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IntroductionIn order to ensure lipid quality of cultured fish and an environmentally sustainable production, new alternative sources of EPA and DHA are needed to replace traditional lipid sources, such as fish oil.MethodsDifferent combinations of alternative marine lipid sources rich in n-3 LC-PUFA available in the market were herein evaluated to replace traditional fish oil (sardine oil) in diets for European sea bass (Dicentrarchus labrax). A commercial-type diet (CTRL), containing 1.6% of EPA + DHA, 5% sardine oil and 8% rapeseed oil was used as a negative control. Another diet (SARDINE) formulated with 8.5% sardine oil, 4.5% rapeseed oil and 2.5% EPA + DHA was used as the positive control. Three experimental diets were formulated to completely replace sardine oil with alternative sources, targeting approximately the same EPA + DHA level as the positive control: the SALMON diet contained 9.9% salmon by-product oil mixed with 3.1% of an algal oil rich in EPA and DHA, while the ALGARAPE and the ALGASOY diets included 4.4% of the algal oil and 8.6% of either rapeseed or soybean oil, respectively. A sixth diet (ALGABLEND) was formulated to partially replace sardine oil with salmon by-product oil and rapeseed oil, balanced with 2% of algae biomass. The experimental diets were hand-fed to 118 g fish for 54 days. ResultsAll diets were well-accepted by fish and no significant differences were found in feed efficiency, growth performance, somatic indexes or whole body composition among treatments. At the end of the trial, regardless the dietary EPA + DHA level, all fillets contained more than 250 mg of EPA + DHA per 100 g fresh weight, meeting EFSA recommendations for cardiovascular risk prevention for European adults (> 250 mg day -1). DiscussionOverall, this study demonstrated that combining expensive sources of n-3 LC PUFA (Veramaris® or Algaessence Feed™ with low-priced sustainable oils (salmon by-products oil or vegetable oils) allows fortifying European sea bass flesh with EPA and DHA, without major textural changes. This approach is a successful strategy for mitigating the negative effects associated with the high inclusion of vegetable oils. However, the retention of n-3 LC-PUFA in muscle was not significantly increased, suggesting that there is a maximum dietary threshold beyond which β-oxidation might be promoted, and hence there is no advantage in increasing the dietary level of these fatty acids in European sea bass diets.

Chestnuts have been consumed in Portugal for immemorial times. These fruits are highly appreciated, not only due to their organoleptic characteristics but also due to their nutritional and functional values. For the nutrients to be more accessible and for the chestnuts to have better flavour and digestibility, it is necessary to heat, cook or roast them, for example. Chestnuts are a very versatile food, in terms of preparation, and can be cooked, roasted, as an accompaniment to dishes, replacing rice, pasta or potatoes, in the base of soups or the preparation of appetizing desserts and cakes. In Portugal the use of chestnuts to produce differentiated food products is traditional, but also new and innovative products are appearing on the market, either made with chestnuts or even with some residues of their processing, in the context of a circular economy. Examples of traditional usages of chestnut in Portugal include chestnut soup, or roasted chestnuts, which are typically consumed in the colder months of autumn and winter. In what concerns more modern trends, the use of chestnut flour to incorporate into a variety of foods, like bread, cookies or pasta is highlighted. This article explores the value of the chestnut sector in Portugal and the use of these fruits to obtain either traditional or innovative foods, such as bread, biscuits, pasta and beverages.

Introduction: Patients with ST-elevation myocardial infarction (STEMI) requiring inter-hospital transfer for primary percutaneous coronary intervention (PCI) often have delays in reperfusion. The door in-door out (DIDO) time is recommended to be less than 30 min. Objectives: To assess the DIDO time of hospitals that transfer patients with STEMI to a PCI center and to assess its impact on total ischemia time and clinical outcomes in patients with STEMI. Methods: We performed a retrospective study of 523 patients with STEMI transferred to a PCI center for primary PCI between January 1, 2013 and June 30, 2017. Results: Median DIDO time was 82 min (interquartile range, 61–132 min). Only seven patients (1.3%) were transferred in ≤30 min. Patients with DIDO times over 60 min had significantly longer system delays (207.3 min vs. 112.7 min; p60 min vs. ≤60 min (5.1% vs. 0%; p=0.006; adjusted odds ratio for in-hospital mortality, 1.27 [95% CI 1.062–1.432]). By the end of follow-up, patients belonging to the >60 min group had a higher mortality (p=0.016), and survival time was significantly shorter (p=0.011). Conclusion: A DIDO time ≤30 min was observed in only a small proportion of patients transferred for primary PCI. DIDO times of ≤60 min were associated with shorter delays in reperfusion, lower in-hospital mortality and longer survival times. Resumo: Introdução: Está recomendado que os doentes com enfarte agudo do miocárdio com supra de ST (EAMcSST) que necessitam de transferência inter-hospitalar para a intervenção coronária percutânea primária (ICPP) tenham um tempo de door in-door out (DIDO) ≤30 minutos. Objetivos: Avaliar o tempo DIDO dos hospitais que transferem pacientes com EAMcSST para ICP e o seu impacto no tempo total de isquemia e outcomes clínicos. Métodos: Estudo retrospetivo com 523 doentes com EAMcSST transferidos para a ICPP, entre 1 de janeiro de 2013 e 30 de junho de 2017. Resultados: A mediana do tempo DIDO foi de 82 minutos (intervalo interquartílico [IQ], 61-132 minutos). Apenas 7 pacientes (1,3%) foram transferidos em ≤30 minutos. Os pacientes com um tempo DIDO >60 minutos apresentavam atrasos de sistema (207,3 min versus 112,7 min; p60 minutos (5,1% versus 0%; p=0,006; odds ratio ajustada para a mortalidade intra-hospitalar, 1,27 [95% IC, 1,062-1,432]). Até à data de follow-up, os doentes pertencentes ao grupo “>60 min” apresentavam uma maior proporção de eventos de morte, p=0,016 e o tempo de sobrevivência era significativamente inferior, p=0,011. Conclusão: O tempo DIDO ≤30 minutos foi observado numa pequena proporção de doentes. DIDO ≤60 minutos associaram-se a menores atrasos na reperfusão, a menor mortalidade intra-hospitalar e a maiores tempos de sobrevivência.

Chemotherapy-associated cardiotoxicity is a common adverse event. Immune checkpoint inhibitors (ICI) – a new class of monoclonal antibodies – have revolutionized the management of various diseases. Their use is expected to increase in the near future and their cardiac side effects have been increasingly recognized. Clinical case: We describe a case of a 67-year-old female patient with urothelial carcinoma undergoing treatment with pembrolizumab who presented to the emergency department with progressive fatigue, retrosternal pain and palpitations for three days. On admission she was diagnosed with acute heart failure (HF). The electrocardiogram revealed a right bundle branch block and ventricular bigeminy. Blood tests showed elevated troponin I, while transthoracic echocardiography revealed severe left ventricular dysfunction. Coronary angiography excluded coronary artery disease. Cardiac magnetic resonance revealed moderate left ventricular dysfunction and late gadolinium enhancement typical of myocarditis. Endomyocardial biopsy confirmed the diagnosis of lymphocytic myocarditis. In the first 48h of hospitalization, she developed transient complete AV block. Corticoid and HF therapy were initiated, leading to symptom improvement and disappearance of the rhythm disturbances. She was discharged on the 12th day, maintaining moderate LV dysfunction, which improved only mildly at a subsequent outpatient assessment. She died suddenly 35 days after discharge. Conclusion: Lymphocytic myocarditis is a serious cardiac side effect of ICI therapy. Pembrolizumab is increasingly used, so it is important to be aware of its effects, in order to perform an early diagnosis and provide adequate treatment. Corticosteroid therapy seems to be crucial in preventing disease progression and enabling ventricular remodeling. Resumo: Introdução: A cardiotoxicidade associada à quimioterapia é um evento adverso comum. Uma nova classe de anticorpos monoclonais – inibidores dos checkpoints imunes – tem revolucionado o tratamento de várias neoplasias, é expectável num futuro próximo o aumento da sua prescrição. Os efeitos colaterais cardíacos são cada vez mais reconhecidos. Caso clínico: Descrevemos o caso de uma doente de 67 anos com carcinoma urotelial sob pembrolizumab, admitida no serviço de urgência (SU) por fadiga, dor retrosternal e palpitações com três dias de evolução. No SU foi diagnosticada com insuficiência cardíaca aguda. O ECG relevou bloqueio completo de ramo direito e bigeminismo ventricular e na avaliação analítica com elevação dos biomarcadores de necrose miocárdica.O ecocardiograma transtorácico revelou disfunção ventricular esquerda grave. A coronariografia excluiu doença coronária. A ressonância cardíaca evidenciou disfunção moderada e padrão sugestivo de miocardite. A biópsia do miocárdio confirmou o diagnóstico de miocardite linfocítica. Nas primeiras 48 h de internamento apresentou períodos de bloqueio AV completo. Foi iniciada corticoterapia e terapêutica neuro-humoral, com rápida melhoria clínica e maior estabilidade elétrica. A doente teve alta ao 12.° dia, mantendo disfunção ventricular moderada. Em ambulatório, foi avaliada apresentando uma ligeira melhoria da fração de ejeção. Ao 35.° dia após alta, a doente faleceu. Conclusão: A miocardite linfocítica é um evento adverso grave associado à imunoterapia. O uso do pembrolizumab tem aumentado, é importante conhecer os seus efeitos adversos, para permitir um diagnóstico precoce e uma adequada terapêutica. A corticoterapia parece ser crucial na prevenção da progressão da doença e no remodeling ventricular.

Abstract Seaweeds are an important source of nutrients and bioactive compounds and have a high potential as health boosters in aquaculture. This study evaluated the effect of dietary inclusion of Gracilaria gracilis biomass or its extract on the European seabass (Dicentrarchus labrax) gut microbial community. Juvenile fish were fed a commercial-like diet with 2.5% or 5% seaweed biomass or 0.35% seaweed extract for 47 days. The gut microbiome was assessed by 16S rRNA amplicon sequencing, and its diversity was not altered by the seaweed supplementation. However, a reduction in Proteobacteria abundance was observed. Random forest analysis highlighted the genera Photobacterium, Staphylococcus, Acinetobacter, Micrococcus and Sphingomonas, and their abundances were reduced when fish were fed diets with algae. SparCC correlation network analysis suggested several mutualistic and other antagonistic relationships that could be related to the predicted altered functions. These pathways were mainly related to the metabolism and biosynthesis of protective compounds such as ectoine and were upregulated in fish fed diets supplemented with algae. This study shows the beneficial potential of Gracilaria as a functional ingredient through the modulation of the complex microbial network towards fish health improvement.

Prostate cancer (PCa) remains a significant global health concern, being a major cause of cancer morbidity and mortality worldwide. Furthermore, profound understanding of the disease is needed. Prostate inflammation caused by external or genetic factors is a central player in prostate carcinogenesis. However, the mechanisms underlying inflammation-driven PCa remain poorly understood. This review dissects the diagnosis methods for PCa and the pathophysiological mechanisms underlying the disease, clarifying the dynamic interplay between inflammation and leukocytes in promoting tumour development and spread. It provides updates on recent advances in elucidating and treating prostate carcinogenesis, and opens new insights for the use of bioactive compounds in PCa. Polyphenols, with their noteworthy antioxidant and anti-inflammatory properties, along with their synergistic potential when combined with conventional treatments, offer promising prospects for innovative therapeutic strategies. Evidence from the use of polyphenols and polyphenol-based nanoparticles in PCa revealed their positive effects in controlling tumour growth, proliferation, and metastasis. By consolidating the diverse features of PCa research, this review aims to contribute to increased understanding of the disease and stimulate further research into the role of polyphenols and polyphenol-based nanoparticles in its management.

The winery industry generates significant amounts of organic waste, such as pruning firewood, stems, and wine lees, which can cause environmental issues and affect the economic sustainability and competitiveness of the industry. Given the known antioxidant and antimicrobial properties of phenolic compounds, we analyzed these by-products to quantify their phenolic composition and evaluate the effectiveness of pruning firewood and stem extracts from six autochthonous varieties of the Dão Region in inhibiting the growth of bacteria from diabetic foot wounds isolated from hospital patients. The study employed colorimetric methods to measure total phenols, ortho-diphenols, and flavonoids in the phenolic composition. The ABTS, DPPH, and FRAP methods were applied to assess the antioxidant capacity, and the disk diffusion method was applied to determine the antimicrobial activity of Gram-positive and Gram-negative bacteria. The results showed that Jaen had the most ortho-diphenols and flavonoids in pruning firewood, and the highest levels of these compounds were located in stem extracts. Jaen also had the highest antioxidant capacity in both pruning firewood and stems across all methods used. Notably, red wine lees displayed the highest biological and antioxidant activities. Moreover, pruning firewood extract displayed great efficacy in inhibiting the growth of Gram-positive bacteria, making it a promising candidate as a natural alternative against antibiotic resistance, which is a global public health concern.

Resumo Fundamento Embora os resultados em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) submetidos a intervenções coronárias percutâneas (ICP) primárias tenham melhorado, as mulheres apresentam maior mortalidade. Objetivos: Avaliar as diferenças de gênero na apresentação, manejo e mortalidade hospitalar, em 30 dias, 6 meses e 1 ano após IAMCSST. Métodos Coletamos retrospectivamente dados de 809 pacientes consecutivos tratados com ICP primária e comparamos mulheres versus homens no banco de dados de cardiologia de intervenção local. O nível de significância utilizado foi p

We report the case of a 17-year-old athlete who resorted to the emergency department for palpitations and dizziness while exercising. He mentioned two exercise-associated episodes of syncope in the last six months. He was tachycardic and hypotensive. The electrocardiogram showed regular wide complex tachycardia, left bundle branch block morphology with superior axis restored to sinus rhythm after electrical cardioversion. In sinus rhythm, it showed T-wave inversion in V1–V5. Transthoracic echocardiography revealed mild dilation and dysfunction of the right ventricle (RV) with global hypocontractility. Cardiac magnetic resonance (CMR) revealed a RV end diastolic volume indexed to body surface area of 180 ml/m2, global hypokinesia and RV dyssynchrony, subepicardial late enhancement in the distal septum and in the middle segment of the inferoseptal wall. The patient underwent a genetic study which showed a mutation in the gene that encodes the desmocolin-2 protein (DSC-2), which is involved in the pathogenesis of arrhythmogenic right ventricular cardiomyopathy (ARVC). According to the modified Task Force Criteria for this diagnosis, the patient presented four major criteria for ARVC. Thus, a subcutaneous cardioverter was implanted, and the patient was followed up at the cardiology department.Arrhythmogenic right ventricular cardiomyopathy diagnosis is based on structural, functional, electrophysiological and genetic criteria reflecting underlying histological changes. This case depicts the essential characteristics for disease recognition. Resumo: Reportamos o caso de um jovem desportista de 17 anos que recorreu ao serviço de urgência por palpitações e tonturas durante o exercício físico. Referia dois episódios de síncope com o exercício nos últimos seis meses. Na admissão apresentava-se taquicárdico e hipotenso. O eletrocardiograma mostrava taquicardia regular de complexos largos com morfologia de bloqueio completo de ramo esquerdo e eixo superior, com necessidade de cardioversão elétrica. Em ritmo sinusal evidenciava inversão da onda T de V1-V5. O ecocardiograma transtorácico demonstrava dilatação e disfunção ligeira do ventrículo direito (VD) por hipocontratilidade global. A RMC revelava um volume telediastólico do VD indexado para a superfície de área corporal de 180 ml/m2, hipocinésia global e dessincronia do VD, realce tardio subepicárdico no septo distal e no segmento médio da parede infero-septal. O doente realizou estudo genético que mostrou mutação no gene DSC2 que codifica a proteína desmocolina-2 implicada na patogénese da miocardiopatia arritmogénica do ventrículo direito (MAVD). De acordo com os critérios Task Force modificados de 2010, o doente apresentava quatro critérios major para o diagnóstico de MAVD. O doente implantou cardiodesfibrilhador subcutâneo, encontrando-se em seguimento na consulta de cardiologia.O diagnóstico de MAVD assenta em critérios estruturais, funcionais, genéticos e eletrofisiológicos que traduzam as alterações histológicas subjacentes. Este caso reflete as características essenciais ao seu reconhecimento.

CASE RESOLUTION We decided to end the procedure because the patient became asymptomatic and the ST-segment elevation resolved. After the procedure, the blood test performed revealed a new increase of troponin I levels (4.4 ng/mL). The patient started therapy with dihydropyridine calcium channel blockers due to the observed vasospasm. While in observation, the patient remained asymptomatic. Five days later, she was discharged on dual antiplatelet therapy. One month later, the patient was readmitted to undergo an elective coronary angiography to reassess the lesion. The coronary angiography only revealed the presence of irregularities without further lesions (videos 1 and 2 of the supplementary data). Therefore, the most probable diagnosis was a spontaneous coronary artery dissection (SCAD). The management of SCAD is still a matter of great discussion especially regarding left main coronary artery lesions and situations of hemodynamic instability as it is well-known that SCADs can heal spontaneously after 1 month.1-3 In this case, we decided not to proceed with the percutaneous coronary intervention because the patient became asymptomatic and the electrocardiographic alterations resolved after the administration of intracoronary nitrates and because we were not sure about the etiology of the severe vasospasm (SCAD vs atherosclerotic lesion). The reassessment coronary angiography performed...

Vibriosis, an often-fatal disease induced by pathogenic members of the Vibrionaceae family, causes severe economic losses in aquacultures. To mitigate/avoid vibriosis outbursts, it is vital to detect and quantify these pathogens as early as possible. However, standard microbiological methods are time-consuming and often underestimate cell counts, which calls for the development of valid alternatives. In this study, real-time polymerase chain reaction (qPCR) was employed to detect the pathogenic species Vibrio alginolyticus, Listonella anguillara, and Vibrio harveyi using a new primer pair targeting the groEL gene. In addition, the DNA extraction efficiency of three methods, two commercial kits and the boiling method, was compared. The most efficient method was the DNeasy Blood and Tissue kit, with a detection limit ranging between 154 and 600 CFU mL−1 in the case of V. alginolyticus and L. anguillara, and 48 CFU mL−1 for V. harveyi. Thus, this study presents the development and evaluation of a method for the early quantification of all three species in saline suspensions. However, the results obtained by spiking a microalgae sample with V. harveyi emphasize the importance of adjusting the DNA control’s standard curve to the relevant extraction matrices, as it affects the DNA extraction efficiency and may hamper an accurate quantification with qPCR.

RESOLUCIÓN DEL CASO Se optó por finalizar la intervención tras la desaparición de los síntomas de la paciente (se obtuvo el consentimiento pertinente) y resolución de la elevación del segmento ST. Tras la intervención, la analítica sanguínea que se realizó reveló nuevas subidas de los niveles de troponina I (4,4 ng/ml). La paciente inició un tratamiento con bloqueadores del canal de calcio, concretamente dihidropiridinas, debido al vasoespasmo observado. La paciente siguió asintomática mientras estuvo en observación. Cinco días después fue dada de alta con tratamiento antiagregante plaquetario doble. Un mes después volvió a ser hospitalizada para realizársele una coronariografía y volver a valorar la lesión. La coronariografía solo reveló la presencia de irregularidades, no así de nuevas lesiones (vídeos 1 y 2 del material adicional). Por tanto, el diagnóstico más probable era ...

Quando o aluno é sujeito ativo na aprendizagem, as atividades letivas tornam-se atrativas, eficientes e envolventes. O software educativo, como simulações e jogos online, cujo caráter lúdico e divertido, promovem o papel ativo do aluno, podem revelar-se estratégias pedagógicas para averiguar a aquisição das aprendizagens realizadas no processo de ensino e de aprendizagem. Contudo, é fundamental a mudança de práticas pedagógicas. A narração multimodal é uma ferramenta que permite a análise de dados. Nesta narração multimodal investiga-se se a utilização de simulações nas aulas de Física, promove o envolvimento dos alunos.

The increase of antimicrobial resistant strains is leading to an emerging threat to public health. Pathogenic Vibrio are responsible for human and animal illness. The Enterobacteriaceae family includes microorganisms that affect humans, causing several infections. One of the main causes of human infection is related to the ingestion of undercooked seafood. Due to their filter-feeding habit, marine invertebrates, such as clams, are known to be a natural reservoir of specific microbial communities. In the present study, Vibrionaceae and coliforms microorganisms were isolated from clams. A microbial susceptibility test was performed using the disk diffusion method. From 43 presumptive Vibrio spp. and 17 coliforms, three Vibrio spp. with MICs to colistin >512 mg L−1 were found. From the 23 antimicrobial resistance genes investigated, only the three isolates that showed phenotypic resistance to colistin contained the mcr-1 gene. Genotypic analysis for virulence genes in EB07V indicated chiA gene presence. The results from the plasmid cure and transformation showed that the resistance is chromosomally mediated. Biochemical analysis and MLSA, on the basis of four protein-coding gene sequences (recA, rpoB, groEL and dnaJ), grouped the isolates into the genus Vibrio but distinguished them as different from any known Vibrio spp.

Introduction: Aortic stenosis is the most prevalent type of valvular disease in Europe. Surgical aortic valve replacement (SAVR) is the standard therapy, while transcatheter aortic valve implantation (TAVI) is an alternative in patients at unacceptably high surgical risk. Assessment by a heart team is recommended by the guidelines but there is little published evidence on this subject. The purpose of this paper is to describe the experience of a multidisciplinary TAVI program that began in 2008. Methods: The heart team prospectively assessed 473 patients using a standardized approach. A total of 214 patients were selected for TAVI and 80 for SAVR. Demographic, clinical and procedural characteristics and long-term success rates were compared between the groups. Results: TAVI patients were older than the SAVR group (median 83 vs. 81 years), and had higher surgical risk scores (median EuroSCORE II 5.3 vs. 3.6% and Society of Thoracic Surgeons score 5.1 vs. 3.1%), as did the patients under medical treatment only. These scores were unable to assess multiple comorbidities. Patients’ outcomes were different between the three groups (mortality with SAVR 25% vs. TAVI 37.6% vs. conservative therapy 57.6%, p=0.001). Conclusions: The heart team program was able to select candidates appropriately for TAVI, SAVR and conservative treatment, taking into account the risk of both invasive treatments. The use of a prospective standardized heart team approach is recommended, but requires continuous monitoring to ensure effectiveness in a timely manner. Resumo: Introdução: A estenose aórtica é atualmente a doença valvular mais prevalente na Europa. A substituição valvular aórtica cirúrgica (SVAC) é atualmente considerada a terapêutica de primeira linha, a implantação de válvula aórtica percutânea (VAP) é considerada uma opção em doentes com elevado risco cirúrgico. A avaliação dos doentes pelo Heart Team encontra-se preconizada pelas recentes guidelines publicadas de doenças valvulares, contudo existem poucas publicações acerca dessa temática. O objetivo deste manuscrito é descrever a experiência de um programa multidisciplinar VAP, iniciado em 2008. Métodos: O Heart Team avaliou de forma prospetiva e padronizada 473 doentes. Desses, 214 foram selecionados para VAP e 80 para SVAC. Os grupos foram comparados no que respeita às suas características demográficas, clínicas, de procedimento e quanto à sua evolução (mortalidade). Resultados: O grupo VAP apresentou maior idade do que o grupo SVAC (mediana 83 versus 81 anos) e apresentou scores de risco cirúrgico mais elevados (mediana Euroscore II 5,3 versus 3,6% e STS 5,1 versus 3,1%), tal como o grupo de doentes apenas sob terapêutica médica. Esses scores não foram capazes de avaliar múltiplas comorbilidades. A mortalidade entre os três grupos apresentou diferenças com significado estatístico (SVAC 25% versus VAP 37,6% versus terapêutica conservadora 57,6%, p=0,001). Conclusões: O programa Heart Team foi capaz de selecionar de forma adequada os doentes para as diversas estratégias terapêuticas tendo em conta o risco de ambos os procedimentos invasivos. Uma abordagem eficiente e standardizada pela Heart Team deve ser estimulada, necessitando de reavaliação continua. Keywords: Severe aortic stenosis, Transcatheter aortic valve implantation, Surgical aortic valve replacement, Heart team, Standardization, Palavras-chave: Estenose aórtica grave, Válvula aórtica percutânea, Substituição valvular aórtica cirúrgica, Heart Team, Standardização

Background: Left atrial deformation (LAD) parameters are new markers of atrial structural remodelling that seem to be affected in atrial fibrillation (AF) and atrial flutter (AFL). This study aimed to determine whether LAD can identify patients with a higher risk of thrombosis and unsuccessful electrical cardioversion (ECV). Methods: Retrospective study including 56 patients with AF or AFL undergoing ECV, with previous transthoracic (TTE) and transoesophageal echocardiography (TEE) studies. Echocardiographic parameters analysed were as follows: left ventricle function, left atrium (LA) dimensions, LAD parameters (positive and negative strain peaks), left atrial appendage (LAA) filling and emptying velocities and the presence of thrombi. Strain values were analysed according to thrombotic risk and success of ECV. Results: Lower mean values of peak-positive strain (PPS) in patients with prothrombotic velocities (

The atmospheric conditions are a strong modulator of grape berry composition, but further research is required to better understand this relationship, which is particularly pertinent under the context of climate change. The present study assesses the relationship between interannual variability in atmospheric conditions (mean, maximum and minimum air temperatures and precipitation totals) on grape berry quality attributes in three main Portuguese wine regions—Douro, Dão and Alentejo—and targets two major varieties growing in Portugal (cv. Touriga Nacional and cv. Aragonez/Tempranillo). Berry weight, titratable acidity (TA), pH, potential alcohol (PA), anthocyanins and total phenols index (TPI) data, collected two to three weeks after the end of the veraison until technological maturity, since 1999 in Douro, 2004 in Alentejo and 2008 in Dão, were selected. Meteorological data were obtained from both automatic weather stations and a climatic database defined at a very-high-resolution grid (

Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly.The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve®, which became dislodged and migrated to the ascending aorta. Due to the previous balloon valvuloplasty, the patient's AS became moderate, and her symptoms improved. After several months, she required another intervention, performed with a St. Jude Portico® repositionable self-expanding transcatheter aortic valve. There was a good clinical response that was maintained at one-year follow-up.The use of a self-expanding transcatheter bioprosthesis with repositioning features is a solution in cases of valve dislocation to avoid suboptimal positioning of a second implant, especially when the two valves have to be positioned overlapping or partially overlapping each other. Resumo: A implantação de válvula aórtica percutânea (VAP) tornou-se um procedimento importante no tratamento de doentes com estenose aórtica grave com elevado risco cirúrgico, cujas complicações devem ser avaliadas e tratadas de forma adequada.Os autores relatam o caso de uma doente de 86 anos, com estenose aórtica grave sintomática, recusada para intervenção cirúrgica dada a idade avançada e comorbilidades. A doente foi submetida a uma primeira implantação de VAP com uma válvula Medtronic CoreValve®, a qual sofreu um deslocamento para a aorta ascendente durante o procedimento. Devido à angioplastia de balão previamente efetuada, a estenose aórtica tornou-se moderada, com melhoria da sintomatologia da doente. Vários meses depois, por agravamento clínico, houve necessidade de reintervenção, a qual foi realizada com um sistema reposicionável Portico®. Verificou-se um segundo posicionamento valvular adequado, com boa resposta clínica da doente, que persiste após um ano de follow-up.A utilização de sistemas reposicionáveis de implantação de VAP constitui, atualmente, uma solução em casos de deslocamento da válvula, de forma a evitar uma segunda implantação subótima, sobretudo quando as duas válvulas têm de ficar em sobreposição. Keywords: Severe aortic stenosis, Transcatheter aortic valve implantation complications, Valve dislocation, Palavras-chave: Estenose aórtica grave, Complicações da válvula aórtica percutânea, Deslocamento da válvula

Triclosan (TCS), a bacteriostatic detected in water bodies, have inauspicious effects in human and biota. Consequently, there is a critical need of monitoring these type of compounds in aqueous matrices. In this sense, sensors, based on polyethyleneimine and polysodium 4-styrenesulfonate layer-by-layer thin-films adsorbed on supports with gold interdigitated electrodes deposited, were developed. The aim was analyze the sensitivity of discrimination of TCS (10−15 M to 10−5 M) in deionized water, Luso® and in an effluent, by measuring the impedance spectra. LbL films can distinguish TCS concentrations in EF, while in LW was achieved an acceptable sensibility when interdigitated electrodes without films were used.

Resumo: O linfoma primário do coração é definido como um linfoma não Hodgkin que envolve o coração e/ou o pericárdio. Trata‐se de uma neoplasia rara que envolve principalmente as cavidades direitas e, em especial, a aurícula direita. Por sua vez, o carcinoma das células renais é uma neoplasia relativamente comum que, em situações mais raras, pode metastizar para o coração. Atualmente, é conhecida uma associação entre a ocorrência de linfomas não Hodgkin e de carcinomas das células renais, apesar dos mecanismos a ela subjacentes não serem claramente conhecidos. Com este artigo, os autores apresentam um caso de um linfoma não Hodgkin primário do coração num doente com uma neoplasia renal síncrona e exploram as bases admitidas para esta associação. Abstract: Primary cardiac lymphoma is defined as non‐Hodgkin lymphoma involving the heart and/or pericardium. It is a rare cancer that primarily affects the right heart and in particular the right atrium. By contrast, renal cell carcinoma is a relatively common cancer, which in rare circumstances can metastasize to the heart. It is now known that there is an association between non‐Hodgkin lymphoma and renal cell carcinoma, although the underlying mechanisms are not fully understood. The authors present a case of primary cardiac non‐Hodgkin lymphoma in a patient with concomitant renal cell carcinoma and explore the possible reasons for this association. Palavras‐chave: Linfoma primário do coração, Neoplasia renal, Ecocardiografia, Biópsia cardíaca, Derrame pericárdico, Keywords: Primary cardiac lymphoma, Renal cancer, Echocardiography, Heart biopsy, Pericardial effusion

Resumo: O fator VIII é um cofator procoagulante, que desempenha um papel crucial na cascata da coagulação intrínseca. Níveis elevados podem ser encontrados em cerca de 11% da população geral adulta. Vários estudos têm evidenciado, de forma consistente, que o seu aumento parece ser um fator de risco para tromboembolismo venoso; alguns estudos relatam também uma provável associação com a trombose arterial, nomeadamente a doença arterial coronária e o acidente vascular cerebral.Os autores apresentam um caso de um doente do género masculino, de 36 anos, com fatores de risco cardiovascular conhecidos, nomeadamente obesidade, tabagismo e dislipidemia mista e com antecedentes pessoais de enfarte agudo do miocárdio aos 26 anos. Internado num serviço de cardiologia por enfarte agudo do miocárdio com supradesnivelamento do segmento ST. A coronariografia evidenciou a presença de trombo oclusivo no segmento distal da artéria obtusa marginal, o qual foi aspirado, tendo‐se verificado posteriormente a ocorrência de no reflow. O estudo analítico realizado posteriormente revelou uma elevação dos níveis de fator VIII; sem outras alterações no estudo de trombofilias.No caso clínico descrito embora o doente apresente vários fatores de risco cardiovascular realça‐se a necessidade de se efetuarem mais estudos sobre o papel do fator VIII na formação de trombo responsável por síndroma coronária aguda e sobre a necessidade de efetuar o seu doseamento perante a evidência de trombo formado. Outra questão pertinente que se levanta é o papel da anticoagulação nestes doentes como parte integrante da terapêutica em contexto de síndroma coronária aguda. Abstract: Factor VIII is a clotting factor that plays a crucial role in the coagulation cascade. Above‐normal levels are found in 11% of the general adult population. Various studies have established a causal association between elevated factor VIII and venous thrombosis; some studies also suggest a relation with arterial thrombosis, particularly myocardial infarction and stroke.We report the case of a 36‐year‐old man with obesity, smoking and dyslipidemia as cardiovascular risk factors and a history of acute myocardial infarction at age 26. He was admitted to the coronary care unit with a diagnosis of ST‐elevation myocardial infarction. Coronary angiography showed a thrombus in the distal segment of the first obtuse marginal artery, which was causing the obstruction. The thrombus was aspirated but there was no reflow. A coagulation study revealed elevated factor VIII; other parameters were normal.Even though this patient presented several cardiovascular risk factors, we highlight the need for more studies on the effect of elevated factor VIII on thrombus formation leading to acute coronary syndrome. Another important question is the use of oral anticoagulation in these patients as an integral part of the management of acute coronary syndrome. Palavras‐chave: Enfarte agudo do miocárdio, Fator VIII, Trombose, Keywords: Acute myocardial infarction, Factor VIII, Thrombosis

New strategies to reduce the environmental and economic costs of pesticides use are currently under study. Microencapsulation has been used as a versatile tool for the production of controlled release agricultural formulations. In this study, the photochemical degradation of the herbicides MCPA and mecoprop has been investigated in different aqueous media such as ultrapure and river water under simulated solar irradiation. To explore the possibility of introducing cyclodextrins in the herbicide formulations, the photodegradation study of the inclusion complexes of MCPA and mecoprop with (2-hydroxypropyl)-β-cyclodextrin (HP-β-CD) was also performed. The half-lives of MCPA and mecoprop inclusion complexes were increased approximately by a factor of three related to the free molecules. Additionally, it has been shown that the photodegradation of MCPA and mecoprop is influenced by their structural features. The additional methyl group existing in mecoprop molecular structure has a positive influence on the stabilization of the radical intermediate formed in the first stage of photodegradation of both herbicides. The results found indicated that MCPA and mecoprop form inclusion complexes with HP-β-CD showing higher photostability compared to free herbicides indicating that HP-β-CD may serve as ingredient in these herbicide formulations.