On second day inwards the patient presented dysphagia. Head magnetic resonance angiogram showed no signs of ischemia or vascular disease and a lumbar puncture was performed but no pleocytosis, albumin-cytological dissociation or hypoglycorrhachia was present. Despite the normal results we suspected of a Guillain–Barré syndrome variant, and started treatment with intravenous immunoglobulin (IVIG) in a dose of 400mg per kilogram and continued for five days with immediate neurological improvement. We present a rare overlapping case of Miller Fisher syndrome and Pharyngeal-Cervical-Brachial variant of Guillain–Barré syndrome.

This paper presents results from an experiment using electroencephalography to measure neurophysiological activations of mechanical engineers and industrial designers when designing and problem-solving. In this study, we adopted and then extended the tasks described in a previous functional magnetic resonance imaging study reported in the literature. The block experiment consists of a sequence of three tasks: problem-solving, basic design and open design using a physical interface. The block is preceded by a familiarizing pre-task and then extended to a fourth open design task using free-hand sketching. This paper presents the neurophysiological results from 36 experimental sessions of mechanical engineers and industrial designers. Results indicate significant differences in activations between the problem-solving and the open design tasks. The paper focuses on the two prototypical tasks of problem-solving layout and open design sketching and presents results for both aggregate and temporal activations across participants within each domain and across domains.

A chronological analysis of Christian pilgrimages over the course of around 2,000 years of existence suggests that there have been swings in their level of popularity: strong whenever the ruling classes whether religious or civil) protect popular sanctuaries and declining whenever policies constraint the practice of pilgrimages. This paper starts with the characterization of two authoritarian regimes, a fascist one in a western European country, Portugal 1928-1974): and a communist one in a central European country, Slovakia 1948-1989): at that time part of Czechoslovakia. The aim of this research was to explore the status quo during the period of government by the two authoritarian regimes, analyse the approach taken by each regime in regards to religious manifestations and how, with the eventual transition to democracy, it served to determine the dynamics surrounding each country´s main pilgrimage shrine, respectively Fatima Portugal) and Levo?a Slovakia. The research findings show that in Portugal there was no interruption on the increasing popularity and development of Fatima, from the authoritarian to democratic regimes. Meanwhile, in Slovakia only after democracy was reinstated, was it allowed for people to manifest freely their religious beliefs that led to a revival of pilgrimages and visits to Levo?a. The findings provide an understanding of the role of the state under authoritarian regimes and the policies implemented that prompted the importance and potential of the two shrines as religious tourism destinations.

Objective(s) To fully understand the dynamics of Intimate Partner Violence (IPV) it is necessary to understand the role of personality. The current understanding of which personality characteristics are associated with IPV victimization is, however, far from comprehensive. Given this gap in the literature, our objective was to examine the associations between the dimensions of the psychobiological model of personality and psychopathological symptoms in women who had experienced IPV. Methods Using a case-control design, a group of women who had experienced IPV and who were living in shelters (n = 50) were compared to a group of control women who had not experienced IPV (n = 50). All women completed the Temperament and Character Inventory–Revised and the Brief Symptom Inventory. Results Victims of IPV showed significantly higher levels of Harm Avoidance and Self-Transcendence, and lower levels of Reward Dependence and Self-Directedness, than the non-IPV control group. Victims of IPV also reported elevated levels of psychopathological symptoms. Personality dimensions showed a broadly consistent pattern of associations across different psychopathological symptoms. A regression analysis indicated that Novelty Seeking was negatively associated with psychopathological symptoms in victims of IPV, but not significantly associated in non-victims. Conclusions The study highlights the important role of Harm Avoidance and Self-Directedness for understanding psychopathological symptoms. Novelty Seeking appears to play an important role in the expression of individuals’ experiences of IPV. These results have important implications for research and practice, particularly the development and implementation of interventions.

Roads have impacts on the fauna arising from habitat fragmentation, roadkill and the barrier effect. Furthermore, roads lead species to change their activity with repercussions on predator–prey interactions and trigger indirect effects that are currently unknown. This study analyzes the effect of a motorway on the trophic behavior of the terrestrial carnivore community of its surroundings. Monthly scat sampling was conducted over a year at three distances from a motorway (0–50 m, 500–550 m and 1000–1050 m). We collected 498 scats, these originating from red fox (39.16%), cat (24.50%), stone marten (24.09%) and badger (12.25%). The relative abundance of the trophic resources in them was estimated together with the trophic diversity and niche overlap of the carnivore species. The results showed a distinct effect of distance from the road on trophic behavior of carnivores, as well as differences between species and seasons. The scats nearest the road had 10–20% more biomass of small mammals, equivalent in relative terms to a 21–48% increase in small mammals’ biomass when compared with scats collected further from the road. This finding indicates changes in predator–prey interactions near the road and shows that the human-generated structural and functional changes to ecosystems spread throughout trophic networks.

Nowadays, there is an increasing need to understand the behavior of COVID-19. After the Directorate-General of Health of Portugal made available the infected patient’s data, it became possible to analyze it and gather some conclusions, obtaining a better understanding of the matter. In this context, the project developed—ioCOVID19—Intelligent Decision Support Platform aims to identify patterns and develop intelligent models to predict and support clinical decisions. This article explores which typologies are associated with different outcomes to help clinicians fight the virus with a decision support system. So, to achieve this purpose, classification algorithms were used, and one target was studied—Patients outcome, that is, to predict if the patient will die or recover. Regarding the obtained results, the model that stood out is composed of scenario s4 (composed of all comorbidities, symptoms, and age), the decision tree algorithm, and the oversampling sampling method. The obtained results by the studied metrics were (in order of importance): Sensitivity of 95.20%, Accuracy of 90.67%, and Specificity of 86.08%. The models were deployed as a service, and they are part of a clinical decision support system that is available for authorized users anywhere and anytime.

This paper identifies the perceptions and behaviours of owners/ managers of rural small and medium‑sized tourism enterprises (SMTEs) regarding the use of social networks at the present time and in the future. Based on a qualitative perspective, nine semi-structured interviews were conducted with owners / managers of SMTEs based in the Minho ‑ Lima region of northern Portugal. The costs reduction in acquiring new customers, improving credibility and corporate reputation are some of the main perceived advantages. Facebook stands out as being the most used social network, given the greater ease of achieving a broader market in an easy and fast way, essentially considering the high number of users. However, this paper also demonstrates that there is a strong lack of knowledge of how social networks, particularly Facebook, can be used in efficiently and effectively way. This paper seeks to contribute to a better understanding of the potential of social networks for tourism businesses operating in the rural context. Understanding these perceptions is important to identify initiatives and communication strategies appropriated to enterprises reality, contributing to encourage a greater and more effective use of social networks.

Neste artigo, pretende-se reflectir acerca do emergir de Novas Tecnologias da Informação e Comunicação, que promovem um novo paradigma de sociedade baseada na informação e no conhecimento. As Novas Tecnologias podem melhorar significativamente a vida da criança com deficiência, ajudando-a a ultrapassar determinadas barreiras. A Escola deverá estar atenta às inovações tecnológicas, para benefício do sucesso educativo.

The crystal structures of two chromone derivatives, viz. ethyl 6-(4-methylphenyl)-4-oxo-4H-chromene-2-carboxylate, C19H16O4, (1), and ethyl 6-(4-fluorophenyl)-4-oxo-4H-chromene-2-carboxylate C18H13FO4, (2), have been determined: (1) crystallizes with two molecules in the asymmetric unit. A comparison of the dihedral angles beween the mean planes of the central chromone core with those of the substituents, an ethyl ester moiety at the 2-position and a para-substituted phenyl ring at the 6-position shows that each molecule differs significantly from the others, even the two independent molecules (a and b) of (1). In all three molecules, the carbonyl groups of the chromone and the carboxylate are trans-related. The supramolecular structure of (1) involves only weak C—H...π interactions between H atoms of the substituent phenyl group and the phenyl group, which link molecules into a chain of alternating molecules a and b, and weak π–π stacking interactions between the chromone units. The packing in (2) involves C—H...O interactions, which form a network of two intersecting ladders involving the carbonyl atom of the carboxylate group as the acceptor for H atoms at the 7-position of the chromone ring and from an ortho-H atom of the exocyclic benzene ring. The carbonyl atom of the chromone acts as an acceptor from a meta-H atom of the exocyclic benzene ring. π–π interactions stack the molecules by unit translation along the a axis.

Background and aims: Clostridium difficile infection (CDI) constitutes an important cause of antibiotic-associated diarrhea. Recurrence after first-line treatment with antibiotics is high and fecal microbiota transplantation (FMT) may be effective for refractory and recurrent CDI. This series aims to describe the efficacy of FMT in the treatment of refractory and recurrent CDI. Methods: A prospectively recorded single-centre case series of patients with persistent or recurrent CDI treated with FMT between June 2014 and March 2015 was analyzed. Primary and secondary outcomes were defined as resolution of diarrhea without recurrence of CDI within 2 months after one or more FMT, respectively. A descriptive analysis was performed. Results: 8 FMT were performed in 6 patients, 3 with refractory CDI and 3 with recurrent CDI. The median age of recipients was 71 years and 66.7% were women. One FMT was delivered through colonoscopy and the remaining 87.5% through esophagogastroduodenoscopy. One upper FMT was excluded due to recurrence of CDI after antibiotic exposure for a respiratory infection. The overall cure rate of FMT was total with lower route and 83.3% with upper route. Primary cure rate was achieved in 83.3% of patients and secondary cure rate was achieved in all patients. Median time to resolution of diarrhea after FMT was 1 day and no complications were reported during follow-up. Conclusion: FMT appears to constitute a safe and effective approach in the management of refractory and recurrent CDI. Difference between primary and secondary cure rates may result of insufficient restoration of intestinal microbiota with a single FMT.

Capsule endoscopy is widely accepted as the preferred diagnostic test in the evaluation of small bowel diseases, especially in the setting of obscure gastrointestinal bleeding. It has revolutionized small bowel examination and has improved the detection of small bowel tumors. However, small bowel tumors are sometimes missed by capsule endoscopy. Furthermore, there are several recent reports comparing capsule endoscopy with other diagnostic modalities, such as double balloon enteroscopy and CT/RM enterography, that challenge the reportedly high negative predictive value of capsule endoscopy in detecting small bowel tumors. We report the case of a patient with overt obscure gastrointestinal bleeding due to a gastrointestinal stromal tumor diagnosed by CT enterography after two negatives capsule endoscopies. This case shows that capsule endoscopy may overlook significant life threatening lesions and highlights the importance of using other diagnostic modalities after a negative capsule endoscopy, especially in patients with a high index of suspicion for small bowel tumoral pathology or persistent/recurrent bleeding.

Inflammatory fibroid polyp (IFP) is an unusual benign gastrointestinal subepithelial tumor (SET). The endosonographic (EUS) features of IFPs were sporadically reported on imaging tips or small case series study. However, the differential diagnosis and optimal treatment of gastric IFP is still challenging. We report an unusual case of a large erosioned and prolapsing gastric submucosal lesion, presenting primarily with obstructive symptoms (“ball valve syndrome”) and anemia. On EUS examination, a 50 mm SET in the distal antrum was seen, with hypoechoic but heterogeneous echo-pattern, located in the second and third sonographic layers of the gastric wall (deep mucosal and submucosal). The fourth (muscle) layer was intact; no peri-lesional adenopathies were identified. A decision was made to proceed to endoscopic treatment because of the mentioned symptoms. Histopathologic evaluation of the resected specimen with immunohistochemical staining was consistent with the diagnosis of IFP. IFP rarely reach these large dimensions or cause symptoms. Despite its benign etiology, endoscopic resection was important in both establishing a histologic diagnosis and treatment. EUS was crucial in the differential diagnosis. The literature concerning IFP is also reviewed.

Matemáticos y físicos han encontrado a lo largo de los tiempos analogías entre las matemáticas y la música. Al mismo tiempo, los músicos se han apoyado en las matemáticas para describir su arte. Este artículo consiste en una sistematización de las conexiones entre contenidos matemáticos y musicales. Los contenidos musicales fueron divididos en los siguientes temas: 1) Teoría y análisis musicales, 2) Acústica y 3) Composición musical. Posteriormente, en cada uno de estos temas, las asociaciones con las matemáticas se sistematizaron basándose en la organización de los Programas de Matemáticas de la Educación Básica y sus Objetivos Curriculares (3er ciclo) y de los Programas de Matemáticas A y B de los 11 y 12 años de la Educación Secundaria Portuguesa. Llegamos a la conclusión de que los elementos musicales y los conceptos que se asocian con las matemáticas se distribuyen en las áreas de la Aritmética, Álgebra, Trigonometría y, en particular, Geometría.

O estudo tem como objetivo investigar representações sociais de professores do Ensino Fundamental sobre a afetividade na prática docente, contrastando-as com definições dos teóricos clássicos Piaget, Wallon e Vygotsky. Fundamenta-se na teoria moscoviciana das representações sociais e em conceitos sobre afetividade em Piaget, em Wallon e em Vygotsky, particularmente no campo da Educação. Com opção pela abordagem qualitativa, a pesquisa foi realizada em três campi de uma escola da rede federal de ensino do Rio de Janeiro. Participaram 10 professores do 2º ano do 1º segmento do Ensino Fundamental (Grupo I), e 10 professores do 9º ano do 2º segmento do Ensino Fundamental (Grupo II). Foram utilizadas entrevistas semiestruturadas individuais, analisadas com apoio da análise de conteúdo temática. Dois temas-chave foram estabelecidos, com respectivas categorias: “Afetividade na escola” e “Referência a teóricos que estudaram a afetividade”. A discussão dos resultados se fundamentou na proposta moscoviciana de um modelo figurativo para estudos de representação social. No Grupo I, o modelo figurativo da representação social de afetividade na prática docente objetivou-se no termo “carinho”, associado a “professor afetuoso”, “abraços e beijos”, “palavras doces” e “aluno afetuoso”. No Grupo II, o modelo figurativo da representação objetivou-se no termo “empatia”, associado a “amizade com os alunos”, “permitir liberdade de expressão”, igualdade com os alunos”, “ser sensível ao saber dos alunos”. Devido ao escasso conhecimento dos autores clássicos (particularmente Piaget e Wallon), ou conhecimentos distorcidos, nos dois grupos a ancoragem pode estar relacionada à formação pedagógica dos professores, que talvez não aprofunde leituras sobre afetividade durante o curso. Os resultados possam instigar professores a estudarem teoricamente a afetividade para ampliar o olhar para suas práticas, assim como os cursos de formação docente a refletirem sobre o modo como estão oferecendo disciplinas que contém as teorias dos referidos autores. Palavras-chave: Representações sociais; Afetividade na prática docente; Professores; Ensino Fundamental.

Alzheimer disease (AD) is the most common neurodegenerative disease featuring progressive and degenerative neurological impairments resulting in memory loss and cognitive decline. The specific mechanisms underlying AD are still poorly understood, but it is suggested that a deficiency in the brain neurotransmitter acetylcholine, the deposition of insoluble aggregates of fibrillar β-amyloid 1−42 (Aβ42), and iron and glutamate accumulation play an important role in the disease progress. Despite the existence of approved cholinergic drugs, none of them demonstrated effectiveness in modifying disease progression. Accordingly, the development of new chemical entities acting on more than one target is attracting progressively more attention as they can tackle intricate network targets and modulate their effects. Within this endeavor, a series of mitochondriotropic antioxidants inspired on hydroxycinnamic (HCA’s) scaffold were synthesized, screened toward cholinesterases and evaluated as neuroprotectors in a differentiated human SH-SY5Y cell line. From the series, compounds 7 and 11 with a 10-carbon chain can be viewed as multi-target leads for the treatment of AD, as they act as dual and bifunctional cholinesterase inhibitors and prevent the neuronal damage caused by diverse aggressors related to protein misfolding and aggregation, iron accumulation and excitotoxicity.

Adherence of adolescents to health practices in the context of sexuality is relevant, not only from the point of view of physical and psychological well-being, but also the model effect of their knowledge of infections transmitted sexually and their behaviours may have on other adolescents and lifestyles adopted. The need thus emerges to work with this target group with issues related with their knowledge of sexually transmitted infections, debating and reflecting on everyday situations of social life in the context of sexuality.

The current pharmacological treatments for Parkinson’s disease only offer symptomatic relief to the patients and are based on the administration of levodopa and catechol-O-methyltransferase or monoamine oxidase-B inhibitors (IMAO-B). Since the majority of drug candidates fail in pre- and clinical trials, due largely to bioavailability pitfalls, the use of polymeric nanoparticles (NPs) as drug delivery systems has been reported as an interesting tool to increase the stealth capacity of drugs or help drug candidates to surpass biological barriers, among other benefits. Thus, a novel potent, selective, and reversible IMAO-B (chromone C27, IC50 = 670 ± 130 pM) was encapsulated in poly(caprolactone) (PCL) NPs by a nanoprecipitation process. The resulting C27-loaded PEGylated PCL NPs (~213 nm) showed high stability and no cytotoxic effects in neuronal (SH-SY5Y), epithelial (Caco-2), and endothelial (hCMEC/D3) cells. An accumulation of PEGylated PCL NPs in the cytoplasm of SH-SY5Y and hCMEC/D3 cells was also observed, and their permeation across Caco-2 and hCMEC/D3 cell monolayers, used as in vitro models of the human intestine and blood-brain barrier, respectively, was demonstrated. PEGylated PCL NPs delivered C27 at concentrations higher than the MAO-B IC50 value, which provides evidence of their relevance to solving the drug discovery pitfalls.

La infección por el virus de la Hepatitis C (VHC) es una de las principales causas de enfermedad hepática crónica, con una prevalencia mundial superior a 200 millones de personas. Normalmente la infección aguda por el virus de la Hepatitis C es asintomática, y por ese motivo, raramente es identificada, evolucionando a la cronicidad en el 80% de los casos. Aún así, cuando se trata de una infección aguda sintomática, apenas el 50% de los casos desencadena una enfermedad hepática crónica. La detección de la infección aguda por el VHC representa una oportunidad única de tratamiento, ya que la probabilidad de respuesta virológica sostenida es de aproximadamente un 90%, lejos de los 30% a 80% en el supuesto de tratamiento de la infección crónica. Se exponen cuatro casos clínicos de infección aguda por el VHC. A las 12 semanas, dos de los individuos verificaron resolución espontánea de la infección. En uno de los casos, con RNA viral positivo a las 12 semanas de vigilancia, mos - tró respuesta virológica sostenida después del tratamiento con monoterapia de interferón pegilado a 2a.

Device assisted enteroscopy (DAE) techniques have been recently developed for the diagnosis and treatment of small bowel diseases. These techniques can also be used to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomies. The main difficulties with DAE-ERCP are related to type of surgery, to the different dimensions and lack of frontal view of the enteroscope and to the resulting limitations with the use of standard accessories, resulting in the need of dedicated accessory devices. Although most ERCP techniques have been successfully performed with DAE-ERCP, biliary self-expandable metallic stents (SEMS) have not yet been used, as dedicated biliary SEMS for the enteroscope are lacking. The authors present a case report showing a new method to place standard biliary trough-the-scope SEMS with DAE-ERCP, using a different technique of stent deployment.