Search Results (219)

Background: Virtual reality (VR), often used with motion sensors, provides interactive tools for physiotherapy aimed at enhancing motor functions. This systematic review examined the effects of VR-based interventions, alone or combined with conventional physiotherapy (PT), on balance and gait in individuals with Parkinson’s disease (PD). Methods: Following PRISMA guidelines, eight randomized controlled trials (RCTs) published between January 2019 and April 2025 were included. Interventions lasted between 5 and 12 weeks and were grouped as VR alone or VR combined with PT. Methodological quality was assessed using the PEDro Scale. Results: Of the 31 comparisons for balance and gait, 30 were favored by the experimental group, with 12 reaching statistical significance. Secondary outcomes (function, cognition, and quality of life) showed mixed results, with 6 comparisons favoring the experimental group (3 statistically significant) and 4 favoring the control group (1 statistically significant). Overall, the studies showed fair to good quality and a moderate risk of bias. Conclusions: VR-based interventions, particularly when combined with PT, show promise for improving balance and gait in PD. However, the evidence is limited by the small number of studies, heterogeneity of protocols, and methodological constraints. More rigorous, long-term trials are needed to clarify their therapeutic potential. Full article

The introduction of non-native species like Xylella fastidiosa to new environments can lead to potentially catastrophic ecological and economic repercussions. This work comprehended the prospection phase (insect sampling and submission of samples to the laboratory) from X. fastidiosa demarcated zones of Área Metropolitana do Porto; Sabrosa; Alijó; Baião; Mirandela; Mirandela II; and Bougado and the research phase (collecting and organizing data and statistical treatment). The results of this study showed the presence of the bacterium in some tested spittlebugs species captured in DZ of Área Metropolitana do Porto, which highlights the role of the vector in mediating the disease’s propagation. Most insects were found in public gardens and in nurseries/gardens where there is a diverse array of food sources, shelter, mating locations, and suitable substrates for egg laying that serve as ideal conditions for the population of Philaenus spumarius. We observed that most insects were found in the first trimester (36.5%), followed by the third trimester (23.2%). Finally, it was shown that, in our study, the most frequent host plants where insects were found included Lavandula dentata, Ulex minor, Ulex europaeus, Quercus suber, Plantago lanceolata. Our findings imply a robust connection between plant communities, ecological conditions, and insect populations with the occurrence of Xylella fastidiosa, particularly within the examined climatic context. Full article

This review explores current knowledge on the environmental, oxidative, and genomic effects of sucralose (E955), an artificial sweetener widely used in food products, including those for children, and known to cross both the placental barrier and into breast milk. Although initially considered safe, research conducted over the past two decades has presented conflicting evidence regarding its long-term impact, particularly on ecosystems and biological systems. Structurally similar to chlorinated compounds such as perfluoralkyl substances (PFAS), sucralose is highly persistent in the environment, which complicates its degradation and removal, especially from aquatic systems. Several studies have reported behavioral, metabolic, and even genomic alterations in aquatic organisms exposed to sucralose, raising concerns about its broader ecological safety. In addition, its presence has been linked to shifts in microbiota composition in both environmental and human contexts. Reports of sucralose-induced oxidative stress further highlight the need for caution in its continued use, particularly in sensitive formulations. Given its widespread presence and resistance to degradation, further investigation into the environmental and biological safety of sucralose is urgently needed. Full article

Background/Objectives: Childhood anemia remains a serious public health issue, negatively affecting cognitive and psychomotor development, with repercussions on school performance and adult productivity. This study aimed to characterize the profile of children aged 6 months to 5 years diagnosed with or at risk of anemia who attended a pediatric hospital in Lisbon, Portugal. Methods: A hospital-based, cross-sectional descriptive study was conducted from September 2023 to September 2024. Descriptive statistics, including frequency distributions and cross-tabulations, summarized participant characteristics and key variables. Results: We observed that 33.3% (74/222) of the children were either anemic or at risk of anemia. Among these, 93.2% (69/74) were confirmed anemic or at risk based on hemoglobin levels. Five children (6.8%) had normal hemoglobin but abnormal red-cell indices, with microcytic (60.0%; 3/5) or normocytic (40.0%; 2/5) patterns. Anemia rates were higher in males (55.1%), children aged 24–59 months, those residing in the Metropolitan Lisbon Area (82.6%), children whose caregivers had only basic or secondary education (58.0%), and those whose mothers were born in foreign countries (48.4%). Microcytic red-cell indices were observed in 63.1% of cases. Serum iron results indicated that 32.0% were pre-anemic and 40.0% anemic. Ferritin levels showed iron-deficiency anemia in 22.2% of tested cases. In addition, 33.3% carried the sickle cell trait, and 35.0% had elevated C-reactive protein, suggesting anemia of inflammation. Conclusions: Anemia is a moderate public health issue, mainly affecting children with less-educated caregivers and migrant mothers. Targeted public health actions, including systematic screening, caregiver education, and multiculturally sensitive interventions, are crucial to address anemia. Full article

Background/Objectives: Copper is an essential micronutrient required for physiological functions, but elevated serum levels impair vascular reactivity and blood pressure regulation. Given PVAT’s critical role in vascular function, this study aimed to investigate the effects of chronic copper overload on the secretory function of mesenteric PVAT, focusing on its vasoregulatory role. Methods: In the first phase, 8-week-old male Wistar rats were assigned to two groups, namely control (saline, i.p.) or copper (25.72 µg/kg/day Cu, i.p., for 30 days), corresponding to twice the recommended daily dose of copper. In the second phase, rats were divided into four groups: control (saline, i.p., water by gavage), copper (Cu, i.p., water by gavage), losartan (saline, i.p., 10 mg/kg/day losartan by gavage), or copper + losartan (Cu, i.p., 10 mg/kg/day losartan by gavage). After euthanasia, mesenteric PVAT was collected for morphometric analysis, gene and protein expression of adipokines, inflammatory molecules, and the renin–angiotensin system. Serum was used for hormone and biochemical measurements. Results: In mesenteric PVAT, chronic copper overload increased adipocyte diameter and reduced lipolysis. It also elevated the secretion of TNF-α and PAI-1 while decreasing IL-10 levels. Additionally, it upregulated the mRNA expression of MCP-1, F4/80, CD86, TLR4, arginase-1, iNOS, ACE1, and AT1R, alongside an increase in serum angiotensin II levels. When copper treatment was combined with losartan, an AT1R antagonist, adipocyte hypertrophy; TNF-α secretion; and the gene expression of TLR4, F4/80, and arginase-1 were attenuated. Conclusions: Chronic exposure to double the recommended dose of Cu disrupts the secretory function of mesenteric PVAT, promoting inflammation and altering the local RAS. These effects appear to occur, at least in part, alongside the activation of the AT1R–TLR4–angiotensin II signaling pathway, triggering the upregulation of vasoregulatory inflammatory markers. Full article

C-phycocyanin (CPC), a bioactive compound derived from Spirulina, has been described as a molecule with antioxidant and anti-inflammatory properties. It has also been demonstrated that sustainably obtained CPC effectively inhibited body mass gain, regulated serum leptin and resistin levels, and prevented the onset of a pro-inflammatory state in Swiss mice fed a hyperlipidic diet. These results highlighted the anti-obesogenic potential of CPC. Brown adipose tissue (BAT) has been identified as a promising target in the treatment of obesity, playing a role in energy expenditure. In this study, Swiss mice fed a high-fat diet were supplemented with 500 mg/kg body weight of CPC daily for 12 and 16 weeks. BAT was collected, and Western blot and ELISA were performed. A reduction in pro-inflammatory cytokines, as well as a decrease in leptin levels was observed in the tissue, which was also associated with a reduction in BAT relative weight to body mass. Furthermore, CPC administration was able to modulate uncoupling protein 1 (UCP1) levels, which is crucial in the thermogenesis process. Therefore, this study demonstrated that supplementation with CPC reduces inflammatory cytokines associated with detrimental effects in the BAT, emerging as a tool in combating obesity and improving BAT function. Full article

Neurodegenerative diseases affect millions worldwide and present an urgent challenge due to the aging of the population. Drug delivery to the brain is limited by the blood–brain barrier (BBB), inspiring the development of nanotransporters like phytosomes. This study aimed to develop phosphatidylcholine (PC)-based phytosomes incorporating macroalgae extracts. Some of them were functionalized with PEG and ApoE to enhance BBB passage. The phytosomes were characterized by the encapsulation rate, size, polydispersity index (PDI), zeta potential, and stability, with BBB passage tested in an in vitro model (transwell hCMEC/D3 cell model). The phytosomes showed high stability and effective extract binding (74.9–80.3%) over four weeks. Although ApoE functionalization did not significantly improve BBB crossing, all nanotransporters successfully traversed the BBB in the model. Full article

Background/Objectives: Breast cancer is the most common malignant neoplasm in women and the leading cause of cancer-related death. Approximately 50% of HER2-negative breast cancers exhibit low expression of this protein (HER2-low). Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate targeting the HER2 receptor which has shown benefit in patients with HER2-low metastatic breast cancer in the DESTINY-Breast04 study. However, few data are available on its efficacy in real-world practice. Methods: We conducted a retrospective multicenter national study (eight centers) including patients with advanced HER2-low breast cancer (immunohistochemistry 1+ or 2+/ in situ hybridization negative) who started T-DXd treatment between January 2022 and March 2024. Patients had received at least one previous line of treatment. The primary endpoint was real-world progression-free survival (rwPFS) in patients with metastatic HER2-low breast cancer treated with T-DXd. The secondary endpoints were real-world overall survival (OS) and objective response rate (ORR). Results: The study included 35 patients (34 female and 1 male patient), with a median age of 54 years at the start of T-DXd. All patients had an ECOG-PS 0–1, and 26 patients (74%) had hormone receptor (HR)-positive disease. The median number of prior lines of treatment was 4 [1–7], and 23 patients (65.8%) had metastases in three or more sites. With a median follow-up of 7.8 months, rwPFS was 6 months (95% CI, 2.3–9.7), and OS was 15 months (95% CI, 4.7–25.3). In HR-positive patients, the median rwPFS was 6 months (95% CI, 1.2–10.7), compared to 4 months (95% CI, 2.1–5.9) in HR-negative patients. The overall ORR was 52.9%. Adverse events of grade 3 or higher were neutropenia (2.9%) and fatigue (2.9%). Conclusions: This study provides real-world data on T-DXd in the treatment of advanced HER2-low breast cancer. It is noteworthy that the population was heavily pre-treated and had a higher proportion of HR-negative patients, which may explain the lower efficacy compared to the DESTINY-Breast04 study. Full article

Background: Carpal tunnel syndrome (CTS) has emerged as an early indicator of cardiac amyloidosis (CA) caused by transthyretin-associated (ATTR) mutations, possibly linked to adverse cardiovascular outcomes. This case series examines the relationship between idiopathic CTS and CA imaging diagnosis. Methods: Twenty-two patients from the cross-sectional study CarPoS (NCT05409833) were included. These patients underwent physical evaluation, laboratory exams, electrocardiography, echocardiography, cardiac magnetic resonance (CMR) imaging, and scintigraphy with ^99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid. Results: Four of the twenty-two patients included had ATTR cardiomyopathy. These patients presented left-ventricle hypertrophy and signs of infiltrative cardiomyopathy in echocardiograms and late gadolinium enhancement in CMR images without having any cardiovascular symptoms. Conclusions: Our findings suggest a high prevalence of CA in patients with bilateral idiopathic CTS, highlighting the importance of screening for CA in patients with CTS. Early detection could significantly impact patient prognosis, underscoring the need for further research into diagnostic and therapeutic strategies. Full article

Background/Objectives: The present review addresses and systematically analyses the most frequently reported neuropsychological and functional connectivity (FC) alterations in individuals with dyslexia compared to controls. By synthesizing extant evidence, this work aims to clarify dyslexic connectivity profiles and provide a foundation for future research and clinical translation. Methods: This systematic review analyzed publications from the last 10 years in two scientific databases, focusing on individuals with dyslexia, without previous injuries, who underwent resting-state functional magnetic resonance imaging (rs-fMRI) assessments, comparing them with typical readers. Results: This review revealed that most dyslexia studies on brain FC using rs-fMRI focused on children (92%), underscoring a gap in research on adults and limiting our understanding of brain maturation processes and neuroplasticity across the lifespan. FC alterations primarily involved ipsilateral connections (60%), with reduced connectivity mainly in the left hemisphere (40%), particularly in posterior regions, aligning with the neurobiological hypothesis of phonological and visual–phonological dysfunctions in dyslexia. Conversely, increased connectivity in the right hemisphere (20%) may indicate the engagement of an alternative network and highlight the complexity of neural adaptations in dyslexia. Conclusions: The findings highlight a significant gap in the study of adult dyslexia and suggest that FC alterations predominantly affect the left hemisphere, with possible compensatory mechanisms in the right hemisphere. Reading fluency improvements in dyslexia may be linked to connectivity changes across multiple brain networks rather than the classical reading circuitry alone. Increased and decreased connectivity in various regions related to executive function, language, and salience processing indicate that broader cognitive mechanisms play a key role in reading performance. Full article

The pine cone is an important forest product for the Portuguese economy. However, it is associated with environmental impacts, such as the generation of waste and the increased risk of forest fires. The objective of this research is to valorise waste from the production of Pinus pinaster Aiton in the form of natural dyes. The pine cone extracts were characterised in different alkaline solutions (1%, 5% and 10% NaOH) in order to evaluate the dyeing process on cotton knitwear, using the CIELab coordinates. The dyed samples were also subjected to light and water fastness tests. The extracts showed an increase in solids content with increasing alkalinity and a reduction in antioxidant content. The phenol content increased in the extract with 5% but decreased with the 10% concentration. All the dyes expressed a pink colour but with different shades. About the L* coordinate (luminosity), the colours became lighter as the NaOH increased. In the a* coordinate, all the samples had a reddish colour, and, in the b* coordinate, all the samples had a yellowish colour. About light and water fastness, all the samples lost colour, but in the water test, it was not noticeable. Full article

Liver metastases from soft tissue sarcoma (STS) (excluding gastrointestinal stromal tumors) are rare and more commonly arise from retroperitoneal and intra-abdominal primary sites. Chemotherapy remains the mainstay of treatment for disseminated disease, but its effectiveness is limited and patients typically have a dismal prognosis with short survival. However, when metastases are confined to the liver (without pulmonary involvement), some patients may benefit from local techniques, either surgical or nonsurgical, that can provide long periods of disease-free survival. Due to the rarity of STS, especially with liver metastases, and the heterogeneity of histologies and biological behavior, there is a lack of standardized treatment guidelines and universally accepted criteria for this specific setting. To fill this gap, a multidisciplinary working group of experts in sarcoma and liver surgery reviewed the literature and available evidence and developed a set of clinical recommendations to be voted and discussed in the I Ibero-American Consensus on the Management of Metastatic Sarcoma, held at the III Spanish-Portuguese Update Meeting on the Treatment of Sarcomas in May 2024. Herein, the voting results of this meeting and the resulting consensus recommendations are presented, and their applicability, strengths, and limitations are discussed. Full article

This review presents an in-depth analysis of the latest methods used for the determination of sucralose (E955), focusing on research conducted over the past 10 years. As a widely used sugar substitute in the food and pharmaceutical industries, sucralose has raised concerns about its environmental persistence, potential genotoxicity, and health impacts. This study examines several spectrophotometric, chromatographic, and electrochemical techniques, evaluating their sensitivity, selectivity, and limitations in differentiating sucralose from natural carbohydrates and other sweeteners. The review highlights the pressing need for novel detection methods that not only improve accuracy in trace detection but also address growing concerns about its bioaccumulation and conversion into harmful metabolites. Advancing these analytical techniques is essential for enhancing food safety, public health surveillance, and environmental risk assessment. Chromatographic methods are dominant in sucralose determination in foods and environmental objects, as they allow the determination of sucralose at micro- and nanomolar levels. However, spectrophotometric and electrochemical methods are frequently used as complementary to chromatographic methodologies, sensitizing them. On the other hand, purely spectrophotometric methods are less popular, and electrochemical methods remain underdeveloped. Therefore, the advancement of sucralose determination must be due to cheaper chromatographic and classical electrochemical methods. Full article

Mental health literacy (MHL) is defined as the ability to obtain, understand, and use information to identify, manage, and prevent mental health problems and helps university health students to manage mental health challenges by reducing stigma, fostering resilience, and promoting coping strategies. Objectives: To assess MHL levels in Portuguese university health students and explore its relationship with academic life and psychosocial domains; Identify knowledge gaps and educational needs regarding a targeted MHL intervention. Methods: A convergent parallel mixed-methods study, involving collecting quantitative (online cross-sectional survey) and qualitative (focus group) data simultaneously, followed by a separate and integrative analysis. Results: Twenty-four students (75% female, mean age = 25.5) were included. Overall, differences were found in the MHL domains in terms of sex (p = 0.025), mental health history variables (p = 0.020; p = 0.044; p = 0.007), and a negative relation with academic environment satisfaction (r_s = −0.571). Focus groups revealed the needs, gaps, and main characteristics for a targeted intervention. Integrative analysis used for data triangulation was possible and helped to converge and reinforce some of the data findings. Conclusions: This study highlights the importance of integrated methodological approaches to explore MHL among undergraduate health students. Also, it highlights the importance of promoting MHL through targeted interventions to enhance well-being and reduce distress in academic contexts. Full article

Background/Objectives: Chlorella and Spirulina supplementation may reduce the risk of cardiometabolic diseases by better controlling blood cholesterol, triglycerides, glucose, weight, and blood pressure (BP). However, the available studies are limited in size and have used different outcomes. Methods: To gain power in assessing the impact of microalgae supplements on cardiovascular risk factors, we searched PubMed on 3 February 2023 for randomised controlled trials assessing the effects of Chlorella and Spirulina on modifiable cardiovascular risk factors. Results: We found 12 studies in Chlorella and 9 studies on Spirulina. Depending on the available outcomes, varying numbers of participants (Chlorella: 168 to 279; Spirulina: 101 to 299) were included. Our analysis showed that Chlorella supplementation had a neutral effect on BP and lipemia. On the other hand, Spirulina intake led to a significant reduction in diastolic BP (−0.42, 95% CI: −0.81 to −0.02, p = 0.04) but did not significantly affect lipemia indexes, despite a trend toward a reduction in total cholesterol (−0.17, 95% CI: −0.39 to 0.06, p = 0.15). This meta-analysis suggests Spirulina supplementation can be used as an adjuvant to control cardiometabolic risk factors, particularly for BP. However, the magnitude of this effect is small and of uncertain clinical significance. Conclusions: Further randomised trials are needed to better assess the potential of these supplements as adjuvants for the control of cardiovascular risk factors. Full article