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Objective: The use of dupilumab in children with atopic dermatitis (AD) demonstrated clinical efficacy in clinical trials. Nevertheless, real-world evidence is still limited. We aim to provide data on this matter regarding a Portuguese pediatric population. Methods: Retrospective analysis of patients with AD below the age of 18 treated with dupilumab in two Portuguese hospitals. Data regarding previous therapies, activity scores, and adverse reactions were collected. Results: Thirty patients were included in the analysis (19 male patients, 63%), with a median age of 14 years (2-17 years). The median follow-up after starting treatment was 80 weeks. The median baseline Eczema Area and Severity Index (EASI) score was 32.3. Sixty percent of patients achieved EASI-90 and 77% EASI-75 at week 16 (n = 30); 79% EASI-90 and 92% EASI-75 at week 52 (n = 24); 64% EASI-90 and 82% EASI-75 at week 104 (n = 11); and 75% EASI-90 and 100% EASI-75 at week 132 (n = 4). Regarding adverse reactions, four patients (12%) presented facial erythema and two patients had eosinophilia above 2000/μL and conjunctivitis. In five patients (17%), there was a need for a dose increase, with treatment failure occurring in two patients (7%). Conclusion: Our data corroborated the evidence from clinical trials, highlighting the maintained efficacy and adequate safety profile of dupilumab in this age group.

Type 2 diabetes mellitus (T2DM) is a growing global health issue that is closely linked to the epidemic of obesity. In addition to genetic factors, environmental and health-risk behaviours (i.e., high-carbohydrate diet and physical inactivity) contribute to a variety of pathophysiological disorders. Advanced exercise protocols, such as Moderate-to-intensity (MIT) and High Intensity Interval Training (HIIT), revealed a strategy for mitigating and/or attenuating the DTMII’s harmful effects by controlling glycated haemoglobin (HbA1c) levels. The goals of this review were to summarize the most recent evidence on the impact of HIIT on HbA1c levels. A mini-review protocol was performed through the PubMed/Medline database. The search comprised experimental and randomized controlled trial studies published in English between 2016 and 2021. The terms HbA1c, T2DM, MIT and HIIT, and their analogues were used. A total of seven studies were finally included. Our findings showed that the HIIT protocol is an effective strategy to induce HbA1c balance and improve glycaemic control than moderate training. The HIIT conducted in the laboratory and involving aerobic exercise on a cycle ergometer appears to be more efficient that MIT. Additional findings include improved beta-cell function, decreased low-grade inflammation, and the induction of cardiovascular benefits. More research is required to investigate the feasibility and safety of HIIT protocols in T2DM patients.

Human Endogenous Retroviruses (HERVs) are derived from ancient exogenous retroviral infections that have infected our ancestors’ germline cells, underwent endogenization process, and were passed throughout the generations by retrotransposition and hereditary transmission. HERVs comprise 8% of the human genome and are critical for several physiological activities. Yet, HERVs reactivation is involved in pathological process as cancer and autoimmune diseases. In this review, we summarize the multiple aspects of HERVs’ role within the human genome, as well as virological and molecular aspects, and their fusogenic property. We also discuss possibilities of how the HERVs are possibly transactivated and participate in modulating the inflammatory response in health conditions. An update on their role in several autoimmune, inflammatory, and aging-related diseases is also presented.

Understanding the physiological and molecular adjustments occurring during tree stress response is of great importance for forest management and breeding programs. Somatic embryogenesis has been used as a model system to analyze various processes occurring during embryo development, including stress response mechanisms. In addition, “priming” plants with heat stress during somatic embryogenesis seems to favor the acquisition of plant resilience to extreme temperature conditions. In this sense, Pinus halepensis somatic embryogenesis was induced under different heat stress treatments (40 °C for 4 h, 50 °C for 30 min, and 60 °C for 5 min) and its effects on the proteome and the relative concentration of soluble sugars, sugar alcohols and amino acids of the embryonal masses obtained were assessed. Heat severely affected the production of proteins, and 27 proteins related to heat stress response were identified; the majority of the proteins with increased amounts in embryonal masses induced at higher temperatures consisted of enzymes involved in the regulation of metabolism (glycolysis, the tricarboxylic acid cycle, amino acid biosynthesis and flavonoids formation), DNA binding, cell division, transcription regulation and the life-cycle of proteins. Finally, significant differences in the concentrations of sucrose and amino acids, such as glutamine, glycine and cysteine, were found.

The emergence of Xylella fastidiosa (Xf) in the Balearic Islands in October 2016 was a major phytosanitary challenge with international implications. Immediately after its detection, eradication and containment measures included in Decision 2015/789 were implemented. Surveys intensified during 2017, which soon revealed that the pathogen was widely distributed on the islands and eradication measures were no longer feasible. In this review, we analyzed the control measures carried out by the Balearic Government in compliance with European legislation, as well as the implementation of its control action plan. At the same time, we contrasted them with the results of scientific research accumulated since 2017 on the epidemiological situation. The case of Xf in the Balearic Islands is paradigmatic since it concentrates on a small territory with one of the widest genetic diversities of Xf affecting crops and forest ecosystems. We also outline the difficulties of anticipating unexpected epidemiological situations in the legislation on harmful exotic organisms on which little biological information is available. Because Xf has become naturalized in the islands, coexistence alternatives based on scientific knowledge are proposed to reorient control strategies towards the main goal of minimizing damage to crops and the landscape.

Organogenesis and somatic embryogenesis have been widely applied as the two main regeneration pathways in plant tissue cultures. However, recalcitrance is still the main restriction in the clonal propagation of many woody species, especially in conifers. They undergo a “phase change” that leads to significant loss of vegetative propagation capacity, reducing the aptitude of tissues and organs to be regenerated in vitro beyond this point. In line with this, the in vitro regeneration of mature conifer trees has been a long-cherished goal in many laboratories worldwide. Based on previous works in Pinus species regeneration from adult trees, we now present data about the culture of apical shoot buds in an attempt to induce organogenesis and somatic embryogenesis to clone mature trees of Aleppo pine (Pinus halepensis). Reinvigorated axillary shoots were submitted to conditions usually applied to induce somatic embryogenesis through the manipulation of culture media, including the use of auxins such as 2,4-Dichlorophenoxyacetic acid and 1-Naphthaleneacetic acid, cytokinins (6-benzyladenine and kinetin), and phytosulfokine (50, 100, and 200 nM). Although somatic embryos could not be obtained, an embryogenic-like tissue was produced, followed by the emergence of actively proliferating non-embryogenic calli. Variations in the consistence, texture, and color of non-embryogenic calli were observed; especially those arising in the media containing phytosulfokine. Reinvigorated shoots, induced by 22 or 44 µM 6-benzyladenine, were obtained through organogenesis and acclimatized, and phenotypically normal plants were obtained.

Introdução: O lúpus eritematoso (LE) é uma patologia multiorgânica autoimune que afeta sobretudo mulheres em idade fértil. A pele é o segundo órgão mais frequentemente atingido, depois das articulações, e pode preceder o envolvimento sistémico. Objetivos: Apresentar aspetos clínicos que evocam a hipótese de manifestações cutâneas específicas de LE e achados histopatológicos que podem contribuir para fundamentar o diagnóstico. Métodos: Estudo de casos com manifestações cutâneas sugestivas de LE, nos quais a correlação clínico-histopatológica possibilitou o diagnóstico de diferentes subtipos de LE. Resultados: A correlação das alterações clínicas e histopatológicas, no contexto analítico apropriado, permitiu identificar casos concretos de manifestações cutâneas específicas de LE: 1) agudo; 2) subagudo (formas anular e papular-escamosa); 2.1) subagudo induzido por fármacos; 3) crónico, nomeadamente 3.1) discóide clássico (face e couro cabeludo); 3.2) túmido; 3.3) paniculite. Descreve-se, adicionalmente, os achados clínicos e histopatológicos expectáveis em outras manifestações cutâneas específicas de LE. Conclusão: O LE exibe grande variabilidade de manifestações cutâneas. A histopatologia é essencial para o diagnóstico, sendo muito importante a preservação e manuseamento apropriado do material de biópsia. A imunofluorescência direta é útil para melhorar a acuidade diagnóstica. O diagnóstico preciso, baseado na correlação clínico-patológica sistemática e integrado no contexto clínico-analítico adequado, é fundamental para o prognóstico e orientação terapêutica dos doentes.

Reportamos o caso de uma mulher de 38 anos, com história de depressão medicada com fluoxetina e bromazepam há 2 anos, que recorreu à urgência por lesões maculopapulares generalizadas, eritematosas e dolorosas com 8 dias de evolução, associadas a febre. Esclarecemos que tomava comprimidos manipulados para emagrecer e iniciara uma nova embalagem há 3 semanas. A progressão das lesões com atingimento das mucosas, formação de bolhas e erosões envolvendo 40% da área de superfície corporal, associadamente ao resultado histopatológico permitiram efetuar o diagnóstico de síndrome de Lyell. Sob prednisolona oral 1,5mg/kg/dia, verificou-se resolução completa do quadro em 15 dias. Pretendemos salientar que os fármacos manipulados para emagrecimento poderão ser, cada vez mais, imputados a esta síndrome; contêm uma miscelânea de componentes, alguns dos quais pouco estudados e cujas interações farmacocinéticas se desconhecem. Tratando-se de manipulados na farmácia, nunca há certeza da sua composição exata ou se diferem consoante o lote.

Introdução: O âmbito da dermatoscopia estende-se para além da avaliação das lesões pigmentadas, designadamente na avaliação de lesões vasculares, infeciosas e inflamatórias, bem como na patologia do couro cabeludo e ungueal. Pretendemos demonstrar características dermatoscópicas que poderão ser úteis no diagnóstico e seguimento de lesões não melanocíticas. Material e métodos: Selecionaram-se 19 doentes nos quais a dermatoscopia foi utilizada no diagnóstico e/ou seguimento de lesões. Os achados dermatoscópico foram comparados com os publicados na literatura. Resultados: Descrevemos o aspeto dermatoscópico de lesões vasculares, como o hemangioma infantil, o glomangioma, o hemangioma hemossiderótico targetóide, o linfangioma cutâneo circunscrito e a malformação arteriovenosa digital adquirida. Dentro das infeções víricas e infestações, detalhamos os achados dermatoscópicos identificadores de molusco contagioso, verruga vírica, pediculose do couro cabeludo e escabiose. Descrevemos também o aspeto dermatoscópico de lesões de poroqueratose actínica disseminada superficial, psoríase, pitiríase rósea, líquen plano, sarcoidose, queratodermia espinulosa palmoplantar, queratólise punctata, mamilo acessório, hiperplasia sebácea e hemorragia subcórnea, confrontando os resultados obtidos com os padrões dermatoscópicos previamente descritos na literatura e aqui revistos. Conclusões: A dermatoscopia é útil no diagnóstico, prognóstico e follow-up de diversas lesões cutâneas, além das melanocíticas. Verifica-se um aumento exponencial das suas aplicações com o reconhecimento de novos padrões dermatoscópicos, colocando-se a dermatoscopia em posição valiosa entre a clínica e a histologia.

A urticária papular (UP), também conhecida como prurigo estrófulo, é uma dermatose infantil relati- vamente frequente devida a hipersensibilidade à picada de mosquitos, pulgas, percevejos e outros insetos. Carac- teriza-se pelo aparecimento de pápulas e, eventualmente, vesículas e/ou bolhas, apresentando evolução crónica ou recorrente. É geralmente pruriginosa e desconfortável, e o acto de coçar resultante pode originar erosões e infeção secundária. Os doentes afetados são frequentemente mal diagnosticados e submetidos a exames auxiliares de diagnóstico desnecessários, onerosos e/ou invasivos. De forma a evitá-lo, o clínico deve saber reconhecer as lesões cutâneas de UP, possíveis exposições e a história natural da doença. Os principais desafios na abordagem da UP são: convencer os pais/doentes de que as lesões estão relacionadas com a picada de inseto, desmistificar a convicção frequente da relação com a ingestão de certos alimentos e identificar e erradicar o insecto envolvido. Neste artigo, descrevemos uma doente de 25 anos de idade com UP bolhosa e efectuamos uma breve revisão da literatura, incluindo os aspectos clínicos, a utilidade da mnemónica “SCRATCH” no diagnóstico correcto e atempado, os principais diagnósticos diferenciais e a abordagem terapêutica baseada na regra dos 3 “P’s” (Prevenção, controlo do Prurido e Paciência). PALAVRAS-CHAVE – Urticária papular; Insetos; Criança; Prurigo.