Desde un lugar extraño. Retos y oportunidades de la teoría feminista queer

This paper traces some of the main contributions of queer literary theory and criticism, developed in particular in the United States of America during the beginning of the 90s, emphasizing the Iberian reception of such texts and how they have contributed to shaping queer feminist theory as an analytical tool. Starting from the fertile semantic instability of the word “queer”, it is intended to provide an overall idea of the challenges and opportunities that come from approaching literary Medievalism from this excentric perspective. This study uses this analytical framework to highlight the strangeness underling the construction of universalizing History in literary texts and, by extension, of the discourses of exclusion that it has created and the cisheteropatriarchal power systems that perpetuate them. Este artículo presenta algunas de las principales contribuciones de la teoría y crítica literarias queer, desarrolladas especialmente en Estados Unidos a comienzos de los años 90, para dar a conocer la recepción ibérica de los textos que han contribuido a conformarlas como herramienta analítica. A partir de la fértil inestabilidad semántica de lo queer, se pretende reflexionar sobre los retos y las oportunidades de ubicarse en los debates sobre Medievalismo literario desde esta óptica excéntrica. Este trabajo utiliza estas herramientas analíticas para evidenciar la rareza de la construcción de la Historia universalizante en los textos literarios y, por extensión, de los discursos excluyentes que ha creado y de los sistemas de poder cisheteropatriarcales que los perpetúa

«A voz das mulheres perigosa e burra»: Um estudo sobre o remorso de Baltazar Serapião

Using a qualitative research methodology that includes the application of the most relevant theoretical proposals to the narrative, and the comparative and specific analysis of the literary corpus, this study aims at analysing the functions of medievalism and the representation of the Middle Ages in Valter Hugo Mãe’s O remorso de Baltazar Serapião (2006). Highlighting the central theme of the novel –the representation of women– this article presents some considerations about the use of medieval models as a comparative/critical confrontation strategy between the time projected in the story and the present.A través de una metodología cualitativa que incluye la aplicación de las propuestas teóricas más relevantes a la narrativa y el análisis comparativo y específico del corpus literario, este estudio tiene como objetivo analizar las funciones del medievalismo y la representación de la Edad Media en la obra O remorso de Baltazar Serapião (2006) de Valter Hugo Mãe. Destacando el tema central de la novela –la representación de las mujeres– este artículo presenta algunas consideraciones sobre el uso de modelos medievales como estrategia de confrontación comparativa/crítica entre el tiempo proyectado en la novela y la actualidad.A través dunha metodoloxía cualitativa que inclúe a aplicación dos máis relevantes para a narrativa ea análise corpus literario propostas teóricas comparativos e específicos, este estudo ten por obxectivo analizar as funcións do medievalismo e representación da Idade Media na obra O Baltazar remorso Serapião (2006), de Valter Hugo Nai. Destacando o tema central da novela-representación das mulleres Este artigo presenta algunhas consideracións sobre o uso de modelos medievais como estratexia comparativa enfrontamento / crítica entre o tempo previsto na novela e hoxe./n[Traductor de Google

Stories of knights and lords. Two examples of medievalism in contemporary spanish fiction

Este artículo propone una lectura comparada de dos novelas españolas de ficción medievalista contemporánea: "La cuadratura del círculo" (1999), de Álvaro Pombo, y "La tierra fértil" (1999), de Paloma Díaz-Mas. La cuadratura del círculo, por una parte, nos sitúa en la Francia del siglo XII —y, de manera muy particular, el contexto de las cruzadas que se llevan a cabo en esos años—, mientras sigue de cerca la vida del joven Acardo. La tierra fértil, por otra parte, traslada la narración al escenario de la Cataluña de la segunda mitad del siglo XIII —más concretamente, durante los reinados del rey Jaume I y de su hijo, Pere III—, y sigue el ascenso y caída del señorío de la familia del joven protagonista, Arnau Bonastre. El análisis de estas dos obras de ficción medievalista tiene como objetivo, en primer lugar, identificar los mecanismos intertextuales y las referencias literarias e historiográficas que permiten a los autores recrear la ambientación y el espíritu medievales de manera veraz. En segundo lugar, se busca también entender e interpretar cómo se procede a la resignificación de ese universo ficcional a través de la incorporación de nuevos sujetos y discursos que —a la luz de los nuevos paradigmas con-temporáneos— multiplican las posibilidades ficcionales de pensar y representar la Edad Media.This article proposes a comparative reading of two Spanish novels of contemporary medievalist fiction: "La cuadratura del círculo" (1999), by Álvaro Pombo, and "La tierra fértil" (1999), by Paloma Díaz-Mas. La cuadratura del círculo places us in 12th century France —and, more explicitly, in the context of the crusades that took place in those years— while closely following the life of a young man called Acardo. La tierra fértil, alternatively, moves the narrative to the setting of Catalonia in the second half of the 13th century —during the reigns of King James I and his son, King Peter II— and follows the rise and fall of the lordship of the family of the young protagonist, Arnau Bonastre. The analysis of these two works of medievalist fiction aims to, on the one hand, identify the intertextual mechanisms and the literary and historiographical references that allow the authors to recreate the medieval setting and spirit in a truthful way. On the other hand, it also seeks to understand and interpret how this fictional universe is re-signified through the incorporation of new subjects and discourses that —in the light of contemporary paradigms— multiply the fictional possibilities of representing and thinking about the Middle Ages

Toxicity of the 3,4-methylenedioxymethamphetamine and its enantiomers to Daphnia magna after isolation by semipreparative chromatography

MDMA (3,4-methylenedioxymethamphetamine) is a chiral psychoactive recreational drug sold in illicit markets as racemate. Studies on the impact of MDMA on aquatic organisms are scarce. While enantioselectivity in toxicity in animals and humans has been reported, none is reported on aquatic organisms. This study aimed to investigate the ecotoxicological effects of MDMA and its enantiomers in Daphnia magna. For that, enantiomers (enantiomeric purity > 97%) were separated by liquid chromatography using a homemade semipreparative chiral column. Daphnids were exposed to three concentrations of (R,S)-MDMA (0.1, 1.0 and 10.0 µg L−1) and two concentrations of (R)- and (S)-enantiomers (0.1 and 1.0 µg L−1) over the course of 8 days. Morphophysiological responses were dependent on the substance form and daphnia development stage, and they were overall not affected by the (R)-enantiomer. Changes in swimming behaviour were observed for both the racemate and its enantiomers, but enantioselective effects were not observed. Reproductive or biochemical changes were not observed for enantiomers whereas a significant decrease in acetylcholinesterase and catalase activity was noted at the highest concentration of (R,S)-MDMA (10 µg L−1). Overall, this study showed that sub-chronic exposure to MDMA racemate and its enantiomers can interfere with morphophysiological and swimming behaviour of D. magna. In general, the (R)-enantiomer demonstrated less toxicity than the (S)-enantiomer.This work was financially supported by national funds through the FCT/MCTES (PIDDAC), under the project PTDC/CTA-AMB/6686/2020, and partially supported through the projects UIDB/04423/2020 and UIDP/04423/2020 (Group of Natural Products and Medicinal ChemistryCIIMAR)

Clinical performance of an infliximab rapid quantification assay

Background: Therapeutic drug monitoring (TDM)-based algorithms can be used to guide infliximab (IFX) adjustments in inflammatory bowel disease (IBD) patients. This study aimed to explore a rapid IFX-quantification test from a clinical perspective. Methods: This manuscript describes a prospective cohort study involving 110 ulcerative colitis (UC) patients on the maintenance phase of IFX. IFX trough levels were quantified using a rapid quantification assay and a commonly-used reference kit. Results: Irrespective of the assay used to measure IFX, its through levels were statistically different between patients with and without endoscopic remission (Mayo endoscopic score = 0), as well as between patients stratified by their faecal calprotectin (FC) levels. Despite the fact that the two methods correlated well with each other [Spearman's rank correlation coefficient = 0.843, p < 0.001; intraclass correlation coefficients = 0.857, 95% confidence interval (CI): 0.791-0.903], there was a discernible systematic variation; values obtained with the reference kit were on average 2.62 units higher than those obtained with the rapid assay. Notwithstanding, 3 mu g/ml was shown to be an acceptable cut-off to assess endoscopic status and inflammatory burden levels using both assays. The percentage of patients that had a positive outcome when the IFX concentration measured by the rapid assay ranked above 3 mu g/ml was 88% both for a Mayo endoscopic score <= 1 and for an FC concentration <250 mu g/g. Conclusions: Based on this study, we concluded that using the rapid IFX assessment system with a 3 mu g/ml threshold is a reliable alternative to the time-consuming enzyme-linked immunosorbent assays in patients on the maintenance phase of IFX.Portuguese IBD Group (GEDII, Grupo de Estudo da Doenca Inflamatoria Intestinal)info:eu-repo/semantics/publishedVersio

estado da arte na abordagem da insuficiência cardíaca

The prevalence of heart failure has increased over the past decades and is a major social and economic burden on healthcare services. Patient quality of life is severely impaired and heart failure is one of the main causes of death in Portugal. The functional organization of multidisciplinary teams engaged in the treatment of these patients is essential to improve health care provision and outcomes, specifically reducing mortality, hospital admissions, and improving quality of life. We describe current approaches to heart failure management and discuss the organization of heart failure units and cooperation among these units and also with other healthcare professionals.publishersversionpublishe

Clinical outcomes after vena cava thrombectomy for renal cell carcinoma with venous extension – institutional experience

INTRODUCTION: Renal cell carcinoma (RCC) frequently progress to involve the inferior vena cava (IVC) and even the right atrium (RA). Nephrectomy and eradication of the tumour thrombus, can extend survival and prevent symptoms of venous congestion. The authors evaluated the institutional experience of a tertiary center in the surgical management of RCC patients with tumour thrombi invading the IVC. METHODS: Retrospective analysis of a single-center consecutive serie of patients with RCC and IVC tumor thrombi treated with surgery in our department between 2012 and 2021 was carried out. Demographic data, diagnostic and procedural characteristics, clinical outcomes and survival analysis were examined. RESULTS: Of the included 18 patients, 33% (n=6) had smoking history, 78% (n=14) hypertension, 33% (n=6) diabetes and dyslipidaemia. Mean tumour size was 8.78±2.47cm (3-12cm), and 67% (n=12) of the cases were renal clear cell adenocarcinoma. On the basis of the Neves classification for IVC thrombus extension, 39% (n=7) of the patients had level I; 28% (n=5) level II; 17% (n=3) level III and 17% (n=3) level IV. The majority underwent radical nephrectomy, with cavotomy and vena cava thrombus removal followed by lateral venorrhaphy of the vena cava (89%,n=16). In one patient an infra-renal IVC ligation was performed and, in another patient, an IVC interposition with PTFE and a protesic-renal bypass were performed. In level IV, combined open sternotomy and cardiac bypass for RA thrombus control were necessary. Mean total operative time was 3h4min±1h19min and median intraoperative blood loss was 600ml requiring a median blood cells transfusion of 3.5units (0,16) during the hospital stay. Median ICU days was 2 days (0,14) and median hospital stay was 8 days (4,61). The mean preoperative serum creatinine was 1.23+0.38 mg/dL. After surgery, there was a mean decrease of serum creatinine of 0.001 mg/dL (p=.991) (paired T test), confirming the absence of renal impairment. Only one patient required reintervention in the post-operative course for splenectomy. Post- operative complications included one case of pulmonary embolism, pneumonia, acute coronary syndrome and two cases of temporary acute renal lesion. There was no 30-day mortality. Five patients underwent adjuvant chemotherapy. Median follow-up time was 19.5 months (6-46.2 months). The four-year overall survival rate was of 52.4% (figure 1). CONCLUSION: For advanced RCC with tumour thrombus extension into the IVC, despite the expected poor prognosis, nephrectomy and eradication of the entire tumour thrombus, has low morbidity and can prolong patient survival, in line with the presented results

Still a Powerful Tool?

Background: New therapies with prognostic benefits have been recently introduced in heart failure with reduced ejection fraction (HFrEF) management. The aim of this study was to evaluate the prognostic power of current listing criteria for heart transplantation (HT) in an HFrEF cohort submitted to cardiopulmonary exercise testing (CPET) between 2009 and 2014 (group A) and between 2015 and 2018 (group B). Methods: Consecutive patients with HFrEF who underwent CPET were followed-up for cardiac death and urgent HT. Results: CPET was performed in 487 patients. The composite endpoint occurred in 19.4% of group A vs. 7.4% of group B in a 36-month follow-up. Peak VO2 (pVO2) and VE/VCO2 slope were the strongest independent predictors of mortality. International Society for Heart and Lung Transplantation (ISHLT) thresholds of pVO2 ≤ 12 mL/kg/min (≤14 if intolerant to β-blockers) and VE/VCO2 slope > 35 presented a similar and lower Youden index, respectively, in group B compared to group A, and a lower positive predictive value. pVO2 ≤ 10 mL/kg/min and VE/VCO2 slope > 40 outperformed the traditional cut-offs. An ischemic etiology subanalysis showed similar results. Conclusion: ISHLT thresholds showed a lower overall prognostic effectiveness in a contemporary HFrEF population. Novel parameters may be needed to improve risk stratification.publishersversionpublishe

Direct tissue-sensing reprograms TLR4+ Tfh-like cells inflammatory profile in the joints of rheumatoid arthritis patients

Funding Information: We thank Cláudia Andrade for technical support and Juliana Gonçalves for testing samples for SARS-CoV-2 exposure. We are extremely grateful to all the participants of the study and to the whole rheumatology department at Hospital Egas Moniz that made this study possible. This work was supported by Fundação para a Ciência e Tecnologia (FCT) PTDC/MEC-REU/29520/2017, by iNOVA4Health UID/Multi/04462 and by Portuguese Society for Rheumatology (SPR) grants to H.S. H.S. is supported by FCT through IF/01722/2013 and CEECIND/01049/2020, DAS and RCT were supported by FCT through PD/BD/137409/2018 and UID/Multi/04462, respectively. Publisher Copyright: © 2021, The Author(s).CD4+ T cells mediate rheumatoid arthritis (RA) pathogenesis through both antibody-dependent and independent mechanisms. It remains unclear how synovial microenvironment impinges on CD4+ T cells pathogenic functions. Here, we identified a TLR4+ follicular helper T (Tfh) cell-like population present in the blood and expanded in synovial fluid. TLR4+ T cells possess a two-pronged pathogenic activity whereby direct TLR4+ engagement by endogenous ligands in the arthritic joint reprograms them from an IL-21 response, known to sponsor antibody production towards an IL-17 inflammatory program recognized to fuel tissue damage. Ex vivo, synovial fluid TLR4+ T cells produced IL-17, but not IL-21. Blocking TLR4 signaling with a specific inhibitor impaired IL-17 production in response to synovial fluid recognition. Mechanistically, we unveiled that T-cell HLA-DR regulates their TLR4 expression. TLR4+ T cells appear to uniquely reconcile an ability to promote systemic antibody production with a local synovial driven tissue damage program.publishersversionpublishe

Methicillin resistant Staphylococcus aureus infection in vascular surgery patients

INTRODUCTION: Surgical site infections are associated with devastating consequences in vascular surgery patients but the data on Methicillin Resistant Staphylococcus aureus (MRSA) infection among those remains scant and conflicting. Most vascular surgery antibiotic prophylaxis assume that all patients submitted to surgery are tested prior to the intervention or that all patients with risk factors for MRSA are presumed to be colonized. However, the costs associated with testing all patients are not negligible, and most of the vascular surgery patients have risk factors for MRSA colonization. The purpose of this study was to evaluate the burden of MRSA clinical infection and its outcome and to adjust clinical practice accordingly. METHODS: A retrospective analysis of clinical data from all patients with MRSA isolations that were submitted to vascular surgery in the year 2019 was conducted. The primary endpoint was in-hospital mortality. Secondary endpoints were timing of infection (pre-existent infection or post-surgical infection), need for ICU and length of hospital stay. RESULTS: Out of 1681 patients admitted for surgery in the year 2019 in the vascular surgery ward, only 21 had clinical infection with positive MRSA isolates. All the patients had risk factors for MRSA colonization. Seventeen were admitted for PAD (Rutherford grade 5 or 6). Eight patients had post-operatory infections, whilst the remaining presented with MRSA infection prior to the intervention. Post-operatory infections ranged from superficial incisional in three patients, deep incisional in one patient, and organ/space/prosthesis infection in four patients (of the last group, two had prosthesis infection). There were five deaths, of which two were unrelated to the infection. Of the three deaths probably infection-related, all were post-operatory surgical site infections, and all were organ/space/prosthesis infections (one with prosthesis infection). There was no patient admitted to the ICU that survived. The mean hospital stay was increased by 26 days (31 days, 95% CI, 19-43). CONCLUSION: Infection by MRSA was less frequent than expected in our population, which may mean that colonization might be smaller than expected. Pre-operative infection was almost always related to chronic wounds and did not increase the risk of post-operative wound infection or death, contrary to post-operative infection, which seems to significantly increase mortality