2016 update of the Portuguese recommendations for the use of biological therapies in children and adolescents with Juvenile Idiopathic Arthritis.

OBJECTIVE: To provide evidence-based guidance for the rational and safe prescription of biological therapies in children and adolescents with juvenile idiopathic arthritis (JIAs) considering the latest available evidence and the new licensed biologics. METHODS: Rheumatologists and Pediatricians with expertise in Pediatric Rheumatology updated the recommendations endorsed by the Portuguese Society of Rheumatology and the Portuguese Society of Pediatrics based on published evidence and expert opinion. The level of agreement with final propositions was voted using an online survey. RESULTS: In total, 20 recommendations to guide the use of biological therapy in children and adolescents with JIAs are issued, comprising 4 general principles and 16 specific recommendations. A consensus was achieved regarding the eligibility and response criteria, maintenance of biological therapy, and procedures in case of non-response, for each JIA category. Specific recommendations concerning safety procedures were also updated. CONCLUSIONS: These recommendations take into account the specificities of each JIA category and are intended to continuously improve the management of JIA patients.

Life cycle assessment of a packaging waste recycling system in Portugal.

Life Cycle Assessment (LCA) has been used to assess the environmental impacts associated with an activity or product life cycle. It has also been applied to assess the environmental performance related to waste management activities. This study analyses the packaging waste management system of a local public authority in Portugal. The operations of selective and refuse collection, sorting, recycling, landfilling and incineration of packaging waste were considered. The packaging waste management system in operation in 2010, which we called "Baseline" scenario, was compared with two hypothetical scenarios where all the packaging waste that was selectively collected in 2010 would undergo the refuse collection system and would be sent directly to incineration (called "Incineration" scenario) or to landfill ("Landfill" scenario). Overall, the results show that the "Baseline" scenario is more environmentally sound than the hypothetical scenarios.

Intraspecific sequence variation in 16S rRNA gene of Ureaplasma diversum isolates.

Ureaplasma diversum infection in bulls may result in seminal vesiculitis, balanoposthitis and alterations in spermatozoids. In cows, it can cause placentitis, fetal alveolitis, abortion and the birth of weak calves. U. diversum ATCC 49782 (serogroups A), ATCC 49783 (serogroup C) and 34 field isolates were used for this study. These microorganisms were submitted to Polymerase Chain Reaction for 16S gene sequence determination using Taq High Fidelity and the products were purified and bi-directionally sequenced. Using the sequence obtained, a fragment containing four hypervariable regions was selected and nucleotide polymorphisms were identified based on their position within the 16S rRNA gene. Forty-four single nucleotide polymorphisms (SNP) were detected. The genotypic variability of the 16S rRNA gene of U. diversum isolates shows that the taxonomy classification of these organisms is likely much more complex than previously described and that 16S rRNA gene sequencing may be used to suggest an epidemiologic pattern of different origin strains.

Thimerosal exposure (from tetanus-diphtheria vaccine) during pregnancy and neurodevelopment of breastfed infants at 6 months.

AIM: We studied the effect on neurodevelopment of infants who are exposed to thimerosal in tetanus-diphtheria (Td) vaccines during pregnancy. METHODS: We compared Gesell Developmental Schedules (GDS) of exclusive breastfed infants at 6 months born to mothers who received Td (1 to 3 doses) against those who were born to mothers who did not take such vaccines. RESULTS: Compared with the group of infants not exposed to ethylmercury in utero, the infants of exposed mothers showed no significant difference in neurodevelopment delays. Although there was a significant correlation between hair-Hg of mothers and hair-Hg of neonates (Spearman r = 0.353; p = 0.0011), there was no significant correlation between the level of in utero exposure to ethylmercury in Td vaccines and neonate's hair-Hg concentrations (Spearman r = 0.060; p = 0.5922). However, regression analysis showed that GDS at 6 months was significantly associated with total mercury concentration of neonate's hair but was not sensitive to the number of vaccines taken by the mother. CONCLUSION: Early neurodevelopment of exclusively breastfed infants is sensitive to in utero exposure to mercury, but maternal thimerosal exposure in tetanus-diphtheria vaccines per se cannot portend clinical neurodevelopment delays measured by GDS at 6 months.

Taxonomic and phylogenetic relationships between neotropical species of ticks from genus Amblyomma (Acari: Ixodidae) inferred from second internal transcribed spacer sequences of rDNA.

The accurate specific identification of ticks is essential for the study, control and prevention of tick-borne diseases. Herein, we determined ribosomal nucleotide sequences of the second internal transcribed spacer (ITS2) of 15 Neotropical hard tick species of the genus Amblyomma Koch found in Brazil. Most of the studied ticks accidentally parasite humans and potentially act as vectors of zoonoses. Lengths of the ITS2 sequences ranged from 956 to 1,207 bp, whereas GC content varied from 62.4 to 66.9%. A matrix of ITS2 divergence was calculated with the ITS2 sequence data obtained showing divergence levels varying from 1.5 to 28.8%. The analysis indicated that this molecular marker can be useful for Amblyomma-specific identification. Phylogenetic inferences based on the ITS2 sequences were used to assess some issues in subgenus taxonomy.

Application of performance indicators in water utilities management--a case-study in Portugal.

This paper presents some issues concerning water supply systems assessment through performance indicators, based upon research work recently carried out in Portugal about water utilities. A proposal of 50 performance indicators divided into five different groups is presented here, namely structural indicators, operational indicators, water and service quality indicators, personnel indicators and economic indicators. These indicators were associated with a hierarchical structure of knowledge or development according to different levels: basic level, development level and strategic level. The performance indicators, structure, their implementation and assessment methodology and examples of some indicators, use concerning the characterisation or assessment of a water utility are also presented in the paper.

Infeccoes pre-natais. Avaliacao de metodo simplificado (Rapi Tex IgM) em sua triagem. / Prenatal infections.Evaluation of a simplified method (Rapi Tex IgM) to their selection

Os autores submeteram 500 recem-nascidos a teste simplificado (Rapi Tex IgM) que por simples reacao de aglutinacao evidencia quantidades anormalmente elevadas de IgM no sangue do cordao umbilical. Os resultados obtidos pela triagem foram avaliados atraves de dosagens de IgM no sangue do cordao umbilical exame morfologico de placentas (macro e microscopia), acompanhamento clinico e laboratorial de alguns casos e exame anatomopatologico dos casos em que ocorreu o obito. Concluem pela validade do teste na triagem de infeccoes pre-natais