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OBJECTIVE Timing of mobilization after chronic subdural hematoma (cSDH) surgery is highly heterogeneous among neurosurgical centers. Past studies have suggested that early mobilization may reduce medical complications without increasing recurrence, but evidence remains scarce. The purpose of this study was to compare an early mobilization protocol with a 48-hour bed rest practice, with a focus on the occurrence of medical complications. METHODS The GET-UP Trial is a prospective, randomized, unicentric, open-label study with an intention-to-treat primary analysis designed to evaluate the impact of an early mobilization protocol after burr hole craniostomy for cSDH on the occurrence of medical complications and functional outcomes. A total of 208 patients were recruited and randomly assigned to either an early mobilization group where they began head-of-bed elevation within the first 12 hours after surgery and proceeded to sedestation, orthostatism, and/or walking as rapidly as tolerated, or to a bed rest group where they remained recumbent with a head-of-bed angle inferior to 30° for 48 hours after surgery. The primary outcome was the occurrence of a medical complication (defined as either an infection, seizure, or thrombotic event) after surgery and until clinical discharge. Secondary outcomes included length of stay measured from randomization to clinical discharge, surgical hematoma recurrence at clinical discharge and 1 month after surgery, and Glasgow Outcome Scale–Extended (GOSE) assessment at clinical discharge and 1 month after surgery. RESULTS A total of 104 patients were randomly assigned to each group. No significant baseline clinical differences were observed before randomization. The primary outcome occurred in 36 (34.6%) patients included in the bed rest group and 20 (19.2%) in the early mobilization group (p = 0.012). At 1 month after surgery, a favorable functional outcome (defined as GOSE score ≥ 5) was observed in 75 (72.1%) patients in the bed rest group and 85 (81.7%) in the early mobilization group (p = 0.100). Surgical recurrence occurred in 5 (4.8%) patients in the bed rest group and 8 (7.7%) in the early mobilization group (p = 0.390). CONCLUSIONS The GET-UP Trial is the first randomized clinical trial to assess the impact of mobilization strategies on medical complications after burr hole craniostomy for cSDH. Early mobilization was associated with a reduction in medical complications without a significant effect on surgical recurrence, compared with a 48-hour bed rest protocol.

Backgroud: Juvenile idiopathic arthritis (JIA) treatment is aimed at inducing remission to prevent joint destruction and disability. However, it is unclear what is the long-term impact on health-related outcomes of the timing of biological disease-modifying anti-rheumatic drug (bDMARD) initiation in JIA. Our aim was to evaluate the long-term impact of the time between JIA onset and the initiation of a bDMARD in achieving clinical remission, on physical disability and health-related quality of life (HRQoL). Methods: Adult JIA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) and ever treated with bDMARD were included. Data regarding socio-demographic, JIA-related characteristics, disease activity, physical disability (HAQ-DI), HRQoL (SF-36) and treatments were collected at the last visit. Patients were divided into 3 groups (£ 2 years, 2-5 years, or > 5 years), according to the time from disease onset to bDMARD initiation. Regression models were obtained considering remission on/off medication, HAQ-DI, SF-36 and joint surgeries as outcomes and time from disease onset to bDMARD start as an independent variable. Results: 361 adult JIA patients were evaluated, with a median disease duration of 20.3 [IQR 12.1; 30.2] years. 40.4% had active disease, 35.1% were in remission on medication and 24.4% in drug-free remission; 71% reported some degree of physical disability. Starting a bDMARD > 5 years after disease onset decreased the chance of achieving remission off medication (OR 0.24; 95% CI 0.06, 0.92; p= 0.038). Patients who started a bDMARD after 5 years of disease onset had a higher HAQ and worse scores in the physical component, vitality and social function domains of SF-36, and more joint surgeries when compared to an earlier start. Conclusion: Later initiation of bDMARDs in JIA is associated with greater physical disability, worse HRQoL and lower chance of drug-free remission in adulthood.

Background and purpose Creutzfeldt-Jakob disease (CJD) is a rare form of rapidly progressive neurodegenerative disorder. Seizures are uncommon in the early stage of CJD, increasing diagnostic difficulty. Methods An autopsy-proven case of CJD presenting initially as an epilepsia partialis continua is reported, in which the initial workup was unremarkable. Retrospectively, the presence of nystagmus, which proved to be non-epileptic, pointed to a cerebellar lesion before a diagnosis of clinically probable CJD was made. Results A 70-year-old man presented with a 3-week history of intermittent rhythmic jerking tremors in his left limbs, interfering with his gait. Examination showed left body clonic movements. Electroencephalography revealed an ictal right centroparietal pattern of focal status epilepticus. Video-oculography revealed right-beating nystagmus (mean slow phase velocity [SPV] 3.4o/s) in the dark and left-beating nystagmus (SPV 2.6o/s) in the light, left-beating nystagmus after head shaking (SPV 4o/s) and during mastoid vibration (SPV 11o/s) and mildly hypoactive horizontal head impulses. Search for occult malignancy, serologies, cerebrospinal fluid analyses, anti-onconeural antigen, auto-immune panel and brain magnetic resonance imaging were unrevealing. Rapid neurological decline was observed. Three weeks later, cerebrospinal fluid was positive for 14.3.3 protein, electroencephalography showed generalized periodic sharp wave complexes and brain magnetic resonance imaging revealed diffusion restriction and T2/fluid-attenuated inversion recovery hyperintensities in the cerebellum, basal ganglia, thalamus and cortex. He died 1 month later. Neuropathological study confirmed the diagnosis of CJD. Conclusion This case highlights that CJD should be considered in the differential diagnosis of new onset epilepsia partialis continua and that neuro-ophthalmological examination can be helpful in pointing to early asymmetric cerebellar involvement.

BACKGROUND: Spastic paraplegia type 7 (SPG7) mutations can present either as a pure form or a complex phenotype with movement disorders. OBJECTIVE: Describe the main features of subjects with SPG7 mutations associated with movement disorders. METHODS: We analyzed the clinical and paraclinical information of subjects with SPG7 mutations associated with movement disorders. RESULTS: Sixteen affected subjects from 11 families were identified. Male sex predominated (10 of 16) and the mean age at onset was 41.25 ± 16.1 years. A cerebellar syndrome was the most frequent clinical movement disorder phenotype (7 of 16); however, parkinsonism (2 of 16), dystonia (1 of 16), and mixed phenotypes between them were also seen. The “ears of the lynx” sign was found in four subjects. A total of nine SPG7 variants were found, of which the most frequent was the c.1529C > T (p.Ala510Val). CONCLUSION: This case series expands the motor phenotype associated with SPG7 mutations. Clinicians must consider this entity in single or familial cases with combined movement disorders.

While dynamic ocular motor abnormalities (e.g., gaze-evoked nystagmus (GEN), low optokinetic nystagmus (OKN), pursuit and vestibulo-ocular reflex (VOR) gains, and dysmetric saccades) have been shown to be potential biomarkers in spinocerebellar ataxia type 3 (SCA3), the value of static abnormalities (e.g., convergent [esodeviation] and divergent strabismus [exodeviation]) is unknown. Moreover, studies on dynamic abnormalities in SCA3 usually do not take into account the existence of potential abduction-adduction asymmetries in patients with degenerative ataxia. Thirty-eight patients with genetically confirmed SCA3 (24 females; mean age ± SD, 49.8± 12.2 years) and 22 healthy controls (12 females, p = 0.589; mean age ± SD, 50.7± 12.5 years, p = 0.651) underwent clinical and video-oculographic assessment. A p value

The design of graphical user interfaces has been evolving from skeuomorph interfaces – which use elements that mimic the aesthetics and functionality of their real-world counterparts – to minimalis...

Introduction. Diabetic neuropathy (DN) is one of the most devastating complications of diabetes mellitus; however, in contrast to other countries, there are no scientific studies in Portugal evaluating the impact of demographic and clinical characteristics of this pathological entity. The aim of this study was to evaluate the impact of gender, metabolic control, age of diabetic patients, as well as time of disease progression, the appearance of complaints related to neuropathic pain. Material and methods. A multicentre study with a non-probabilistic, convenience sample of 359 patients was performed employing the quantitative method, using the Statistical Package for Social Science 24 software. The p-value of p < 0.05 was defined to consider a result statistically significant. The Spearman correlation coefficient (r) was determined to determine the relationship between categorical variables. Results. There was no statistically significant difference in the prevalence of DN between genders (p = 0.633 and r = 0.025). There was a statistically significant relationship between the value of HbA1c and DN, with p = 0.010 and r = 0.136. There is a relationship between age and complaints of neuropathic pain, with p = 0.034 and r = 0.112. The variable, time of disease progression, is also correlated with the appearance of complaints of neuropathic pain with p = 0.020 and r = 0.112. Conclusion. The prevalence of neuropathic pain in subjects with diabetes is not negligible and is associated with modifiable risk factors that can be identified, possibly modified and prevented. The correct approach for these patients, which involves screening and early treatment, is decisive improving functionality and quality of life.

Protein crystallisation has been shown as a viable alternative to conventional protein purification methods. However, the stochastic and spontaneous nature of the primary nucleation process makes protein crystallization difficult to control. An approach often used in the crystallization of small organic and inorganic molecules to improve the reproducibility of the process and better control the crystallization outcome is seeding. This study presents for the first time the investigation of seeding on batch protein crystallization in a meso oscillatory flow reactor (meso-OFR). Seeded and unseeded lysozyme batch crystallization experiments were carried out, where the influence of the initial lysozyme concentration (initial supersaturation) and the seed quantity on the onset of nucleation, crystal properties and yield was assessed. No major influence of the seed quantity on the product crystal size was verified for the initial lysozyme concentration of 20mgmL-1 (below the secondary nucleation threshold - SNT), while for the initial lysozyme concentration of 25mgmL-1 (above the SNT) the onset of nucleation and mean crystal size significantly decrease with increasing seed quantity. Further, crystal yield increases with both the initial lysozyme concentration and seed quantity. Overall, the results highlight seeding as a promising technique to improve control over the crystallization time and product crystal size., This work was financially supported by: Base Funding - UIDB/00511/2020 of the Laboratory for Process Engineering, Environment, Biotechnology and Energy – LEPABE - funded by national funds through the FCT/MCTES (PIDDAC)., info:eu-repo/semantics/publishedVersion

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina A Dermatite Atópica é uma doença inflamatória crónica na qual existe um defeito da barreira da pele existindo uma passagem facilitada de alergénios, irritantes ambientais e agentes infeciosos. A sua incidência é maior em crianças até os cinco anos de idade e o seu diagnóstico prende-se com os critérios de Hanifin e Rajka. As lesões típicas dividem-se em formas agudas com eritema, exsudação e crostas e em formas crónicas, que são lesões liquenificadas. A xerose e o prurido são manifestações importantes nas quais a terapêutica atua. O tratamento desta doença é sobretudo sintomático com emolientes, corticoides e eventualmente anticorpos monoclonais, cada vez mais utilizados na prática. Existe uma panóplia de questionários para avaliação da qualidade de vida. O DLQI (Dermatology Life Quality Index) e o CDLQI (Children Dermatology Life Quality Index) são muito usados para esse fim. O QoLIAD (Quality of Life Index for Atopic Dermatitis) é específico desta patologia e é constituído por 25 questões. Os questionários mais usados para avaliação da severidade da Dermatite Atópica são o EASI (Índice de Severidade e Área de Eczema) e o SCORAD (SCORing de Dermatite Atópica). Assim, estas ferramentas permitem uniformizar a análise. Neste trabalho, serão abordados os aspetos que têm maior impacto na qualidade de vida do doente, como o prurido, o impacto no sono, na vida social, na saúde física e mental, entre outros.Sendo uma doença cada vez mais prevalente, achei pertinente abordar este tema, não só de modo a apelar ao cuidado especial com estes doentes, mas também dar a conhecer à comunidade médica o extenso prejuízo na qualidade de vida. Atopic Dermatitis is a chronic inflammatory disease in which there is a defect in the skin barrier and there is a facilitated passage of allergens, environmental irritants and infectious agents. Its incidence is higher in children up to five years old and its diagnosis is based on the criteria of Hanifin and Rajka. Typical lesions are divided into acute forms with erythema, oozing and crusting and chronic forms, which are lichenified lesions. Xerosis and pruritus are important manifestations in which the therapy works. The treatment of this disease is mainly symptomatic with emollients, corticoids, and eventually monoclonal antibodies, which are increasingly being used in practice.There is a range of questionnaires to assess quality of life. The DLQI (Dermatology Life Quality Index) and the CDLQI (Children Dermatology Life Quality Index) are widely used for this purpose. The QoLIAD (Quality of Life Index for Atopic Dermatitis) is more specific to this pathology and consists of 25 questions. The most used questionnaires to assess the severity of Atopic Dermatitis are the EASI (Eczema Severity and Area Index) and the SCORAD (SCORing of Atopic Dermatitis). Thus, these tools enable to standardize the analysis.This work will address the aspects that have the greatest impact on the patient's quality of life, such as pruritus, the impact on sleep, social life, physical and mental health, among others.As an increasingly prevalent disease, I thought it would be pertinent to address this issue not only in order to call for special care with these patients but also to make the medical community aware of the extensive impairment in quality of life.

ObjectiveTo compare physical disability, mental health, fatigue and health-related quality of life (HRQoL) across juvenile idiopathic arthritis (JIA) categories in adulthood and between JIA and adult-onset rheumatic diseases.MethodsCross-sectional analysis nested in a cohort of adult patients with JIA registered in the Rheumatic Diseases Portuguese Register (Reuma.pt). Physical disability (Health Assessment Questionnaire—Disability Index), mental health symptoms (Hospital Anxiety and Depression Scale), fatigue (Functional Assessment of Chronic Illness Therapy—Fatigue Scale (FACIT-F)) and HRQoL (EuroQol-5D (EQ5D) and Short Form (SF-36)) were compared across JIA categories. Patients with polyarticular JIA and enthesis-related arthritis (ERA) JIA were compared respectively to patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), matched for gender and age, adjusted for disease duration and activity.Results585 adult patients with JIA were included. Comparison across JIA categories showed that persistent oligoarthritis and patients with ERA reported a higher score in EQ5D and SF-36 physical component when compared with other JIA categories.Polyarticular JIA reported less disability and fatigue than patients with RA (median Health Assessment Questionnaire of 0.25 vs 0.63; pConclusionPersistent oligoarticular JIA and ERA are the JIA categories in adulthood with better HRQoL. Overall, adult polyarticular and patients with ERA JIA have lower functional impairment and better quality-of-life than patients with RA and SpA.

This work was funded by FEDER funds through the COMPETE 2020 Programme and National Funds through the FCT---Fun-dação para a Ciência e a Tecnologia, I. P., under the scope of the project. This work also received funding from the European Community’s H2020 program under grant agreement No. 716510 (ERC-2016-STG TREND), 640598 (ERC-StG-2014, NEWFUN), and 685758 (1D-Neon). This work was supported by the Applied Molecular Biosciences Unit – UCIBIO and Associate Laboratory for Green Chemistry – LAQV which are financed by Portugal national funds from /2016 and SFRH/BD/132057/2017 from the FCT/MCTES and MIT Portugal PhD Program (to I. C. and M. J. O., respectively). Professor César Laia (LAQV-REQUIMTE, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Portugal) is acknowledged for permitting the use of DLS equipment. Professor Ludwig Krippahl (NOVA LINCS, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Portugal) is acknowledged for developing the gel analysis application eReuss. M. J. O. acknowledges Rocío Palomares Jurado PhD for visualisation/data presentation support and continued interest in the project. M. J. O. acknowledges David Peitinho MSc for help and advice in Python script. Diego Wiechers de Carvalho BSc is acknowledged for purifying the recombinant Plasmodium falciparum histidine-rich protein 2 sample and Daniela Gomes PhD for providing SEM images. Publisher Copyright: © The Royal Society of Chemistry 2021. The development of robust and sensitive point-of-care testing platforms is necessary to improve patient care and outcomes. Surface-enhanced Raman scattering (SERS)-based immunosensors are especially suited for this purpose. Here, we present a highly sensitive and selective SERS immunoassay, demonstrating for example the detection of horseradish peroxidase (HRP), in a sandwich format. The strength of our biosensor lies in merging: (i) SERS-immunotags based on gold nanostars, allowing exceptional intense SERS from attached Raman probes, covalent attachment of anti-HRP antibodies by a simple chemical method providing exceptional antigen binding activity; (ii) the ease of preparation of the capture platform from a regenerated cellulose-based hydrogel, a transparent material, ideal for microfluidics applications, with low background fluorescence and Raman signal, particularly suited for preserving high activity of the covalently bound anti-HRP antibodies. The sandwich complexes formed were characterised by atomic force microscopy, and by scanning electron microscopy coupled with electron diffraction spectroscopy; and (iii) the robustness of the simple Classical Least Squares method for SERS data analysis, resulting in superior discrimination of SERS signals from the background and much better data fitting, compared to the commonly used peak integral method. Our SERS immunoassay greatly improves the detection limits of traditional enzyme-linked immunosorbent assay approaches, and its performance is better or comparable to those of existing SERS-based immunosensors. Our approach successfully overcomes the main challenges of application at point-of-care, including increasing reproducibility, sensitivity, and specificity, associated with an environmentally friendly and robust design. Also, the proposed design withstands several cycles of regeneration, a feature absent in paper-SERS immunoassays and this opens the way for sensitive multiplexing applications on a microfluidic platform. preprint published

Background Twin-to-twin Transfusion Syndrome (TTTS) is a serious complication of monochorionic twin pregnancies. Affects about 10% to 15% of pregnancies and it is associated with high fetal and neonatal mortality, as well as cardiac and neurological morbidity in surviving fetuses. The main objective was to characterize a series of fetuses with TTTS since the pathophysiology of the syndrome is not fully understood and the clinical spectrum is broad. Methods Post-mortem macroscopic and microscopic examination of 26 fetuses (from 2010 to 2020) with TTTS syndrome. Results The most frequent macroscopic findings in placenta were discrepancy in size and pallor/placental congestion. Other macroscopic findings not described in the literature were calcifications, areas of infarction and hematomas. Infarction areas and villi heterogeneity growth were the most common microscopic findings, described in the literature. Regarding the fetus, the restriction of intrauterine growth, the alteration of anthropometric parameters and the presence of a plethoric/anemic fetus were the main characteristics associated with this syndrome. The most common microscopic findings were signs of anoxia and congestive organs, already described in the literature. We also found frequently pulmonary abnormalities as new findings in our study. Conclusions The results allowed the identification of TTTS aspects that can contribute to the characterization of this syndrome. Given that the progression of TTTS remains unpredictable and the mortality rate for both fetuses is 90%, it becomes increasingly important to identify strategies for diagnosing and characterizing the syndrome.

Background Foetal Hydrops (FH) is an abnormal accumulation of fluid inside two or more serous cavities and may be linked with polyhydramnios and/or placental oedema. It has been correlated with several causes such foetal anaemia, chromosomal anomalies, congenital abnormalities, infections, twin-to-twin transfusion syndrome and maternal causes such as diabetes. Regardless the advances in diagnosis and therapy, the overall perinatal mortality rate remains high. Thereby, the main goal is to evaluate the autopsy findings including between 2010 and 2019. Methods 105 cases including perinatal and new-born autopsies with different gestation stages were studied, in order to understand the macroscopic and microscopic events that can elucidate FH. Results Macroscopically, a large number of foetuses demonstrated oedema effusions and intrauterine growth restriction. Regarding placenta, the most common macroscopic finding is oedema, such as described in the literature. Nodules and hemorrhagic areas are the new findings observed. Oedema remains the most relevant microscopic finding, whereas unspecified villi alterations and trophoblast pseudoinclusions were the new findings. Conclusions The results allowed the identification of new characteristics that can contribute to the knowledge of this foetal condition that remains a challenge. Future studies need to focus on identifying strategies for diagnosis and treatment is critical for foetal hydrops.

The fabrication of low-cost, flexible, and recyclable electronic devices has been the focus of many research groups, particularly for integration in wearable technology and the Internet of Things (IoT). In this work, porous zinc oxide (ZnO) nanostructures are incorporated as a UV sensing material into the composition of a sustainable water-based screen-printable ink composed of car-boxymethyl cellulose (CMC). The formulated ink is used to fabricate flexible and foldable UV sensors on ubiquitous office paper. The screen-printed CMC/ZnO UV sensors operate under low voltage (≤2 V) and reveal a stable response over several on/off cycles of UV light exposure. The devices reach a response current of 1.34 ± 0.15 mA and a rise and fall time of 8.2 ± 1.0 and 22.0 ± 2.3 s, respectively. The responsivity of the sensor is 432 ± 48 mA W−1, which is the highest value reported in the literature for ZnO-based UV sensors on paper substrates. The UV-responsive devices display impressive mechanical endurance under folding, showing a decrease in responsivity of only 21% after being folded 1000 times. Their low-voltage operation and extreme folding stability indicate a bright future for low-cost and sustainable flexible electronics, showing potential for low-power wearable applications and smart packaging. publishersversion published

Renewable cellulose substrates with submicron- and nanoscale structures have revived interest in paper electronics. However, the processes behind their production are still complex and time- and energy-consuming. Besides, the weak electrolytic properties of cellulose with submicron- and nanoscale structures have hindered its application in transistors and integrated circuits with low-voltage operation. Here, we report a simple, low-cost approach to produce flexible ionic conductive cellulose mats using solution blow spinning, which are used both as dielectric interstrate and substrate in low-voltage devices. The electrochemical properties of the cellulose mats are tuned through infiltration with alkali hydroxides (LiOH, NaOH, or KOH), enabling their application as dielectric and substrate in flexible, low-voltage, oxide-based field-effect transistors and pencil-drawn resistor-loaded inverters. The transistors exhibit good transistor performances under operation voltage below 2.5 V, and their electrical performance is strictly related to the type of alkali ionic specie incorporated. Devices fabricated on K+-infiltrated cellulose mats present the best characteristics, indicating pure capacitive charging of the semiconductor. The pencil-drawn load resistor inverter presents good dynamic performance. These findings may pave the way for a new generation of low-power, wearable electronics, enabling concepts such as the "Internet of Things".

Dissertação de Mestrado Integrado em Medicina Veterinária ABSTRACT - Currently the dissemination of antimicrobial resistance has become a major public health concern worldwide. The pressure they exert on the bacterial microbiota enables a preferential selection of resistant bacteria. Urinary tract infection (UTI) is a frequent clinical problem in companion animals and among the most common reasons for antimicrobial therapy. The present study aimed to evaluate the influence of antimicrobial therapy in companion animals on colonization by extended spectrum β-lactamase ESBL, cephalosporinases (AmpC) and carbapenemases – producing Enterobacterales and to verify if antimicrobial resistance is transmitted to the pet owners with whom they share a home. The study sample included 14 animals (11 dogs and 3 cats) with UTI and 25 humans belonging to 14 families. Dog and cat owners were asked to deliver fecal samples from themselves and their animals at specific times since diagnosis of infection up to two months after its resolution. Cultures of fecal samples in MacConkey medium with cefotaxime and meropenem were performed to select resistant bacteria, followed by PCR to detect β lactamase producing genes. No carbapenemase-producing Enterobacterales were found, however, in 24.2% of the fecal samples ESBL and AmpC-producing Escherichia coli or Klebsiella pneumoniae were identified. TEM-1 β-Lactamase was the most identified in animals (23.5%) and humans (28.6%). ESBL-producing genes of the CTX-M type were the most detected, in particular blaCTX-M-15. Approximately 9% of the resistance genes detected were cephalosporinases (blaCMY-2). The administration of antibiotics to pets has been reflected in an increase in antimicrobial resistance not only in themselves but also in humans. In two families, both human and animal were colonized at the same time with an ESBL/AmpC-producing bacteria. In one of this families, transmission of a bacteria, or a plasmid carrying the blaCTX-M-15 gene, may have occurred from a cat to a human, and from this to another human from the same household. Further studies are needed to ascertain the presence of interspecies transmission of AMR in this study. RESUMO - Infecção do tracto urinário em animais de companhia: o tratamento influencia a transmissão e colonização por Enterobacterales produtoras de ESBL, AmpC e Carbapenemase para humanos? - Atualmente um dos principais problemas de saúde pública é a disseminação da resistência bacteriana aos antibióticos. A pressão por estes exercida na microbiota bacteriana possibilita uma seleção preferencial das bactérias resistentes. A infeção do trato urinário (ITU) é uma afeção frequentemente observada em clínica de pequenos animais, sendo uma das razões mais comuns para instituição de terapêutica antimicrobiana. Devido ao contacto próximo entes eles, os animais de companhia podem ter um papel muito importante na transmissão de bactérias resistentes ao Homem. O presente estudo teve como objetivo avaliar a influência da terapêutica antimicrobiana em animais de companhia, na colonização por Enterobacterales produtoras de β-Lactamase de espectro alargado (ESBL), cefalosporinases (AmpC) e carbapenemases e verificar se ocorre transmissão de resistência antimicrobiana aos tutores com quem os animais de companhia partilham casa. A amostra em estudo incluiu 14 animais (11 cães e 3 gatos) com ITU e 25 humanos pertencentes a 14 famílias. Foi pedido aos tutores dos cães e gatos que entregassem amostras fecais, suas e dos seus animais, em tempos específicos desde o diagnóstico de infeção até dois meses após a sua resolução. Foram realizadas culturas das amostras fecais em meio MacConkey com cefotaxima e com meropenem para seleção de bactérias resistentes, seguidas de PCR para deteção de genes produtores de β-lactamases. Não foram encontradas Enterobacterales produtoras de carbapenemases, no entanto, em 24,2% das amostras fecais identificaram-se Eschericia coli ou Klebsiella pneumoniae produtoras de ESBL e AmpC. A β-Lactamase TEM-1 foi a mais identificada em animais (23,5%) e humanos (28,6%). Os genes produtores de ESBLs do tipo CTX-M foram os mais detetados, em particular o blaCTX-M-15. Aproximadamente 9% dos genes de resistência detetados eram de cefalosporinases (blaCMY-2). A administração de antibióticos a animais de companhia refletiu-se num aumento de resistência antimicrobiana não só neles mesmos, como nos humanos. Em duas famílias, tanto o humano como o animal estavam na mesma altura colonizados com uma bactéria produtora de ESBL/AmpC. Num dos casos, poderá ter ocorrido transmissão de uma bactéria, ou de um plasmídeo portador do gene blaCTX-M-15, de um gato para um humano, e deste para um outro humano do mesmo agregado familiar. São no entanto necessários mais estudos para aferir sobre a transmissão de resistência antimicrobiana inter-espécies neste estudo. N/A

Novel nature-based engineered functional materials combined with sustainable and economically efficient processes are among the great challenges for the future of mankind. In this context, this work presents a new generation of versatile flexible and highly conformable regenerated cellulose hydrogel electrolytes with high ionic conductivity and self-healing ability, capable of being (re)used in electrical and electrochemical devices. They can be provided in the form of stickers and easily applied as gate dielectric onto flexible indium–gallium–zinc oxide transistors, decreasing the manufacturing complexity. Flexible and low-voltage (

Introduction: Colonic lipomas are common mesenchymal tumours. They are usually asymptomatic and incidentally diagnosed during endoscopic or radiological examinations. Taking into account their typical endoscopic and radiological features and benign nature, tissue sampling, resection or follow-up are generally not required. Case Report: A 61-year-old woman with poor surgical fitness presented with colonic subocclusion and lower gastrointestinal bleeding. A colonoscopy performed 1 month earlier showed a large polypoid lesion with necrotic and ulcerated areas occupying the lumen of the proximal ascending colon with inconclusive histology. An abdominopelvic computed tomography scan with intravenous contrast was done revealing a cecal-colonic intussusception of a heterogeneous mass. The patient was successfully managed conservatively. A delayed revision colonoscopy showed a significantly smaller atypical subepithelial lesion with no necrosis or ulceration. A single, large and deep incision with a pre-cut needle-knife® allowed the direct collection of lesion tissue using standard biopsy forceps through the so-called single-incision needle-knife® (SINK) biopsy technique. Histological examination was compatible with submucosal lipoma. After 18 months of follow-up, the patient remains asymptomatic. Discussion/Conclusion: Colonic lipoma complications are rare and can lead to misdiagnosis; in general, they are surgically managed. A conservative approach and a minimally invasive endoscopic procedure allowed a definite diagnosis avoiding the morbidity and mortality of a major surgical intervention in a high-risk patient.