Porto Biomedical Journal

Can students make a difference in science during a pandemic? No abstract available

Metabolic syndrome: what we know and what we need to know No abstract available

The Sustainable Development Goals and the Community of Portuguese Speaking Countries (CPLP) in the post-COVID-19 era The universalization and full realization of the objectives and goals of the United Nations 2030 Agenda for Sustainable Development can be called into question by the significant drop in international funding available to support developing countries. This situation may be worsened by the effects caused by the COVID-19 pandemic and the consequent increase in nonregular cooperation programs, based on humanitarian and emergency actions. The promotion of horizontalization strategies for the Sustainable Development Goals (SDGs), considering interventions with a transversal nature, in a 360° view, which encourages the promotion of strategic alliances, multisectoral and multidimensional partnerships as well as shared financing mechanisms, appears as a credible hypothesis to assure the commitment with sustainable development. The article addresses some perceptions of multilateral organizations, namely within the scope of the United Nations System and Bretton Woods institutions, and how the strategic development cooperation instruments created by Community of Portuguese Speaking Countries may contribute to boosting post-COVID-19 cooperation scenarios aligned with the accomplishment of the SDGs in this community.

Socioeconomic, behavioural and sexual-health factors associated with nutritional status of female commercial sex workers in Dhaka city, Bangladesh: a cross-sectional study Objectives: To investigate the prevalence of nutitional status of female commercial sex workers (FCSWs) in Dhaka city and to determine which socio-economic, behavioural and sexual health practices associated with chronic energy deficiency (CED) and overweight/obesity. Methods: Cross-sectional study conducted among 635 FCSWs (308 hotel-based/HBSWs and 327 floating-based/FBSWs). Research tools were pretested questionnaire and anthropometric measurement (height–weight). Multistage sampling technique was employed to collect the data according to probability proportional to size from 7 hotels and 3 spots. Socio-demographic, sexual-health and behavioural data were collected by direct interview of the FCSWs from working places and were processed by statistical software package. Multinomial logistic regression model was used to determine the factors influencing BMI kg/m2 of FCSWs. Results: Mean age of the FCSWs was 21.1 years with a range of 14 to 55 years. Vast majority of FCSWs were illiterate (65.8%), widowed/separated/abandoned (44.6%) followed by 43.5% married. Prevalence of CED (<18.5 kg/m2) and overweight/obesity (≥25) was 22.8% and 16.3%, respectively. CED rate was almost doubled among FBSWs than HBSWs (P < .001). From the fitted MNLR model, variables like being HBSWs [odds ratio (OR) = .518], no mass media exposure (OR = 2.29) are found to be significant (P < .05) in the model of normal BMI verses CED. Similarly, being HBSWs (OR = 2.2), <26 years age (OR = .418), one-time coital frequency with normal clients (OR = .412), 1 to 7 days monthly absent (OR = .381), no alcohol consumption (OR = .149), drug habit (cannabis) (OR = .441), monthly income ≤7000 BDT (OR = .487) are found to be significant in the model of normal BMI verses overweight/obesity. Conclusion: FCSWs face double burden of malnutrition. Older age, higher income, being hotel-based FCSW, frequency of coitus, monthly abstinence from sex work, regular alcohol consumption and taking no drug are influential factors for overweight/obesity while being floating FCSW and having no mass media items (TV/Radio) are important determinants of CED.

Experience of a Portuguese radiation therapy department in the treatment of synchronous and metachronous head, neck, and oesophageal cancers Background: Multiple primary cancers in patients with head and neck squamous cell carcinoma (HNSCC) and oesophageal squamous cell carcinoma (ESCC) share common features. Their treatment approach can be a challenge. This retrospective study aims to estimate the cumulative incidence and to describe the outcome of patients with multiple primary cancers, treated in a Tertiary Centre in Portugal. Methods: The study includes patients with HNSCC, ESCC, and multiple tumours (synchronous or metachronous), treated with curative intent in a Centre, between 2004 and 2019. The analysis is focused on the clinical baseline characteristics, the treatment approach, and the outcomes. Patients with distant metastasis at tumour diagnosis were excluded. Results: Of a total of 820 cases, 31 had multiple tumours. In 15.8 years, the cumulative incidence of multiple tumours was 6.45%. Twenty-seven patients were treated with curative intent (n = 7 synchronous, n = 20 metachronous). The most frequent HNSCC cancers in synchronous tumours were oropharynx and hypopharynx tumours (n = 4); oral cavity was the most frequent HNSCC cancer (n = 12) in metachronous tumours. The primary treatment included surgery, adjuvant or definitive radiation therapy or chemoradiation. With a median follow-up time of 73 months, the median overall survival was 51.8 months for synchronous and 102 months for metachronous tumours. Conclusions: Multiple tumours of HNSCC and ESCC are uncommon. In the small group of Portuguese patients analysed, there is a potential pattern of occurrence and treatment outcome. Due to the limited number of patients this study has included, the authors have considered that additional prospective studies with large samples are needed.

Diagnostic importance of mean platelet volume, platelet distribution width and platelet large cell ratio as screening tool in immune thrombocytopenia Objective: To determine diagnostic importance of mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (PLCR) in diagnosing cases of immune thrombocytopenia. Methodology: The study was done in Khyber Teaching hospital from January 2017 to May 2018. Cases with low platelet count of all the ages and both the genders were included in the study by non probability purposive sampling technique and were subjected to bone marrow aspiration to rule out other causes of thrombocytopenia and thus confirm the diagnosis of immune thrombocytopenia. The platelet indices were noted and their sensitivity, specificity and accuracy were determined for immune thrombocytopenia. Mean and standard deviation were used for quantitative data. Percentage and frequency were used to measure qualitative data. Data was analysed by SPSS. Results: 84 cases with thrombocytopenia of mean age 23.4 ± 12.1 years (range 7–81 years) were included in the study. There were 38 (45.2%) males and 46 (54.8%) females. There were 40 cases of immune thrombocytopenia. The sensitivity and specificity for PDW (59.1% and 43.1%, respectively), MPV (59.1% and 52.9%, respectively), and PLCR (50% and 52.9%, respectively) were found low to be used as screening tool for immune thrombocytopenia. Conclusion: The MPV, PDW and PLCR has low sensitivity and specificity and therefore should not be used as reliable screening tool in giving preliminary diagnosis of the immune thrombocytopenia.

Eosinopenia as predictor of infection in patients admitted to an internal medicine ward: a cross-sectional study Background: The identification of infection in an internal medicine ward is crucial but not always straightforward. Eosinopenia has been proposed as a marker of infection, but specific cutoffs for prediction are not established yet. We aim to assess whether there is difference in eosinophil count between infected and noninfected patients and, if so, the best cutoffs to differentiate them. Methods: Cross-sectional, observational study with analysis of all patients admitted to an Internal Medicine Department during 2 consecutive months. Clinical, laboratory and imaging data were analyzed. Infection at hospital admission was defined in the presence of either a microbiological isolation or suggestive clinical, laboratory, and/or imaging findings. Use of antibiotics in the 8 days before hospital admission, presence of immunosuppression, hematologic neoplasms, parasite, or fungal infections were exclusion criteria. In case of multiple hospital admissions, only the first admission was considered. Sensitivity and specificity values for eosinophils, leukocytes, neutrophils, and C-reactive protein were determined by receiver operating characteristic curve. Statistical analysis was performed with IBM SPSS Statistics® v25 and MedCalc Statistical Software® v19.2.3. Results: A total of 323 hospitalization episodes were evaluated, each corresponding to a different patient. One hundred fifteen patients were excluded. A total of 208 patients were included, 62.0% (n = 129) of them infected at admission. Ten patients had multiple infections. Infected patients had fewer eosinophils than uninfected patients (15.8 ± 42 vs 71.1 ± 159 cell/mm3; P < .001). An eosinophil count at admission ≤69 cell/mm3 had a sensitivity of 89.1% and specificity of 54.4% (area under the curve 0.752; 95% confidence interval 0.682–0.822) for the presence of infection. Eosinophil count of >77 cells/mm3 had a negative likelihood ratio of 0.16. Conclusions: Eosinophil count was significantly lower in infected than in uninfected patients. The cutoff 69 cells/mm3 was the most accurate in predicting infection. Eosinophil count >77 cells/mm3 was a good predictor of absence of infection.

Identification of afzelin potential targets in inhibiting triple-negative breast cancer cell migration using reverse docking Background: Triple-negative breast cancer (TNBC) tends to be aggressive and metastatic, characteristics attributable to its cellular migration capabilities. Afzelin is a chemical compound with anti-metastatic potentials. This study aimed to predict proteins involved in TNBC cell migration which could be inhibited by afzelin. Methods: The protein database was constructed from the Kyoto Encyclopedia of Genes and Genomes pathways collection which related to cell motility, then screened for druggability using SuperTarget and Therapeutic Target Database. The involvement of druggable proteins in the TNBC metastasis process was investigated through existing publications in The National Center for Biotechnology Information PubMed database. Inhibitory potential of afzelin toward target proteins was compared to the proteins' known-inhibitor, using the reverse docking method. Results: Ten proteins identified as potential targets of afzelin, with the top 3 being ERK2, KRas, and FAK, respectively. Afzelin's 3-O-rhamnoside group played a dominant role in forming hydrogen bonds with the target proteins. Further analysis with STRING suggested that afzelin might be able to inhibit chemotaxis and haptotaxis of TNBC cells. Conclusions: Afzelin was predicted to inhibit TNBC cell motility, by targeting ERK2, KRas, and FAK activation.

Effects of a nursing care program focused on basic self-care in older acute medical in-patients: a randomized controlled trial Background: Acute illness and hospitalization are often associated with decreased independence in basic activities of daily living. The aim of this study was to test the hypothesis that a nursing care program focused on basic self-care (N_BSC) improves functional outcomes in older patients admitted to an acute medical unit. Methods: This was a 2-group randomized controlled trial with repeated measures: 182 older patients admitted to an acute medical unit were randomly allocated to the usual care group (n = 91) and intervention group (n = 91). The intervention consisted of nursing care centered on basic self-care that includes promotion of daily walking and all daytime meals seated, out of bed. The main outcome was changes in the number of independent basic activities of daily living (BADL) from 2 weeks before admission (baseline) to discharge. Results: There was significant effect of the N_BSC on the outcomes. Changes from baseline to discharge in the number of independent BADL differ significantly between the intervention and usual care group. Intervention group patients were discharged with a superior functional status than usual care group. On discharge they were able to perform independently 2.93 BADL, whereas usual care patients performed independently 1.90 BADL (P < .001). Conclusions: N_BSC for hospitalized older adults was feasible and program participants were discharged with better functional status than a clinically similar comparison group. N_BSC could be readily adapted for use in other hospitals and warrants further evaluation as a potential new tool for improving outcomes for hospitalized older patients.

Stigma toward people with mental disorders in adolescents: comparison between Portugal and Moldova Background: Mental disorders are one of the most significant public health challenges. Stigma toward people with mental disorders decreases help-seeking behaviors, and may be a cause of depression and anxiety. Research on the level of stigma and comparison between different countries in adolescence is scarce. We aim to study stigma toward people with mental disorders in adolescents, and to evaluate differences between Portugal and Moldova. Methods: In a cross-sectional analysis, we evaluated 657 high school students from Portugal and 612 from Moldova. Data were collected by a self-reported questionnaire that, beyond stigma, evaluated individual and family characteristics. Stigma was evaluated using the Attribution Questionnaire for Children (AQ-8-C) and the Depression Stigma Scale (DSS). Data were summarized using means and standard deviations, and comparison was performed using Student t test and analysis of variance. Results: The mean (standard deviation) level of mental disorder stigma measured by the AQ-8-C was 32.10 (8.77) in Moldova and 24.32 (9.20) in Portugal, P < .001. Adolescents from Moldova presented higher values for all items except for "Fear," with higher mean value in Portugal and for "Help" with no significant differences between countries. Regarding the Depression Stigma Scale, adolescents from Moldova presented higher values, both for personal stigma [19.84 (4.78) vs 15.09 (5.08), P < .001] and for perceived stigma [26.43 (4.30) vs 22.62 (5.15), P < .001]. Stigma levels did not differ according to having or not someone with a mental disorder in the class or family. Conclusion: The level of stigma toward people with mental disorders is higher in Moldova than in Portugal.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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