Surgical treatment of onychomatricoma with dermal graft : case report.

Relata-se caso de mulher de 58 anos que apresentou espessamento da unha do h?lux esquerdo acompanhado por crescimento lento de les?o n?dulo-vegetante no leito ungueal. Ap?s bi?psia incisional com exame anatomopatol?gico a les?o foi diagnosticada como onicomatricoma, uma rara neoplasia benigna espec?fica do complexo ungueal. O tratamento de escolha do onicomatricoma ? cir?rgico, sendo realizado no presente caso a reconstru??o do leito ungueal atrav?s de enxerto d?rmico.Case report of a 58-year-old woman that presented with nail thickening of the left hallux in association with a slow- growing nodular/vegetative lesion on the nail matrix. After incisional biopsy and histopathological examination, the lesion was diagnosed as an onychomatricoma, a rare benign neoplasia that occurs specifically in the nail matrix. The treatment of choice for the onychomatricoma is surgery and in the present case, a reconstruction of the ungula matrix was achieved through a dermal graft

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Institutions and the external capital structure of countries

A widespread view holds that countries that finance themselves through foreign direct investment and portfolio equity, rather than bonds and loans, are less prone to crises. But what determines countries' external capital structures? In a cross-section of advanced economies, emerging markets, and developing countries, we find that equity-like liabilities as a share of countries' total external liabilities are positively and significantly associated with indicators of educational attainment, openness, natural resource abundance and, especially, institutional quality. These relationships are robust to attempts to control for possible endogeneity, suggesting that better institutional quality may help improve countries' external capital structures.Foreign direct investment Portfolio equity External debt External liabilities

Transi????es da imagem:fotografia, contemporaneidade, cultura e hibridismo

104 f.:ilSubmitted by JURANDI DE SOUZA SILVA ([email protected]) on 2013-03-21T20:04:41Z No. of bitstreams: 2 dissertacaoandrefariaspt 2.pdf: 5686907 bytes, checksum: 226ba7565404ee37a8eebc284620378e (MD5) dissertacaoandrefariaspt 1.pdf: 4298528 bytes, checksum: c08446fbd05567fdb66beb24114638e7 (MD5)Approved for entry into archive by Rodrigo Meirelles([email protected]) on 2013-03-23T14:22:45Z (GMT) No. of bitstreams: 2 dissertacaoandrefariaspt 2.pdf: 5686907 bytes, checksum: 226ba7565404ee37a8eebc284620378e (MD5) dissertacaoandrefariaspt 1.pdf: 4298528 bytes, checksum: c08446fbd05567fdb66beb24114638e7 (MD5)Made available in DSpace on 2013-03-23T14:22:45Z (GMT). No. of bitstreams: 2 dissertacaoandrefariaspt 2.pdf: 5686907 bytes, checksum: 226ba7565404ee37a8eebc284620378e (MD5) dissertacaoandrefariaspt 1.pdf: 4298528 bytes, checksum: c08446fbd05567fdb66beb24114638e7 (MD5) Previous issue date: 2009A pesquisa investiga a fotografia enquanto linguagem contempor??nea e h??brida, faz uso de tecnologias ??pticas rudimentares e avan??adas, cria interfaces com diversas outras linguagens art??sticas, investiga a hist??ria da fotografia com o intuito de compreender a evolu????o dos m??todos fotogr??ficos, coleta equipamentos obsoletos em antiqu??rios e assist??ncias t??cnicas dando-lhes novos significados. A abordagem do contexto fotogr??fico sugerido por Rosalind Krauss resulta em um debate metaf??rico da linguagem fotogr??fica, deixando de lado uma poss??vel leitura menos abrangente da utiliza????o da imagem fotogr??fica propriamente dita enquanto objeto ??nico de an??lise e meio de cria????o. Termos como arte tecnol??gica, hibridismo e fotografia digital s??o realidades palp??veis, acredito no potencial desta indaga????o acad??mica para a difus??o da fotografia contempor??nea e h??brida no contexto da arte baiana. Quanto ?? po??tica, recorro ao hibridismo cultural, ?? uma an??lise filos??fica do tempo a partir de teorias de Henri Bergson e ao levantamento de algumas quest??es sobre arqueologia e evolucionismo.Salvado

Interven??o dos enfermeiros especialistas em enfermagem de reabilita??o na promo??o da autonomia dos idosos de um ACES

Relat?rio de Est?gio de Natureza Profissional no ?mbito do Mestrado em Enfermagem de Reabilita??o apresentada na Escola Superior de Sa?de do Instituto Polit?cnico de Viana do CasteloINTRODU??O: O conceito de autonomia ? multidimensional, sendo a sua promo??o/manuten??o um direito fundamental da pessoa e um dever dos profissionais de sa?de, nomeadamente dos enfermeiros. Acredita-se que o esclarecimento e a reflex?o em torno deste conceito melhorariam a qualidade dos cuidados de enfermagem, tendo o Enfermeiro Especialista em Enfermagem de Reabilita??o, um papel primordial na manuten??o/promo??o da autonomia, sendo o idoso a faixa et?ria com maior vulnerabilidade e fragilidade. OBJETIVO: Identificar a perce??o dos Enfermeiros Especialistas em Enfermagem de Reabilita??o, de um Agrupamento de Centros de Sa?de de Portugal, quanto ? implementa??o das interven??es promotoras da autonomia nos cuidados que prestam aos idosos. METODOLOGIA: Trata-se de um estudo de natureza quantitativa, descritivo-correlacional. A amostra ? n?o probabil?stica por conveni?ncia e participaram no estudo 18 Enfermeiros Especialistas em Enfermagem de Reabilita??o que trabalham nas Equipas de Cuidados Continuados Integrados de um Agrupamento de Centros de Sa?de de Portugal. A recolha de dados foi realizada com o preenchimento de um question?rio online, onde foi aplicada a Escala de Autoavalia??o da Promo??o da Autonomia dos Idosos. RESULTADOS: As dimens?es que a amostra perceciona investir mais s?o o ?Desenvolvimento de interven??es avaliativas na ?rea do autocuidado? (M= 3.69, DP= 0.69), a ?Capacita??o do Cuidador? (M= 3.50, DP= 0.66), o ?Desenvolvimento de interven??es emocionais, sociais e de autocuidado? (M= 3.34, DP= 0.634) e o ?Desenvolvimento de interven??es f?sicas e cognitivas? (M= 3.25, DP= 0.79). As dimens?es que a amostra perceciona investir menos s?o o ?Desenvolvimento de interven??es de atividades instrumentais de vida di?ria? (M=2.12, DP= 0,67) e o ?Desenvolvimento de interven??es avaliativas nas ?reas emocionais, cognitivas e sociais? (M= 2.74, DP= 1.06). Observou-se tamb?m uma correla??o negativa moderada e estatisticamente significativa (r= -0.554, p<0.05) entre a dimens?o ?Desenvolvimento de interven??es de atividades instrumentais de vida di?ria? e o Tempo total de experi?ncia profissional como Enfermeiro, pelo que, estes resultados sugerem que os enfermeiros com mais anos de experi?ncia profissional promovem menos este item. CONCLUS?O: Os Enfermeiros Especialistas em Enfermagem de Reabilita??o parecem dar mais import?ncia ?s interven??es avaliativas do autocuidado e da capacita??o dos cuidadores, e menos import?ncia ?s interven??es de atividades instrumentais de vida di?ria e ?s interven??es avaliativas nas ?reas emocionais, cognitivas e sociais. Todavia, desenvolvem interven??es para a promo??o da autonomia em todas as suas dimens?es.INTRODUTION: The concept of autonomy is multidimensional, being its promotion/maintenance a fundamental right and a duty of health professionals, namely nurses. It is believed that clarifying and reflecting on this concept would improve the quality of nursing care, with the Specialist Nurse in Rehabilitation Nursing playing a key role in maintaining/promoting autonomy, being the elderly the most vulnerable age group. OBJECTIVE: To identify the perception of Specialist Nurses in Rehabilitation Nursing, from a Group of Health Centers in Portugal, regarding the implementation of autonomy-promoting interventions in the care they provide to the elderly. METHODOLOGY: This is a quantitative, descriptive-correlational study. The sample is non-probabilistic by convenience and participated 18 Specialist Nurses in Rehabilitation Nursing working in Integrated Continuous Care Teams from a Group of Health Centers in Portugal. Data collection was done by filling out an online questionnaire, where the Self-Assessment Scale of Elderly Autonomy was applied. RESULTS: The dimensions that the sample perceives to invest the most are "Development of evaluative interventions in self-care" (M= 3.69, DP= 0.69), "Caregiver Empowerment" (M= 3.50, DP= 0.66), "Development of emotional, social, and self-care interventions" (M= 3.34, DP= 0.634), and "Development of physical and cognitive interventions" (M= 3.25, DP= 0.79). The dimensions that the sample perceives to invest the least are "Development of interventions for instrumental activities of daily living" (M=2.12, DP= 0,67) and "Development of evaluative interventions in emotional, cognitive, and social areas" (M= 2.74, DP= 1.06). A moderate, statistically significant negative correlation (r= -0.554, p<0.05) was also observed between the dimension "Development of interventions for instrumental activities of daily living" and the Total Time of Professional Experience as a Nurse, therefor, these results suggest that nurses with more years of professional experience promote this item less. CONCLUSION: Specialist Nurses in Rehabilitation Nursing seem to attach more importance to evaluative interventions in self-care and caregiver empowerment, and less importance to interventions in instrumental activities of daily living and evaluative interventions in emotional, cognitive, and social areas. However, they develop interventions to promote autonomy in all its dimensions

Fruit set of distylous Psychotria carthagenensis Jacq. (Rubiaceae) mediated by Apis mellifera (Apidae) and species of Augochloropsis (Halictidae)

Heterostyly is a floral polymorphism consisting in the presence of two morphs in the population that differ reciprocally in the position of their sexual organs. Heterostylous species depend on visitors to produce fruits, but the efficiency of insect species as pollinators greatly varies and depends on the morph visited. The aim of the present study was to determine the effect of a single visit by the bees Apis mellifera and species of Augochloropsis on the fruit set of the distylous species Psychotria carthagenensis.After a single visit from each bee species, flowers were bagged to monitor the fruit set. Pollination effectiveness between pollinators and morphs was compared. The results of the experiments were compared with data from manual intermorph cross-pollination using the G test. There were no significant differences in the fruit set between treatments (insect visit and cross-pollination), and between flowers visited by Augochloropsis spp. and flowers visited by A. mellifera. Our results suggest that pollination effectiveness of the studied bees was not related to floral morph, and that both exotic and native bees showed similar performances on the fruit set of P. carthagenensis