Cinesiterapia Respiratória no doente crítico com COVID-19: a intervenção do enfermeiro de reabilitação - Estudo de Caso

Aim: This study aims to describe rehabilitation nurse interventions in Respiratory Kinesitherapy in critically ill with COVID-19 patient undergoing venovenous extra-corporeal membrane oxygenation and its response concerning to gasometric and ventilatory parameters before and after each session. Methodology: Case study of a 63-year-old person with history of obesity and high blood pressure. Retrospective data were collected from the clinical process, referring to a 38-day ICU stay. Results: The most performed techniques used in Respiratory Kinesitherapy by rehabilitation nurses were suctioning through closed system, vibrations, sudden decompression, selective costal openings, forced manual expiration, directed ventilation and mechanical in-exhaler. Globally, all sessions showed that there was an improvement in inspiratory and expiratory volumes, as well as in static compliance. Machanical in-exhaler was used after a week of hospital stay, after all other possible interventions were performed, and all outcomes showed global improvements, without any adverse events. Conclusion: Implementation of structured and individualized respiratory kinesitherapy interventions can significantly benefit recovery of critical ill patients. Techniques that weren´t described for covid 19 cases were used effectively.Objetivo: Este estudio tiene como objetivo: describir las intervenciones del enfermero de rehabilitación en términos de Kinesiterapia Respiratoria en los pacientes con COVID-19 sobre ventilación mecánica y oxigenación com membrana extracorpórea, analizando la respuesta en términos de parámetros gasométricos y ventilatorios antes y después de cada sesión. Método: Estudio de caso de un paciente de 63 años con antecedentes patológicos de obesidad y hipertensión arterial. Se recopilaron datos retrospectivos del proceso clínico, durante una permanência en UCI de 38 días. Resultados: Las técnicas más utilizadas en Kinesiterapia Respiratoria fueron, la aspiración de secreciones en circuito cerrado, vibraciones, descompresión repentina, aberturas costales selectivas, espiración manual forzada, ventilación dirigida y in-exsuflador mecánico. En todas las sesiones, hubo una mejoria en los volúmenes inspiratorio y espiratorio, así como en la compliance estática. El in-exsuflador mecánico se inició después de una semana de hospitalización, después de agotarse todas las intervenciones posibles, siendo que todos los resultados mostraron mejoras globales, sin eventos adversos. Conclusión: La implementación de intervenciones de kinesiterapia respiratoria estructuradas e individualizadas puede contribuir significativamente en la recuperación de un paciente en una situación crítica, habiendo sido utilizadas técnicas que aín no se han descrito para los casos de COVID-19 de manera efectiva.Objetivo: Este estudo tem como objetivo: descrever as intervenções do enfermeiro de reabilitação em termos de Cinesiterapia Respiratória na pessoa com COVID-19, com ventilação mecânica e em oxigenação extra-corpórea por membrana, analisando a resposta em termos de parâmetros gasométricos e ventilatórios antes e após cada sessão. Método: Estudo de caso de uma pessoa com 63 anos, com antecedentes de obesidade e hipertensão arterial. Realizou-se colheita de dados retrospetiva de processo clínico, referente a um período de internamento em UCI de 38 dias. Resultados: As técnicas mais utilizadas na Cinesiterapia Respiratória foram a aspiração de secreções em circuito fechado, vibrações, descompressão brusca, aberturas costais seletivas, expiração manual forçada, ventilação dirigida e in-exsuflador mecânico. Na globalidade das sessões, verificou-se uma melhoria nos volumes inspiratórios e expiratórios, assim como melhoria na compliance estática. Começou a usar-se o in-exsuflador mecânico ao fim de uma semana de internamento, depois de se esgotarem todas as intervenções possíveis, sendo que todos os outcomes apresentaram melhorias globais, sem eventos de adversos. Conclusão: A implementação de intervenções de cinesiterapia respiratória estruturadas e individualizadas, podem contribuir significativamente na recuperação da pessoa em situação crítica, tendo-se usado com eficácia técnicas que não estavam descritas para casos COVID- 19

Ecological footprint reduction recommendations for higher education Iistitutions

Obra editada por: Sara Moreno Pires, Federico Maria Pulselli, George Malandrakis, Sandra Caeiro e Alessandro GalliERASMUS+, KA203 2019-2022, Agreement No. 2019-1-ELO1-KA203-062941info:eu-repo/semantics/publishedVersio

Aloysia citrodora extract as a chemopreventive agent against HPV16-induced lesions: findings from K14-HPV16 mice

Aim: Aloysia citrodora has a long history of traditional use in treating various ailments. This study evaluated the in vivo chemopreventive efficacy and systemic toxicity of an extract of A. citrodora in a transgenic mouse model of HPV16 (human papillomavirus type 16)-induced cancer. Methods: The experiment involved six groups (n = 5): group 1 (G1, wild-type (WT), water), group 2 (G2, HPV, water), group 3 (G3, WT, 0.013 g/mL), group 4 (G4, HPV, 0.006 g/mL), group 5 (G5, HPV, 0.008 g/mL), and group 6 (G6, HPV, 0.013 g/mL). Throughout the assay, humane endpoints, body weight, food, and water consumption were recorded weekly. The internal organs and skin of the mice were collected for analysis after they were sacrificed. Toxicological parameters that were studied included hematological and biochemical blood markers, splenic and hepatic histology, and hepatic oxidative stress. Results: A. citrodora extract seems to reduce the incidence of dysplastic and in situ carcinoma skin lesions induced by HPV16 in this model, suggesting that dietary supplementation with concentrations of 0.008 g/mL and 0.013 g/mL may have beneficial chemopreventive effects. Conclusions: The extract did not induce any concentration-dependent toxicological effects on any of the parameters included in the study, indicating a favorable toxicological profile under these experimental conditions.info:eu-repo/semantics/publishedVersio

Recomendações de redução da pegada ecológica para instituições de ensino superior

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Raccomandazioni per la riduzione dell'impronta ecologica delle università

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Συστάσεις μείωσης του Οικολογικού Αποτυπώματος για τα Ιδρύματα Τριτοβάθμιας Εκπαίδευσης

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Multidimensional assessment of institutionalized elderly: the reality of a brazilian institution

Background: The population aging in Brazil is characterized by the accumulation of progressive disabilities in their functional activities and daily life. To consider the elderlies in his/her multiple dimensions turns out to be a critical issue to improvetheir assistance to an institu-tionalized level, improving their health and quality of life. To perform a mini-overall evaluation of institutionalized elderly person to trace their profile in relation to the socio-demographic, functional capacity, nutritional status and cognition. Methods: Descriptive study, with a cross-sectional design and quan-titative approach performed in a long - stay institution for the elderly in Natal, RN. The research was approved by the Research Ethics Com-mittee of the Federal University of Rio Grande do Norte, under opinion number 164/2011.Results: 63.3% of the elderly were female, with ages varying from 61 to 103 years. 60.0% were single; 56.7% were literate. 66.7% had no children and 55% lived with their families before the institutio-nalization. As for the institutionalization time, 63.3% resided in the institution for four years. As what concerns the aspects of health, 73.3% of the elderly presented hearing difficulties, 90% make use of medicines predominantly to diabetes and hypertension. There is clear evidence that the institutionalization has been harmful to the elderly as with regards basic activities of daily living, nutritional status and cognitive aspects. Conclusion: The progressive disability in functional activities of daily life interferes directly in the quality of life, increasing dependency and minimizing the autonomy of these individuals. It is necessary to effec-tive implementation of public policies directed to the institutionalized elderly from the perspective of effective actions for improved attention and assistance

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio