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Purpose: To analyze the efficacy and safety of a MIGS device (XEN gel stent ®) in the management of glaucoma in our tertiary center. Methods: Retrospective analysis of patients submitted to XEN ® implant alone or combined with cataract surgery. Patients with previous filtering surgeries were included. Intraocular pressure (IOP) was evaluated at 1st week, 1st, 3rd, 6th and 12th months after surgery. BCVA, RNFL thickness and number of antiglaucoma medications were evaluated 1 year after surgery. Early and late complications and need for an additional glaucoma surgery were recorded. Results: Thirty-four eyes from 28 patients were included. The main diagnosis was primary open angle glaucoma (POAG) (58.8%). IOP decreased from 20.5±4.9 mmHg to 15.4±4.1 mmHg 1 year after surgery (p

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Background: Life participation is an outcome of critical importance to patients receiving peritoneal dialysis (PD). However, there is no widely accepted or validated tool for measuring life participation in patients receiving PD. Methods: Online consensus workshop to identify the essential characteristics of life participation as a core outcome, with the goal of establishing a patient-reported outcome measure for use in all trials in patients receiving PD. Thematic analysis of transcripts was performed. Results: Fifty-six participants, including 17 patients and caregivers, from 15 countries convened via online videoconference. Four themes were identified: reconfiguring expectations of daily living (accepting day-to-day fluctuation as the norm, shifting thresholds of acceptability, preserving gains in flexibility and freedom), ensuring broad applicability and interpretability (establishing cross-cultural relevance, incorporating valued activities, distinguishing unmodifiable barriers to life participation), capturing transitions between modalities and how they affect life participation (responsive to trajectory towards stable, reflecting changes with dialysis transitions) and maximising feasibility of implementation (reducing completion burden, administrable with ease and flexibility). Conclusions: There is a need for a validated, generalisable outcome measure for life participation in patients receiving PD. Feasibility, including length of time to complete and flexible mode of delivery, are important to allow implementation in all trials that include patients receiving PD.

Cancer survivors are at an increased risk of adverse outcomes, including thyroid neoplasms, given the high radiosensitivity of this gland. The aim of this study is to assess the incidence and timeframe of thyroid complications in cancer patients, followed systematically since their radiation therapy, and to identify risk factors for the development of hypothyroidism and thyroid cancer.We performed a retrospective study, including 282 subjects, who received neck, craniospinal, or total body irradiation (TBI). Patients were grouped into four primary diagnostic clusters: leukaemia, Hodgkin's disease, central nervous system, and head and neck tumours.Hypothyroidism was observed in 56.7% of patients, on average 6.8 ± 5.9 years after the treatment. Neck and craniospinal irradiation presented a 3.5-fold increased risk for the development of hypothyroidism compared to TBI. Papillary thyroid cancer was diagnosed in 8.5% of the patients, on average, 18.5 ± 4.9 years after radiotherapy (RT). Female gender, younger age, and lower irradiation doses were independently associated with thyroid cancer development.Our study provides useful information about the risk of hypothyroidism and thyroid cancer after RT, as it was performed in a cohort of patients closely followed since the oncological therapies, and, thus, may give new insights into the follow-up management of these patients.

Background. Mediastinal thyroid carcinoma is extremely rare, with few cases reported in the literature. Case Report. A 73-year-old man presented with weight loss for 6 months. Imaging by computed tomography (CT) documented a large mediastinal mass below the thyroid gland and pulmonary metastases. Neck ultrasound found two spongiform nodules in the right thyroid lobe, and fine-needle aspiration citology (FNAC) of these nodules revealed they are benign. Endobronchial ultrasound-guided needle biopsy of the mediastinal mass was compatible with papillary thyroid cancer. A few weeks later, the patient developed overt hyperthyroidism due to Graves’ disease, which was treated with antithyroid drugs. 99mPertechnetate scintigraphy showed increased diffuse uptake in the thyroid parenchyma but the absence of uptake in the paratracheal mass and in the lung nodules. The patient was not considered eligible for surgical intervention or therapy with tyrosine kinase inhibitor due to tracheal and mediastinal vessel invasion and was treated with palliative radiotherapy. Two months later, restaging PET-FDG showed an intense uptake in the right lobe of the thyroid gland, lymph nodes, lungs, bone, muscle, myocardial, kidney, and adrenal gland. Conclusion. In this case, thyroid carcinoma presented as a mediastinal mass with concurrent hyperthyroidism due to Graves’ disease. Although uncommon, the clinicians should be aware of these situations. Obtaining a prompt histological examination of an intrathoracic mass is crucial to ensure an early diagnosis and treatment.

O novo Ensino Médio, que inicia em 2022, traz consigo importantes desafios para gestores escolares, professores e estudantes. Embora haja um grande convencimento da necessidade de uma mudança curricular, as ferramentas para viabilizar esta mudança não são simples e demandam um esforço coletivo para alcançar as metas ambiciosas da Base Nacional Curricular Comum (BNCC) e da Lei do Novo Ensino Médio (Lei nº 13.415/2017). As universidades, como centros formadores, devem ser peças fundamentais para difusão de conhecimento e práticas pedagógicas afins ao que se espera nesta nova proposta curricular. Nesta direção, o Programa de Pós-Graduação Profissional de Ensino de Física (PPGPF), que é o Polo 11 do Programa Nacional de Mestrado Profissional em Ensino de Física (MNPEF), por meio de parte dos seus docentes, colaboradores e egressos, se mobilizou na construção de uma proposta de ação formativa, apoiada pela Secretaria de Estado da Educação, do Esporte e da Cultura, composta de seis módulos, independentes, nos quais os cursistas foram apresentados a fundamentos importantes de algumas teorias educacionais, além de várias técnicas educacionais, entre elas ensino por investigação, grupos colaborativos, gamificação e ambientes digitais de experimentação. Nesta ação, foram apresentados alguns dos produtos educacionais desenvolvidos em dissertações de mestrado do PPGPF. Este trabalho relata os detalhes desta ação, seus impactos diretos em termos de capacitação de professores e as perspectivas que estabelecem a partir da formação da rede de colaboração e socialização dos produtos educacionais desenvolvidos nos projetos de pesquisa.

O entendimento mais atual de ensino exige que ele seja feito de forma interdisciplinar, para uma melhor compreensão da natureza e os seus fenômenos. Apoiado nisso, este trabalho apresenta um material didático em formato audiovisual que permite trabalhar conteúdos de Física de forma interdisciplinar usando a Paleontologia, que é uma das especialidades da Biologia. Foram elaboradas e publicadas 5 videoaulas, agrupadas em uma lista de reprodução intitulada “Newton e os Dinossauros”. Nas videoaulas, são apresentadas informações sobre a biomecânica e o comportamento do combate de dinossauros, e, a partir destas situações, são apresentadas as Leis de Newton.

The WHO considers that antimicrobial resistance (AMR) is among the ten greatest global public health risks of the 21st century. The expansion of human populations and anthropogenically related activities, accompanied by the fragmentation of natural habitats, has resulted in increased human-wildlife interaction. Natural ecosystems are therefore subjected to anthropogenic inputs, which affect the resistome of wild animals. Thus, urgent multisectoral action is needed to achieve the Sustainable Development Goals following the One Health approach. The present work falls within the scope of this approach and aims to characterize the AMR of the faecal microbiome of the red fox (

This work focuses on the identity constructions of Haitian immigrants in Chile. A qualitative study was conducted based on in-depth semi-structured interviews, which included analyzing thematic and intersectional contents in order to understand the identity constructions of the participants in their migration trajectories from Haiti to Chile. Results associated with the work and social experiences of the participants are presented, along with the ethnic-racial and sex-gender orders, bringing together differentiating axes such as religion, nationality, social class, and immigrant status. We found that the articulation of dimensions of oppression in Chile configures a Haitian-migrant-worker identity positioned as a radical otherness; incipient changes in sex-gender identities are also reported, emerging from subaltern social positions and as adaptation strategies in an adverse context.

Ana Marta,1,2 João Coelho,1 Rita Vieira,1 Ana Figueiredo,1 Rita Reis,1 Isabel Sampaio,1 Maria João Menéres,1,2 Pedro Menéres1,2 1Department of Ophthalmology, Centro Hospitalar e Universitário do Porto, Oporto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar, Oporto, PortugalCorrespondence: Ana MartaDepartment of Ophthalmology, Centro Hospitalar e Universitário do Porto, Largo do Prof. Abel Salazar, Porto, 4099-001, PortugalEmail analuisamarta2@gmail.comPurpose: To compare the predictability of biometric results in patients undergoing cataract surgery combined with Ahmed glaucoma valve (AGV) implantation according to tube position.Methods: A retrospective cohort study was performed in patients who underwent phacoemulsification surgery combined with AGV implantation with the tube in posterior (group PC) and anterior (group AC) chamber, between November 2012 and April 2020. The main outcome was the mean biometric prediction error, according to tube position, using different formulas.Results: The study included 49 eyes of 36 patients, 23 eyes in group PC and 26 eyes in group AC. Gender (p=0.774), age (p=0.822), type of glaucoma (p=0.168), preoperative correct distance visual acuity (p=0.139), axial length (p=0.765), anterior chamber depth (p=0.351), keratometry (p=0.577) and intraocular lens power (p=0.608) were similar between groups. Only preoperative intraocular pressure was higher in group PC (p=0.005). The mean prediction errors using Haigis, SRK/T, Hoffer Q, Holladay 1, Barrett Universal II, Kane and Hill RBF formulas were all positive in group PC (hyperopic) and all negative (myopic) in group AC. In group PC, there was no significant difference in prediction error between these formulas (p> 0.05). In group AC, the formula with the worst prediction error was Haigis (p=0.001), and the best was Barrett Universal II (p=0.043).Conclusion: The biometric predictability and expected final refraction in phacoemulsification surgery combined with AGV implantation are modified by the position of the tube.Keywords: glaucoma, Ahmed valve, cataract, phacoemulsification, biometry

Background: Scars interfere with the motor system; however, the influence of c-section scars has not been described yet. The aim of this study is to relate the presence of abdominal scars from a caesarean section with changes in postural control—stability and orientation and abdominal and lumbar neuromuscular control in the orthostatic position. Methods: Cross-sectional analytical observational study comparing healthy primiparous women with caesarean delivery (n = 9) and physiologic delivery (n = 12) who have delivered more than one year before. The relative electromyographic activity of the rectus abdominis, transverse abdominis/oblique internus and lumbar multifidus muscles, antagonist co-activation, the ellipse area, amplitude, displacement, velocity, standard deviation, and spectral power of the centre of pressure, and thoracic and lumbar curvatures, were evaluated in the standing position in both groups, through an electromyographic system, a pressure platform and spinal mouse system. In the “caesarean delivery” group, scar mobility was evaluated using a modified adheremeter. Results: Significant differences in CoP medial-lateral velocity and mean velocity were observed between groups (p < 0.050), while no significant differences were in the level of muscle activity, antagonist co-activation, and thoracic and lumbar curvatures (p > 0.05). Conclusions: The information provided by the pressure signal seems to identify postural impairments in women with c-sections.

PURPOSE To compare the retinal vasculature characteristics between eyes of patients with and without phacomatosis. METHODS Case-control observational study with retinal vasculature evaluation by optical coherence tomography and optical coherence tomography angiography of the macula and disk. RESULTS The study included 80 eyes. Neurofibromatosis Type 1 patients presented with a higher central macular thickness (P = 0.007), a lower optical disk nervous fiber layer (P = 0.006), a lower perimeter, area, and circularity of the foveal avascular zone (P < 0.05), a higher vascular density of macular avascular layer (AMVD) (P = 0.004), and a lower papillary vascular density of superficial capillary plexus (SPVD) (P = 0.048). Patients with tuberous sclerosis presented with an increase in central macular thickness (P = 0.024) and in vascular densities (P < 0.05) [except for macular vascular density of deep capillary plexus (PMVD), AMVD, and SPVD]. Patients with Sturge-Weber syndrome showed a decrease in optical disk nervous fiber layer (P < 0.001), subfoveal choroid thickness (P = 0.011), macular vascular density of superficial capillary plexus (SMVD) (P = 0.036), and SPVD (P < 0.001). CONCLUSION Phacomatosis patients showed statistically significant differences of retinal vasculature characteristics, compared to eyes without pathology. Further studies are needed to determine when and if these parameters change with the course of the disease and if they can be used as biomarkers for disease severity or progression.

International audience; Outcomes reported in randomized controlled trials in peritoneal dialysis (PD) are diverse, are measured inconsistently, and may not be important to patients, families, and clinicians. The Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative aims to establish a core outcome set for trials in PD based on the shared priorities of all stakeholders. We convened an international SONG-PD stakeholder consensus workshop in May 2018 in Vancouver, Canada. Nineteen patients/caregivers and 51 health professionals attended. Participants discussed core outcome domains and implementation in trials in PD. Four themes relating to the formation of core outcome domains were identified: life participation as a main goal of PD, impact of fatigue, empowerment for preparation and planning, and separation of contributing factors from core factors. Considerations for implementation were identified: standardizing patient-reported outcomes, requiring a validated and feasible measure, simplicity of binary outcomes, responsiveness to interventions, and using positive terminology. All stakeholders supported inclusion of PD-related infection, cardiovascular disease, mortality, technique survival, and life participation as the core outcome domains for PD.

When pharmacological treatment is needed to reach control of gestational diabetes mellitus (GDM), insulin is still first-line agent but metformin has been progressively pointed as an effective alternative. Our aim is to confirm whether metformin is an effective and safe option to insulin, by comparing maternal and foetal outcomes between women with GDM treated with these drugs. Retrospective study including 399 women with GDM, 135 needing pharmacological treatment. Comparison of demographic features, risk factors for GDM, maternal and foetal outcomes between women treated with insulin (G1, 41/135) and those treated with metformin (G2, 94/135). X2/Fisher tests were performed. Significance was set at p

El objetivo de este trabajo es conocer las experiencias de racismo del colectivo migrante haitiano en Chile desde una perspectiva interseccional. Atendemos a sus experiencias opresivas y también a sus resistencias frente a estas experiencias. Realizamos un estudio cualitativo con 16 personas haitianas (10 hombres y 6 mujeres) de entre 21 y 44 años, residentes en Santiago de Chile, con las cuales efectuamos 29 entrevistas semiestructuradas en profundidad. Como método de análisis de información, realizamos un análisis de contenido temático desde un enfoque interseccional. Identificamos racismo estructural, prejuicios manifiestos y racismo internalizado en la experiencia de los y las participantes. El color de piel se presenta como el marcador racial más importante y se encuentra articulado con la nacionalidad, la condición de migrante y/o el sexo-género. También, damos cuenta del fenómeno de racialización sexualizada hacia los hombres haitianos. Las diversas resistencias de los y las participantes hacia el racismo, muestran un reconocimiento positivo de las posiciones sociohistóricas de las personas haitianas. De este modo, pesquisamos identidades sociales resistentes e incipientes configuradas en torno al color de piel y la nacionalidad haitiana. Para líneas de investigación futura, creemos relevante extender el estudio del racismo en Chile desde el campo de la migración internacional, para atender a las estructuras racializadas desde las cuales se ejerce racismo hacia personas de pueblos originarios, afrochilenos y/o mestizos chilenos de piel oscura. Con este trabajo buscamos contribuir a visibilizar la presencia y consecuencias del racismo en Chile, y a promover la integración integral de la comunidad haitiana.

¿Por qué justifican las personas la violencia intergrupal ejercida entre la policía y manifestantes en protestas sociales? En este artículo se examinan las actitudes hacia la violencia perpetrada en Chile por Carabineros contra manifestantes y la violencia ejercida por manifestantes contra Carabineros en el marco del contexto post estallido social del 18 de octubre de 2019. Se evalúa el papel que juegan la percepción de injusticia en los procedimientos y el trato de Carabineros hacia manifestantes, la evaluación de la legitimidad de Carabineros y la identificación grupal con manifestantes y Carabineros en predecir la justificación de la violencia hacia Carabineros y hacia manifestantes. Se presentan los resultados de una encuesta no-probabilística online sobre legitimidad y violencia policial realizada a adultos en Chile durante enero de 2021 (n = 2.594). A través de un análisis de sendero, se encontró que la percepción de injusticia en los procedimientos de trato de Carabineros hacia los manifestantes es un factor clave al predecir la percepción de legitimidad de esa institución. Es más, al reducir la legitimidad de Carabineros, la percepción de injusticia en los procedimientos y el trato se traducen en una menor justificación de la violencia de Carabineros y una mayor justificación de la violencia de manifestantes. El artículo termina destacando la importancia de considerar las percepciones de injusticia en los procedimientos y el trato de Carabineros para lograr reducir el conflicto entre estos y los manifestantes en protestas en Chile.

Nisa Silva,1 André Ferreira,1,2 Pedro Manuel Baptista,1 Ana Figueiredo,1 Rita Reis,1 Isabel Sampaio,1 João Beirão,1,3 Riccardo Vinciguerra,4,5 Pedro Menéres,1,3 Maria João Menéres1,3 1Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal; 2Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, 4200-319, Portugal; 3Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal; 4Ophthalmology Department, Humanitas San Pio X Hospital, Milan, Italy; 5The School of Engineering, University of Liverpool, Liverpool, UKCorrespondence: Nisa SilvaOphthalmology Department, Centro Hospitalar Universitário do Porto, Portugal Largo do Prof. Abel Salazar, Porto, 4099-001, PortugalTel +351918367661Fax +351222077500Email nisapinhosilva@gmail.comBackground: To evaluate biomechanical parameters of the cornea provided by Corvis ST in patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma and to compare with healthy controls.Methods: This was a cross-sectional study of patients with ocular hypertension, primary open-angle glaucoma, and amyloidotic glaucoma that underwent Corvis ST imaging. Primary outcome was the comparison of corneal biomechanical parameters between study groups after adjusting for age, gender, Goldmann intraocular pressure (GAT-IOP), and prostaglandin analogues medication. Secondary outcome was the comparison of different IOP measurements in each group.Results: One hundred and eighty-three eyes from 115 patients were included: 61 with primary open-angle glaucoma, 32 with amyloidotic glaucoma, 37 with ocular hypertension and 53 were healthy controls. Amyloidotic glaucoma group had smaller radius (p=0.025), lower deflection amplitude at highest concavity (p=0.019), and higher integrated radius (p=0.014) than controls. Ocular hypertension group had higher stiffness parameter at first applanation (p=0.043) than those with primary open-angle glaucoma, and higher stress–strain index (p=0.049) than those with amyloidotic glaucoma. Biomechanically corrected intraocular pressure was significantly lower than Goldmann intraocular pressure in group with primary open-angle glaucoma (p=0.005) and control group (p=0.013), and Goldmann intraocular pressure adjusted for pachymetry in group with primary open-angle glaucoma (p=0.01).Conclusion: Eyes with amyloidotic glaucoma have more deformable corneas, while eyes with ocular hypertension have less deformable corneas. These findings may be linked to the susceptibility to glaucomatous damage and progression. There were significant differences between Goldmann applanation tonometry and biomechanically corrected intraocular ocular pressure provided by Corvis ST.Keywords: corneal biomechanics, ocular hypertension, glaucoma, amyloidosis, Goldmann tonometry

Introduction: Malignant pleural effusion (MPE) is a common manifestation in patients with advanced lung cancer. The LENT score was developed as a risk stratification system to predict the survival of these patients. However, following the discovery of molecular markers and a new era of personalized therapy, prognostic estimation became a challenging exercise. The aim of this study was to evaluate the performance of LENT score in predicting MPE survival in EGFR and ALK mutated lung adenocarcinoma. Methods: A retrospective single-center study of patients with MPE from lung adenocarcinoma followed between January 2008 to December 2018. Results: Forty-two patients were included in the study (mean age 76.4 ± 12.6 years, 52% female). Of these patients, 29% exhibited EGFR gene mutation or ALK gene translocation and received tyrosine kinase inhibitor therapy (TKI), in contrast to 71% of patients without identification of mutational factors and receiving conventional chemotherapy. Based on LENT score, in the sub-group treated with conventional chemotherapy, 67% had a moderate-risk category and 33% a high-risk category, with a median overall survival (OS) of 109 (31-406) and 36 (11-77) days, respectively. In the sub-group treated with targeted therapy, 75% were in a moderate-risk category and 25% in a high-risk category with a median OS of 1033 (245-1710) and 238 (27-not available) days, respectively. Patients receiving targeted therapy had a longer survival than patients receiving conventional chemotherapy in all LENT score risk categories (p

Introdução: A imunoterapia tem vindo a melhorar os outcomes dos doentes no carcinoma pulmonar de não pequenas células (CPNPC). No entanto, estudos recentes sugerem que a disrupção da microbiota induzida por antibióticos pode ter repercussões na sua eficácia. O objetivo deste estudo foi avaliar os outcomes de doentes com CPNPC avançado com PD‑L1≥50% tratados com imunoterapia em primeira linha considerando o tratamento concomitante com antibióticos (ATB). Métodos: Selecionámos os processos clínicos de todos os doentes da consulta de Pneumologia Oncológica do nosso hospital tratados com imunoterapia em 1.ª linha com pembrolizumab desde abril de 2017. Foi realizada análise estatística comparativa de dados demográficos e eficácia (resposta à terapêutica e sobrevida livre de progressão) entre dois subgrupos em função da utilização, ou não, de ATB nos 30 dias anteriores ou posteriores ao início da imunoterapia. Resultados: Foram incluídos 41 doentes, idade média de 65 anos, 70,7% do género masculino e 87,8% com exposição prévia ao fumo do tabaco. Em 13 (31,7%) desses doentes foi administrado ATB com duração média de tratamento de 10,5 dias. Os doentes submetidos a tratamento com ATB apresentaram taxas de progressão da doença superiores e estatisticamente significativas em comparação com o grupo controlo (61,5% vs. 25,9%). No entanto, a sobrevida livre de progressão (PFS) não foi significativamente diferente entre esses dois grupos. Conclusões: Como sugerido por estudos prévios, em doentes sob imunoterapia a taxa de controlo de doença foi inferior aquando utilização de ATB. Maior tempo de follow -up irá permitir-nos perceber se este impacto negativo se traduz em pior PFS ou sobrevida global neste subgrupo de doentes.

OBJECTIVE: To evaluate the surgical outcomes of patients with hereditary transthyretin amyloidosis (TTR-FAP) who underwent Ahmed glaucoma valve (AGV) implantation. METHODS: A retrospective cohort study was performed on patients with a diagnosis of TTR-FAP secondary glaucoma, who underwent AGV implantation in our department, between November 2010 and July 2019. The cumulative probability of treatment success was measured with Kaplan-Meier survival analysis. The primary outcome was success, defined as intraocular pressure (IOP) ≥ 6 mmHg and ≤21 mmHg with or without medication, with no need for further glaucoma surgery and without loss of light perception at last follow-up. Secondary outcomes were postoperative IOP, number of IOP-lowering medications, and rates of complications. RESULTS: The study included 114 eyes of 87 patients. The mean follow-up duration was 3.81 ± 2.11 years (y) [range, 1.00–8.28 y]. Compared to the preoperative values, the mean IOP was reduced from 28.20 ± 7.01 to 12.87 ± 3.76 mmHg at the final visit (p

Enquadramento: o Investimento na Vida Pessoal (IVP) pode indicar-nos a valorização e atribuição de objetivos de vida do idoso, em todos os seus atributos e caraterísticas. Objetivo: avaliar o nível e determinantes de IVP percecionado pelos idosos institucionalizados. Metodologia: estudo não experimental, descritivo-correlacionai e quantitativo, realizado numa amostra de 90 idosos institucionalizados da região Centro do País. Foi utilizado um questionário, o índice de Barthel, escala de Apgar Familiar, escala da Espiritualidade, escala de Satisfação com a Vida e escala de Avaliação de Investimento na Vida Pessoal. Resultados: a perceção dos idosos sobre o IVP é para 37,8% elevado, moderado para 30,0% e baixo para 32,2%. Os homens avaliam o investimento de uma forma mais positiva que as mulheres (p =0,047), assim como os idosos com habilitações académicas superiores (p = 0,041) e com maior nível de independência funcional (p = 0,037) Também a família tem um efeito positivo e significativo (p = 0,020) no IVP do idoso, à semelhança da existência de mais esperança (p = 0,002) e maior satisfação com a vida (p = 0,013). Conclusão: os níveis de IVP dos idosos é diferenciados mas maioritariamente positivo e correlaciona-se de forma significativa com diversas variáveis que trabalhadas contribuem para um envelhecimento ativo e com qualidade.

Resumen La marihuana es la droga ilicita mas consumida en el mundo con prevalencia de 2,5 a 5% y la segunda sustancia fumada despues del tabaco. Los componentes del humo por la combustion de esta sustancia son similares a los producidos en la combustion del tabaco, pero difieren en la sustancia psicoactiva y en la practica de fumar. La inhalacion del humo de cannabis produce consecuencias sobre el aparato respiratorio. Por ello se hace necesario actualizar la evidencia disponible para ofrecer informacion cientifica al neumologo. En este articulo se revisa el impacto del consumo de cannabis en los pulmones, teniendo en cuenta que la ruta mas popular de la ingestion de cannabis es a traves de las vias respiratorias.

Marijuana is the most widely usedillegal drug in the world, with a prevalence of 2.5%-5%, and the second most commonly smoked substance after tobacco. The components of smoke from combustion of marijuana are similar to those produced by the combustion of tobacco, but they differ in terms of psychoactive components and use. Inhalation of cannabis smoke affects the respiratory tract, so the available evidence must be updated in order to provide pulmonologists with the latest scientific information. In this article, we review the impact of cannabis consumption on the lungs, taking into account that the respiratory route is the most popular route of cannabis consumption.

Background: Chest movement quantification and noninvasive monitoring have been useful in evaluation of newborn (NB) lung function. Different methods have already been tested, however, there is little progress regarding the agreement of these new tools in neonatal practice. Aim: To evaluate the agreement between the tidal volume (Vt) estimated by the three-dimensional analysis of the thoracoabdominal movement in the Matlab® software and the Vt predicted by the body weight of term newborns (NBs). Methods: This is a cross-sectional, quantitative and analytical study with NBs filmed for 2 minutes in a dorsal position and maximal exposure of the thoracoabdominal region. Vt (in ml) was estimated from the three-dimensional analysis of thoracoabdominal movement in the Matlab® software and compared to the predicted Vt per kilogram of weight for each NB (5 ml/kg), on a Bland-Altman plot. Results: Thirteen NBs (gestational age: 39.1 ± 0.8 weeks), with a mean weight and length of 3175.4 ± 493.8g and 49 ± 2.8cm, respectively, were included in the study. Vt estimated by the kinematic analysis was 16.3 ± 4.2 ml and 15.9 ± 2.5 ml according to the calculation for the predicted value for weight. The difference between the means of the studied values was 0.4 ml (bias), with p = 0.624 and confidence interval of -5.2 to 6.0 ml. Conclusions: The methods for Vt measuring are interchangeable in this sample of NBs, suggesting that the three-dimensional analysis of thoracoabdominal motion in Matlab® software can estimate the Vt of terms NBs, in a simple, fast and noninvasive way. Thus, the evaluation by Matlab® is promising and should be tested with methods that are gold standard for Vt evaluation.

Metronomic oral vinorelbine (MOV) could be a treatment option for unfit patients with advanced non-small cell lung cancer (NSCLC) based on its safety profile and high patient compliance. We retrospectively collected data on 270 patients [median age 76 (range 48–92) years, M/F 204/66, PS 0 (27)/1 (110)/≥ 2 (133), median of 3 serious comorbidities] with stage IIIB-IV NSCLC treated with MOV as first (T1) (67%), second (T2) (19%) or subsequent (T3) (14%) line. Schedules consisted of vinorelbine 50 mg (138), 40 mg (68) or 30 mg (64) three times a week continuously. Patients received an overall median of 6 (range 1–25) cycles with a total of 1253 cycles delivered. The overall response rate was 17.8% with 46 partial and 2 complete responses and 119 patients (44.1%) experienced stable disease > 12 weeks with an overall disease control rate of 61.9%. Median overall time to progression was 5 (range 1–21) months [T1 7 (1–21), T2 5.5 (1–19) and T3 4 (1–19) months] and median overall survival 9 (range 1–36) months [T1 10 (1–31), T2 8 (1–36) and T3 6.5 (2–29) months]. Treatment was extremely well tolerated with 2% (25/1253) G3/4 toxicity (mainly G3 fatigue and anemia) and no toxic deaths. We observed the longer OS 14 (range 7–36) months in a subset of squamous NSCLC patients receiving immunotherapy after metronomic oral vinorelbine. We confirmed MOV as an extremely safe treatment in a large real world population of advanced NSCLC with an interesting activity mainly consisting of long-term disease stabilization. We speculate the possibility of a synergistic effect with subsequent immunotherapy.

This work is focused on the study of thermomechanical behavior of a Polyoxymethylene-based gear at high temperatures using ANSYS16. The deformation of the gear teeth due to thermal loads was also studied through coupled thermal-structural analyses. The displacement results are obtained by numerical and experimental studies and compared with each other. It was concluded that the experimental and numerical results are in agreement.

The stone marten (Martes foina) is one of the most common species of marten in Europe. Due to increased urbanization and forest degradation, it is now often found in urban habitats, which increased the possibility of parasites transmission between wildlife-domestic animals and humans. Our preliminary study of this mustelid in Portugal, aimed to assess prevalence of helminths. Six helminth parasites were found (Crenosoma vulpis, Angiostrongylus sp., Toxocara sp., Toxascaris leonina, Ancylostomatidae and Strongyloides sp.). To our knowledge, this is the first report of Toxascaris leonina in this host species.

Skin disorders currently affect millions of people worldwide with physical and often traumatic psychological implications for quality of life. The primitive topical application of mud, urine, oils, plant extracts and animal products give evidence to the knowledge of ancient societies on the need to maintain a healthy skin and treat skin disorders. Cyclodextrins were first isolated and reported by the French scientist Villiers in 1891, as the product of bacteria-induceddegradation of starch. The developments of biotechnological and industrial chemistry processes of the 20th century led to the synthetic or semi- synthetic modification of many natural molecules. In the treatment of any skin disorder, the efficacy of dermal therapy is dependent on the efficient delivery of the drug to the target sites of drug action. Skin penetration enhancers are a group of agents used in dermal formulations to facilitate the disruption of physiological barrier system of the skin for enhanced drug penetration.

Marijuana is the most widely usedillegal drug in the world, with a prevalence of 2.5%-5%, and the second most commonly smoked substance after tobacco. The components of smoke from combustion of marijuana are similar to those produced by the combustion of tobacco, but they differ in terms of psychoactive components and use. Inhalation of cannabis smoke affects the respiratory tract, so the available evidence must be updated in order to provide pulmonologists with the latest scientific information. In this article, we review the impact of cannabis consumption on the lungs, taking into account that the respiratory route is the most popular route of cannabis consumption.

Hospital environmental conditions, human occupancy, and the characteristics of the equipment influence the survival of microbial communities and raise a concern with regard to nosocomial infections. The objective of the present work was to use the monitoring of Pseudomonas aeruginosa, Klebsiella spp. and non-tuberculous mycobacteria as a strategy to improve knowledge on microbial colonization of non-critical equipment and surfaces, in a tertiary hospital from Central Portugal. A 3-month microbiological survey was performed in a district teaching hospital. A total of 173 samples were obtained from the wards Hematology, Urology, Medicine, and Renal Transplants, and 102 presumptive strains recovered. Per sampling, Pseudomonas Isolation agar showed 42.8 to 73.3% of presumptive P. aeruginosa colonies and MacConkey agar recovered mostly Staphylococcus. Most of the colonies recovered in Middlebrook 7H10-PANTA belonged to the genus Methylobacterium. Taps and WC shower curtains carry high bacterial species diversity. The Redundancy Analysis grouped the samples in those mostly handled by patients, and those mostly handled by healthcare staff or of mixed use. This study shows that the preferential users of the space and equipment seem to be important contributors to the microbial community. The most recovered genus was Methylobacterium, known as colonizer of the water distribution system therefore, it is possible that the water points and biofilms in taps also contribute as dispersion hotspots.

PURPOSE: To evaluate the effectiveness, recurrence rate, and complications of carbon-dioxide laser vaporization in the treatment of Bartholin's gland cysts. METHODS: A retrospective study including 127 patients with symptomatic Bartholin' gland cysts submitted to carbon-dioxide laser vaporization at our institution from January 2005 to June 2011. Patients with Bartholin's gland abscesses and those suspected of having neoplasia were excluded. All procedures were performed in an outpatient setting under local anaesthesia. Clinical records were reviewed for demographic characteristics, anatomic parameters, intraoperative and postoperative complications, and follow-up data. Data were stored and analyzed in Microsoft Excel® 2007 software. A descriptive statistical analysis was performed, and its results were expressed as frequency (percentage) or mean±standard deviation. Complication, recurrence, and cure rates were calculated. RESULTS: The mean age of the patients was 37.3±9.5 years-old (range from 18 to 61 years-old). Seventy percent (n=85) of them were multiparous. The most common symptom was pain and 47.2% (n=60) of patients had a history of previous medical and/or surgical treatment for Bartholin's gland abscesses. Mean cyst size was 2.7±0.9 cm. There were three (2.4%) cases of minor intraoperative bleeding. Overall, there were 17 (13.4%) recurrences within a mean of 14.6 months (range from 1 to 56 months): ten Bartholin's gland abscesses and seven recurrent cysts requiring reintervention. The cure rate after single laser treatment was 86.6%. Among the five patients with recurrent disease that had a second laser procedure, the cure rate was 100%. CONCLUSIONS: At this institution, carbon-dioxide laser vaporization seems to be a safe and effective procedure for the treatment of Bartholin's gland cysts. OBJETIVO: Avaliar a eficácia, a taxa de recorrência e as complicações da vaporização laser com CO2 no tratamento dos cistos da glândula de Bartholin. MÉTODOS: Estudo retrospectivo com 127 pacientes que apresentavam cistos sintomáticos da glândula de Bartholin submetidas à vaporização laser CO2 na nossa instituição de janeiro de 2005 a junho de 2011. Foram excluídas todas as pacientes com abcessos da glândula de Bartholin ou com suspeita de câncer. Todos os procedimentos foram realizados em regime ambulatorial, sob anestesia local. A coleta dos dados foi feita com base na consulta do processo clínico, tendo-se procedido à análise das características demográficas, dos parâmetros anatômicos, das complicações intra e pós-operatórias e dos dados de acompanhamento. Os dados foram armazenados e analisados no software Microsoft Excel® 2007, e os resultados foram apresentados como frequência (porcentagem) ou média±desvio padrão. As taxas de complicações, recorrência e cura foram calculadas. RESULTADOS: A idade média das pacientes foi de 37,3±9,5 anos (variando entre 18 e 61 anos). Setenta por cento (n=85) delas eram multíparas. A queixa mais frequente foi dor e 47,2% (n=60) das pacientes tinham antecedentes de tratamento médico e/ou cirúrgico por abcesso da glândula de Bartholin. A dimensão média dos cistos foi de 2,7±0,9 cm. Foram verificados três (2,4%) casos de hemorragia intraoperatória ligeira e 17 (13,4%) recorrências durante um período médio de 14,6 meses (variando entre 1 e 56 meses): dez abscessos da glândula de Bartholin e sete cistos recorrentes, que precisavam de uma nova intervenção cirúrgica. A taxa de cura após um único tratamento à laser foi de 86,6%. Dentre as cinco pacientes com doença recorrente que foram submetidas a um segundo procedimento com laser, a taxa de cura foi de 100%. CONCLUSÕES: Na presente instituição, a vaporização laser com CO2 parece ser uma opção terapêutica segura e eficaz no tratamento dos cistos da glândula de Bartholin.

OBJETIVO: Avaliar as alteracoes epidemiologicas, de perfil clinico e de prognostico obstetrico em pacientes portadoras de diabetes mellitus pre-gestacional. METODOS: Estudo retrospetivo (coorte) de todas as gestacoes simples, com diagnostico de diabetes previo que foram seguidas num centro com apoio perinatal diferenciado entre 2004 e 2011 (n=194). Analisaram-se tendencias relacionadas com dados demograficos e variaveis clinicas maternas, dados de indicadores de cuidados pre-concepcionais e durante a gravidez, e de controle metabolico. Dados do parto como a idade gestacional (IG) do parto, via do parto e peso do neonato foram variaveis tambem estudadas. RESULTADOS: A frequencia global de diabetes previa, durante o periodo estudado, foi de 4,4 por mil, nao se verificando variacoes significativas durante o periodo de estudo. Os casos de diabetes tipo 2 permaneceram constantes. Em 67% dos casos o parto foi de termo (maximo de 80% em 2010 - 2011), registrou-se uma reducao significativa dos partos por cesarea eletiva (p=0,03) e na incidencia de neonatos considerados grandes para a IG (p=0,04) ao longo dos anos em estudo. Apesar dos bons resultados relacionados com o controle metabolico ao longo da vigilância da gravidez nao foi registrada nenhuma melhora ao longo do tempo. Da mesma forma a proporcao de gestantes diabeticas com avaliacao pre-concepcional permaneceu pouco animadora. CONCLUSOES: O seguimento de gestantes portadoras de diabetes mellitus em unidades multidisciplinares parece permitir um ajuste metabolico tao precoce quanto possivel, de forma a conseguir melhorar o prognostico obstetrico. A melhora nos cuidados pre-concepcionais continua sendo um desafio.

Objective The study aimed to evaluate effectiveness and recurrence rate of vulvar intraepithelial neoplasia (VIN) treatment according to treatment modalities as follows: imiquimod (Aldara), laser ablation, laser excision, wide local excision, and skinning vulvectomy. It also aimed to analyze risk factors associated to VIN recurrence. Materials and methods Between January 1997 and December 2010, 29 women were treated and followed up for VIN in our center. Demographics, risk factors, treatment modality, effectiveness, and recurrence data were recorded retrospectively. Study analysis used Student t test and χ2 test. Results The median age was 52 years (range = 22-77 years); 52% were smokers, 31% were immunosuppressed, and 34% had concomitant or previous lower genital tract dysplasia. Of all patients, 38% had laser ablation, 31% had laser excision, 24% had wide local excision, and 3% had vulvectomy and imiquimod, with 86.2% overall effectiveness and 20% recurrence (2 laser excision and 2 wide local excision), within a mean of 35 months. Conclusions Excisional treatment has diagnostic and treatment advantages in VIN lesions. The goal is to prevent development of invasive vulvar cancer while preserving normal vulvar anatomy and function.

Introduction: School violence is a public health problem with serious individual and social consequences. This case report aims to alert family doctors to the high prevalence of bullying and to emphasize the importance of their involvement in the pre- vention, diagnosis, and treatment of the possible consequences of bullying. Case description: A 15 year old male patient visited his family doctor and complained of aggression by his classmates. He also complained of insomnia, irritability, poor appetite and school refusal. School officials were not aware of the problem. The school principal reported the case to the child protection services but did not accept the family doctor's justification for school absences or the family's request to transfer the boy to another school. The case was discussed by the family doctor and the head of child protection services. They decided that the adolescent should be enrolled in another school. After integration in the new school, he began to reveal emotional maladjustment with aggres- sive behaviour against himself and others. He was referred to child psychiatry emergency services. The adolescent revealed de- pressive symptoms related to school violence. Comment: The management of bullying requires a multidisciplinary team. The family doctor is uniquely placed to identify risks, advise families, and follow psychiatric co-morbidity. The family doctor should consider bullying when there are unexplained psychosomatic symptoms, school problems, disruptive behaviors or suicidal thoughts. The emphasis should be placed on pri- mary prevention. Family doctors should improve and develop their skills related to the management of bullying.

This paper discusses the new practices developed in the discipline of Preventive and Social Dentistry I (OPS I) of the UEFS Dentistry Course according to the National Curriculum Guidelines (DCN) for Dentistry Courses and Oral Health Policies of the SUS, in relation to students and professionals of the education and health areas. Using a problematizing approach to the teaching-learning process, curricular internship under teacher guidance has brought students closer to the reality that makes up the Family Health Units (USF). This fact makes it possible for students and professors a) to experience the routine and practice of the health service, b) to carry out actions to promote health with an approach focusing on risk factors or protection against diseases of the mouth and other aggravations, and c) to monitor home visits and activities in health education involving Family Health Teams, oral health and the community. The locus of operation of the Family Health Teams (ESF) has become the area of training of the health professionals, thus allowing students to integrate actions in their services and in the community, thus giving them an understanding of the ESF work process and the importance of knowing the social reality of the population as a determinant of general and oral health. This strategy aims not only at training excellent technicians, but also at training a generalist professional with broad scientific knowledge, who is sensitive, who knows how to care, welcome and listen to patients, and who feels responsible for their health. O presente trabalho discute as novas práticas desenvolvidas na disciplina de Odontologia Preventiva e Social I (OPS I) do curso de Odontologia da UEFS, em consonância com as Diretrizes Curriculares Nacionais (DCN) para o curso de Odontologia e às Políticas de Saúde Bucal no SUS, junto aos estudantes e profissionais da área de educação e de saúde. Utilizando-se uma concepção problematizadora no processo de ensino-aprendizagem, o estágio curricular, sob orientação docente, tem aproximado os discentes da realidade que compõe as Unidades de Saúde da Família (USF). Tal fato possibilita aos discentes e professores: a) vivenciarem a rotina e a prática do serviço de saúde; b) realizarem ações de promoção de saúde, com abordagem sobre os fatores de risco ou proteção para doenças da boca e outros agravos; c) acompanharem visitas domiciliares e atividades de educação em saúde, envolvendo Equipes de Saúde da Família, de Saúde Bucal e comunidade. O território de atuação das Equipes de Saúde da Família (ESF) tem se constituído como cenário de formação dos profissionais de saúde, o que permite aos graduandos integrarem ações junto ao serviço e à comunidade, proporcionando aos mesmos a compreensão do processo de trabalho da ESF e a importância do conhecimento da realidade social da população como determinante da saúde geral e bucal. Esta estratégia visa, além da formação de um excelente técnico, um profissional generalista, com amplo conhecimento científico, sensível, que saiba cuidar, acolher e ouvir o usuário, responsabilizando-se por sua saúde.