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The European Commission and the EEA agreed to reinforce efforts to improve knowledge on implementation of air quality legislation through a joint pilot project. The Air Implementation Pilot run from March 2012 to June 2013 and aimed at better understanding the challenges cities faced in implementing air quality policy. Twelve European cities were selected and invited to join the project. One of the focus of the Pilot project was to assess the use of models for air quality assessment and management, share experiences, and identify needs for further guidance. The results of the analysis of modelling practices are presented in this work. More than 20 different models have been used for air quality assessment and management in these cities. The main purposes for which cities applied models are air quality assessment, quantification of source contribution and long term planning. The cities have found models helpful and the outputs have been used in urban air quality assessment and management, including the evaluation of strategies to reduce PM ambient levels. However, the cities found difficulties in the application of models as for instance the quality and availability of input data or the validation and uncertainty estimation of the model results.

O edema pulmonar de re-expansão é uma complicação pouco frequente que pode surgir após tratamento de colapso pulmonar prolongado secundário a derrame pleural, pneumotórax e atelectasia. A sua apresentação clínica é variável podendo manifestar-se apenas por sintomas ligeiros, contudo, cursa com insuficiência respiratória nos casos de maior gravidade. Apesar de se tratar de uma entidade infrequente apresenta mortalidade elevada. O tratamento é sintomático e assenta essencialmente em medidas de suporte hemodinâmico e ventilatório. Os autores descrevem o caso de uma doente de 37 anos que desenvolve um quadro fulminante de edema pulmonar de re-expansão bilateral acompanhado por insuficiência respiratória e choque hipovolémico após colocação de drenagem torácica para descompressão de pneumotórax espontâneo à direita.

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Purpose: Imaging studies are crucial adjuncts when studying acute and chronic diseases, so pregnant and lactating women are as likely to be evaluated with one of the available imaging modalities. Due to the specific condition of the mother and child in this time period it is crucial to make an appropriate selection of imaging studies. Methods: We review the existing literature and analyse the latest evidence and guidelines regarding neuroimaging safety during pregnancy and lactation, proposing an algorithm of action based on risk/benefits assessment. Results: Choosing the most appropriate neuroimaging modality implicates assessing the pretest pertinence of the study—the possibility of a serious treatable neurologic disease, pondering what is the most useful imaging modality for the diagnosis and evaluating the associated risks. Among physicians (and patients), however, the risk component is perhaps the least well understood, with misperceptions regarding safety and potential hazards. Computed tomography (CT) risks are principally related to ionizing radiation and intravenous (IV) administration of iodinated contrast. However, as very low risks for the mother and foetus have been reported and CT remains the most available tool for initial rapid diagnosis of acute neurological conditions, it should not be withheld in urgent situations. Magnetic resonance imaging (MRI), unlike CT, does not use ionizing radiation or iodinated contrast mediums, having the best anatomical detail possible. However, there are some usage safety concerns regarding the magnetic field strength and gadolinium-based contrast use. Conclusion: There are lacking longitudinal and prospective studies to sustain evidence based choices of imaging studies during pregnancy and lactation. Ultimately the decision should be based on the risk/benefit, taking into account the patient's safety, care and outcomes. However, using a specific algorithm can guide decisions in daily clinical practice. [ABSTRACT FROM AUTHOR]

Byline: C. Borrego, J.M. Martins, S. Lemos, C. Guerreiro The development of a second generation Gaussian dispersion model (POLARIS) has been carried out. This model is significantly different from traditional Gaussian dispersion models, because its dispersion parameters have a continuous variation with the atmospheric stability. The new model was applied to the region of Setubal. The fossil fuel power plant in this region was taken as a point source, and data from 1993 were used. The results obtained using POLARIS were compared with air quality data and with results obtained from the POLUX and ISCST models for the same conditions. In terms of the statistical parameters, NMSE (normalised mean square error) and correlation coefficients, it can be seen that POLARIS gives the best approximation to the measured data. It also can be seen that POLARIS provides more results within a 'factor of two', related to the measured concentrations, than the other two models for Setubal case.

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK, Background The iatrogenic risk of HIV vertical transmission, calculated in initial epidemiologic studies of this infection seemed to contra‐indicate the performance of invasive prenatal diagnosis (PND) techniques. The implementation of [...]

This study is focused on the characterization of particles emitted in the metal active gas welding of carbon steel using mixture of Ar + CO2, and intends to analyze which are the main process parameters that influence the emission itself. It was found that the amount of emitted particles (measured by particle number and alveolar deposited surface area) are clearly dependent on the distance to the welding front and also on the main welding parameters, namely the current intensity and heat input in the welding process. The emission of airborne fine particles seems to increase with the current intensity as fume-formation rate does. When comparing the tested gas mixtures, higher emissions are observed for more oxidant mixtures, that is, mixtures with higher CO2 content, which result in higher arc stability. These mixtures originate higher concentrations of fine particles (as measured by number of particles by cm3 of air) and higher values of alveolar deposited surface area of particles, thus resulting in a more severe worker's exposure. [ABSTRACT FROM AUTHOR]

Nuclear medicine practices involve the handling of a wide range of pharmaceuticals labelled with different radionuclides, for diagnostic and therapeutic purposes. This work intends to evaluate the potential risks of internal contamination of nuclear medicine staff in several Portuguese nuclear medicine services and to conclude about the requirement of a routine internal monitoring. A methodology proposed by the International Atomic Energy Agency (IAEA), providing a set of criteria to determine the need, or not, for an internal monitoring programme, was applied. The evaluation of the risk of internal contaminations in a given set of working conditions is based on the type and amount of radionuclides being handled, as well as the safety conditions with which they are manipulated. The application of the IAEA criteria showed that 73.1 % of all the workers included in this study should be integrated in a routine monitoring programme for internal contaminations; more specifically, 100 % of workers performing radioimmunoassay techniques should be monitored. This study suggests that a routine monitoring programme for internal exposures should be implemented in Portugal for most nuclear medicine workers. [ABSTRACT FROM PUBLISHER]

Adenylate kinases are involved in the activation of antiviral drugs such as the acyclic phosphonates analogs PMEA and (R)PMPA. We examine the in vitro phosphorylation of PMEA and PMPA bearing a borano- or a H- group on the phosphorus atom. The α-borano or α-H on PMEA and PMPA were detrimental to the activity of recombinant human AMP kinases 1 and 2. Docking PMEA to the active site of AMP kinase 1 indicated that the borano group may prevent two conserved critical Arg interactions with the α-phosphate, resulting in substrate bad positioning. [ABSTRACT FROM AUTHOR]

The Portuguese Food Based Dietary Guidelines (FBDG), namely Food Wheel Guide, as well as the National Food, Nutrition and Physical Activity Survey 2015-2016, advise the Portuguese population to substitute animal protein for vegetable protein. At the same time, 10,1% of the Portuguese families suffered from food insecurity issues, mainly due to lack of financial resources. This study will be the first to investigate the possibilities of associating the health impacts of different risks and benefits through a Risk-Benefit Assessment (RBA) with different methodologies that estimate the economic sustainability of substituting unprocessed red meat by legumes produced in Portugal, e.g. beans and chickpeas in the Portuguese population. An overview of the current Portuguese diet as well as a literature review of the RBA methodology was performed, with specific reference to substitution studies, as means of promoting healthy and sustainable diets. For a socioeconomic analysis, relevant literature of specific authorities (FAO, EFSA, ECDC), and published studies (Public Health and Environment institutes), was evaluated and the different methodologies, such as the Willingness To Pay (WTP), behavioral economics and a cost analysis were compared amongst them as to their advantages and disadvantages. From the literature review it can be concluded that not only income or food prices are the only factors that explain food choices. However, if healthier diets are proved to be unaffordable for many people’s households, especially the Portuguese families, then nutrient adequate consumption dietary patterns will not improve, even in their lowest prices form, with nutrition education and behavioral change. This way, associating a RBA with a cost analysis is a valuable approach to evaluate the health impact in relation to the cost of substituting red meat for legumes in a household, giving estimates that support policies that promote nutritious foods for all. [ABSTRACT FROM AUTHOR]

Introduction Sarcopenia is the age-related loss of skeletal muscle mass, strength and function. Uncontrolled diabetes, obesity, chronic inflammation and lipid abnormalities, cause decreases in muscle strength, which contributes to disease-related morbidity. Objectives The main goal of this study was to correlate the prevalence of sarcopenia with atherosclerosis and cardiovascular risk factors, mainly estimated by cholesterol, triglycerides, C-reactive protein (CRP) and HbA1c levels, in the elderly. Methodology A quantitative observational cross-sectional study was performed in a convenience sample of individuals aged over 60 years old recruited non-randomly. Main study variables were body composition (seca® mBCA515), muscle strength (peak torque, Humac NORM isokinetic dynamometer), risk of falls (TUG test), muscle function (LEFS) and lipids, inflammation and glycaemic profile (cobas b101-Roche®). Results Total cholesterol levels fully correlated with LDL and non-HDL cholesterol, and partially with triglycerides, but not with HDL-cholesterol levels, HbA1c, or BMI. LDL-cholesterol levels did not correlate with muscle mass (free-fat mass (%)), strength, function, or risk of falls. Similarly, HDL-cholesterol levels did not correlate with muscle function or falls risk. Cholesterol ratio, obtained by dividing total cholesterol by HDL-cholesterol levels, was significantly higher in individuals with CRP levels above 3 mg/L. Interestingly, when compared to normal values, individuals with triglycerides above 150 mg/dL showed a statistically significant decrease in muscle strength. Conclusion From the biochemical measured parameters, our data showed that only high triglycerides levels positively correlated with sarcopenia risk, demonstrated by reduced muscle strength. While cholesterol ratio positively correlated with increased inflammation, blood cholesterol levels seem to be independent factors regarding sarcopenia prevalence. [ABSTRACT FROM AUTHOR]

Unilateral destructive brain lesions of early development can result in compensatory thickening of the ipsilateral cranial vault. The aim of this study was to determine the frequency of these bone changes among patients with epilepsy and precocious destructive lesions, and whether a relationship exists between these changes and epileptiform discharges lateralization. Fifty-one patients had their ictal / interictal scalp EEG and skull thickness symmetry on MRI analyzed. Patients were divided into three main groups according to the topographic distribution of the lesion on the MRI: hemispheric (H) (n=9); main arterial territory (AT) (n=25); arterial borderzone (Bdz) (n=17). The EEG background activity was abnormal in 26 patients and were more frequent among patients of group H (p= 0.044). Thickening of the skull was more frequent among patients of group H (p= 0.004). Five patients (9.8%) showed discordant lateralization between epileptiform discharges and structural lesion (four of them with an abnormal background, and only two of them with skull changes). In one of these patients, ictal SPECT provided strong evidence for scalp EEG false lateralization. The findings suggest that compensatory skull thickening in patients with precocious destructive brain insults are more frequent among patients with unilateral and large lesions. However, EEG lateralization discordance among these patients seems to be more related to EEG background abnormalities and extent of cerebral damage than to skull changes.

A epilepsia generalizada idiopática (EGI) frequentemente não é diagnosticada corretamente em adultos, com sérias consequências para os pacientes. O objetivo deste estudo foi avaliar os fatores mais frequentemente associados a dificuldades no diagnóstico diferencial entre epilepsias parciais e generalizadas em adultos. Avaliamos 41 pacientes com diagnostico de crises parciais complexas com elementos de anamnese e EEG indicando um possível diagnóstico diferencial. Foi possível a mudança do diagnóstico de epilepsia parcial para EGI em 25 pacientes: 22 (88%) com EMJ; um com ausência juvenil, um com síndrome de ausências com mioclonias periorais e um com ausência com mioclonias palpebrais. Mioclonias, uma das características da EMJ e outras formas de EGI, geralmente não eram espontaneamente relatadas pelos pacientes. Abalos mioclônicos unilaterais eram confundidos com crises parciais motoras. Ausências breves e pouco frequentes e anormalidades focais no EEG contribuíram para o não reconhecimento de EGI. Todos os 25 pacientes apresentavam crises sem controle adequado antes da revisão diagnóstica. Após o diagnóstico correto e mudança para monoterapia com acido valpróico ou valproato de sódio, 19 (76%) ficaram livre de crises e seis (24%) dos 25 pacientes apresentaram melhora significativa. A associação de lamotrigina em três destes pacientes propiciou redução significativa da frequência de crises. Em conclusão, anamnese detalhada e questionamento direcionado para determinar a presença de mioclonias e crises tipo ausência e a sua interpretação no contexto clínico são fundamentais para o diagnóstico correto das EGI em adultos.

The purpose of this study was to compare the serum levels of androgens between hyposexual and non-hyposexual patients with epilepsy. Adult male patients with epilepsy were investigated. Serum levels of testosterone (T) and free-T, estradiol, and sex hormone binding globulin (SHBG) were measured and the free androgen index (FAI) was calculated. While there were no differences between hyposexual and non-hyposexual patients in the serum levels of T, free-T, and estradiol, or to the FAI, the serum levels of SHBG were significantly higher in hyposexual patients than in non-hyposexual patients. Thus, the effects of increased SHBG upon serum levels of testosterone biologically active in patients with epilepsy and hyposexuality were not detected by the methods used in this study. Four (44%) of nine hyposexual patients who were re-evaluated after two years follow-up improved sexual performance. Thus, clinical treatment that results in good seizure control may improve sexual performance in some patients with epilepsy.

In order to evaluate the psychological variables that affect sexual dysfunction (SD) in epilepsy, where compared 60 epileptics (Group 1) with 60 healthy individuals (Group 2), through the State-Trait Anxiety Inventory (Spielberger et al., 1970), Beck Depression Inventory (Beck, 1974) and Sexual Behavior Interview (Souza, 1995). Sexual dysfunction (SD), anxiety and depression were found more frequently in Group 1 than in Group 2 and were not related to sex. Variables such as the onset duration and frequency of seizures as well as the use to medication were not associated with SD. Temporal lobe epilepsy was related to SD (p = 0.035) but not to anxiety or depression. Anxiety and depression were related to SD in both groups. Perception in controlling the seizures was closely related to anxiety (p = 0) and depression (p = 0.009). We conclude that psychological factors play an important role in the alteration of sexual behavior in epileptics and that suitable attention must be given to the control of these variables.

The occurrence of de novo psychogenic seizures after epilepsy surgery is rare, and is estimated in 1.8% to 3.6%. Seizures after epilepsy surgery should be carefully evaluated, and de novo psychogenic seizures should be considered especially when there is a change in the ictal semiology. We report a patient with de novo psychogenic seizures after anterior temporal lobe removal for refractory temporal lobe epilepsy. Once psychogenic seizures were diagnosed and psychiatric treatment was started, seizures stopped.

The western Africa is the origin of the HIV2 infection where Guinea Bissau has been the country where the rate of infection is higher. This infection have extended to Europe through the relationship established between European countries and there African colonies in the past. At 2010, 1.295 cases of HIV 2 infection were notified in Portugal, which represents nearly 3.3% of all HIV infections. Almost 510 of these cases are classified as AIDS. Although the majority of notified cases is from African patients there is still a significant contribution of the Portuguese people in these numbers. Retrospective analysis of HIV2 infected women and men followed at Faro's Hospital HIV/AIDS consult between January 1992 and June 2012. In this sample were included every patient older than 15 years and were excluded every patient than haven't been at the consult for a period superior to 18-24 months. Deceased patients and address change were also exclusion factors. Of all 1500 patients followed in consult, 35 of them were infected with HIV2 (2.3%); 18 women and 17 men. There were 3 patients that were co-infected with HIV1 and HIV2. Mean age were 52.9 years. 19 of the infected patients were leucodermic and 16 were melanodermic. The majority of patients (19 cases) were Portuguese. The rest of them were from Africa where Guinea Bissau were the only country represented. In opposition to the HIV1 infection, the sexual transmission is by far the more common way of being infected. There's no case of vertical transmission known in our population. At the first contact, the majority of patients appear asymptomatic (16 cases) while a minority (4 cases) manifest themselves by AIDS. There is an AIDS case that result from HIV1 and HIV2 co-infection (only one intravenous drug user in the group). The more common treatment is the association of NRTI and PI. The HIV2 infection is characterized by a longer clinical evolution when compared to the HIV1 infection. That fact explains why the mean age of patients is higher in the first case. This study shows that there isn't a gender incidence difference between men and women. Despite what happens at a national level, at local level the HIV2 infection is more prevalent among patients born in Portugal. It's important to notice that the HIV1 and HIV2 co-infection is rising and that leads to some questions like viral synergism with consequent rapid disease progression. [ABSTRACT FROM AUTHOR]