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- The 2018 periodontitis case definition improves accuracy performance of full-mouth partial diagnostic protocolsPublication . Botelho, João; Machado, Vanessa; Proença, Luís; Mendes, José JoãoWe aimed to compare the accuracy performance of the new 2018 periodontitis case definition by the European Federation of Periodontology (EFP)/ American Association of Periodontology (AAP) with Centers for Disease Control (CDC)/AAP 2012 in full-mouth partial recording protocols (PRP). Retrospective data from NHANES 2011-2012 and 2013-2014 were analyzed. For each case definition, full-mouth diagnostic was defined as the reference standard. Patients were diagnosed for the presence of periodontitis and staging for each PRP. Sensitivity, specificity, accuracy and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass ROC/AUC analyses. Our performance analysis shows that the new 2018 classification outperforms the 2012 classification regarding the diagnosis and staging of periodontitis on full-mouth PRPs. This recent case definition has strengthened the utility of PRPs and its improvements certainly explain the observed findings. Also, our findings contribute to the reliability of PRPs and its use in future worldwide epidemiological surveys.
- 3D bioprinting of novel κ-carrageenan bioinks : an algae-derived polysaccharidePublication . Marques, Diana M. C.; Silva, João C.; Serro, Ana Paula; Cabral, Joaquim M. S.; Sanjuan-Alberte, Paola; Ferreira, Frederico C.Novel green materials not sourced from animals and with low environmental impact are becoming increasingly appealing for biomedical and cellular agriculture applications. Marine biomaterials are a rich source of structurally diverse compounds with various biological activities. Kappa-carrageenan (κ-c) is a potential candidate for tissue engineering applications due to its gelation properties, mechanical strength, and similar structural composition of glycosaminoglycans (GAGs), possessing several advantages when compared to other algae-based materials typically used in bioprinting such as alginate. For those reasons, this material was selected as the main polysaccharide component of the bioinks developed herein. In this work, pristine κ-carrageenan bioinks were successfully formulated for the first time and used to fabricate 3D scaffolds by bioprinting. Ink formulation and printing parameters were optimized, allowing for the manufacturing of complex 3D structures. Mechanical compression tests and dry weight determination revealed young’s modulus between 24.26 and 99.90 kPa and water contents above 97%. Biocompatibility assays, using a mouse fibroblast cell line, showed high cell viability and attachment. The bioprinted cells were spread throughout the scaffolds with cells exhibiting a typical fibroblast-like morphology similar to controls. The 3D bio-/printed structures remained stable under cell culture conditions for up to 11 days, preserving high cell viability values. Overall, we established a strategy to manufacture 3D bio-/printed scaffolds through the formulation of novel bioinks with potential applications in tissue engineering and cellular agriculture.
- ABC traffic light: a health education toolPublication . Dias, Maria do Rosário; Correia, Paula Grade; Correia, Patrícia RodriguesIt is during the childhood period of one’s life trajectory that the exponential increase of vocabulary acquisition occurs. In Portugal, language disorders are the most frequently seen child development impairments, affecting 3 to 15 per cent of children under six years. Because delays in the acquisition of basic vocabulary can compromise inter-peer relational communication, a timely therapeutic assessment and intervention becomes all the more crucial. A speech therapy ludic-pedagogic intervention tool—the ABC Traffic Light—was created so as to aid in promoting basic vocabulary acquisition in children aged between three and six years. It consists in a traffic light with three built-in pouches, each of which containing cards suggestive of activities of varying difficulty levels. The empirical range of the proposed tool in the context of speech therapy assessment and intervention sessions should be highlighted.
- Abcesso epidural – uma complicação anestésicaPublication . Carvalho, Inês; Tomé, Sara; Neto, Miguel; Dinis, Isabel"Os abcessos epidurais são infeções muito graves do Sistema Nervoso Central. Constituem lesões focais confinadas ao crânio ou coluna vertebral que exercem compressão cerebra lou medular causando sintomas severos e complicações permanentes. Este caso clínico constitui a descrição de uma complicação pós-operatória após uma artroplastia total do joelho.Embora seja uma entidade rara, tem-se vindo a verificar um aumento de incidência nos últimos 30 anos que se deve, não só aos avanços tecnológicos no campo da imagiologia,mas também ao envelhecimento progressivo da população e ao acréscimo do número de anestesias regionais. A chave para o tratamento desta complicação é o seu reconhecimento precoce, pelo que a hipótese diagnóstica deverá ser colocada, especialmente em casos de doentes imunocomprometidos submetidos a técnicas anestésicas regionais, sob pena de comprometer a cura completa e levar ao desenvolvimento de sequelas graves."
- About the effect of eye blinking on drug release from pHEMA-based hydrogels: an in vitro studyPublication . Galante, Raquel; Paradiso, Patrizia; Moutinho, Maria Guilhermina; Fernandes, Ana Isabel; Mata, José; Matos, António; Colaço, Rogério; Saramago, Benilde; Serro, Ana Paula"The development of new ophthalmic drug delivery systems capable of increasing the residence time of drugs in the eye and improve its bioavailability relatively to eyedrops has been object of intense research in recent years. Several studies have shown that drug loaded therapeutic soft contact lenses (SCLs) constitute a promising approach, with several potential advantages as compared with collyria. The main objective of this work is to study the effect of repetitive load and friction cycles caused by the eye blinking, on the drug release from hydrogels used in SCLs which, as far as we know, was never investigated before. Two poly-2-hydroxyethylmethacrylate based hydrogels, pHEMA-T and pHEMA-UV, were used as model materials. Levofloxaxin was chosen as model drug. The hydrogels were fully characterized in what concerns structural and physicochemical properties. PHEMA-UV revealed some superficial porosity and a lower short range order than PHEMA-T. We observe that the load and friction cycles enhanced the drug release from pHEMAUV hydrogels. The application of a simple mathematical model, which takes into account the drug dilution caused by the tear flow, showed that the enhancement of the drug release caused by blinking on this hydrogel may be relevant in in vivo conditions. Conversely, the more sustained drug release from pHEMA-T is not affected by load and friction cycles. The conclusion is that, depending on the physicochemical and microstructural characteristics of the hydrogels, blinking is a factor that may affect the amount of drug delivered to the eye by SCLs and should thus be considered."
- About the sterilization of chitosan hydrogel nanoparticlesPublication . Galante, Raquel; Rediguieri, Carolina F.; Kikuchi, Irene Satiko; Vasquez, Pablo A. S.; Colaço, Rogério; Serro, Ana Paula; Pinto, Terezinha J. A.In the last years, nanostructured biomaterials have raised a great interest as platforms for delivery of drugs, genes, imaging agents and for tissue engineering applications. In particular, hydrogel nanoparticles (HNP) associate the distinctive features of hydrogels (high water uptake capacity, biocompatibility) with the advantages of being possible to tailor its physicochemical properties at nano-scale to increase solubility, immunocompatibility and cellular uptake. In order to be safe, HNP for biomedical applications, such as injectable or ophthalmic formulations, must be sterile. Literature is very scarce with respect to sterilization effects on nanostructured systems, and even more in what concerns HNP. This work aims to evaluate the effect and effectiveness of different sterilization methods on chitosan (CS) hydrogel nanoparticles. In addition to conventional methods (steam autoclave and gamma irradiation), a recent ozone-based method of sterilization was also tested. A model chitosan-tripolyphosphate (TPP) hydrogel nanoparticles (CS-HNP), with a broad spectrum of possible applications was produced and sterilized in the absence and in the presence of protective sugars (glucose and mannitol). Properties like size, zeta potential, absorbance, morphology, chemical structure and cytotoxicity were evaluated. It was found that the CS-HNP degrade by autoclaving and that sugars have no protective effect. Concerning gamma irradiation, the formation of agglomerates was observed, compromising the suspension stability. However, the nanoparticles resistance increases considerably in the presence of the sugars. Ozone sterilization did not lead to significant physical adverse effects, however, slight toxicity signs were observed, contrarily to gamma irradiation where no detectable changes on cells were found. Ozonation in the presence of sugars avoided cytotoxicity. Nevertheless, some chemical alterations were observed in the nanoparticles.
- Accidental father-to-son HIV-1 transmission during the seroconversion periodPublication . Ezeonwumelu, Ifeanyi; Bártolo, Inês; Martin, Francisco; Abecasis, Ana; Campos, Teresa; Romero-Severson, Ethan O.; Leitner, Thomas; Taveira, NunoA 4-year-old child born to an HIV-1 seronegative mother was diagnosed with HIV-1, the main risk factor being transmission from the child's father who was seroconverting at the time of the child's birth. In the context of a forensic investigation, we aimed to identify the source of infection of the child and date of the transmission event. Samples were collected from the father and child at two time points about 4 years after the child's birth. Partial segments of three HIV-1 genes (gag, pol, and env) were sequenced and maximum likelihood (ML) and Bayesian methods were used to determine direction and estimate date of transmission. Neutralizing antibodies were determined using a single cycle assay. Bayesian trees displayed a paraphyletic–monophyletic topology in all three genomic regions, with the father's host label at the root, which is consistent with father-to-son transmission. ML trees found similar topologies in gag and pol and a monophyletic–monophyletic topology in env. Analysis of the time of the most recent common ancestor of each HIV-1 gene population indicated that the child was infected shortly after the father. Consistent with the infection history, both father and son developed broad and potent HIV-specific neutralizing antibody responses. In conclusion, the direction of transmission implicated the father as the source of transmission. Transmission occurred during the seroconversion period when the father was unaware of the infection and was likely accidental. This case shows how genetic, phylogenetic, and serological data can contribute for the forensic investigation of HIV transmission.
- Accuracy of inertial measurement units when applied to the countermovement jump of track and field athletesPublication . Miranda-Oliveira, Paulo; Branco, Marco; Fernandes, OrlandoIn this study, we aimed to assess the countermovement jump (CMJ) using a developed instrument encompassing an off-the-shelf Inertial Measurement Unit (IMU) in order to analyze performance during the contraction phase, as well as to determine the jump height and the modified reactive strength index (RSImod), using force plate (FP) data as reference. Eight athletes (six males and two females) performed CMJs with the IMU placed on their fifth lumbar vertebra. Accuracy was measured through mean error (standard deviation), correlation, and comparison tests. The results indicated high accuracy, high correlation (r), and no statistical differences between the IMU and the FP for contraction time (r = 0.902; ρ < 0.001), negative impulse phase time (r = 0.773; ρ < 0.001), flight time (r = 0.737; ρ < 0.001), jump time (r = 0.708; ρ < 0.001), RSImod (r = 0.725; ρ < 0.001), nor minimum force (r = 0.758; ρ < 0.001). However, the values related to the positive impulse phase did not have the expected accuracy, as we used different devices and positions. Our results demonstrated that our developed instrument could be utilized to identify the contraction phase, jump height, RSImod, and minimum force in the negative impulse phase with high accuracy, obtaining a signal similar to that of an FP. This information can help coaches and athletes with training monitoring and control, as the device has simpler applicability making it more systematic.
- Accuracy of panoramic radiograph for diagnosing periodontitis comparing to clinical examinationPublication . Machado, Vanessa; Proença, Luís; Morgado, Mariana; Mendes, José João; Botelho, JoãoIn this study, we explore the diagnostic accuracy of a Radiographic-based Periodontal Bone Loss (R-PBL) method as a screening tool for periodontitis, in the form of radiographic bone loss, under the 2018 case definition in comparison to the 2012 case definition. The analysis was based on 456 patients (253 females and 203 males), screened for periodontal status in the Study of Periodontal Health in Almada-Seixal (SoPHiAS) project and subjected to a panoramic dental X-ray. Patients were diagnosed for the presence of periodontitis following the 2018 and 2012 case definition. R-PBL classification was defined by alveolar bone loss and diagnosed as no periodontitis (≥80% remaining alveolar bone), mild to moderate periodontitis (66% to 79%), or severe periodontitis (<66%). We appraise the X-ray quality to look for the influence on the performance of R-PBL. Sensitivity, specificity, accuracy, and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass Receiver operating characteristic/are under the curve (ROC/AUC) analyses. Our results show that the tested R-PBL method under the 2018 case definition is a reliable tool in periodontitis cases screening. This method does not replace clinical periodontal evaluation, but rather, it screens patients towards a definitive periodontitis diagnosis. These results will contribute to support the development of automated prediction systems towards periodontitis surveillance.
- Acute kidney injury associated with COVID-19 infection : a case reportPublication . Duarte, Tiago; Caeiro, Fernando; Góis, Mário; Matos, António; Viana, Lena; Vieira, César; Paulos, Jorge; Paixão, Paulo; Matos, Bruno; Germano, Nuno; Nolasco, FernandoSARS-Cov2 infection is a highly transmissible disease associated with serious pulmonary disease. Renal involvement is frequent and associated with poor prognosis; however, mechanisms of kidney injury are not well established. We present a SARS-Cov2 patient with severe acute kidney injury. Kidney biopsy findings revealed a pattern of acute tubular necrosis with isometric vacuolization of the proximal tubule. The interstitium and glomeruli were normal. Electronic microscopy showed multiple viral-like particles in both the glomeruli and proximal tubule. This case study shows how SARS-Cov 2 infection can result in different kinds of kidney lesion.