Search

Introdução: A monitorização da temperatura, manutenção da normotermia, prevenção e tratamento da hipotermia perioperatória são considerados, atualmente, standard of care. É necessária a existência de protocolos que visem a monitorização, avaliação, prevenção e controlo da hipotermia na fase intraoperatória. Esta associação, evita complicações, garante a segurança e conforto do doente cirúrgico, levando à qualidade de todo o processo cirúrgico. Objetivo: Mapear as intervenções de enfermagem para a manutenção da normotermia no perioperatório. Métodos: Scoping Review com base nos princípios preconizados pelo Joanna Briggs Institute. Realizada pesquisa nas bases: SCOPUS, Web of Science e EBSCOhost Web da Escola Superior de Enfermagem do Porto e as bases de dados consultadas foram a CINAHL Complete, MedcLatina e a MEDLINE Complete. Para pesquisa de literatura cinzenta foi utilizado o Repositório Científico de Acesso Aberto de Portugal – RCAAP. Foram incluídos estudos publicados com livre acesso online, em texto integral, em português, espanhol ou inglês, com limite temporal entre 2013 a 2023. Resultados: Para conseguir a normotermia perioperatória, os enfermeiros devem adotar métodos de aquecimento do doente. Os estudos apontam para a utilização de mantas térmicas, cobertores aquecidos e ar forçado, e monitorizar a temperatura do doente de forma regular e estruturada. Conclusão: A manutenção da normotermia perioperatória pode ser conseguida através da adoção do aquecimento do doente e é essencial para garantir a segurança, melhorar o resultado do procedimento cirúrgico, garantir o conforto e a satisfação do doente com a experiência cirúrgica.

Background Standard of care treatment of non-muscle invasive bladder cancer (NMIBC) with intravesical Bacillus Calmette Guérin (BCG) is associated with side effects, disease recurrence/progression and supply shortages. We recently showed in a phase I trial (NCT03421236) that intravesical instillation in patients with NMIBC with the maximal tolerated dose of Ty21a/Vivotif, the oral vaccine against typhoid fever, might have a better safety profile. In the present report, we assessed the immunogenicity of intravesical Ty21a in patients of the clinical trial that had received the maximal tolerated dose and compared it with data obtained in patients that had received standard BCG.Methods Urinary cytokines and immune cells of patients with NMIBC treated with intravesical instillations of Ty21a (n=13, groups A and F in NCT03421236) or with standard BCG in a concomitant observational study (n=12, UROV1) were determined by Luminex and flow cytometry, respectively. Serum anti-lipopolysaccharide Typhi antibodies and circulating Ty21a-specific T-cell responses were also determined in the Ty21a patients. Multiple comparisons of different paired variables were performed with a mixed-effect analysis, followed by Sidak post-test. Single comparisons were performed with a paired or an unpaired Student’s t-test.Results As compared with BCG, Ty21a induced lower levels of inflammatory urinary cytokines, which correlated to the milder adverse events (AEs) observed in Ty21a patients. However, both Ty21a and BCG induced a Th1 tumor environment. Peripheral Ty21a-specific T-cell responses and/or antibodies were observed in most Ty21a patients, pointing the bladder as an efficient local immune inductive site. Besides, Ty21a-mediated stimulation of unconventional Vδ2 T cells was also observed, which turned out more efficient than BCG. Finally, few Ty21a instillations were sufficient for increasing urinary infiltration of dendritic cells and T cells, which were previously associated with therapeutic efficacy in the orthotopic mouse model of NMIBC.Conclusions Ty21a immunotherapy of patient with NMIBC is promising with fewer inflammatory cytokines and mild AE, but induction of immune responses with possible antitumor potentials. Future phase II clinical trials are necessary to explore possible efficacy of intravesical Ty21a.

Dietary protein quality plays a key role in maintaining intestinal mucosal integrity, but also modulates the growth of luminal microorganisms. This work assessed the effect of dietary protein sources on the performance, gut morphology, and microbiome in Nile tilapia. Four isonitrogenous and isolipidic diets comprising equivalent amounts of the protein supply derived from either PLANT, ANIMAL, INSECT, or BACTERIAL (bacterial biomass) sources were fed to triplicate groups of fish (IBW: 12 g) for 46 days. Fish fed the ANIMAL and BACTERIAL diets showed significantly higher weight gains than those fed the PLANT and INSECT diets (p < 0.05). Relative abundance at the phylum level showed that Bacteroidetes, Fusobacteria, and Proteobacteria were the more abundant phyla in tilapia’s intestine, while Cetobacterium was the most representative genus in all treatments. Interesting patterns were observed in the correlation between amino acid intake and genus and species abundance. Metabolism prediction analysis showed that BACTERIAL amine and polyamine degradation pathways are modulated depending on diets. In conclusion, different protein sources modulate the relationship between bacteria functional pathways and amino acid intake.

This is a two-center, case series of three patients with postoperative refractory cystoid macular edema (CME) and disruption of the iris–lens diaphragm, submitted to scleral fixation of fluocinolone acetonide implant. All patients achieved successful CME reduction with visual acuity improvement. The surgical procedure was uneventful in all cases; however, one patient developed hypotony with leakage from the scleral tunnel, which was successfully resolved with reinforcement of the suture and injection of viscoelastics in the anterior chamber. No case of implant migration was observed and patients did not report any visual field disturbances. Our results emphasize this surgical technique as an effective and safe procedure for patients with persistent CME and disruption of the iris–lens diaphragm.

Background Nosocomial meningitis is a medical emergency that requires early diagnosis, prompt initiation of therapy, and frequent admission to the intensive care unit (ICU). Methods A retrospective study was conducted in adult patients diagnosed with nosocomial meningitis who required admission to the ICU between April 2010 and March 2020. Meningitis/ventriculitis and intracranial infection were defined according to Centers for Disease Control and Prevention guidelines. Results An incidence of 0.75% of nosocomial meningitis was observed among 70 patients. The mean patient age was 59 years and 34% were ≥65 years. Twenty-two percent of patients were in an immunocompromised state. A clear predisposing factor for nosocomial meningitis (traumatic brain injury, basal skull fracture, brain hemorrhage, central nervous system [CNS] invasive procedure or device) was present in 93% of patients. Fever was the most frequent clinical feature. A microbiological agent was identified in 30% of cases, of which 27% were bacteria, with a predominance of Gram-negative over Gram-positive. Complications developed in 47% of cases, 24% of patients were discharged with a Glasgow coma scale

Abstract Daily medication use can be affected by the gradual loss of functional ability. Thus, elderly patients are at risk for nonadherence due to functional decline, namely, decreases in cognitive skills and visual and manual dexterity. The main objective was to assess the ability of older people to self-manage their medication and to identify the main predictors for unintentional nonadherence. A cross-sectional study was conducted (2014–2017) in community centers and pharmacies. Functional assessment was performed with the Portuguese versions of the Drug Regimen Unassisted Grading Scale (DRUGS-PT) and the Self-Medication Assessment Tool (SMAT-PT). A purposive sample including 207 elderly patients was obtained. To identify the main predictors, binary logistic regression was performed. The average DRUGS-PT score was slightly lower than that in other studies. On the SMAT-PT, the greatest challenge for patients was identifying medications by reading labels/prescriptions. The main difficulties identified were medication memorization and correct schedule identification. The scores were higher with the real regimen than with the simulated regimen, underlining the difficulties for patients in receiving new information. Regarding the predictors of an older individual’s ability to self-manage medications, two explanatory models were obtained, with very high areas under the curve (> 90%). The main predictors identified were cognitive ability, level of schooling and daily medication consumption.

Introduction: Moral distress occurs when one knows the morally correct action to take but is constrained from taking that action. The aims of this study were to translate into European Portuguese and culturally adapt the “Measure of Moral Distress – Healthcare Professionals” questionnaire to the context of the Portuguese healthcare system and to explore the frequency and intensity of moral distress occurring among medical students. Material and Methods: The “Measure of Moral Distress – Healthcare Professionals” questionnaire was translated and culturally adapted to European Portuguese, following the internationally accepted “COnsensus-based Standards for the selection of health Measurement INstruments”. Afterwards, a web-based survey was conducted, following the “Checklist for Reporting Results of Internet E-Surveys” guidelines. Medical students were asked to rate potentially morally distressing situations on frequency and intensity. Results: Of approximately 4300 medical students, 939 (22%) completed the survey. Participants experienced, on average, 16 morally distressing situations. Median of composite score of moral stress was 79 (IQR 44 - 118). Only 31% of the students felt well prepared to handle a morally distressing situation, 26% considered leaving medical school and 28% thought about choosing a non-clinical specialty due to moral distress. Conclusion: Despite a plethora of studies on this topic, the results suggested that moral distress is still a common phenomenon among medical students with a cumulative effect over time. These results emphasize the importance of a critical review of medical education, reducing the harmful effects of preventable psychological phenomena in clinical practice and in the lives of future healthcare professionals.

Several feed additives have proved to be beneficial in eliciting fish health. Β-glucans and curcumin are compounds with immunomodulatory capacities known to increase growth performance, stimulate immunity, improve general health, and enhance disease resistance in fish. The present study aimed to evaluate the effects of dietary Phaeodactylum tricornutum extracts rich in β-glucans and curcumin on gilthead seabream health status prior to and following an intestinal inflammatory stimulus. Three experimental diets were formulated: a practical commercial-type diet (CTRL), a CTRL diet supplemented with 1% microalgae-derived β-glucans extract (BG), and a CTRL diet supplemented with 0.2% of curcumin (CUR). After 30 days of the feeding trial, fish were sampled and subjected to an oral administration of 1% dextran sodium sulphate (DSS) to induce intestinal inflammation. Four groups were considered: a group of fish continued to be fed on the CTRL diet while the remaining groups were exposed to DSS, including CTRL-D (CTRL + DSS), BG-D (BG + DSS), and CUR-D (CUR + DSS), for 6 days. Growth, plasma and gut humoral immunity, liver and gut oxidative stress biomarkers, and intestinal gene expression were evaluated. No significant differences were found in growth after 30 days of feeding; however, seabream fed BG had decreased anti-protease activity and nitric oxide concentration in plasma while those fed CUR had increased mRNA levels of the tnfα, csf1r, and hep genes compared to those fed CTRL. After the inflammatory stimulus, hematocrit was enhanced in fish fed BG-D and CUR-D while red blood cell counts increased in those fed CTRL-D. Superoxide dismutase activity decreased in the intestine of all DSS groups while lipid peroxidation increased in the gut of fish fed CTRL-D and BG-D compared to CTRL. Moreover, the mRNA expression levels of csfr1 and sod decreased in fish fed CTRL-D and BG-D compared to CTRL, respectively. Despite the mild intestinal inflammatory condition induced by DSS, CUR was able to partially ameliorate its effects, improving the hematological profile and assisting against the oxidative stress.

O objetivo desta pesquisa é analisar as estratégias de consolidação da marca e seu vínculo com o território do Complexo do Alemão, no Rio de Janeiro, a partir do Instagram da marca brasileira Kurandé. O estudo se justifica pelo predomínio de trabalhos sobre marcas territoriais ligados essencialmente a produtos e cidades. Exemplo são as de Melbourne, na Austrália e Porto Alegre (RS), no Brasil, que criaram assinaturas visuais, denominadas identidades territoriais, para promover a localidade, estimular o turismo, investimentos externos e as importações. Assim, mostra-se relevante por analisar as estratégias das comunidades periféricas para sua inserção no mercado, ao mesmo tempo em que constroem uma imagem que busca a quebra de estereótipos sobre esses territórios. Utilizamos o aporte sobre branding territorial de Giovana Almeida (2017), assim como de consumo de ativismo por Ana Miranda e Izabela Domingues (2018). O contexto da pós-modernidade e da identidade cultural são observados pela ótica de Stuart Hall (2014). A ligação da marca Kurandé com o Complexo do Alemão é percebida também pelo viés da Teoria do Empoderamento, com Joice Berth (2019), marcas emocionais, de Marc Gobé (2010) e descolonização, de Grada Kilomba (2019). Henry Jenkins, Sam Ford e Joshua Green (2018) permitiram analisar o Instagram da Kurandé com o aporte da cultura da conexão gerada pelas mudanças nas mídias e plataformas digitais. Como resultado, percebe-se uso de elementos identitários, seja na produção fotográfica, na marca, nome dos produtos e narrativa emocional criada, com marcadores do território, do povo negro e da ancestralidade. Esta pesquisa também visa ampliar o diálogo no campo do branding, design e comunicação ao trazer perspectivas teóricas emergentes e interdisciplinares.

A escrita dos sujeitos muda ao longo do tempo, com o amadurecimento pessoal e as suas experiências de vida. Este facto justifica o ensino formal de géneros textuais que os sujeitos tenham produzido anteriormente ou que julguem dominar. Tal é o caso dos textos associados ao contexto profissional. Exemplificando como o ensino de língua poderá ser mobilizado para a vida profissional ativa, este trabalho apresentará os resultados decorrentes de uma implementação didática dedicada à carta de apresentação de resposta a anúncio de emprego que acompanha o currículo, num curso técnico e superior profissional. A investigação segue os princípios sociointeracionistas de ensino dos géneros textuais e respetivas análise e descrição do género a partir das produções textuais iniciais e finais dos alunos. Este trabalho compreenderá uma análise qualitativa e contrastiva das práticas textuais dos alunos na produção inicial e na produção final, a partir da arquitetura interna dos textos (e os respetivos planos da infraestrutura geral dos textos, dos mecanismos de textualização e dos mecanismos de responsabilização enunciativa), depois de treinado um plano de texto específico. Apesar de os alunos já terem contactado com o referido género em anteriores contextos formais de ensino e/ou de trabalho, a análise demonstra que alguns dos obstáculos para uma redação com sucesso são a adequação ao registo formal e a falta de uma representação equilibrada do sujeito perante o empregador, associados à resistência em escrever, observada em sala de aula, o que significa que a própria escrita não é entendida como objeto de treino.

Introduction: The ILUVIEN ® (fluocinolone acetonide) Clinical Evidence in Portugal (ICE-PT) study is a retrospective, multicenter, observational study evaluating the effectiveness and safety of the FAc implant in patients with diabetic macular edema. Methods: Patients included in this study had received the 0.2 µg/day fluocinolone acetonide implant for the treatment of diabetic macular edema and had measurements of visual acuity and retinal thickness assessed by optical coherence tomography for at least 12 months pre- and post-fluocinolone acetonide implant administration, with ⩾2 follow-up visits. Outcomes measured included visual acuity, central foveal thickness, and intraocular pressure. Results: There was a significant increase in mean visual acuity compared with baseline at 3, 6, 9, and 12 months post-fluocinolone acetonide in both the overall study population and the pseudophakic subgroup ( p

Leishmaniasis is a neglected zoonotic disease caused by a variety of pathogenic Leishmania species. In the New World, especially in Brazil, visceral leishmaniasis (VL) is caused by Leishmania infantum. The pathogen can infect several animal species including dogs, foxes, rodents, primates, felines, equines and humans. Dogs act as the primary domestic reservoirs. This study aimed to use polymerase chain reaction (PCR) for detecting Leishmania infection in horses living in a canine visceral leishmaniasis (CVL) endemic region. DNA samples from horse peripheral blood were used to perform PCR. Templates were amplified using primers for the kinetoplast DNA (kDNA) minicircles, which were able to detect different species of Leishmania. In addition, primers for internal transcribed spacer (ITS) of ribosomal DNA were used for detection of Trypanosomatidae sp. Amongst the 75 (39%) positive PCR samples from total 192 samples, 21 samples were positive for kDNA and 63 samples were positive for either ITS, ITS1, or ITS2 gene markers. The kDNA PCR and sequencing allowed the detection of L. infantum in horse blood samples. To our knowledge, this is the first report of equine infection with L. infantum in Southern Brazil. These results proved that L. infantum could also infect horses in addition to humans and dogs, as well as in European countries. This conclusion emphasizes the urgent need to follow up investigation of the infection in these animals.

Diabetic macular edema (DME) is a leading cause of blindness in the working population. Herein, we report the case of a patient with recurrent DME for about 6 years, uncontrolled by several medical and surgical treatments, that was successfully treated with a single sustained-release fluocinolone acetonide intravitreal implant in her right eye. The affected eye had presented a visual acuity of 2/10 and a central macular thickness of 488 µm prior to the injection. After treatment with the fluocinolone acetonide intravitreal implant, the patient’s right eye presented an improvement in best corrected visual acuity to 6/10 and a reduction of central macular thickness to 198 µm. These functional and anatomical results were continuous and sustained during a follow-up period of more than 12 months, and with an acceptable and manageable safety profile. These results show that fluocinolone acetonide intravitreal implantation is an effective treatment option in DME and should be considered in the DME treatment pathway.

Introduction: Anti-vascular endothelial growth factor therapy has revolutionized the treatment of wet age-related macular degeneration; however, it is important to monitor actual use of ranibizumab and related treatment outcomes in routine practice. Material and Methods: This was a retrospective, observational study to monitor the 2-year outcomes following ranibizumab treatment for wet age-related macular degeneration in Portugal. Patients treated between January 2009 and December 2009 were retrospectively evaluated. All decisions were made by the treating physician in accordance with their usual routine clinical practice. The primary assessment was mean change in visual acuity score using Early Treatment Diabetic Retinopathy Study or Snellen equivalent. Results: A total of 128 patients with wet age-related macular degeneration were analyzed (mean age 79.4 years; mean visual acuity score 54.2 letters). Mean change in visual acuity score from baseline was –1.6 letters (n = 82) at year one and –5.1 letters (n = 72) at year two. The mean number of ranibizumab injections was 3.8 (year one) and 1.6 (year two). On average, patients attended 8.6 and 5.0 visits and optical coherence tomography was used in 75.0% of patients in year one and in 56.3% of patients in year two, respectively. Discussion: Despite a relatively high number of visits, including monitoring visits and use of optical coherence tomography - guided therapy, few injections were administered and visual acuity was not improved. Conclusion: These findings indicate that as-needed treatment resulted in under-dosing in a real-life setting in Portugal. Such limitations may also be related to increasing numbers of patients, resulting in clinic saturation.

Introduction: Colonoscopy is a useful tool in modern medicine and is increasingly employed for both diagnostic and treatment purposes. However, bowel preparations can cause electrolyte imbalance, with the risk apparently related to the type of bowel cleansing solution used, the age of the patient and their comorbidities. Symptomatic hyponatremia, especially coma, is a rare complication of oral bowel preparation for colonoscopy and is thought to result from excessive antidiuretic hormone secretion. Case description: The authors report the case of a 48-year-old man who developed symptomatic hyponatremia (coma) after bowel preparation with sodium picosulfate/magnesium oxide/citric acid prior to a colonoscopy. The patient was admitted to an intensive care unit where other causes of coma were excluded. The symptoms of hyponatremia rapidly resolved after sodium level correction with intravenous administration of hypertonic saline. Discussion: Hyponatremic coma is an uncommon but serious complication of colonoscopy bowel preparation. Patients at risk (>65 years old, chronic kidney disease, heart failure, history of electrolyte problems, or taking thiazide diuretics, angiotensin-converting-enzyme inhibitors or antidepressants) should be closely monitored during bowel cleansing and macrogol-based solutions should preferably be used.

Background: Combined central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) is an uncommon retinal vascular disease which causes sudden visual acuity loss and is associated with poor prognosis and the development of severe complications. We report a very rare case of combined CRAO and CRVO in a patient with factor V Leiden (FVL) mutation (only 3 cases published). To our knowledge, this is the first case of combined CRAO and CRVO treated with hyperbaric oxygen therapy (HBOT). Case and Results: A 49-year-old woman presented with complaints of sudden loss of vision in her left eye (LE), with best corrected visual acuity (BCVA) of 1/20. A complete ophthalmic evaluation with fundus angiography showed combined CRAO and CRVO. The patient was urgently treated with HBOT (she completed a total of 9 sessions in 7 days), with marked visual acuity and angiographic improvement (BCVA of 10/10). Forty-five days later, she developed a new LE CRVO, and BCVA decreased to 5/10 and later to Conclusions: Combined CRAO and CRVO in young adults should be investigated thoroughly for embolic sources, thrombophilic disorders and local ocular conditions. This is the first case of this severe disease that was treated with HBOT, and the visual result was very good.

En este artículo se presenta el análisis de dos textos como ejemplares del género de texto crónica de periodismo radiofónico sobre el vino. A partir de una metodología descendente basada en la noción de actividad de lenguaje, se describirá el género a través de ocurrencias textuales, eligiendo los siguientes puntos de vista: la sociedad de consumo como una cuestión social contemporánea relevante, la organización temática y la organización argumentativa (esta última estrechamente asociada a la modalidad deóntica) como cuestiones lingüísticas que marcan el género y que expresan la dinámica persuasiva del especialista, un agente económico indirectamente implicado en la venta del producto.

A relação entre a água e os humanos é universal na vida social, sem água não há vida e a humanidade não sobrevive sem ela. Estas são premissas do senso comum e das ciências biológicas. A forma como esta relação é estabelecida e o sentido particular que lhe é atribuído em cada contexto geográfico, etnográfico e histórico são já objectos de atenção antropológica. Os estudos produzidos apresentam uma grande diversidade de perspectivas teóricas de acordo com o eixo de análise escolhido, as áreas disciplinares e com o momento social histórico e político vivido das transformações ocorridas na relação entre humanos e este elemento natural (Hipocrates, 1996). Com a disciplinarização da ciência e da química em particular, o líquido água transformou-se em H20, concepções que conviveram e convivem em simultâneo com noções “não científicas” da água e das águas, classificadas e hierarquizadas de acordo com critérios sensoriais (Strang, 2004, 2006), do domínio da experiência e do contacto com este elemento, denominado e percebido como líquido, substância, virtude, remédio, medicamento (Durand, 2003; Quintela, 2001, 2004; Marras, 2004), em todos os seus estados materializáveis (Martel, 1989). Convivem, também, com a atenção dada aos objectos que se produziram para este primeiro nível de contacto, como mediadores desta primeira relação íntima com o corpo, como banheiras, chuveiros e bidés nas suas diversas formas de uso e objectivos (Goubert, 1986; Corbin, 1986; Roche, 1997), bem como com as reflexões sobre a relação com os recursos do meio ambiente: água, rios, lagos, lagoas, mares, poças, montanhas.

Purpose: We report a case of a foveal macroaneurysm with long-standing macular edema in a rare location, successfully treated with intravitreal ranibizumab. Methods: We report the case of a 52-year-old man with left eye long-term visual loss due to macular edema caused by a retinal macroaneurysm, localized about 400 μm from the center of the fovea, and its response to 6 monthly ranibizumab intravitreal injections. His best-corrected visual acuity and morphological data evaluated by optical coherence tomography and fluorescein angiography are presented. Results: His best-corrected visual acuity improved from 1/10 to 3/10 after the 3rd injection, and from 1/10 to 4/10 after the 6th one. The central retinal thickness was evaluated by optical coherence tomography and improved from 310 to 233 μm, with the resolution of both the associated serous detachments and the cystoid macular edema; an almost complete reabsorption of the hard exudates at the end of the treatment was also observed. The macroaneurysm lumen almost obliterated after the 3rd injection and completely collapsed at the end of treatment. Conclusions: Intravitreal ranibizumab may be effective in the treatment of long-standing macular edema associated with foveal macroaneurysms. To the best of our knowledge, this is the first report of a retinal macroaneurysm located so close to the foveal avascular zone.

Este artigo objetiva realizar um estudo contrastivo entre as estratégias argumentativas utilizadas nos preâmbulos constitucionais português e brasileiro, de 1976 e 1988, respectivamente, de forma a verificar o ethos constitucional construído. Considerando o preâmbulo constitucional como um gênero textual incluído (Rastier, 1989), a análise das componentes temática e discursiva (Bronckart, 1999) fornece subsídios para estabelecer, a partir de índices linguísticos, uma análise comparativa dos textos. Os resultados obtidos mostram que, face a contextos históricos diferenciados de produção, o ethos constitucional do preâmbulo português mostra-se pedagógico, ao contrário do brasileiro que é mais protetor, e com uma tonalidade mais assimétrica.

This paper describes the vegetative and reproductive morphology of Cabombaceae species in Brazil, discussing its strategies for survival in an aquatic habitat. Through studies in the field, in cultivation and in the herbarium, we examined the following species: Cabomba aquatica, C. caroliniana, C. furcata and C. haynesii. In cultivation, only C. aquatica, C. furcata and C. haynesii produced flowers. In those three species, the flowers opened during the day on two consecutive days, submerging during the night, although the stigmata of the first two were receptive only on the first day, their anthers dehiscing on the following day. The flowers of C. haynesii remained unreceptive on the first day of anthesis, the stigmata and anthers maturing only on the second day, at different times. Fruit developed when the flowers were submerged. The data provided here are useful for the identification of these species, as well as laying the groundwork for future taxonomic and ecological studies.

The aim of this work is twofold; to identify some rhetoric-argumentative strategies present in potentially inductive behavior texts and to show that the textual aspects are constrained by the social activity to which they are related. Considering that these texts have an actional force that may guide the interlocutor´s way of acting/ thinking, we try to identify how the textual construction of the image of the enunciative instances –ethos – can confi rm this force. Preliminary analysis of selected excerpts demonstrates that the linguistic resources used for the construction of the textual ethos is heterogeneous and is strongly constrained by contextual elements. The excerpts were obtained from institutional texts belonging to the religious - the book of Exodus chapter 20 - and the political /juridical - the Preamble of the Portuguese Republic Constitution - social activities.Key words: actional force, behavior inductive texts, institucional texts, rhetoric-argumentative strategies, textual ethos.

Introduction: Optic disc hypoplasia is a common feature in fetal alcohol syndrome. Thus, we aimed to evaluate the optic disc morphology changes and the peripapillary retinal nerve fiber layer thickness in these patients. Material and Methods: We performed spectral-domain optical coherence tomography in a cohort of 11 patients (22 eyes) with fetal alcohol syndrome and in an age-matched control group. We evaluated optic nerve head parameters (optic disc area and diameter, rim area, cup/disc horizontal and vertical ratios) and peripapillary retinal nerve fiber layer thickness. Results: Mean optic disc area, rim area and optic disc diameter were, respectively, in fetal alcohol syndrome patients and control subjects: 1.540 ± 0.268 and 1.748 ± 0.326 mm2; 1.205 ± 0.286 and 1.461 ± 0.314 mm2; 1.417 ± 0.124 and 1.501 ± 0.148 mm (p < 0.05). We found no significant differences between groups for cup/disc ratios. Mean retinal nerve fiber layer thickness was significantly lower in fetal alcohol syndrome patients (90.500 ± 9.344 µm) as compared to controls (111.000 ± 7.855 µm) (p < 0.0001). Analysis showed a significant decrease in retinal nerve fiber layer thickness for the superior, inferior and nasal quadrants (p < 0.005). The temporal quadrant showed no significant differences. Discussion: Optic disc area, rim area and optic disc diameters were significantly reduced in fetal alcohol syndrome patients. Although mean peripapillary retinal nerve fiber layer thickness was decreased, the temporal quadrant was spared. Conclusion: In addition to a smaller optic disc area/ diameter and rim area, we found a heterogeneous peripapillary retinal nerve fiber layer thickness loss in fetal alcohol syndrome patients with sparing of the temporal quadrant. Spectral-domain optical coherence tomography may be useful to determine the presence of fetal alcohol syndrome status.

Background. Quantitative diagnostic ultrasound imaging has been proposed as a method of estimating muscle quality using measures of echogenicity. The Rectangular Marquee Tool (RMT) and the Free Hand Tool (FHT) are two types of editing features used in Photoshop and ImageJ for determining a region of interest (ROI) within an ultrasound image. The primary objective of this study is to determine the intrarater and interrater reliability of Photoshop and ImageJ for the estimate of muscle tissue echogenicity in older adults via grayscale histogram analysis. The secondary objective is to compare the mean grayscale values obtained using both the RMT and FHT methods across both image analysis platforms. Methods. This cross-sectional observational study features 18 community-dwelling men (age = 61.5 ± 2.32 years). Longitudinal views of the rectus femoris were captured using B-mode ultrasound. The ROI for each scan was selected by 2 examiners using the RMT and FHT methods from each software program. Their reliability is assessed using intraclass correlation coefficients (ICCs) and the standard error of the measurement (SEM). Measurement agreement for these values is depicted using Bland-Altman plots. A paired t-test is used to determine mean differences in echogenicity expressed as grayscale values using the RMT and FHT methods to select the post-image acquisition ROI. The degree of association among ROI selection methods and image analysis platforms is analyzed using the coefficient of determination (R2). Results. The raters demonstrated excellent intrarater and interrater reliability using the RMT and FHT methods across both platforms (lower bound 95% CI ICC = .97–.99, p < .001). Mean differences between the echogenicity estimates obtained with the RMT and FHT methods was .87 grayscale levels (95% CI [.54–1.21], p < .0001) using data obtained with both programs. The SEM for Photoshop was .97 and 1.05 grayscale levels when using the RMT and FHT ROI selection methods, respectively. Comparatively, the SEM values were .72 and .81 grayscale levels, respectively, when using the RMT and FHT ROI selection methods in ImageJ. Uniform coefficients of determination (R2 = .96–.99, p < .001) indicate strong positive associations among the grayscale histogram analysis measurement conditions independent of the ROI selection methods and imaging platform. Conclusion. Our method for evaluating muscle echogenicity demonstrated a high degree of intrarater and interrater reliability using both the RMT and FHT methods across 2 common image analysis platforms. The minimal measurement error exhibited by the examiners demonstrates that the ROI selection methods used with Photoshop and ImageJ are suitable for the post-acquisition image analysis of tissue echogenicity in older adults.

Com este estudo pretendemos caracterizar os níveis de ansiedade dos lançadores e saltadores iniciados e juvenis portugueses. A amostra foi constituída por 147 atletas (89 masculinos e 58 femininos). Foram subdivididos em grupos de acordo com as variáveis independentes a serem testadas, nomeadamente: escalão (61 iniciados e 86 juvenis), especialidade (78 saltos e 69 lançamentos), top ten (17 masculinos e 26 femininos). Para os propósitos do estudo utilizámos o Questionário de Auto-avaliação (CSAI-2) e o ICPC. Os procedimentos estatísticos foram: cálculos de frequências e o coeficiente de correlação Produto – momento de Pearson. No geral, os resultados tendem confiar os encontrados nos estudos de referência e sugerem que o ICPC, se utilizado de forma sistemática, é bom instrumento para os treinadores aprofundarem os seus conhecimentos sobre os atletas.

O objetivo deste trabalho foi correlacionar os dados climáticos e parasitários através de exames laboratoriais e da pastagem. O experimento foi realizado no período de março a junho de 2004, utilizando 110 bezerros com idade média de cinco meses, em pastos com diferentes relevos. Foi avaliado o número de ovos por grama de fezes (OPG), a coprocultura e o número de larvas na pastagem em intervalos de 15 dias, e dados climáticos deciduais. A coprocultura revelou a presença de 60% de parasitas do gênero Trichostrongylus spp. e 40% de Cooperia spp. assim como Moniezia spp. e oocistos de Eimeria spp. A temperatura permitiu a sobrevivência e o desenvolvimento das larvas infectantes na pastagem durante o experimento. O aumento do número de larvas na pastagem está associado ao acréscimo da precipitação após um período de seca. O relevo com maior número de larvas apresentou maior concentração de massa seca de capim arroz (Echinochloa spp.). Pode-se comprovar que em condições climáticas ideais ocorreu uma rápida contaminação da pastagem com larvas infectantes quando animais naturalmente infectados foram transferidos para a área após colheita de milho.The objective of this work was to correlate climatic and parasitological data from laboratory and field samples. The experiment was executed from March to June of 2004, using 110 naturally infected five months old calves. The counting of eggs per gram of feces (EPG), fecal culture and the number of larva on pasture was evaluated every 15 days in relation to decidual climatic data. The EPG increased during the study. The same observation occurred with the pluviometric level. Coproculture revealed the presence of 60% of Trichostrongylus spp. and 40% of Cooperia spp. as well as Moniezia spp. and Eimeria spp. oocists. The temperature during all the experimental periods was favorable to infecting larvae survival and development on pasture. The area with higher larvae count had the higher dry matter of "capim arroz" (Echinochloa spp.). It can be concluded that in optimal climatic conditions, there is a rapid pasture contamination with infecting larvae after the naturally contaminated animals are transferred to the area after corn harvest.

Este trabalho visa, por um lado, identificar algumas estratégias retórico-argumentativas presentes em textos considerados potenciais indutores de comportamento; por outro, mostrar que a materialização linguístico-textual destas é condicionada pela atividade social aos quais se filiam. Considerando que estes textos têm uma força acional a eles associada, com o objetivo de orientar o modo de agir/pensar do interlocutor, identificar-se-á de que forma a construção textual da imagem do enunciador – ethos – pode vir a corroborar este efeito. As análises preliminares de alguns excertos mostram que os recursos linguísticos utilizados para a construção do ethos textual neste grupo de texto é heterogênea e fortemente condicionada por aspectos contextuais diversos. Os exemplares de textos institucionais em análise foram extraídos de atividades sociais distintas: da religiosa (Livro de Êxodo, capítulo 20) e da jurídico-política (Preâmbulo da Constituição da República Portuguesa). Palavras-chave: força acional, textos indutores de comportamento, textos institucionais, estratégias retórico-argumentativas, ethos textual.

Este estudo, baseado na perspectiva teórica do Interacionismo Socio-discursivo, centra-se no estudo do papel de algumas instâncias agentivas no gênero textual anúncio publicitário. Primeiramente, objetiva mostrar que o papel destes agentes é diferente conforme o tipo de agir e a prática social em que estes se inserem, podendo vir a ser materializados distintamente neste gênero textual. Em segundo lugar, visa a mostrar que, de acordo com a atividade a que este gênero se interliga, pode-se imaginar a existência de diferentes níveis de atorialidade. Este artigo baseia-se na análise de alguns exemplares do gênero textual anúncio publicitário que circularam em Portugal de 2007 a 2011. Uns exemplos provêm da atividade de benemerência, enquanto que os outros são originários da atividade de produção e comercialização de vinhos.

Human Immunodeficiency Virus (HIV) infection is presently considered a chronic disorder. Infected people need a thorough medical surveillance and chronic therapy, which affects families and other caregivers. Infected children are also affected by their parents' infection and by the stigma that is still associated with this particular illness. Regular meetings were organized for HIV infected children, their families and the health team with recreational and formative purposes. These meetings were evaluated in a strongly positive manner by all the intervenients. The goal to maintain these activities is proposed as a way of improving the follow-up and the prognosis of these children.

Introduction: The concept and study of relevance has been a central subject in information science. Although research in information retrieval has been focused on topical relevance, other kinds of relevance are also important and justify further study. Motivational relevance is typically inferred by criteria such as user satisfaction and success. Method: Using an existing dataset composed by an annotated set of health Web documents assessed for relevance and comprehension by a group of users, we build a multivariate prediction model for the motivational relevance of search sessions. Analysis: The analysis was based on lasso variable selection, followed by model selection using multiple logistic regression. Results: We have built two regression models; the full model, which considers all variables of the dataset, has a lower estimated prediction error than the reduced model, which contains the statistically-significant variables from the full model. The higher values of evaluation metrics,including accuracy, specificity and sensitivity in the full model support this finding. The full model has an accuracy of 91.94%, and is better at predicting motivational relevance. Conclusions: Our findings suggest features that can be considered by search engines to estimate motivational relevance, to be used in addition to topical relevance. Among these features, a high level of success in Web search and in health information search on social networks and chats are some of the most influencing user features. This shows that users with higher computer literacy might feel more satisfied and successful after completing the search tasks. In terms of task features, the results suggest that users with clearer goals feel more successful. Moreover, results show that users would benefit from the help of the system in clarifying the retrieved documents.