Background Recent research shows that both pediatric and adult patients with eosinophilic esophagitis (EoE) experience esophageal remodeling marked by increased collagen deposition in which TGF-β ...plays an important role. However, limited data are available on the intensity and reversibility of fibrous remodeling in adults with EoE. Objective We sought to analyze differences in collagen deposition in the lamina propria (LP) and profibrogenic cytokine gene expression along with other changes induced by prolonged treatment with fluticasone propionate in adults with EoE. Methods Ten adults given consecutive diagnoses of EoE were studied prospectively. Deep esophageal biopsy specimens were obtained before and after 1 year of treatment with fluticasone propionate. Collagen deposition in the LP was assessed in tissue sections with the aid of the Masson trichrome technique. IL5 , TGFB1 , fibroblast growth factor 9 (FGF9) , and CCL18 gene expression was quantified through real-time PCR. EoE results were compared among samples from 10 adult patients with gastroesophageal reflux disease and 10 control subjects with healthy esophagi. Results Patients with EoE showed a significant increase in subepithelial collagen deposition; this correlated positively with eosinophil density in the LP and the patient’s age. Prolonged steroid treatment induced a nonsignificant reduction in subepithelial fibrosis, which remained significantly higher than in control subjects. Profibrogenic cytokine gene expression also increased in patients with EoE, with IL5 ( P < .001), FGF9 ( P = .005), and CCL18 ( P = .008) all significantly upregulated. After 1 year of treatment, a reduction was observed in gene expression; for CCL18 expression, this decrease was statistically significant ( P < .001). Conclusions Esophageal remodeling is associated with upregulated gene expression of profibrogenic cytokines in adults with EoE. Prolonged treatment with fluticasone propionate leads to a nonsignificant reduction in subepithelial collagen deposition accompanied by downregulation of profibrogenic cytokine gene expression, with that of CCL18 being especially significant.
For some time now, images in science have been an object of study in the history of science. The multiple roles that images play in scientific practice have been recognised and discussed. However, ...little attention has been given to science related images in educational contexts. The case of geology is all the more relevant because it is considered that it has a specific visual language that is intrinsic to its own constitution as a science. This work aims to contribute to counter this situation through the analysis of geology-related images present in textbooks for Portuguese secondary education in the period between 1836 and 1974. Temporal limits correspond to the creation of secondary education in Portugal and to the end of the Estado Novo. For this period, five textbooks were chosen and their images analysed. The place of geological subjects in the context of science teaching in Portuguese secondary education was also traced. The interpretation of the results shows that images present in textbooks had other purposes besides introducing students to the typical visual language of geology. In fact, one of their main intentions was to "shape" the student's mind into a "rational way of thinking".
This paper addresses the public intervention on behalf of geology and geologists made by members of the geological community in Portugal, from the 1940s through the 1960s, when the country was living ...under a dictatorship known as the Estado Novo. Three men stood out during this intervention: Mendes Correia (1888-1960), Carrington da Costa (1891-1982) and Carlos Teixeira (1910-1982). The content and form of their oral and written discourses, their intended audiences, and their scientific and institutional career paths are analyzed. One of the main themes of the discourses was the vindication of a professional space for geology in Portuguese society, a circumstance that led to a confrontation with a widely acknowledged techno-scientific professional group: engineers. This paper demonstrates that the public intervention in favor of geology and geologists was part of a broader process of the Portuguese geological community asserting its scientific and social importance.
Shaping Doctors and Society Carneiro, Ana; Mota, Teresa Salomé; Amaral, Isabel
Media history,
01/2019, Letnik:
25, Številka:
1
Journal Article
Recenzirano
This article is an exploratory approach to the study of the Portuguese medical press, between the 1880s and 1926, that is, from the last decades of the liberal monarchy (1820-1910) to the end of the ...First Republic (1910-1926). Around 130 medical journals were identified so far. They were divided in groups according to the place of publication, and a typology was established based on two combined criteria-contents and affiliation. The weekly journal A Medicina Contemporânea will be used as a sample, mainly because it exemplifies in a single journal the dual purpose of the Portuguese medical press taken as whole. The establishment of the medical press coincided with the emergence of mass press and doctors' engagement in laboratory-based medicine, and constituted an apparatus with two aims in mind: shaping doctors not only technically and scientifically, but also ideologically with the aim of creating a market for their profession, building up a medical community, and a social and cultural elite; shaping society and improving the 'race' by taking care of the bodies and minds of the Portuguese, organizing public opinion through ideological indoctrination, and influencing political decision-making to make a republic regime viable.
•The association of acne with malignant melanoma (MM) in men is unclear.•This study followed over 240,000 men in Sweden from adolescence to middle age.•Acne was not associated with subsequent MM.
To ...evaluate the association of acne in late adolescence with the risk for subsequent malignant melanoma (MM) in men.
Swedish register-based cohort study of 242,096 males born between 1952 and 1956, who took part in compulsory assessments for Swedish military conscription in late adolescence between 1969 and 1975, with subsequent diagnoses of MM (n=1,058) up to December 31, 2009. Covariates included measures of childhood circumstances and information from adolescence on presence of acne, physical fitness, cognitive function, body mass index (BMI), and a summary of diagnoses. Cox regression was used for the analysis.
In total 1,058 men were diagnosed with MM. Acne was not associated with subsequent MM, with an adjusted hazard ratio (and 95% confidence interval) of 0.95 (0.61 to 1.49). Men with parents who were agricultural workers, and men who lived in northern Sweden, had lower physical fitness, or lower cognitive function had a lower risk of MM. Overweight and obesity was associated with a raised risk, with an adjusted hazard ratio of 1.39 (1.14, 1.71).
Acne in late adolescence is unlikely to represent a raised risk for subsequent MM in men. Overweight or obesity was identified as a raised risk for MM, possibly due to the associated increased skin surface area.
Stuttering is a speech fluency disorder, in which people know perfectly well the message they want to convey, even though their speech is characterized by changes in rhythm, repetitions, ...prolongations, pauses and blocks, and may also be associated with states of anxiety or emotional tension. Up to one in every six children, typically between two and five years old, experience a period of transitory speech disfluency, with usual spontaneous recovery before reaching school age, with a prevalence rate of stuttering of up to 1% of the adult population, and a higher incidence rate in males (4:1). In Portugal, it is estimated that stuttering affects around 100 thousand people, acquiring importance due to its frequency and association with lower self-esteem, anxiety and social isolation, with negative impact on people's ability to communicate and on their well-being and social interactions. The aim of this article is to highlight the complexity of the diagnostic and therapeutic approach of stuttering in pediatrics, with a particular focus on differentiating between normal speech disfluencies and childhood-onset fluency disorder (stuttering) and referral criteria, in order to raise awareness and facilitate early detection of these cases.
Aim
To estimate the prevalence of chronic heart failure (CHF) in mainland Portugal in 1998.
Methods and population
A community‐based epidemiological survey involving subjects attending primary care ...centres selected by a combined two‐stage sampling and stratified procedure. General practitioners (GPs) randomly selected in proportion to the population of the District, evaluated subjects attending primary care centres aged over 25 years, recruited consecutively and stratified by age. CHF cases were identified according to the Guidelines of the European Society of Cardiology for CHF diagnosis.
Results
5434 eligible subjects were evaluated by 365 GPs; 551 patients with CHF were identified. The overall prevalence and 95% CI of CHF in mainland Portugal is 4.36% (3.69–5.02%), 4.33% in males (3.19–5.46%), and 4.38% in females (3.64–5.13%). Age‐specific CHF prevalence was as follows: 1.36% in the 25–49 years‐old group (0.39–2.33%), 2.93% in the 50–59 years‐old group (5.58–9.37%), 7.63% in the 60–69 years‐old group (5.58–9.37%), 12.67% in the 70–79 years‐old group (10.73–14.6%), and 16.14% in group over 80 years old (13.81–18.47%). The prevalence of CHF due to systolic dysfunction was 1.3% and the prevalence of CHF with normal systolic function was 1.7%.
Conclusions
The overall prevalence of CHF in Portugal was slightly higher than that of other European studies and increases sharply with age. The prevalence of CHF due to systolic dysfunction is very similar to that reported by other recent European studies. The differences found may correspond to differences in methodology rather than actual differences in the population.
For quite a while, scientific biography was relegated to a subordinate status in the history of science. In the last two decades, however, it has seen a revival, which can be explained both by its ...popularity among general audiences as it conveys a closer image of scientists and scientific practice, and science historians' reappraisal of biography as a literary genre and as a source for their research. When writing scientific biographies or using them as a source, however, historians have to contend with complex questions, such as the extent to which a particular biography is representative of larger patterns, and they face a variety of problems associated with the use of sources such as oral testimonies and obituaries. In this paper, the scientific lives of Joaquim Filipe Nery da Encarncaoo Delgado (1835-1908) and Francisco Luis Pereira de Sousa (1870-1931), both engineers working at the Portuguese Geological Survey, and Carlos Teixeira (1910-1982), a leading geologist working in the academia, will be analysed. Through this comparison, the authors aim to characterize the development of Portuguese geology in different contexts in the period spanning from the mid-nineteenth to the twentieth century.
The practice and methods of geological fieldwork in the Portuguese Geological Survey evolved during the middle part of the twentieth century. Between the 1920s and the 1940s, the Survey's field ...assistants played a key role in conducting geological fieldwork; special attention will be given to their training. In 1940, Georges Zbyzsewski (1909-1999) was hired as a geologist by the Survey and he was responsible for conducting the majority of fieldwork. Scientific collaborators from outside the Survey also began to play a key role in the institution. From the 1950s onwards, several new specialities were hired by the Survey, especially geologists and field assistants. The pace of geological fieldwork recorded an unprecedented increase. The characteristics of the teams that carried out this task in the Survey were instrumental in this achievement.
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