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Ana Filipa Moleiro,1,2 Ana Maria Cunha,1 Rodrigo Vilares-Morgado,1,2 António José Cruz,3 Ana Isabel Almeida,4 Fernanda Peixoto,1 Fernando Falcão-Reis,1,2 Jorge Meira,1 Vítor Leal1 1Department of Ophthalmology, Centro Hospitalar e Universitário de São João, Porto, Portugal; 2Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Porto, Portugal; 3Department of Infectious Diseases, Centro Hospitalar e Universitário de São João, Porto, Portugal; 4Department of Neuroradiology, Centro Hospitalar e Universitário de São João, Porto, PortugalCorrespondence: Ana Filipa Moleiro, Department of Ophthalmology, Centro Hospitalar e Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal, Tel +351 915689259, Email anafomoleiro@gmail.comAbstract: The pandemic caused by SARS-CoV-2 remains a health care concern, despite vaccination programs. Mucormycosis, especially rhino-orbital-mucormycosis, has been described as a severe complication of COVID-19. Although it has been described mostly in India and other developing countries, few cases in the western world have also been described. We present a case of rhino-orbito-mucormycosis after recovery from severe COVID-19 in Portugal. A 75-year-old diabetic and obese man presented with right proptosis associated with right eye pain and low vision one month after recovery from severe COVID-19. Considering the most probable etiology for this clinical picture, anti-fungal therapy with liposomal amphotericin B was promptly initiated, followed by endoscopic sinus debridement. However, due to persistent and progressive infection, and after a multidisciplinary revision of the case, orbital exenteration was performed. One year after surgery, the patient is stable, without clinical or imagological signs of relapse of the disease. Although the evolution of the pandemic, along with vaccination programs, led to a lower incidence of severe COVID-19 disease, there are still patients presenting with severe COVID-19, requiring intensive care and at risk for serious complications. This case illustrates the importance of being aware of the development of post-COVID-19 mucormycosis and the need for close surveillance of patients recovering from severe COVID-19. COVID-19 prompt diagnosis and multidisciplinary approach are essential for a timely intervention achieving better survival while minimizing morbidity.Keywords: Mucorales, SARS-CoV-2, orbit, fungal infections, exenteration

Jorge Meira, 1,* Maria Luís Marques, 2,* Fernando Falcão-Reis, 1, 3 Eva Rebelo Gomes, 2 Ângela Carneiro 1, 3 1Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal; 2Department of Allergy and Clinical Immunology, Centro Hospitalar Universitário do Porto, Porto, Portugal; 3Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal*These authors contributed equally to this workCorrespondence: Jorge MeiraDepartment of Ophthalmology of São João Hospital, Avenida Prof. Hernâni Monteiro, Porto 4202 – 451, PortugalTel +351225512100Fax +351225513669Email jorgesmeira@gmail.comIntroduction: Contrast rapid sequence angiography with fluorescein or indocyanine green (ICG) is a diagnostic procedure commonly used in ophthalmology. Adverse reactions to fluorescein and ICG are rare and may be classified as toxic, of hypersensitivity and non-specific. The evaluation and management of a patient with an adverse reaction is a challenge for the majority of ophthalmologists, as is the assessment of risk factors that may contraindicate the procedure.Purpose: We aim to review the concepts underlying adverse reactions to fluorescein and ICG, especially those of hypersensitivity, and present a proposal or the evaluation of the patients in need to perform retinal angiography and for the treatment of immediate reactions to fluorescein and ICG.Methods: The available literature was examined using PubMed-Medline, and using the MeSH terms “fluorescein”, “Indocyanine green”, “ophthalmic dyes”, “retinal angiography”, “adverse reactions”, and “allergic reaction”.Conclusion: This review may help ophthalmologists to identify patients with higher risk of a hypersensitivity reaction and give them tools to recognize patients with suspected hypersensitivity that may benefit from an allergy study.Keywords: fluorescein, indocyanine green, ophthalmic dyes, retinal angiography, adverse reactions, hypersensitivity reaction

Introduction: Individuals with mental health disorders often lack access to appropriate care, including psychosocial rehabilitation programs, which are considered essential for their recovery. In 2019, as part of the intervention by the Community and Mental Health Service, at Hospital de Magalhães Lemos , we initiated a psychoeducational group for patients with psychotic spectrum disorders, with the purpose of providing our patients with comprehensive information about their condition and effective management strategies. Our 8-week program consisted of 16 sessions, including icebreaker activities, discussion of certain themes, sharing of experiences and practice of stress management techniques. Objectives: The aim of this study was to assess and quantify the impact of our 2023 program. Methods: Out of a total of 20 patients interviewed for our program in 2023, 16 began the program and 12 completed it. The program's evaluation was based on several assessment tools, including a sociodemographic questionnaire, a knowledge assessment questionnaire, the Positive and Negative Syndrome Scale (PANSS) , the Insight and Treatment Attitudes Questionnaire (ITAC), the World Health Organization Quality of Life (WHOQOL) , and the Medication Adherence Rating Scale (MARS). We also created a health agenda to organize an individual plan of care. Results: Our findings indicated an improvement in insight and attitudes towards treatment by 8.6%, an enhancement in treatment adherence by 5%, and an increase in knowledge by 11.9%. In terms of quality of life, we observed a slight improvement in the psychological domain by 0.6% and in the social domain by 1.2%. Regarding the impact on psychotic symptomatology, there was an average decrease in 4 points in the negative subscale and in 3 points in the general psychopathology subscale, whereas the positive subscale remained unchanged. None of the patients required hospitalization during this period. Conclusions: Our study revealed some improvement in nearly all the evaluated parameters. There was an improvement of the therapeutic relationship, which we believe has contributed to lower scores in the negative symptoms and general psychopathology subscale. As for the study limitations, we acknowledge that we will need to expand our sample through additional programs in the next years, to include it in early intervention psychosis programs and to re-evaluate our patients' outcomes after a more extended follow-up period, particularly if they continue to participate in our monthly mutual support group. Additionally, we must consider potential study biases, including the subjectivity of PANSS evaluations and the influence of other confounding factors, such as changes in treatment regimens during the program. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Tissue engineering is a promising approach for the repair of articular cartilage defects, with engineered constructs emerging that match native tissue properties. However, the inflammatory environment of the damaged joint might compromise outcomes, and this may be impacted by the choice of cell source in terms of their ability to operate anabolically in an inflamed environment. Here, we compared the response of engineered cartilage derived from native chondrocytes and mesenchymal stem cells (MSCs) to challenge by TNFα and IL‐1β in order to determine if either cell type possessed an inherent advantage. Compositional (extracellular matrix) and functional (mechanical) characteristics, as well as the release of catabolic mediators (matrix metalloproteinases [MMPs], nitric oxide [NO]) were assessed to determine cell‐ and tissue‐level changes following exposure to IL‐1β or TNF‐α. Results demonstrated that MSC‐derived constructs were more sensitive to inflammatory mediators than chondrocyte‐derived constructs, exhibiting a greater loss of proteoglycans and functional properties at lower cytokine concentrations. While MSCs and chondrocytes both have the capacity to form functional engineered cartilage in vitro, this study suggests that the presence of an inflammatory environment is more likely to impair the in vivo success of MSC‐derived cartilage repair. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2901–2910, 2018. [ABSTRACT FROM AUTHOR]

Pyoderma is among the main dermatological conditions observed in the veterinary clinic for pets. It is commonly caused by Staphylococcus pseudintermedius and treatment is based on antimicrobial therapy, often instituted without microbiological diagnosis and in vitro susceptibility tests, increasing the selective pressure for resistant microorganisms that represents a serious problem for veterinary and human medicine. The aim of this study was to identify the main pathogens isolated from canine pyoderma treated at a veterinary hospital in Brazil, as well as the antimicrobial resistance profile and the presence of the mecA resistance gene in staphylococcal isolates. A total of 115 samples were collected and 105 were identified by the MALDI-TOF MS technique as staphylococcal: S. pseudintermedius (74/105); S. intermedius (25/105); S. epidermidis (1/105); S. haemolyticus (1/105); S. delphini (1/105); S. schleiferi (1/105); S. xylosus (1/105). The higher rates of drug resistance were: ampicillin (65/105), penicillin (62/105), doxycycline (37/105) and tetracycline (33/105). Among the samples analyzed, 25/105 strains of Staphylococcus spp. were multidrug resistant (MDR), according to the index of multiple antimicrobial resistance (MAR). The 100 strains identified as S. intermedius and S. pseudintermedius were sent for polymerase chain reaction (PCR); only two strains of S. pseudointermedius were positive for the expression of the mecA gene. The high frequency of MDR found and the detection of the mecA gene raises concern in Public Health, considering the zoonotic potential of S. pseudintermedius and the increasingly close contact between humans and dogs. [ABSTRACT FROM AUTHOR]

The article has aimed to characterize the essential oil extracted from Ocotea diospyrifolia (Meisn.) Mez. leaves, in terms of its chemical composition and antioxidant, hemolytic, and phytotoxic potentials, as well as its toxicity against Artemia salina. The major constituents identified by CG-MS were d-elemene, spathulenol, and b-atlantol. When screened for potential biological activities, the essential oil presented low toxicity against Artemia salina, and a capacity of lysing red blood cells. Also, the evaluation of its in vitro antioxidant activity, using the phosphomolybdenum method, showed better results when compared to butylhydroxytoluene (BHT) and rutin. In conclusion, the results obtained showed certain in vitro toxicity, leading to an interesting target for cytotoxicity evaluations of carcinoma cells.

The clinical success of fiber posts has been attributed to their lower elastic modulus. The tested hypothesis was that fiber posts could lead to lower risk of post debonding and lower risk of root fracture, despite an increase in root stresses. Stress analyses were carried out with a 3D finite element model of a premolar restored with a metallic or a fiber post. Bonded and non-bonded post/cement interface conditions were simulated. We calculated risk-of-fracture indices by determining the highest principal stress values divided by the tensile strength. Shear stresses along the post/cement interface were analyzed for the bonded models. Compared with the premolar restored with a metallic post, the fiber post generated lower stresses along the interface and higher stresses in the root. However, with the fiber post, fracture was less likely to occur in the root, since its core and post fracture indices were higher. [ABSTRACT FROM AUTHOR]