P851-Padrões de uso do smartphone potencialmente disfuncionais em adultos portugueses

A globalização da informação em múltiplos domínios da vida dos indivíduos congrega vantagens e riscos. O presente estudo propôs-se avaliar a existência de padrões de uso do smartphone potencialmente disfuncionais junto de uma amostra de conveniência constituída por 164 participantes adultos. Os participantes responderam a: versão portuguesa do Smartphone Addiction Inventory; questionário sociodemográfico; questionário de sintomas clínicos sugestivos de uso problemático/dependência de smartphones. Ainda que a maioria dos participantes (90.9%) não apresente sintomas de perturbação associada ao uso de smartphones, 6.7% apresenta sintomas moderados e 2.4% sintomas graves. Os resultados sugerem a importância da realização de rastreios neste domínio.

e-Literacia em saúde em jovens adultos: Estudo exploratório

Este estudo pretendeu caracterizar o nível de e-literacia em saúde em jovens adultos portugueses. Participaram 109 indivíduos, com idades entre 18 e 25 anos, que responderam a um questionário sociodemográfico e à Escala de E-literacia em Saúde. Globalmente, os jovens apresentam razoável e-literacia em saúde funcional, níveis medianos de e-literacia crítica, e fraca e-literacia comunicacional. Os resultados revelam não existirem diferenças estatisticamente significativas entre os dois sexos quanto à e-literacia em saúde global, funcional, comunicacional, e crítica, e que a e-literacia crítica em saúde é superior nos participantes que completaram o mestrado do que nos jovens com menor escolaridade.

Formação de treinadores: Importância da liderança, compatibilidade treinador-atleta e rendimento desportivo

Este estudo tem como objetivo analisar a associação entre o estilo de liderança, compatibilidade treinador-atleta e classificação do clube em atletas seniores de futsal da divisão nacional. 107 atletas responderam a um questionário sociodemográfico; Escala Multidimensional de Liderança no Desporto; e Medida de Compatibilidade Treinador-Atleta. Foi demonstrada a importância dos estilos de liderança para a compatibilidade treinador-atleta, sendo que, para atletas do sexo feminino, a demonstração de comportamentos de confiança/entusiasmo acerca das suas capacidades por parte dos treinadores, e os aspetos mais pessoais da relação assumem particular importância para o rendimento.

Escala de Literacia em Saúde Oral (ELSO): construção e estudo psicométrico

O presente estudo visou a construção e validação de um instrumento de avaliação da literacia em saúde oral para a população adulta portuguesa. A escala de Literacia em Saúde Oral (ELSO) é constituída por 107 itens, organizados em 3 subescalas de literacia em saúde oral: Funcional; Comunicacional; Crítica. 108 indivíduos, 73,1% do sexo feminino, com idades entre 18 e 72 anos (M=32.08; DP=12.33) responderam a um questionário sociodemográfico-clínico, à ELSO e à Dental Anxiety Inventory - DAI. O questionário apresenta boa sensibilidade, elevada fidelidade e uma validade aceitável, sendo que o estudo da sua estrutura deverá merecer aprofundamento.

Literacia em saúde: um retrato da população adulta portuguesa

O presente estudo tem como objetivo descrever os níveis de literacia em saúde em adultos portugueses. Foi estudada uma amostra de conveniência constituída por 316 indivíduos, com idades compreendidas entre os 18 e os 78 anos (M=35.12; DP=14.49), 66.1% do sexo feminino. Os participantes responderam a um questionário sociodemográfico e à Escala de Literacia em Saúde. Os resultados indicam que os níveis globais de Literacia em Saúde são medianos. Ao nível da Literacia Comunicacional, os participantes revelam possuir competências razoáveis, porém ao nível da Literacia Funcional estas são apenas medianas e ao nível da Literacia Crítica são claramente fracas.

Escala de e-Literacia em Saúde (EeLS): Contributo para a construção e validação de um instrumento de e-literacia em saúde

Apresenta-se o processo de construção e validação de um instrumento de avaliação da e-literacia em saúde para a população adulta portuguesa. A Escala de e-Literacia em Saúde (EeLS) é constituída por 16 itens, organizados em 3 subescalas: (1) e-Literacia em Saúde Funcional; (2) e-Literacia em Saúde Comunicacional; (3) e-Literacia em Saúde Crítica. O questionário foi administrado de forma eletrónica, participando no estudo 316 indivíduos, 66.1% do sexo feminino, com idades compreendidas entre 18 e 78 anos (M=35.12; DP=14.49). A EeLS revelou apresentar boa sensibilidade, elevada fidelidade e boa validade interna, assim como uma boa validade convergente-discriminante.  

Adaptação do Smartphone Addiction Inventory para a população portuguesa

O presente estudo teve como objetivo adaptar linguística e culturalmente para a população portuguesa o Smartphone Addiction Inventory. Participaram 164 indivíduos, com idade média de 29.09 anos (DP=10.15), com nível de escolaridade maioritariamente do ensino superior (84.2%). Procedeu-se à tradução/adaptação do instrumento, em articulação com a equipa que desenvolveu a versão original. Os participantes responderam à versão portuguesa do SPAI, a um breve questionário sociodemográfico e a um questionário de avaliação de sintomas clínicos sugestivos de uso problemático e de dependência de smartphones. A versão portuguesa do SPAI revela apresentar boa fidelidade e razoável validade interna e externa.

Escala de Literacia em Saúde (ELS): Construção e estudo psicométrico

O presente estudo teve como objetivo a construção e validação de uma escala de literacia em saúde para a população adulta portuguesa. Foi construída a Escala de Literacia em Saúde (ELS), constituída por 111 itens, que avaliam 3 domínios - Literacia em Saúde Funcional, Comunicacional e Crítica – e que foi testada em 316 indivíduos adultos. O questionário apresenta boa sensibilidade, elevada fidelidade e boa validade interna e externa, podendo constituir-se como uma ferramenta de avaliação importante para a avaliação de necessidades de intervenção no domínio da literacia em saúde na população portuguesa.

Uso Problemático da Internet em Adultos: Que relação com sintomas clínicos?

Este estudo teve como objetivo analisar a relação entre o uso problemático da internet, sintomas de depressão, ansiedade e stress, e autoconceito. Participaram 265 adultos, que responderam a um questionário sociodemográfico, à Escala de Uso Generalizado Problemático da Internet, Escala de Ansiedade, Depressão e Stress-21 de Lovibond & Lovibond e ao Inventário de Autoconceito. Quanto maior revela ser a preferência de interação social online, a utilização da Internet para regular o humor, a autorregulação deficiente e as consequências negativas do uso da Internet, maior é a intensidade dos sintomas de ansiedade, depressão, e stress e menor o autoconceito total.

Post-inflammatory Ileitis Induces Non-neuronal Purinergic Signaling Adjustments of Cholinergic Neurotransmission in the Myenteric Plexus

Uncoupling between ATP overflow and extracellular adenosine formation changes purinergic signaling in post-inflammatory ileitis. Adenosine neuromodulation deficits were ascribed to feed-forward inhibition of ecto-5′-nucleotidase/CD73 by high extracellular adenine nucleotides in the inflamed ileum. Here, we hypothesized that inflammation-induced changes in cellular density may also account to unbalance the release of purines and their influence on [³H]acetylcholine release from longitudinal muscle-myenteric plexus preparations of the ileum of 2,4,6-trinitrobenzenesulfonic acid (TNBS)-treated rats. The population of S100β-positive glial cells increase, whereas Ano-1-positive interstitial cells of Cajal (ICCs) diminished, in the ileum 7-days after the inflammatory insult. In the absence of changes in the density of VAChT-positive cholinergic nerves detected by immunofluorescence confocal microscopy, the inflamed myenteric plexus released smaller amounts of [³H]acetylcholine which also became less sensitive to neuronal blockade by tetrodotoxin (1 μM). Instead, [³H]acetylcholine release was attenuated by sodium fluoroacetate (5 mM), carbenoxolone (10 μM) and A438079 (3 μM), which prevent activation of glial cells, pannexin-1 hemichannels and P2X7 receptors, respectively. Sodium fluoroacetate also decreased ATP overflow without significantly affecting the extracellular adenosine levels, thus indicating that surplus ATP release parallels reactive gliosis in post-inflammatory ileitis. Conversely, loss of ICCs may explain the lower amounts of adenosine detected in TNBS-treated preparations, since blockade of Ca_v3 (T-type) channels existing in ICCs with mibefradil (3 μM) or inhibition of the equilibrative nucleoside transporter 1 with dipyridamole (0.5 μM), both decreased extracellular adenosine. Data indicate that post-inflammatory ileitis operates a shift on purinergic neuromodulation reflecting the upregulation of ATP-releasing enteric glial cells and the depletion of ICCs accounting for decreased adenosine overflow via equilibrative nucleoside transporters.

Fever, Malaise, and Dyspnea in a Diabetic Heart Transplant Patient: A Case Report

Patients with solid-organ transplants usually present at the emergency department with nonspecific symptoms. The physician should consider a great variety of syndromes and diseases, given the greater risk that solid-organ transplant patients carry because of immunosuppression and transplant-related conditions. Myocardial infarction caused by cardiac allograft vasculopathy must be always suspected and ruled out, even when initial symptoms do not orientate in that direction. We present a case that conjugates signs that can be present in different pathologies. It shows that fever is not always related to infection or rejection but could also appear in acute cardiac allograft vasculopathy. It emphasizes the need of a multi-disciplinary team led by a heart transplant specialist when dealing with this sort of clinical case.

Culture-independent methods reveal high diversity of OXA-48-like genes in water environments

The carbapenemase OXA-48 was identified for the first time in 2001 and is now one of the greatest concerns in terms of antibiotic resistance. While many studies report clinical OXA-48-like producers, few reports refer bla_OXA-48-like genes in environmental bacteria. The main goal of this study was to evaluate the diversity of bla_OXA-48-like genes in aquatic systems, using culture-independent approaches. For that, environmental DNA was obtained from riverine and estuarine water and used to construct clone libraries of bla_OXA-48-like gene polymerase chain reaction amplicons. bla_OXA-48-like libraries from river and estuarine water DNA comprised 75 and 70 clones, respectively. Sequence analysis showed that environmental bla_OXA-48-like genes show a broader diversity than that so far observed in clinical settings. In total, 50 new OXA-48 variants were identified as well as sequences identical to previously reported OXA-48, OXA-181, OXA-199, OXA-204 and OXA-162. Though we have no evidence that these genes were carried by bacteria that are members of the natural heterotrophic flora or bacteria that have entered this particular water environment through anthropogenic sources, these results reinforce the role of aquatic systems as antibiotic resistance reservoirs. The variants of bla_OXA-48 here described should be taken into account when designing molecular strategies for detecting this gene.

Inhalation injury in a burn unit: a retrospective review of prognostic factors

Inhalation injury (InI) is known to seriously affect the prognosis of burn patients, as it is strongly associated with high morbidity and mortality. Despite major advances in the treatment of burn patients in the past years, advances in the treatment of smoke InI have been somewhat limited; mortality reduction mostly results from improvements in critical care. It is difficult to separate the contribution of InI from other mechanisms that also affect respiratory tract and lungs. The aim of this study was to compare patients with and without InI and to identify prognostic factors among patients with smoke InI. Patients with InI displayed higher total body surface area (TBSA) burned, higher incidence of pneumonia and acute respiratory distress syndrome (ARDS), a higher rate of positive blood cultures and a significantly higher death rate. We could conclude that older age, higher TBSA, ARDS and pneumonia were independent predictive factors for mortality in our global study population. Older age and higher TBSA were the only independent factors found to be predictive of mortality in patients with InI.

Inhibition of cholinergic neurotransmission by β3-adrenoceptors depends on adenosine release and A1-receptor activation in human and rat urinary bladders

The direct detrusor relaxant effect of β₃-adrenoceptor agonists as a primary mechanism to improve overactive bladder symptoms has been questioned. Among other targets, activation of β₃-adrenoceptors downmodulate nerve-evoked acetylcholine (ACh) release, but there is insufficient evidence for the presence of these receptors on bladder cholinergic nerve terminals. Our hypothesis is that adenosine formed from the catabolism of cyclic AMP in the detrusor may act as a retrograde messenger via prejunctional A₁ receptors to explain inhibition of cholinergic activity by β₃-adrenoceptors. Isoprenaline (1 µM) decreased [³H]ACh release from stimulated (10 Hz, 200 pulses) human (-47 ± 5%) and rat (-38 ± 1%) detrusor strips. Mirabegron (0.1 µM, -53 ± 8%) and CL316,243 (1 µM, -37 ± 7%) mimicked isoprenaline (1 µM) inhibition, and their effects were prevented by blocking β₃-adrenoceptors with L748,337 (30 nM) and SR59230A (100 nM), respectively, in human and rat detrusor. Mirabegron and isoprenaline increased extracellular adenosine in the detrusor. Blockage of A₁ receptors with 1,3-dipropyl-8-cyclopentylxanthine (DPCPX, 100 nM) or the equilibrative nucleoside transporters (ENT) with dipyridamole (0.5 µM) prevented mirabegron and isoprenaline inhibitory effects. Dipyridamole prevented isoprenaline-induced adenosine outflow from the rat detrusor, and this effect was mimicked by the ENT1 inhibitor, S-(4-nitrobenzyl)-6-thioinosine (NBTI, 30 µM). Cystometry recordings in anesthetized rats demonstrated that SR59230A, DPCPX, dipyridamole, and NBTI reversed the decrease in the voiding frequency caused by isoprenaline (0.1-1,000 nM). Data suggest that inhibition of cholinergic neurotransmission by β₃-adrenoceptors results from adenosine release via equilibrative nucleoside transporters and prejunctional A₁-receptor stimulation in human and rat urinary bladder.

Early Macrophage Infiltration and Sustained Inflammation in Kidneys From Deceased Donors Are Associated With Long-Term Renal Function

Kidney transplants from living donors (LDs) have a better outcome than those from deceased donors (DDs). Different factors have been suggested to justify the different outcome. In this study, we analyzed the infiltration and phenotype of monocytes/macrophages and the expression of inflammatory and fibrotic markers in renal biopsy specimens from 94 kidney recipients (60 DDs and 34 LDs) at baseline and 4 months after transplantation. We evaluated their association with medium- and long-term renal function. At baseline, inflammatory gene expression was higher in DDs than in LDs. These results were confirmed by the high number of CD68-positive cells in DD kidneys, which correlated negatively with long-term renal function. Expression of the fibrotic markers vimentin, fibronectin, and α-smooth muscle actin was more elevated in biopsy specimens from DDs at 4 months than in those from LDs. Gene expression of inflammatory and fibrotic markers at 4 months and difference between 4 months and baseline correlated negatively with medium- and long-term renal function in DDs. Multivariate analysis point to transforming growth factor-β1 as the best predictor of long-term renal function in DDs. We conclude that early macrophage infiltration, sustained inflammation, and transforming growth factor-β1 expression, at least for the first 4 months, contribute significantly to the difference in DD and LD transplant outcome.

Indoxacarb biotransformation in the German cockroach

Insecticides that are used for pest control undergo physical and biological (enzymatic) degradation. Indoxacarb is an oxadiazine class sodium channel blocker insecticide used for German cockroach (Blattella germanica L.) control. At present, no information is available on enzymatic biotransformation or metabolism of indoxacarb in this important urban pest. We studied the biotransformation pathways of indoxacarb in one susceptible and three field strains with varying susceptibility levels using liquid chromatography and high-resolution mass spectrometry. As shown in other insect species we found evidence for hydrolase-based bioactivation of indoxacarb to a toxic decarbomethoxylated metabolite, DCJW. In addition, both indoxacarb and DCJW were further metabolized to hydroxy, oxadiazine ring-opened and hydroxylated ring-opened metabolites. In general, higher indoxacarb disappearance, increased formation of DCJW and the above-mentioned metabolites were observed in the three field strains. In vitro biotransformation studies showed that hydroxylated and oxadiazine ring-opened metabolite formation is NADPH/cytochrome P450-dependent. Bioassays and in vivo metabolism experiments using the enzyme-inhibiting insecticide synergists, piperonyl butoxide (PBO) and S,S,S,-tributyl phosphorotrithioate (DEF), provided insights into potential indoxacarb resistance mechanisms that may proliferate in German cockroach field strains following unchecked selection pressures. The information presented here is an essential step toward developing indoxacarb resistance management programs and also reveals mechanisms of secondary/tertiary indoxacarb toxicity.