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INTRODUCTION: Type 1 diabetes is a chronic disease characterized by a selective loss of pancreatic ?-cells with a disproportionate recent increase at ages under 5-years old. Its etiology is multifactorial, to which immune factors contribute through pancreatic autoantibodies. Our main aim is to assess whether the type of pancreatic autoantibody influence the clinical symptoms, glycated hemoglobin and glycemia at diagnosis of type 1 diabetes in children diagnosed under ten-years of age. METHODS: Observational, retrospective and analytical study carried out with a total of 95 patients included. We compared two groups (aged ?60 months and >60 months) and each type of autoantibody (positive/negative) regarding demographic, immune, clinical and laboratory characteristics. The autoantibodies studied were islet cell autoantibodies (against cytoplasmic proteins in the ?-cell), antibodies to glutamic acid decarboxylase, anti-insulin and anti-zinc transporter 8. The impact of autoimmunity, glycated hemoglobin, gender and age on clinical and laboratory parameters of these children was analyzed. RESULTS: Children diagnosed over 60 months had a higher glycated hemoglobin value (p=0.005) and this laboratory parameter was the only one that showed an impact on the initial presentation as diabetic ketoacidosis (CI95%: OR=1.66;p=0.001). The value of glycemia at admission showed to be influenced negatively by age (?=--0.25;p=0.022) and positively by glycated hemoglobin (?=0.35;p=0.001). None of the autoantibodies evaluated seemed to interfere in the clinical and laboratory manifestations of type 1 diabetes. CONCLUSION: Demographic, clinical and laboratory characteristics showed no statistically significant differences between two groups of positive/negative pancreatic autoantibodies analyzed. It is crucial to develop further studies in the scope of autoimmunity that allow to structure potential immune phenotypes and assist in the discovery of new therapeutic targets.

ABSTRACT Objectives: Evaluate the celiac disease (CD) markers, within the scope of its screening, in a pediatric population with diagnosis of type 1 diabetes (T1D) at Hospital de Braga (HB) and determine the prevalence of CD in the sample. Reflect on CD screening algorithm applied in this pediatric population. Subjects and methods: Retrospective observational study with 94 patients diagnosed with T1D at age 10 years or younger, followed up at the HB Outpatient Diabetology Consultation, including those referred from other hospitals. Record of clinical information, IgA anti-transglutaminase and anti-endomysium and HLA DQ2/DQ8 haplotypes. Results: We obtained positive serological test for CD in 4 patients. This test had 100% sensitivity and specificity. The prevalence of CD was 4.3% (n = 4). Positive HLA screening in 84.6% of patients, with both sensitivity and negative predictive value of 100% and specificity of 16.67%. Diagnosis of CD was made on average 3.40 ± 3.32 years after the diagnosis of TD1. All cases of CD registered non-gastrointestinal manifestations, none had gastrointestinal symptoms. Conclusion: This study proved that there is a higher prevalence of CD in pediatric population with TD1, when compared to general population, and clarified the importance of CD screening. Furthermore, it was observed that serological screening for CD antibodies is an excellent screening test and HLA typing, although not the most suitable first line test, can be useful in excluding the possibility of patients with T1D developing CD.

Abstract Objective The aim of this study was to design a domestic water temperature, pH and turbidity monitoring system that could constantly log temperature, pH and turbidity of water and give alerts in case the parameters are outside the acceptable limits for potable water. Results The system was designed, assembled and performed as expected. The study indicates that the proposed and designed system outperforms the existing manual monitoring system as it can constantly track and store changes in water quality. This could be used to prepare better treatment processes as well as identify problems in the water distribution system early enough.

Mangrove forests serve as a buffer against sedimentation from the mainland into the sea, protect the area from coastal erosion, and prevent seawater intrusion in some ecological types of coastal environments. Additionally, because soil and below-ground biomass retain a significant quantity of carbon, they are essential for carbon sequestration. The current study seeks to estimate the soil organic carbon stock of mangroves associated with natural regeneration, mangrove rehabilitation areas and abandoned shrimp ponds, in Mahakam Delta, East Kalimantan, Indonesia. A 125-meter-long transect line was used to collect data, with three sampling points representing the length of the transect line. Each soil sample was taken at three different depths: 0-50 cm, 50-100 cm, and 100-150 cm. After that, the samples were taken to the laboratory for carbon analysis. The mangrove rehabilitation area had the highest bulk density at 8.64 gr/cm3, followed by natural mangroves along the river border at 7.67 gr/cm3, and abandoned ponds had the lowest at 7.16 gr/cm3. The rehabilitation area had the highest soil carbon stock at 1120 tons/ha, followed by natural mangroves along the riverside at 686 tons/ha and abandoned ponds at 383 tons/ha. In accordance with the study, mangrove rehabilitation regions had larger soil carbon stocks than natural regeneration along the riverside and abandoned ponds. In order to protect the ecologically significant mangrove ecosystem and minimize the effects of climate change, mangrove restoration and rehabilitation are necessary.

Introduction: Stickler syndrome is a connective tissue disorder that can include midfacial underdevelopment and cleft palate, ocular findings (myopia, cataract, and retinal detachment), hearing loss that is both conductive and sensorineural and mild spondyloepiphyseal dysplasia and/or precocious arthritis. The phenotypical expression of Stickler syndrome is variable and typically associated with allelic heterogeneity. Description of case: Full-term newborn, cesarean delivery at 40 weeks. Fetal ultrasounds with orofacial malformation and mild hydronephrosis. The prenatal genetic screening test was negative. Fetal karyotype and array were normal with a male genomic profile. Fetal cerebral MRI showed brachycephalic skull configuration. At 10 minutes of life, the newborn had hypoxemia and was admitted to the Neonatal Intensive Care Unit. He had macrocephaly, but height and weight were adequate for the gestational age. At observation, he had axial hypotonia, craniofacial dysmorphia and posterior cleft palate. Mandibular hypoplasia and findings were compatible with connective tissue disease in 3D-CT. He had marked retinal choroiditis and pathological myopia and did not pass the neonatal hearing screening. Echocardiogram and capnography were normal. The hypothesis of Stickler syndrome was confirmed genetically with the COL11A1 gene mutation, variant c.2952+1G>T. Nowadays, at 13 months old, he maintains a multidisciplinary approach, with normal growth and psychomotor development. Conclusion: This case aims to illustrate a patient with a typical phenotype of a rare syndrome with posterior genetic confirmation. Multidisciplinary monitoring is essential to allow the timely diagnosis of complications associated with this syndrome (mitral valve prolapse or retinal detachment) and to assess the evolution of growth and psychomotor development.

INTRODUÇÃO: O sono tem um papel crucial no desenvolvimento da criança e adolescente. Os distúrbios do sono constituem uma das perturbações comportamentais mais comuns em idade pediátrica. Afetam 20%-30% das crianças sendo os mais comuns a insónia comportamental da infância. O Questionário de Hábitos de Sono das Crianças (CSHQ) avalia o sono das crianças em idade escolar, validado em português para aplicação dos 2-10 anos. Este estudo pretendeu caracterizar os hábitos e perturbações do sono numa população pediátrica saudável numa USF e verificar a utilidade e importância do CSHQ-PT. MATERIAL E MÉTODOS: Estudo descritivo correlacional e transversal numa amostra pediátrica entre os 2-10 anos de idade. Aplicação do CSHQ-PT. Índice de Perturbação do Sono (IPS) com ponto de corte de 44. Amostra selecionada por conveniência. Questionários aplicados durante 3 meses no momento que antecedeu a consulta de Saúde Infantil e Juvenil. RESULTADOS: Obtiveram-se 157 questionários. IPS acima do ponto de corte em 67,3%, valores mais elevados nos mais jovens e quando a perceção parental é positiva. Subescalas com valores mais elevados nas parassónias para os rapazes; resistência em ir para a cama, ansiedade no sono e despertares noturnos nas crianças mais novas. Correlação positiva entre despertar noturno e os minutos dormidos à semana. DISCUSSÃO/CONCLUSÃO: Incidência elevada de perturbações do sono, semelhante ao publicado anteriormente. Mediana de horas de sono concordante com o recomendado pela National Sleep Foundation. Valores de IPS superiores na idade pré-escolar. Destaca-se a disparidade entre a identificação parental e a existência de uma perturbação do sono

INTRODUÇÃO: A púrpura de Henoch-Schönlein (PHS) caracteriza-se por púrpura palpável associada a dor abdominal, artralgia ou atingimento renal. A variante bolhosa é rara em pediatria, geralmente com bom prognóstico. CASO CLÍNICO: Menino de 3 anos e 8 meses com febre e lesões purpúricas que evoluíram para púrpura palpável e edema tibiotársico bilateral com limitação da marcha. Por persistência de febre, agravamento das lesões cutâneas com aparecimento de vesículas, bolhas purpúricas e ulcerações, edema articular com incapacidade para a marcha e para ortostatismo e dor abdominal, foi reavaliado no serviço de urgência. Analiticamente proteína C reativa 29 mg/L e albumina 3 g/dL, sem outras alterações. Decidido internamento sob amoxicilina/ácido clavulânico e metilprednisolona. Apresentou boa evolução clínica, mantendo lesões cicatriciais e manchas hiperpigmentadas. DISCUSSÃO: A púrpura de Henoch-Schönlein bolhosa é rara em idade pediátrica e um desafio diagnóstico. A corticoterapia pode ser benéfica em alguns casos, sendo necessários mais estudos que corroborem a sua utilização. Na generalidade dos casos tem bom prognóstico.

Penelitian ini bertujuan untuk mengetahui gambaran dinamika kepuasan pernikahan pada wanita keturunan Arab yang melakukan pernikahan dengan etnis lain. Pernikahan wanita keturunan Arab dengan etnis di luar Arab dianggap bertentangan dengan adat istiadat. Kepuasan pernikahan pada penelitian ini dilihat dari beberapa aspek kepuasan pernikahan, di antaranya komunikasi, kepribadian pasangan, kemampuan menyelesaikan masalah, hubungan seksual, aktivitas waktu luang, kehadiran anak dan menjadi orangtua, mengatur keuangan, kesesuaian peran, orientasi keagamaan, serta keluarga dan teman. Penelitian ini menggunakan metode kualitatif dengan 2 partisipan. Karakteristik partisipan adalah wanita keturunan Arab yang menikah dengan etnis lain, usia pernikahan antara dua sampai lima tahun, dan tingkat pendidikan minimal SMA atau sederajat. Pengumpulan data diperoleh melalui wawancara dan observasi. Hasil penelitian menunjukkan adanya rasa ketidaknyamanan dalam rumah tangga ketika keluarga besar tidak menyetujui pernikahan partisipan, namun hal tersebut kurang memberikan pengaruh besar kepada kepuasan pernikahan kedua partisipan. Faktor yang berpengaruh besar dalam kepuasan pernikahan kedua partisipan adalah faktor ekonomi atau keuangan.

Abstract — The present study intends to describe the dynamics of marital satisfaction of women of Arabian descent who married a spouse of another ethnicity. The marriage of women of Arabian descent with someone from a different ethnicity is considered as breaking the cultural norms. In the present study, marital satisfaction consists of many aspects, namely communication, the personality of the spouse, the ability to solve conflicts, sexual relationship, leisure activity, the presence of children and parenting, financial management, role suitability, religious orientation, as well as family and friends. The present study employed qualitative methods with 2 participants. Participants were women of Arabian descent who married someone from another ethnicity for two to five years and at least graduated from high school. Data were gathered through interview and observation. The results showed that participants feel uncomfortable due to their marriage being disapproved by their extended family, however it does not seem to influence their marital satisfaction significantly. The most significant factor influencing marital satisfaction of both participants was financial or economic factor. Abstrak — Penelitian ini bertujuan untuk mengetahui gambaran dinamika kepuasan pernikahan pada wanita keturunan Arab yang melakukan pernikahan dengan etnis lain. Pernikahan wanita keturunan Arab dengan etnis di luar Arab dianggap bertentangan dengan adat istiadat. Kepuasan pernikahan pada penelitian ini dilihat dari beberapa aspek kepuasan pernikahan, di antaranya komunikasi, kepribadian pasangan, kemampuan menyelesaikan masalah, hubungan seksual, aktivitas waktu luang, kehadiran anak dan menjadi orangtua, mengatur keuangan, kesesuaian peran, orientasi keagamaan, serta keluarga dan teman. Penelitian ini menggunakan metode kualitatif dengan 2 partisipan. Karakteristik partisipan adalah wanita keturunan Arab yang menikah dengan etnis lain, usia pernikahan antara dua sampai lima tahun, dan tingkat pendidikan minimal SMA atau sederajat. Pengumpulan data diperoleh melalui wawancara dan observasi. Hasil penelitian menunjukkan adanya rasa ketidaknyamanan dalam rumah tangga ketika keluarga besar tidak menyetujui pernikahan partisipan, namun hal tersebut kurang memberikan pengaruh besar kepada kepuasan pernikahan kedua partisipan. Faktor yang berpengaruh besar dalam kepuasan pernikahan kedua partisipan adalah faktor ekonomi atau keuangan.

Tinea capitis, uma infeção do couro cabeludo por dermatófitos, é a infeção fúngica mais comum em idade pediátrica. A apresentação clínica é variável, desde uma dermatose descamativa não inflamatória até à evolução para lesões tipo Kerion celsi que podem ser semelhantes a abcessos bacterianos. Relatamos o caso de um rapaz de 22 meses de idade, admitido no Serviço de Urgência com uma lesão em placa eritemato-descamativa do couro cabeludo e fronte, com flutuação e drenagem espontânea, com 2 semanas de evolução e agravamento após aplicação de corticoide tópico e com febre desde há 3 dias. Os estudos laboratoriais revelaram leucocitose, aumento da proteína C reativa e hemocultura negativa. Foi internado para tratamento com flucloxacilina endovenosa e submetido a drenagem cirúrgica.À observação por Dermatologia foi diagnosticado um Kerion celsi, tendo iniciado tratamento com itraconazol oral, betametasona e clotrimazol tópicos. O exame microbiológico do exsudado foi negativo. O exame micoló- gico do raspado da lesão revelou a presença de hifas e a cultura mostrou o crescimento de Trichophyton mentagrophytes. Devido à reação inflamatória cutânea exuberante e aparecimento de múltiplas pápulas eritematosas na face, iniciou betametasona oral ao quarto dia de internamento. Manifestou melhoria clínica com total resolução do abcesso após 15 dias de antibioticoterapia. Teve alta medicado com itraconazol e esquema de redução de corticoide oral, com seguimento em consulta de dermatologia apresentando resolução parcial. A tinea capitis tem geralmente um prognóstico favorável, com total resolução da infeção na maioria dos casos. Nos casos de Kerion celsi, a terapêutica conjugada com corticoide oral é necessária para reduzir a inflamação e prevenir a alopécia cicatricial. O reconhecimento atempado desta condição é muito importante e as lesões do couro cabeludo que se assemelhem a abcesso devem ser cuidadosamente investigadas para que a terapêutica antifúngica seja iniciada e não se submetam os pacientes a intervenções cirúrgicas desnecessárias.

Functional magnetic resonance imaging (fMRI) techniques can be used to assess cerebrovascular dysfunction in Alzheimer’s disease, an important and early contributor to pathology. We hypothesized that bradykinin receptor inhibition alleviates the vascular dysfunction in a transgenic arcAβ mouse model of cerebral amyloidosis and that fMRI techniques can be used to monitor the treatment response. Transgenic arcAβ mice, and non-transgenic littermates of 14 months-of-age were either treated with the bradykinin receptors 1 and 2 blocker noscapine or received normal drinking water as control over 3 months (n = 8–11/group) and all mice were assessed using fMRI at the end of the treatment period. Perfusion MRI using an arterial spin labeling technique showed regional hypoperfusion in arcAβ compared to non-transgenic controls, which was alleviated by noscapine treatment. Similarly, measuring cerebral blood volume changes upon pharmacological stimulation using vessel dilator acetazolamide revealed recovery of regional impairment of cerebral vascular reactivity in arcAβ mice upon noscapine treatment. In addition, we assessed with immunohistochemistry beta-amyloid (Aβ) and inflammation levels in brain sections. Immunohistological stainings for Aβ deposition (6E10) and related microgliosis (Iba1) in the cortex and hippocampus were found comparable between noscapine-treated and untreated arcAβ mice. In addition, levels of soluble and insoluble Aβ38, Aβ40, Aβ42 were found to be similar in brain tissue homogenates of noscapine-treated and untreated arcAβ mice using electro-chemiluminescent based immunoassay. In summary, bradykinin receptors blockade recovered cerebral vascular dysfunction in a mouse model of cerebral amyloidosis. fMRI methods revealed the functional deficit in disease condition and were useful tools to monitor the treatment response.