Screening for Autism Spectrum Disorders - Validation of the Portuguese Version of the Social Communication Questionnaire.

There are no assessment and screening tools for Autism Spectrum Disorders (ASD) validated for the Portuguese population. The Social Communication Questionnaire (SCQ) is an useful screening tool of ASD diagnosis. The main objectives of our study were to produce a Portuguese version of the SCQ (SCQ-PF), study its internal consistency, sensitivity and specificity in order to evaluate its validity as a screening instrument for ASD. We also wanted to study the impact of intellectual disability and verbal impairment and other mental disorders on SCQ-PF psychometric properties. The study included 211 children and adolescents, aged 4-17, divided in three groups: ASD Group (n = 96), Other Mental Disorders Group (OMD) (n = 63) and No Mental Disorders (NMD) Group (n = 52). Parents or other primary caregiver provided information on the SCQ items. The SCQ-PF score was significantly higher in the ASD group than in the other groups (p < 0.001). As to internal consistency, Cronbach's alpha was 87%. ASD subjects were distinguished from subjects without ASD (OMD and NMD Groups) and the area under the curve (AUC) was 0.897 (95% Confidence Interval: 0.852-0.943), for a cutoff of 14, which yielded the highest AUC, with values of sensitivity and specificity 0.76 and 0.93, respectively. These findings show that SCQ- PF with a cutoff of 14 is an acceptable and useful screening tool for ASD in the Portuguese population.

[Readmission to an Adolescent Psychiatry Inpatient Unit: Readmission Rates and Risk Factors]. / Reinternamentos Hospitalares num Serviço de Pedopsiquiatria: Taxa de Readmissão e Fatores de Risco.

INTRODUCTION: Most mental disorders have a chronic evolution and therefore a certain amount of psychiatric readmissions are inevitable. Several studies indicate that over 25% of child and adolescent inpatients were readmitted within one year of discharge. Several risk factors for psychiatric readmissions have been reported in the literature, but the history of repeated readmissions is the most consistent risk factor. Our aim is to calculate the readmission rates at 30 days and 12 months after discharge and to identify associated risk factors. MATERIAL AND METHODS: The authors consulted the clinical files of patients admitted to the Inpatient Unit between 2010 and 2013, in order to calculate the readmission rates at 30 days and at 12 months. The demographic and clinical characteristics of the readmitted patients were analyzed and compared with a second group of patients with no hospital readmissions, in order to investigate possible predictors of readmission. RESULTS: A total of 445 patients were admitted to our inpatient unit between 2010 and 2013. Six adolescents were readmitted in a 30 days period (1.3%) and 52 were readmitted in a 12 month period after discharge (11.5%). Duration of the hospitalization and the previous number of mental health admissions were significant predictors of future hospital readmissions (p = 0.04 and p = 0.014). DISCUSSION: The low readmission rates may reflect the positive clinical and sociofamilial support being provided after discharge. CONCLUSION: Rehospitalisation is considered a fundamental target for intervention concerning prevention and intervention in mental healthcare. Thus, knowledge regarding their minimisation is crucial.

Introdução: A maioria das perturbações mentais tem uma evolução crónica pelo que certos reinternamentos são inevitáveis. Vários estudos indicam taxas de reinternamento pedopsiquiátrico superiores a 25%. O nosso objetivo é calcular as taxas de readmissão no internamento pedopsiquiátrico do Centro Hospitalar do Porto a 30 dias e um ano após a alta, e identificar os fatores de risco associados. Material e Métodos: A metodologia consistiu na consulta dos processos clínicos dos doentes internados na Unidade de Internamento do Centro Hospitalar do Porto entre 2010 e 2013, a fim de calcular as taxas de readmissão. Foram também recolhidas as características demográficas e clínicas dos doentes readmitidos. Finalmente, os resultados do grupo de doentes reinternados foram comparados com um segundo grupo de doentes selecionados aleatoriamente e sem readmissões hospitalares, a fim de investigar possíveis fatores de risco para reinternamentos. Resultados: Um total de 445 doentes foi admitido entre 2010 e 2013. Seis adolescentes foram readmitidos no período de 30 dias (1,3%) e 52 foram readmitidos nos 12 meses após a alta (11,5%). A análise comparativa revelou que a duração do internamento e o número de internamentos anteriores são preditores significativos (p = 0,04 e p = 0,014) para reinternamento.D iscussão: As baixas taxas de readmissão podem refletir não só a eficácia da intervenção terapêutica durante o internamento como também um bom suporte clínico e sociofamiliar após a alta. Conclusão: Os reinternamentos são considerados um alvo fundamental quanto à prevenção e intervenção nos cuidados de saúde mental. Assim, o conhecimento sobre a sua minimização é crucial.

Estudo comparativo da infiltração marginal em Copings de Níquel-Cromo fixados com diferentes cimentos resinosos / Marginal microleakage in nickel-chromium copings fixed with different resin cements - A comparative study

Objetivo: Avaliar, com o corante azul-de-metileno, a microinfiltração marginal na interface de dentes preparados para coroas totais metalocerâmica e copings, fixados com diferentes cimentos resinosos. Método: Quarenta dentes foram preparados e moldados paraconfeccionar copings em níquel-cromo. A amostra foi dividida em 4 grupos, conforme o agente de cimentação: Grupo I: copings cimentados com Scothbond e RelyX ARC; Grupo II: copings fixados com Single Bond e RelyX ARC; Grupo III: colados com RelyX U100; Grupo IV: fixados com Pavavia F. Os dentes foram armazenados por 6 meses em água destilada a 37OC, submetidos à ciclagem térmica e recolocados na água por mais 6 meses. Exceto nas margens, foram impermeabilizados externamente e imersos em soluçÆo de azul-de-metileno a 1%, por 72 horas. Os copings foram seccionados com discos de carborundum e avaliados com e sem cimento resinoso na superfície do preparo, sendoaplicado para cada face um escore de infiltraçÆo, variando de 0 a 4.Resultados: Na análise com cimento, o grau 0 ocorreu em 65% dasobservaçães do grupo I; 52% no Grupo IV; 42,5% no II e 5% no Grupo III. Na avaliaçÆo sem cimento, ocorreu 95% de graus 0 nas observaçães do Grupo IV; 90% para o I, 57% no Grupo II e 50% no III. Por meio do teste de Kruskal Wallis foi constatada diferença estatisticamente significante entre os grupos (p<0,05), sendo os Grupos I e IV superiores aos demais. ConclusÆo: Antes e após a remoçÆo do cimento, o Panavia F e o Scothbond Multiuso + RelyX ARC apresentaram maior resistência a penetraçÆo do corante...

Objective: To evaluate marginal microleakage at the interface of teethprepared for full metal-ceramic crowns and copings fixed with differentresin cements, using methylene blue staining. Method: Forty teeth were prepared and impressions were obtained to fabricate Ni-Cr copings. The sample was assigned to four groups,according to the luting agent: Group I: coping cemented with Scotchbond and RelyX ARC; Group II: copings fixed with Single Bond and RelyX ARC; Group III: copings fixed with RelyX U100; Group IV: copings fixed with Pavavia F. The teeth were stored in distilled water at37 ºC for six months, subjected to a thermocycling regimen and storedagain in water for another six months. The tooth surfaces were rendered waterproof except for the margins and were immersed in a 1% methylene blue solution for 72 h. The copings were sectioned with carborundum disks and evaluated with or without resin cement on the prepared dental surface. Each face was scored 0 to 4 for leakage.Results: Analysis of the samples with cement revealed that score 0 wasattributed to 65% of the samples of Group I; 52% of Group IV; 42.5% ofGroup II and 5% of Group III. In the analysis of samples without cement,score 0 was attributed to 95% of the samples of Group IV; 90% of Group I; 57% of Group II and 50% of Group III. Statistically significant difference among the groups was found by the Kruskal-Wallis test (p<0.05). Groups I and IV were superior to the others. Conclusion: Before and after removal of the cement, Panavia F and Scotchbond + RelyX ARC presented greater resistance to dyepenetration...

Frequency of adverse drug reactions in hospitalized patients: a systematic review and meta-analysis.

PURPOSES: To perform a comprehensive systematic review of prospective studies about frequency of adverse drug reactions (ADRs) occurring during hospitalization (ADR(In) ), including a thorough study quality assessment, meta-analysis and heterogeneity evaluation. METHODS: Systematic review of several databases: Pubmed, EMBASE, CINAHL, Cochrane, ISI, International Pharmaceutical Abstracts, Scirus, NHS economic, and others, as well as manual search. Inclusion criteria were: prospective studies (assessing all patients before discharge, by a specialized team, at least once a week); with data about ADRs occurring during hospitalization, using WHO's or similar definition of ADR. Two independent reviewers assessed eligibility criteria, extracted data, and evaluated risk of bias. RESULTS: From 4139 studies initially found, 22 were included. Meta-analysis indicate that ADRs may occur in 16.88% (CI95%: 13.56,20.21%) of patients during hospitalization; however, this estimate has to be viewed with caution because there was significant heterogeneity (I² = 99%). The most significant moderators of heterogeneity were risk of bias, population, ward, and methodology for ADR identification. Low risk of bias studies adjusted for population (pediatric versus adult) had I² = 0%. CONCLUSIONS: These data are useful as a broad characterization of in-hospital ADRs and their frequency. However, due to heterogeneity, our estimates are crude indicators. The wide variation in methodologies was one of the most important moderators of heterogeneity (even among studies using intensive monitoring). We suggest criteria to standardize methodologies and reduce the risk of bias.

Necrophagous species of Diptera and Coleoptera in northeastern Brazil: state of the art and challenges for the Forensic Entomologist / Espécies necrófagas de Diptera e Coleoptera na Região Nordeste do Brasil: estado da arte e desafios para o Entomologista Forense

Inventories on necrophagous insects carried out in Brazil encompass mostly species from the southeastern and central-western regions of the country. This review aims to produce the first checklist of necrophagous Diptera and Coleoptera species of forensic relevance in northeastern Brazil, an area that concentrates high rates of homicides. We performed a literature survey on scientific articles, theses and dissertations regarding necrophagous insect species in the region, and contacted scientists who develop research on forensic entomology. Fifty-two species of Diptera belonging to eight families with previous record of necrophagy were reported in the region: Sarcophagidae, Calliphoridae, Muscidae, Fanniidae, Piophilidae, Phoridae, Anthomyiidae and Stratiomyidae. Coleopteran species from six families of forensic relevance were registered, although taxonomical identification remained superficial. Bait traps were the most frequent methodology used, followed by collection on animal carcasses. Seven Dipteran species from two families were registered on human cadavers. All species had been previously reported in other Brazilian states and/or other countries, although none has been effectively used in legal procedures in the region. The status of research on forensic entomology in northeastern Brazil is incipient, and the checklist produced here contributes to the knowledge on the local diversity of necrophagous insects.

Inventários de insetos necrófagos no Brasil abordam em sua maioria espécies das regiões Sudeste e Centro-Oeste do país. Esta revisão visa apresentar um checklist de espécies necrófagas de Diptera e Coleoptera de importância forense no Nordeste brasileiro, uma área que concentra elevadas taxas de homicídio. Nós conduzimos uma revisão bibliográfica consultando artigos, teses e dissertações sobre espécies necrófagas na região, e contatamos cientistas que desenvolvem pesquisa em entomologia forense. Cinquenta e duas espécies de Diptera pertencentes a oito famílias com registro prévio de necrofagia foram registrados na região: Sarcophagidae, Calliphoridae, Muscidae, Fanniidae, Piophilidae, Phoridae, Anthomyiidae e Stratiomyidae. Espécies de Coleoptera de seis famílias de importância forense foram listadas, embora a identificação taxonômica tenha sido superficial. Armadilhas contendo iscas foram o método de coleta mais frequente, seguidas de coleta sobre carcaças animais. Sete espécies de Diptera pertencentes a duas famílias foram registradas sobre cadáveres humanos. Todas as espécies haviam sido previamente registradas em outros estados brasileiros e/ou em outros países, embora nenhuma tenha sido efetivamente utilizada em procedimentos legais na região. O status da pesquisa em entomologia forense no Nordeste do Brasil é incipiente, e o checklist apresentado neste trabalho contribui para sistematizar o conhecimento sobre a diversidade local de insetos necrófagos.

Babesiosis due to the canine Babesia microti-like small piroplasm in dogs-first report from Portugal and possible vertical transmission.

BACKGROUND: Canine babesiosis (or piroplasmosis) is endemic in northern Portugal, but molecularly confirmed cases of infection with small piroplasms have not been reported in the country. Three German shepherd dogs - a bitch and its 2-month old pup and an unrelated male - clinically suspected of piroplasmosis were assessed for babesial infection. RESULTS: Parasitemia with small piroplasms was detected by microscopy in two dogs. All three dogs were positive by PCR and the Babesia microti-like small piroplasm (syn. Theileria annae) was identified by DNA sequencing. These are the first confirmed cases of babesiosis caused by the B. microti-like piroplasm both in dogs from Portugal and in dogs suspected of clinical piroplasmosis outside of Spain. CONCLUSIONS: Although the bitch and the male had visited neighboring Galicia (northwestern Spain), where the disease is endemic, incursion of this piroplasm into northern Portugal is evident and infection of the non-traveled pup was due to either vertical transmission or autochthonous tick infection.

Bionomics of two forensically important blowfly species Chrysomya megacephala and Chrysomya putoria (Diptera: Calliphoridae) reared on four types of diet.

The use of heterogeneous animal tissues for the rearing of necrophagous insect species can produce uneven biological data, which can compromise the determination of larval age and, consequently, estimates for post-mortem intervals. We investigated the development of two species, Chrysomya megacephala and Chrysomya putoria (Diptera: Calliphoridae), reared on four substrates: minced beef (control) and semi-synthetic diets with the addition of sardine, rumen or chicken eggs. No differences in total developmental times were detected among larvae reared on different diets. Length and width of larvae were partially affected by the type of food. Third instar larvae and pupae of both species were heavier on beef treatment when compared with other substrates. Overall mortality was lower when beef was used as food. Longevity of adults and sex ratio were not negatively affected by the use of diets. Egg-based diet was the least effective for both species. Given the fact that several bionomical parameters of larvae reared on diets were close to those obtained when minced beef was offered, and considering the putrid odour, frequency of contamination and lack of homogeneity of animal tissue, semi-synthetic diets can be used for rearing C. megacephala and C. putoria.

Atendimento fonoaudiológico em grupo / Speech therapy group care

Tema: atendimento fonoaudiológico em grupo na área da Fonoaudiologia. Para sua realização, visitou-se os textos publicados em revistas científicas da área, nos últimos 15 anos, e os capítulos de livros e dissertações que se detiveram em tematizar o atendimento fonoaudiológico em grupo. Objetivo: identificar, entender e discutir: 1) os princípios teóricos que justificam a indicação do atendimento em grupo, que o estruturam e o sustentam de maneira a explicitar como a dinâmica do grupo age sobre os sintomas ; 2) os critérios para a composição e formação dos grupos e, principalmente, 3) a intervenção do fonoaudiólogo e a possibilidade de eficácia de sua terapêutica. Conclusão: o levantamento bibliográfico identificou diferentes práticas fonoaudiológicas em grupo, atreladas a diversas perspectivas teóricas. No que diz respeito aos critérios de formação, à função do fonoaudiólogo no grupo, à prevalência do atendimento em grupo em relação ao individual, houve divergências de opiniões, dado que os textos visitados, não (cor)responderam com a consistência teórica esperada. Tal resultado se deve ao fato de haver uma certa adoção irrefletida de conceitos de outras áreas, sem argumentação e sem a reestruturação que sua transposição para a clínica fonoaudiológica, exigiria. Sugere-se que estas incoerências ocorrem porque não se evidencia a preocupação em articular os estudos teóricos aos elementos que configuram a clínica fonoaudiológica, a saber: a semiologia, a etiologia, a diagnóstica e a terapêutica.

Background: the theme of this literature review is the group therapy in the Speech Therapy area. To perform it, we studied the texts published in scientific journals of the field, in the last 15 years, in the form of articles, book chapters and dissertations, which were focused on the group therapy. Purpose: the goal is to identify, understand and discuss, the following themes: 1) the theoretical principles that justify the indication of group therapy, structuring and maintaining it in order to explain how the dynamics of the group may act on the symptoms; 2) the criteria for the composition and formation of groups and especially, 3) the intervention of speech therapists and the possibility of their therapeutic effectiveness. Conclusion: it was concluded that the literature review on group therapy in the area of Speech Therapy identified different practices, linked to different theoretical perspectives. Regarding the criteria for group formation, the function of the speech therapist in the group, the prevalence of the group intervention in relation to the individual intervention, and there were differences of opinion since the review of the literature did not correspond to the expected theoretical consistency. This happened because there is a certain reflected adoption of concepts from other areas, without argumentation and without a restructuring demanded by the transposition to the speech therapy clinic. This is because there is no evident concern to articulate the theoretical studies to the elements that make up the speech therapy clinic, namely: the semiology, the etiology, the diagnosis and the therapeutics.

Evaluation of the synergistic potential of vancomycin combined with other antimicrobial agents against methicillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus spp strains.

Methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus spp (CNS) are the most common pathogens that cause serious long term infections in patients. Despite the existence of new antimicrobial agents, such as linezolid, vancomycin (VAN) remains the standard therapy for the treatment of infections caused by these multidrug-resistant strains. However, the use of VAN has been associated with a high frequency of therapeutic failures in some clinical scenarios, mainly with decreasing concentration of VAN. This work aims to evaluate the synergic potential of VAN plus sulfamethoxazole/trimethoprim (SXT), VAN plus rifampin (RIF) and VAN plus imipenem (IPM) in sub-minimum inhibitory concentrations against 22 clinical strains of MRSA and CNS. The checkerboard method showed synergism of VAN/RIF and VAN/SXT against two and three of the 22 strains, respectively. The combination of VAN with IPM showed synergistic effects against 21 out of 22 strains by the E-test method. Four strains were analyzed by the time-kill curve method and synergistic activity was observed with VAN/SXT, VAN/RIF and especially VAN/IPM in sub-inhibitory concentrations. It would be interesting to determine if synergy occurs in vivo. Evidence of in vivo synergy could lead to a reduction of the standard VAN dosage or treatment time.

Evaluation of the synergistic potential of vancomycin combined with other antimicrobial agents against methicillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus spp strains

Methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus spp (CNS) are the most common pathogens that cause serious long term infections in patients. Despite the existence of new antimicrobial agents, such as linezolid, vancomycin (VAN) remains the standard therapy for the treatment of infections caused by these multidrug-resistant strains. However, the use of VAN has been associated with a high frequency of therapeutic failures in some clinical scenarios, mainly with decreasing concentration of VAN. This work aims to evaluate the synergic potential of VAN plus sulfamethoxazole/trimethoprim (SXT), VAN plus rifampin (RIF) and VAN plus imipenem (IPM) in sub-minimum inhibitory concentrations against 22 clinical strains of MRSA and CNS. The checkerboard method showed synergism of VAN/RIF and VAN/SXT against two and three of the 22 strains, respectively. The combination of VAN with IPM showed synergistic effects against 21 out of 22 strains by the E-test method. Four strains were analyzed by the time-kill curve method and synergistic activity was observed with VAN/SXT, VAN/RIF and especially VAN/IPM in sub-inhibitory concentrations. It would be interesting to determine if synergy occurs in vivo. Evidence of in vivo synergy could lead to a reduction of the standard VAN dosage or treatment time.

Anthocyanins present in selected tropical fruits: acerola, jambolão, jussara, and guajiru.

Many tropical fruits are rich in anthocyanins, though limited information is available about the characterization and quantification of these anthocyanins. The identification and quantification of anthocyanin pigments in four tropical fruits were determined by HPLC-MS/MS. Fruits studied included acerola (Malphigia emarginata), jussara (Euterpe edulis), jambolão (Syzygium cumini), and guajiru (Chrysobalanus icaco). All four fruits were found to contain anthocyanin pigments. Anthocyanidin backbones included cyanidin, delphinidin, peonidin, pelargonidin, petunidin, and malvidin. Guajiru contained several acylated forms, while acerola, jussara, and jambolão contained only nonacylated glycosides. These results demonstrate that these tropical fruits are rich in anthocyanins and that the anthocyanins are widely ranging in anthocyanidin backbone, glycosylation, and acylation.

Prevalencia de periodontite em pacientes submetidos à hemodialise / Prevalence of periodontitis in maintenance hemodialysis patients

A doença periodontal é uma alteração dos tecidos que suportam os dentes em resposta à infecção bacteriana cronica, podendo ser dividida em dois diferentes drupos: as gengivites e as periodontites.

Determination of the flavonoid components of cashew apple (Anacardium occidentale) by LC-DAD-ESI/MS.

Liquid chromatography, with diode array detection and electrospray ionization mass spectrometry (LC-DAD-ESI/MS), was used to identify and quantify flavonoids in cashew apple. One anthocyanin and thirteen glycosylated flavonols were detected in a methanol-water extract. Among them, the 3-O-galactoside, 3-O-glucoside, 3-O-rhamnoside, 3-O-xylopyranoside, 3-O-arabinopyranoside and 3-O-arabinofuranoside of quercetin and myricetin, as well as kaempferol 3-O-glucoside were identified by direct comparison with standards or positively identified flavonoids in cranberry. The anthocyanin was the 3-O-hexoside of methyl-cyanidin. Trace amounts of delphinidin and rhamnetin were detected in the hydrolyzed extract, suggesting their glycosides were present, but undetectable, in the original extract. The concentrations of the 14 flavonoids in the tested sample were determined. This is the first report of these flavonoids in cashew apple.