The impact of anemia on treatment management and clinical outcomes of women hospitalized for uterine leiomyomas

Objectives: Uterine leiomyomas are the most common benign gynecological tumors. Symptomatic leiomyomas represent a major cause of hospitalization, particularly those associated with abnormal uterine bleeding (AUB) and anemia. The aim of this study was to identify predictors of anemia in women hospitalized due to uterine leiomyomas and evaluate its impact on treatment management and clinical outcomes.Material and methods: Population-based retrospective study of women hospitalized for uterine fibroids in publichospitals in mainland Portugal between 2010 and 2015. Data were extracted from the national database of the CentralAdministration of the Portuguese Health System. Comparative and multivariable logistic regression analysis was performed to assess outcomes.Results: A total of 36 295 patients were hospitalized due to uterine leiomyomas during this period. Of those, 11.5%presented with anemia. Age, obesity, intramural type of leiomyoma and AUB are independent predictors of anemia(p < 0.001, AUC 0.7056). Anemia was associated with a high risk of inpatient hospitalization (OR: 5.161, 95% CI: 4.376–6.085), urgent admission (OR: 1.953, 95% CI: 1.797–2.121), radical surgical approach (OR: 2.559, 95% CI: 2.298–2.849), laparoscopic hysterectomy (OR: 1.575, 95% CI: 1.393–1.780) and intra- and post-operative complications (OR: 5.285, 95% CI: 4.332–6.448). It was also associated with longer hospital stays (p < 0.001). These outcomes were more pronounced in acute anemic patients.Conclusions: Anemia has a significant impact on treatment approaches and clinical outcomes of women hospitalized for uterine leiomyomas. Age, obesity, intramural leiomyomas and AUB are some predictors of anemia that could represent a risk-stratification opportunity, allowing for its prompt identification and correction, therefore improving patient care

The ileum as a determinant organ of the functional liver cell mass in rats

PURPOSE: To evaluate if the ileum resection changes the functioning liver cell mass, the hepatic metabolism and the biodistribution of radiopharmaceutical in rats. METHODS: Twelve Wistar rats weighing 285g±34g were randomly divided into the ileum resection group (n = 6) and sham group rats (n = 6). After 30 days, they were anesthetized and 0.1mL of 99m-Tc-phytate(0.66MBq) was injected via femoral vein. After 30 minutes, blood samples were collected for red blood cells radioactive labeling and serum ALT, AST and gammaGT. Liver samples were used for 99m-Tc-phytatepercentage of radioactivity/gram of tissue and histopathology. Student’s t test was used with significance 0.05. RESULTS: There was a higher uptake of 99m-Tc-phytate in the liver of sham rats, compared to the ileum resection group (p<0.05). GammaGT, ALT and AST were increased in ileum resection rats compared to sham (p<0.05). The he patocytes count was significantly lower in ileum resection group than in sham (p<0.05). Liver: body mass ratio was lower in experimental animals than in sham group (p<0.05). CONCLUSION: These data support that the ileum has important role in liver function and liver mass regulation, and they have potential clinical implications regarding the pathogenesis of liver injury following lower bowel resection

Determinants influencing distance learning at health technology higher education institutions in Portugal

POAT-01-6177-FEDER-000047FCT_UIDB/05608/2020. FCT_UIDP/05608/2020.introducing distance learning within higher education institutions (HEIs) is a key societal issue, especially in the health sector, due to its in vivo learning nature. Public policies play an important role in these digital environments. This study aims to identify the determinants influencing national public policies that foster digital learning transformation in Health HEIs in Portugal. A prospective survey, using the structural analysis of Godet’s method, is conducted, and data are gathered from different health sector stakeholders. Despite the efforts to increase digital literacy and funding for digital learning in HEIs, a weak strategy and implementation of a national plan for distance learning in Health HEIs are still prevalent. The driver to success is grounded on national and international cooperation between health professionals, hospitals, and HEIs through transferability processes of innovative practices.info:eu-repo/semantics/publishedVersio

Fêmur Curto Congênito

Objetivo: relatar um caso de paciente com fêmur curto, uma patologia congênita rara que traz importantes repercussões na qualidade de vida das pessoas acometidas. Descrição do caso:&nbsp;Y.C.S.S. sexo feminino, seis meses de idade, apresentando alterações fenotípicas que levaram à hipótese diagnóstica de discrepância de membros inferiores. A investigação radiológica confirmou suspeita diagnóstica de fêmur curto congênito em paciente pediátrico. Considerações finais: O fêmur curto congênito (FCC) é uma displasia óssea do tipo femoral, em que há discrepância no comprimento entre os membros inferiores.&nbsp;Embora a etiologia seja desconhecida, certas teorias têm sido sugeridas, como uso de drogas, viroses e traumas na gestação. Foram também relatados casos familiares da patologia.&nbsp;Uma das formas de tratamento utilizado no FCC é o alongamento ósseo, no qual as técnicas mais empregadas utilizam as corticotomias e colocação de fixador externo com alongamento progressivo. O prognóstico depende da classificação da patologia e do tipo de tratamento possível, sendo de evolução variável e imprevisível

Comparative Effectiveness of COVID-19 Vaccines in Preventing Infections and Disease Progression from SARS-CoV-2 Omicron BA.5 and BA.2, Portugal

We estimated comparative primary and booster vaccine effectiveness (VE) of SARS-CoV-2 Omicron BA.5 and BA.2 lineages against infection and disease progression. During April-June 2022, we implemented a case-case and cohort study and classified lineages using whole-genome sequencing or spike gene target failure. For the case-case study, we estimated the adjusted odds ratios (aORs) of vaccination using a logistic regression. For the cohort study, we estimated VE against disease progression using a penalized logistic regression. We observed no reduced VE for primary (aOR 1.07 [95% CI 0.93-1.23]) or booster (aOR 0.96 [95% CI 0.84-1.09]) vaccination against BA.5 infection. Among BA.5 case-patients, booster VE against progression to hospitalization was lower than that among BA.2 case-patients (VE 77% [95% CI 49%-90%] vs. VE 93% [95% CI 86%-97%]). Although booster vaccination is less effective against BA.5 than against BA.2, it offers substantial protection against progression from BA.5 infection to severe disease.The acquisition of sequencing equipment and reagents used in this study by the Instituto Nacional de Saúde Doutor Ricardo Jorge was partially funded by the HERA project (grant no. 2021/PHF/23776) supported by the European Commission through the European Centre for Disease Control, and also partially funded by the GenomePT project (grant no. POCI-01-0145-FEDER-022184), supported by COMPETE 2020–Operational Programme for Competitiveness and Internationalisation, Lisboa Portugal Regional Operational Programme, Algarve Portugal Regional Operational, under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund, and by the Portuguese Science and Technology Foundation. Algarve Biomedical Center Laboratory received public funding through the Project ALG-D2-2021-06 Variants Screen in Southern Portugal– Monitoring Variants of Concern in Southern Portugal and the Portuguese Science and Technology Foundation national support through the Comprehensive Health Research Center (grant no. UIDP/04923/2020)info:eu-repo/semantics/publishedVersio

Tratamento cirúrgico pela técnica de Keystone para recuperação funcional e estética do hálux após queimadura química - relato de caso

O trabalho tem como objetivo descrever o caso de uma paciente que sofreu queimadura química no hálux esquerdo. Paciente com onicocriptose foi submetida a tratamento com ácido fênico, evoluindo com necrose, odor fétido e secreção purulenta. Após avaliação médica, diagnosticou-se queimadura de terceiro grau infectada, sendo submetida, a princípio a abordagem não cirúrgica, e posteriormente a realização de retalho cutâneo Keystone para fechamento da lesão com recuperação completa após dois meses. Concluiu-se, com tal estudo, que o uso de ácidos pode evoluir com queimaduras químicas graves, comprometendo a função e viabilidade do dedo. Ademais, em feridas profundas, retalho Keystone mostra-se boa alternativa local com rápida recuperação

Telecondutas : nódulo de tireoide

Telemedicin

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio