[Neonatal parenteral nutrition prescription practices in Portugal]

INTRODUCTION

The use of guidelines for neonatal parenteral nutrition (PN) improves its clinical efficiency and the safety of prescription.

OBJECTIVE

To evaluate the practices of neonatal parenteral nutrition prescription in Portugal, and the adherence to the National Consensus on neonatal PN (2008).

METHODS

A questionnaire based on a multiple choice response on parenteral nutrition prescription was conducted, and sent to the coordinators of the 50 public and private Portuguese neonatal special care units, 25 being level III and 25 level II.

RESULTS

Parenteral nutrition was prescribed in 32 neonatal units, 23 of which (71.9%) responded to the questionnaire. Of the respondents, 19 (82.6%) refer to follow the National Consensus, the remaining following local guidelines; 17 (73.9%) of units referred to using an electronic based system for prescription. In preterm neonates, most mentioned: administering judiciously the fluid intake during the first post-natal week; starting amino acids from the first post-natal day with 1.5-3g/kg/d, increasing up to 3-4g/kg/d; starting lipids from the first three post-natal days with 1g/kg/d, increasing up to 3g/kg/d; administering 40-70mg/kg/d of calcium and of phosphorus with the fixed calcium:phosphorus ratio of 1.7: 1 (mg:mg); and estimating the osmolality of the solutions, and weekly monitoring of serum triglycerides, blood urea, serum phosphorus and liver function.

CONCLUSIONS

The high response rate is probably representative of the practice of PN prescription in Portugal. Most of the units used the National Consensus on neonatal PN as a reference, thus contributing to better nutritional support for neonates.

The genetic diversity of Plasmodium malariae and Plasmodium brasilianum from human, simian and mosquito hosts in Brazil

Plasmodium malariae is a protozoan parasite that causes malaria in humans and is genetically indistinguishable from Plasmodium brasilianum, a parasite infecting New World monkeys in Central and South America. P. malariae has a wide and patchy global distribution in tropical and subtropical regions, being found in South America, Asia, and Africa. However, little is known regarding the genetics of these parasites and the similarity between them could be because until now there are only a very few genomic sequences available from simian Plasmodium species. This study presents the first molecular epidemiological data for P. malariae and P. brasilianum from Brazil obtained from different hosts and uses them to explore the genetic diversity in relation to geographical origin and hosts. By using microsatellite genotyping, we discovered that of the 14 human samples obtained from areas of the Atlantic forest, 5 different multilocus genotypes were recorded, while in a sample from an infected mosquito from the same region a different haplotype was found. We also analyzed the longitudinal change of circulating plasmodial genetic profile in two untreated non-symptomatic patients during a 12-months interval. The circulating genotypes in the two samples from the same patient presented nearly identical multilocus haplotypes (differing by a single locus). The more frequent haplotype persisted for almost 3 years in the human population. The allele Pm09-299 described previously as a genetic marker for South American P. malariae was not found in our samples. Of the 3 non-human primate samples from the Amazon Region, 3 different multilocus genotypes were recorded indicating a greater diversity among isolates of P. brasilianum compared to P. malariae and thus, P. malariae might in fact derive from P. brasilianum as has been proposed in recent studies. Taken together, our data show that based on the microsatellite data there is a relatively restricted polymorphism of P. malariae parasites as opposed to other geographic locations.

Assessment of paediatric CT exposure in a Portuguese hospital

In this study, the characterisation of radiation exposure of paediatric patients in computerised tomography (CT) procedures was performed for a Portuguese hospital. Dosimetric data and technical parameters used for CT examinations were retrieved, compiled and analysed over a period of 1 y. Five paediatric age groups were considered, covering the age interval from 0 (newborn) to 18 y old and, for each age group, the relative frequency of the most frequent CT examinations (head, ears, sinuses, chest and abdomen examinations) is analysed. The exposure settings used (kilovolt and milliampire) were compared with the values established in the local (hospital) clinical protocols for consistency analysis. Average CT dose index(vol) and dose length product values, per age group, are presented as well as the corresponding estimated mean effective dose values. Results showed an evident need for a protocol review, in order to adjust practices to international guidelines for performing optimised paediatric CT examinations. Also, an increased awareness of staff to Radiological Protection principles in CT in particular, these of utmost importance, seems necessary.

Modeling morphogen gradient formation from arbitrary realistically shaped sources

Much of the analytical modeling of morphogen profiles is based on simplistic scenarios, where the source is abstracted to be point-like and fixed in time, and where only the steady state solution of the morphogen gradient in one dimension is considered. Here we develop a general formalism allowing to model diffusive gradient formation from an arbitrary source. This mathematical framework, based on the Green's function method, applies to various diffusion problems. In this paper, we illustrate our theory with the explicit example of the Bicoid gradient establishment in Drosophila embryos. The gradient formation arises by protein translation from a mRNA distribution followed by morphogen diffusion with linear degradation. We investigate quantitatively the influence of spatial extension and time evolution of the source on the morphogen profile. For different biologically meaningful cases, we obtain explicit analytical expressions for both the steady state and time-dependent 1D problems. We show that extended sources, whether of finite size or normally distributed, give rise to more realistic gradients compared to a single point-source at the origin. Furthermore, the steady state solutions are fully compatible with a decreasing exponential behavior of the profile. We also consider the case of a dynamic source (e.g. bicoid mRNA diffusion) for which a protein profile similar to the ones obtained from static sources can be achieved.

First results on angular distributions of thermal dileptons in nuclear collisions

The NA60 experiment at the CERN Super Proton Synchrotron has studied dimuon production in 158A GeV In-In collisions. The strong excess of pairs above the known sources found in the complete mass region 0.2<M<2.6 GeV has previously been interpreted as thermal radiation. We now present first results on the associated angular distributions. Using the Collins-Soper reference frame, the structure function parameters lambda, mu, and nu are measured to be zero, and the projected distributions in polar and azimuth angles are found to be uniform. The absence of any polarization is consistent with the interpretation of the excess dimuons as thermal radiation from a randomized system.

Regards Through Adolescence: Comparison Between an Adolescent’s Suicidal Behaviour Consultation and an Adolescence Consultation

The aim of this study is a comparison between two different adolescents’ consultations: NES Consultation, which assists youngsters from 11 to 21 years old with self-destructive behaviours and Adolescence Consultation, which assists adolescents from 13 to 21 years old, without any specific diagnose or psychopathology.

Our sample it is composed of 100 youngsters, 15 males and 35 females from NES C (average age 15.5) and 14 males and 36 females from AC group (average age 15.6).

Data was collected from semi-structure interviews (at the assessment moment) and clinical documentation forms, analysed with SPSS program, through qui-square test (nominal variables).

Major findings: absence of significant differences between youngsters who cut themselves in the two consultations; in reported difficulties category, the hypothesis that there would be significant differences between the two groups was not fully confirm, it figured to be only true for school difficulties sub-category; significant differences found on depressive syndromatic diagnose sub-category; the results on source of reference category showed a significant difference between the groups we studied; the number of adolescents from the AC who have previously had suicidal ideation, although significantly different from NES C, can't be disregard. Inquiring about suicidal ideas and thoughts whenever attending an adolescent in difficulties should be the standard, not the exception, recognizing that we will not be able to bring to an end suicide but listening and understanding the suffering adolescent, we can win some time, and at the meantime, plenty of things can change.

Evidence for radial flow of thermal dileptons in high-energy nuclear collisions

The NA60 experiment at the CERN SPS has studied low-mass dimuon production in 158A GeV In-In collisions. An excess of pairs above the known meson decays has been reported before. We now present precision results on the associated transverse momentum spectra. The slope parameter Teff extracted from the spectra rises with dimuon mass up to the rho, followed by a sudden decline above. While the initial rise is consistent with the expectations for radial flow of a hadronic decay source, the decline signals a transition to an emission source with much smaller flow. This may well represent the first direct evidence for thermal radiation of partonic origin in nuclear collisions.

J/psi production in Indium-Indium collisions at 158 GeV/nucleon

The NA60 experiment studies muon pair production at the CERN Super Proton Synchrotron. In this Letter we report on a precision measurement of J/psi in In-In collisions. We have studied the J/psi centrality distribution, and we have compared it with the one expected if absorption in cold nuclear matter were the only active suppression mechanism. For collisions involving more than approximately 80 participant nucleons, we find that an extra suppression is present. This result is in qualitative agreement with previous Pb-Pb measurements by the NA50 experiment, but no theoretical explanation is presently able to coherently describe both results.

[Gestational immunology]

This review summarises the fundamental immunologic principles regarding the cellular and molecular relations involved with immune function in a normal gestation. During the past decades, more information has been gathered to explain these complex immunological mechanisms. These mechanisms include both fetal factors such as trophoblast cell properties and altered MHC Class I expression and local maternal factors such as specialized uterine natural killer cells and a shifting of the T-helper cell cytokine profile from a type 1 to a type II array. Other novel immunomodulators are found to be expressed in the local uterine environment to aid in fetal survival. Increased knowledge about the immune relationship between the mother and the fetus permits not only a better understanding about pathological outcomes of pregnancy and gestational complications of autoimmune diseases but also the development of therapeutic approaches for solid organ transplantation.

First measurement of the rho spectral function in high-energy nuclear collisions

We report on a precision measurement of low-mass muon pairs in 158 AGeV indium-indium collisions at the CERN SPS. A significant excess of pairs is observed above the yield expected from neutral meson decays. The unprecedented sample size of 360,000 dimuons and the good mass resolution of about 2% allow us to isolate the excess by subtraction of the decay sources. The shape of the resulting mass spectrum is consistent with a dominant contribution from pi+pi- -->rho -->mu+mu- annihilation. The associated space-time averaged spectral function shows a strong broadening, but essentially no shift in mass. This may rule out theoretical models linking hadron masses directly to the chiral condensate.

Synthesis, surface active and antimicrobial properties of new alkyl 2,6-dideoxy-l-arabino-hexopyranosides

Synthesis of alkyl 2,6-dideoxy-L-arabino-hexopyranosides was accomplished by the reaction of 1,5-anhydro-2,6-dideoxy-L-arabino-hex-1-enitol with fatty alcohols in dichloromethane, catalyzed by triphenylphosphine hydrobromide. Reaction with octanol and dodecanol gave the corresponding alpha-glycosides in 50% and 42% yield, the beta-glycosides in 20% and 21% yield and the alpha-anomer of the Ferrier product in 10% and 9% yield, respectively. Deacetylation of the alpha-/beta-glycosides with sodium methoxide in methanol afforded the amphiphilic L-arabino-hexopyranosides in 94-99% yield. The surface tension at the air-water interface of the octyl L-glycosides and of the dodecyl alpha-L-glycoside aqueous solutions at 35 degrees C was measured with a du Noüy ring tensiometer and surface properties such as critical micelle concentration (CMC), relative surface excess, molecular area at the interface and Gibbs micellization free energy were evaluated. The stereochemistry of the hexopyranoside ring in unimers and aggregates is correlated to the hydrophobicity and packing efficiency on the air-water interface. The antibacterial and antifungal activities of the surface-active glycosides were evaluated using the paper disk diffusion method. The dodecyl alpha-L-arabino-hexopyranoside was quite active over Bacillus cereus and Bacillus subtilis, while low activity was found for this glycoside over Enterococcus faecalis and Listeria monocytogenes. The octyl glycosides tested showed low activity over almost all the above-mentioned bacteria, and also over the fungus Candida albicans. No inhibition of Salmonella enteritidis and of the filamentous fungus Aspergillus niger was detected for any of the compounds tested.

Sugar bislactones by one-step oxidative dimerisation with pyridinium chlorochromate versus regioselective oxidation of vicinal diols

Synthesis of 10-membered bislactones by PCC oxidation of methyl 2,6-di-O-pivaloyl-alpha-D-glucopyranoside and methyl 4,6-O-benzylidene-alpha-D-glucopyranoside is described, with emphasis on their structure elucidation using the information gained by combination of NMR spectroscopic techniques with X-ray diffraction data. In alternative, the use of PCC and PCC adsorbed on silica gel or alumina for the regioselective oxidation of vicinal diols in sugars is also reported. Both bislactones showed antifungal activity against Candida albicans, and were slightly active against the bacteria Bacillus subtilis. The bislactone presenting pivaloyl protecting groups also promoted some growth inhibition of Staphylococcus aureus.

Traumatic bone cyst: report of two cases and review of the literature

Traumatic bone cysts usually are found in young individuals and most frequently have the radiographic appearance of well-circumscribed radiolucent lesions with a tendency to scallop between the roots of the teeth. Two well-documented cases of traumatic bone cysts are presented in which some differences related to their radiographic features were observed. The possible explanations for these differences are discussed and a brief review of the literature regarding the main characteristics of traumatic bone cyst lesions also is provided.

[Epidemiology of anorexia nervosa. Prevalence of anorexia nervosa in female adolescents from the districts of Lisboa and Setubal]

Prevalence studies of anorexia nervosa (AN) have shown differences depending of the country and method applied. The partial syndrome is being emphasized. There has been no epidemiological study done on AN in the Portuguese population of continental Portugal. Our objectives were: 1) to study the prevalence of AN in Portuguese populations; 2) to study the presence of partial syndrome and of body image disturbance; 3) to calculate the number of girls dieting; 4) to correlate with other variables. A population of 2,398 girls ranging 10 to 21 years old, from 30 State secondary schools in the Lisbon and Setubal districts were studied. A questionnaire was answered with questions allowing assessment of all DSM IIIR criteria for AN.

RESULTS

Prevalence of AN--0.37%, partial syndrome--12.6%, body image disturbance without weight loss--7%, wish to decrease weight in normal or low weight girls--38%, overweight--15.3%, the peak of age for AN was 15 years, the most prevalent socio-economic class for AN was 2 (scale 1 (higher) to 5). School performance was worse with AN and the age menarche was sooner.

[2-(Imidazol-4-yl)ethylamine]-([2-(imidazol-4-yl)ethyl][(1-methyl-imidazol-2-yl)methyl]amine)copper(II) diperchlorate

In the title mononuclear complex, [Cu(C(5)H(9)N(3))(C(10)H(15)N(5))](ClO(4))(2), the Cu(II) centre is surrounded by two N-donor ligands, which impose a square-pyramidal environment on the metal. The new tridentate ligand [2-(imidazol-4-yl)ethyl][(1-methylimidazol-2-yl)methyl]amine (HISMIMA) lies in the basal plane, while the histamine ligand occupies the apical and one of the basal positions around the Cu(II) ion.

Granulocyte-macrophage colony-stimulating factor in post-remission therapy of acute myeloid leukemia

The impact on occult leukemia of GM-CSF as a sensitizing agent has not been studied. We treated 41 adult patients with de novo acute myeloid leukemia, 25 of whom achieved complete remission and were given 1 to 3 post-remission courses, each course including GM-CSF begun 4 days prior to chemotherapy and given until day 3. After a median follow-up of 32 months, the probability of remaining in continuous complete remission was 17% at 46 months. GM-CSF in this setting was not associated with an improved outcome, arguing against a priming effect.

Alterations induced by the antifungal compounds ketoconazole and terbinafine in Leishmania

The antiproliferative effects and ultrastructural alterations induced in vitro by two antifungal compounds, the azole ketoconazole and the allylamine terbinafine on Leishmania amazonensis are reported. Promastigotes treatment with ketoconazole and terbinafine induced growth arrest and cell lysis in 72 hours. Combination of the two agents produced additive effects on promastigote axenic growth and synergistic effects on intracellular amastigote proliferation. The amastigotes, either axenically grown or infecting murine macrophages, were about 100-fold more sensitive to the drugs. These compounds induced the appearance of large multivesicular bodies, especially after ketoconazole treatment, increased amount of lipid inclusions as well as numerous, polymorphic volutin granules, particularly in terbinafine-treated cells. Multivesicular bodies were observed in close apposition with organelles such as mitochondria, which also showed alterations in the distribution and appearance of cristae, and the formation of paracrystalline arrays within the matrix. Some cells presented large portions of cytoplasm wrapped by endoplasmic reticulum and many parasites also presented myelin-like endoplasmic reticulum profiles. Such alterations together with the strong acid phosphatase activity observed in the multivesicular bodies and volutin granules may indicate the existence of an unusual autophagic process in cells treated with ergosterol biosynthesis inhibitors.

Molecular cloning and sequence analysis of the gene of the molybdenum-containing aldehyde oxido-reductase of Desulfovibrio gigas. The deduced amino acid sequence shows similarity to xanthine dehydrogenase

In this report, we describe the isolation of a 4020-bp genomic PstI fragment of Desulfovibrio gigas harboring the aldehyde oxido-reductase gene. The aldehyde oxido-reductase gene spans 2718 bp of genomic DNA and codes for a protein with 906 residues. The protein sequence shows an average 52% (+/- 1.5%) similarity to xanthine dehydrogenase from different organisms. The codon usage of the aldehyde oxidoreductase is almost identical to a calculated codon usage of the Desulfovibrio bacteria.

Clusters of 5S rRNAs in the intergenic region of ubiquitin genes in Tetrahymena pyriformis

Here, we report the molecular analysis of two independent 5S rRNA clusters found in the intergenic region of two ubiquitin genomic clones isolated from Tetrahymena pyriformis. Each cluster contains two 120-bp-long coding regions organized in tandem with 142/145-bp-long spacers.