Caso Raro de Quisto do Colédoco Todani Tipo III

rare biliary tree disorders, which are divided in several subtypes according to Todani classification. Type III choledochal cyst is one of the rarest subtype. Symptoms are almost always associated with complications such as cholangitis or pancreatitis, usually due to biliary stasis, choledocholithiasis, recurrent infection or inflammatory events. This article describes a case of a patient who presented to the emergency department due to fever and abdominal pain, owing to Todani type III cystic obstruction with representative findings in the computed tomography study and endoscopic confirmation.info:eu-repo/semantics/publishedVersio

confiança enfermeiro-cliente, um conceito em construção no CHLN-HPV.

A temática “confiança” é alvo de análise e reflexão nos vários sectores da sociedade actual, incluindo o sector da saúde. De facto, o binómio Confiança versus Desconfiança está sempre presente no seio de qualquer relação interpessoal, sendo definido como uma necessidade humana básica. Os cuidados de enfermagem devem ser orientados por modelos que se centrem na humanidade e singularidade da pessoa, transformando o cuidado numa relação gratificante para ambos os intervenientes. Objectivo: Divulgar o percurso desenvolvido no Centro Hospitalar Lisboa Norte – Hospital Pulido Valente, no âmbito do Projecto Institucional da Rede Internacional PRAQSI denominado “Cuidar do Debate”, explicitando os ganhos obtidos relativamente à relação de confiança enfermeiro-cliente, enquanto elemento intrínseco à relação de cuidar. Metodologia: Investigação/Acção baseada na análise, na partilha e na reconstrução das práticas de Enfermagem ao longo de três Workshops. Resultados: Foram observadas mudanças na prática clínica dos enfermeiros, das quais salientamos: aumento da mobilização do conceito de confiança no seio das equipas clínicas, melhoria da relação de ajuda/confiança em enfermeiro–cliente–família e maior sensibilidade para a escuta. Conclusões: A construção da relação de confiança é um processo dinâmico no qual os enfermeiros e os clientes são actores aliados. O enfermeiro assume um papel preponderante, devendo desempenhá-lo com as competências inerentes à profissão. O enfermeiro é o instrumento terapêutico da relação de cuidar, pelo que se aconselha a replicação desta metodologia nos contextos clínicos em colaboração com as instituições de ensino superior.info:eu-repo/semantics/publishedVersio

Bilateral Shoulder Arthritis in COVID-19 Patient After Prolonged Mechanical Ventilation Assist: a Case Report

Prolonged immobilization and, in particular, mechanical ventilation, have been linked to muscle atrophy. Anecdotal reports in the literature describe rhabdomyolysis as a potential late complication of COVID-19 infection which, in severe cases, may coexist with fluid collections. We report a case of a 28-year-old patient that had been recently hospitalized with SARS-CoV-2 pneumonia, with need for invasive ventilation support. Days after being discharged, the patient presents with retrosternal thoracalgia irradiating to the left upper limb. On physical examination, abduction and external rotation were limited due to pain complaints and there was soft tissue swelling of the corresponding shoulder and arm. Imaging evaluation was essential to establish the underlying condition, revealing bilateral arthritis communicating with large rotator cuff collections, which was considered of septic nature.info:eu-repo/semantics/publishedVersio

Antiophidian properties of plant extracts against Lachesis muta venom

Snakebites comprise a serious health problem in several countries due to their global incidence, which exceeds 2.5 million per year, and the elevated number of victim fatalities. To counteract envenomations, antivenoms have been used regularly for more than a century. Apart from side effects including anaphylactic reactions, antivenoms are not able to efficiently neutralize local tissue damage, which contributes to increasing the severity and morbidity observed in patients. This fact, in turn, may be responsible for economic hardship, particularly in rural populations of developing countries. In the present work, we evaluated the antiophidian properties of 12 Brazilian plant extracts against the hemolytic, coagulant, hemorrhagic and proteolytic effects of Lachesis muta venom. Taken together, our data revealed that most of these aqueous products were capable of inhibiting those activities at different levels, except for Sapindus saponaria extract. In contrast, Stryphnodendron barbatiman extract completely neutralized all the analyzed biological activities. Thus, we may conclude that Brazilian flora may also be useful against L. muta accidents.(FAPERJ) Fundacao de Amparo a Pesquisa do Estado do Rio de JaneiroFAPESPCNPqCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)International Foundation for Science (IFS, Sweden

A self-sensing and self-heating planar braided composite for smart civil infrastructures reinforcement

Allocating different capabilities to structural elements simultaneously is still challenging. In this study, a field-applicable multifunctional planar braided composite with the abilities of reinforcing, self-sensing and self-heating was developed for the first time. In this route, three commercial fabrics were used, including cotton, cotton/polyamide, and polyester. The fabrics were first chemically treated and then coated with a carbon nanomaterial-based polymeric conductive paste using screen printing with different concentrations and layers. The samples were then covered and sealed with a thermoplastic polyurethane-based polymer to avoid environmental factors effects. Smart planar composites (SPC) were also used as reinforcement for cementitious specimens. The electrical conductivity and joule heating capability of the samples were also evaluated. The microstructure of the SPCs was investigated using various tests. The mechanical and self-sensing performances of the cementitious composite reinforced with different SPCs were assessed using different load patterns. The results showed a heating rate of 0.44 ˚C/s, a joule heating power of 0.7 W/˚C, and a maximum temperature of 44 ˚C which proved the proper heating capability of the cementitious composites reinforced with SPCs. The great correlation between electrical resistivity changes and strain values indicated the high potential of the composite in strain sensing for different applications. The SPCs also improved the post-crack behaviour of the specimen and its flexural strength and failure strain by approximately 50% and 118%, respectively. The outcomes of this study draw a bright horizon in multifunctional braided composite development with different applications in civil infrastructures, which is a crucial step for intelligent cities' advances.This work was partly financed by the Institute for Sustainability and Innovation in Engineering Structures (ISISE) and the R&D Unit of the Centre for Textile Science and Technology (2C2T) founded by the Portuguese Foundation for Science and technology (FCT) under the reference “UIDP/00264/2020”. The first author also acknowledges the support provided by the FCT/PhD individual fellowship with reference of “2021.07596.BD”

Angiosarcoma Cardíaco. Uma Revisão

Based on a case of a patient with angiosarcoma (AS) of the right atrium with superior vena cava syndrome associated with urticaria and polyarthralgias, who died soon after surgery, the authors present a brief review of the subject of cardiac AS, an extremely rare pathology, usually diagnosed late due to its non-specific symptomatology. Several topics are discussed, including mechanisms of clinical manifestations caused by blood flow obstruction and valve dysfunction, local invasion with arrhythmias and pericardial effusion, embolic phenomena and constitutional symptoms. Imaging and histopathologic methods of diagnosis are considered, as well as references to cytogenetic analysis. Surgery is the first treatment choice, but heart AS are frequently not completely resectable and concomitant metastases at the time of surgery are common, both usually leading to a dismal prognosis. Chemotherapy, radiotherapy and even heart transplantation do not substantially improve the survival of these patients. Urticaria is not generally assumed by most authors to be associated with malignancy, but there are rare reports of its association with some malignant tumors

Bird collisions in a railway crossing a wetland of international importance (Sado estuary, Portugal)

L. Borda-de-Água et al. (eds.), Railway Ecology, chapter 7, p. 103-115Many studies have evaluated bird mortality in relation to roads and other human structures, but little is known about the potential impacts of railways. In particular, it is uncertain whether railways are an important mortality source when crossing wetlands heavily used by aquatic birds. Here we analyze bird collisions in a railway that crosses the Nature Reserve of the Sado Estuary (Portugal) over an annual cycle, documenting bird mortality and the flight behaviour of aquatic birds in relation to a bowstring bridge. During monthly surveys conducted on 16.3 km of railway, we found 5.8 dead birds/km/10 survey days in the section crossing wetland habitats (6.3 km), while <0.5 dead birds/km/10 survey days were found in two sections crossing only forested habitats. Most birds recorded were small songbirds (Passeriformes), while there was only a small number of aquatic birds (common moorhen, mallard, flamingo, great cormorant, gulls) and other non-passerines associated with wetlands (white stork). During nearly 400 h of observations, we recorded 27,000 movements of aquatic birds across the Sado bridge, particularly in autumn and winter. However, only <1% of movements were within the area of collision risk with trains, while about 91% were above the collision risk area, and 8% were below the bridge. Overall, our case study suggests that bird collisions may be far more numerous in railways crossing wetland habitats than elsewhere, although the risk to aquatic birds may be relatively low. Information from additional study systems would be required to evaluate whether our conclusions apply to other wetlands and railway linesinfo:eu-repo/semantics/publishedVersio

The importance of population contextual data for large-scale biomonitoring using an apex predator: The Tawny Owl (Strix aluco)

Top predators are often used as sentinel species in contaminant monitoring due to their exposure and vulnerability to persistent, bioaccumulative and, in some cases, biomagnificable contaminants. Some of their ecological traits can vary in space and time, and are known to influence the contamination levels and therefore information on ecological traits should be used as contextual data for correct interpretation of large-scale contaminant spatial patterns. These traits can explain spatiotemporal variation in contaminant exposure (traits such as diet and dispersal distances) or contaminant impacts (traits such as population trend and clutch size). The aim of our research was to review the spatial variation in selected contextual parameters in the Tawny Owl (Strix aluco), a species identified by the COST Action European Raptor Biomonitoring Facility as one of the most suitable candidates for pan-European biomonitoring. A considerable variation in availability of published and unpublished contextual data across Europe was found, with diet being the most extensively studied trait. We demonstrate that the Tawny Owl is a suitable biomonitor at local scale but also that taking spatial variation of other contextual data (e.g. diet) into account is necessary. We found spatial gaps in knowledge about the species ecology and biology in Southern Europe, along with gaps in certain population parameters (e.g. population trends) in several countries. Based on our findings, we proposed a minimal recommended scheme for monitoring of population contextual data as one of the first steps towards a pan-European monitoring scheme using the Tawny Owl

The cost of promiscuity: sexual transmission of Nosema microsporidian parasites in polyandrous honey bees

Multiple mating (and insemination) by females with different males, polyandry, is widespread across animals, due to material and/or genetic benefits for females. It reaches particularly high levels in some social insects, in which queens can produce significantly fitter colonies by being polyandrous. It is therefore a paradox that two thirds of eusocial hymenopteran insects appear to be exclusively monandrous, in spite of the fitness benefits that polyandry could provide. One possible cost of polyandry could be sexually transmitted parasites, but evidence for these in social insects is extremely limited. Here we show that two different species of Nosema microsporidian parasites can transmit sexually in the honey bee Apis mellifera. Honey bee males that are infected by the parasite have Nosema spores in their semen, and queens artificially inseminated with either Nosema spores or the semen of Nosema-infected males became infected by the parasite. The emergent and more virulent N. ceranae achieved much higher rates of infection following insemination than did N. apis. The results provide the first quantitative evidence of a sexually transmitted disease (STD) in social insects, indicating that STDs may represent a potential cost of polyandry in social insects