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Abstract: The phosphorus distribution in volcanic sediments of three lakes that are under different anthropogenic pressures in São Miguel island (Azores – Portugal) was evaluated using a sequential extraction scheme. The P-fractionation scheme employs sequential extractions of sediment with NH4Cl, bicarbonate-dithionite (BD), NaOH (at room temperature), HCl and NaOH (at 85°C) to obtain five P-fractions. The P-fractionation shows that in lakes with higher trophic status (Lake Furnas and Lake Sete Cidades), the NaOH extracted P is the dominant fraction, that contribute with more than 50% to total sedimentary phosphorus. The rank order of P-fractionation for these two lakes was NaOH>NaOH (85°C)>HCl>BD>NH4Cl for Furnas lake and NaOH>HCl>NaOH (85°C)>NH4Cl>BD for Sete Cidades lake. On the other hand, the trend of P contribution in the oligotrophic lake Fogo shows that the most inert P pools have the higher concentrations, with more than 50% of the P contribution from the last extraction step with NaOH at 85°C. For this lake, the rank order of P-fractionation was NH4Cl>BD>NaOH>HCl>NaOH (85°C). The Phosphorus Maximum Solubilization Potential (P-MSP) was also calculated and the results show that for the more bio-available P-fractions (first and second extraction step), the P-MSP values for Furnas and Sete Cidades lakes are sensibly higher than the results obtained in Fogo lake, an indication of the non-point diffuse load discharged in the first ones. [Copyright &y& Elsevier]

Annual vaccination is fundamental for individual and group protection against seasonal influenza infection. International and Portuguese healthcare organizations have established influenza vaccination coverage rate (VCR) targets for risk groups, namely 75% in people ≥ 65 years old. The Vacinómetro® initiative has been monitoring influenza VCR among target risk groups in Portugal since 2009,: Group 1, ≥ 65 years old; Group 2, patients with chronic conditions; Group 3, healthcare workers in direct contact with patients; and Group 4, 60-64 years old. Besides VCR, social-demographic and health-related variables have been evaluated. During the study period (2009/2010 - 2019/2020), the VCR increased in the 4 target risk groups: from 58.6% to 76.0% in Group 1 (reaching the WHO target); 33.3% to 72.0% in Group 2; 25.0% to 58.9% in Group 3; and 36.6% to 42.8% in Group 4. "Physician recommendation" was the main driver for vaccination whereas "lack of habit" was the main barrier to vaccination. Vacinómetro® data demonstrate that free-of-charge vaccination has a positive impact on VCR. The observed positive trends in influenza VCR demonstrate that public health measures implemented in Portugal to facilitate access to influenza vaccine result in increased vaccine uptake. Strategies to promote population literacy and the physician's awareness should be continued and reinforced. Free-of-charge vaccination criteria extended to more risk groups would also contribute to higher influenza VCR in Portugal., Competing Interests: Conflicts of Interest MM and CG are Sanofi Pasteur employees and may hold shares. The remaining authors did not receive any financial support and have no conflicts of interest to declare for the execution of the study., (Copyright © 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)

In Portugal, family doctors work with a well-defined list of patients to whom they provide healthcare throughout their lives. Several studies showed that larger list sizes are associa- ted with poorer health outcomes and compromise the quality of care. A significant increase in the average list size has been observed in recent years due to the Portuguese unfavorable socioeconomic context and the lack of family doctors. In 2017, the Portuguese Association of General and Fa- mily Medicine (APMGF) developed technical and scientific research that ultimately typified a set of different clinical practice contexts. It considers the geographic and socioeconomic characteristics and a set of population-based indicators, adjusting the list size according to the population's specific needs. Such adjustments ensure health care services with better quality, safety, efficacy, and personalized to their features. In this paper, a brief review is made on this topic, focusing on the work developed by APMGF and its main results.

Self-compassion has been associated with less distress, particularly when people face stressful and negative events. This study analyzed the mediation role of coping and affect in the relation between self-compassion and negative emotional symptoms during the quarantine decreed by Portuguese Health Authorities in the first phase of the coronavirus outbreak. A total of 428 Portuguese adults (75% women; M age = 40.8, SD = 11.6) completed an online survey comprised by the Self-Compassion Scale (predictor); Short Version of Depression, Anxiety and Stress Scale (outcomes); The Positive and Negative Affect Schedule; and Brief-COPE. These instruments were adapted to COVID 19's epidemic. Parallel mediation analyses demonstrated that self-compassionate participants were at less risk of suffering from symptoms of depression, anxiety, and stress during the quarantine. Plus, the relation between self-compassion and depressive, anxious, and stress symptoms were mediated by negative affect and dysfunctional coping style, but only for symptoms of depression. The findings support coping strategies and affect as links between self-compassion and distress but also the importance of separately analyzing the role of self-compassion, negative affect, and coping on symptoms of anxiety, depression, and stress. Low self-compassion might increase negative affect, maintaining stress responses to face demanding events during the COVID-19 epidemic. Results were discussed in the context of the pandemic outbreak.

Context.—: Related to the advances in prenatal diagnosis and the emergence of medically challenging situations, there has been an increased interest in conducting a pathologic study of first-trimester abortion products., Objective.—: To evaluate measurements across a large group of first-trimester spontaneous abortion specimens. Potential goals include a validation of prenatal embryo and gestational-sac measurements as a function of gestational age (GA)., Design.—: A retrospective case study of first-trimester spontaneous abortions between June 2015 and April 2017 in Centro de Genética Clínica Embryo-Fetal Pathology Laboratory, Porto, Portugal. Considering the inclusion criteria, 585 complete gestational sacs, 182 embryos, and 116 umbilical cords were selected. We recorded the weight of the gestational sacs and embryos and measurements of gestational sacs, umbilical cords, and embryo crown-rump length. Models were computed using regression techniques., Results.—: Gestational-sac diameter percentiles 5, 25, 50, 75 and 95 were calculated according to GA, and at each 1-week interval the diameter increased an average of 3 mm. Umbilical cord length percentiles 5, 25, 50, 75 and 95 were calculated according to GA, and at each 1-week interval, the length increased an average of 1.35 mm. Embryo crown-rump length estimated mean ± SD values were GA 6 weeks, 5.3 ± 2.3 mm; GA 7 weeks, 9.4 ± 4.8 mm; GA 8 weeks, 13.7 ± 8.2 mm; GA 9 weeks, 20.8 ± 9.1 mm; GA 10 weeks, 22.6 ± 13.4 mm; GA 11 weeks, 29.4 ± 12.9 mm; and GA 12 weeks, 52 mm., Conclusions.—: Pathologic measurements obtained should be compared to expected measurements and correlated with ultrasound findings, clinical information, and microscopic findings. Deviations from expected values could lead to an understanding of early pregnancy loss.

Introduction: Chronic kidney disease (CKD) is a major global public health problem associated with increased risk of cardiovascular morbidity, premature mortality, and decreased quality of life. In Portugal, the PREVADIAB study showed a prevalence of CKD stages 3-5 of 6.1%. To overcome the limitations of the PREVADIAB study, the RENA study aimed to provide an estimate of the prevalence of CKD at a national level and to characterize CKD patients., Methods: This was a cross-sectional study including users of Primary Health Care Units aged 18 or more. After obtaining written informed consent, sociodemographic and clinical data were recorded through a structured questionnaire, anthropometric measurements were taken, and blood and urine samples were collected. All participants initially meeting the criteria for CKD were contacted at least 3 months after the initial assessment for confirmation of the analytical results., Results: A total of 3,135 individuals were included, 65.4% were female, and the mean age was 56.7 ± 15.9 years. The prevalence of hypertension, dyslipidemia, and diabetes was 38, 32, and 16%, respectively, and 31% were obese. After data adjustment by gender, age group, and geographical region, the global prevalence of CKD was 20.9% (95% CI: 6.5-35.3%), with no differences between genders and a significant increase with the advance of the age groups., Conclusion: Our study showed a CKD prevalence above the worldwide and Europe average. Despite the study limitations, it has become clear that it is urgent to identify CKD patients earlier and to develop awareness and educational programs to prevent CKD and its associated diseases., (© 2020 S. Karger AG, Basel.)

To examine effects of mother's anxiety and depression and associated risk factors during early pregnancy on fetal growth and activity. Repeated measures of mother's anxiety (State-Anxiety Inventory (STAI-S)) and depression (Edinburgh Postnatal Depression Scale (EPDS)) and related socio demographics and substance consumption were obtained at the 1st and 2nd pregnancy trimesters, and fetus' (N = 147) biometric data and behavior was recorded during ultrasound examination at 20-22 weeks of gestation. Higher anxiety symptoms were associated to both lower fetal growth and higher fetal activity. While lower education, primiparity, adolescent motherhood, and tobacco consumption predicted lower fetal growth, coffee intake predicted lower fetal activity. Vulnerability of fetal development to mother's psychological symptoms as well as to other sociodemographic and substance consumption risk factors during early and mid pregnancy is suggested.