Factores de riesgo asociados al desarrollo de complicaciones del estoma de eliminación y de la piel periestomal

Enquadramento: A confeção de um estoma constitui-se como um evento gerador de mudanças influenciado por diversos fatores, nomeadamente a presença de complicações do estoma e/ou pele periestomal. Estima-se que 80% das pessoas com ostomia experienciam, pelo menos, uma complicação relacionada com o estoma ao longo da sua vida. Objetivos: Identificar os fatores de risco associados ao desenvolvimento de complicações do estoma de eliminação e da pele periestomal. Metodologia: Revisão da literatura, com base na estratégia metodológica do Instituto Joanna Briggs para Scoping Reviews. Foram identificados 1492 artigos, sendo incluídos para análise 22.Resultados: A maioria dos fatores de risco para o desenvolvimento de complicações não é modificável. Dos sensíveis à intervenção do enfermeiro evidenciam-se a educação pré e pós-operatória, a marcação do local do estoma e o acompanhamento após a alta hospitalar. Conclusão: O reconhecimento de fatores de risco associados ao desenvolvimento de complicações do estoma permite ao enfermeiro, por um lado, identificar precocemente indicadores de vulnerabilidade nos seus clientes e, por outro lado, intervir de forma mais efetiva.Background: Stoma formation leads to changes that are influenced by several factors, namely the presence of stoma and/or peristomal skin complications. It is estimated that 80% of ostomy patients have at least one stoma-related complication throughout their life. Objectives: To identify the risk factors associated with the development of elimination stoma and peristomal skin complications. Methodology: Literature review, based on the methodological strategy of the Joanna Briggs Institute for scoping reviews. A total of 1,492 articles were identified, of which 22 were included for analysis. Results: Most of the risk factors for the development of complications are non-modifiable. Pre and postoperative education, stoma site marking, and follow-up after hospital discharge are some of the nursing-sensitive factors. Conclusion: The identification of risk factors associated with the development of stoma complications allows nurses to early identify patients’ vulnerability indicators and intervene more effectively.Marco contextual: La confección de un estoma constituye un acto que genera cambios y en el que influyen diversos factores, en particular, la presencia de complicaciones del estoma y/o de la piel periestomal. Se estima que el 80 % de las personas con ostomía experimenta, al menos, una complicación relacionada con el estoma a lo largo de su vida. Objetivos: Identificar los factores de riesgo asociados al desarrollo de complicaciones del estoma de eliminación y de la piel periestomal. Metodología: Revisión de la literatura, con base en la estrategia metodológica del Instituto Joanna Briggs para Scoping Reviews. Se identificaron 1492 artículos, de los cuales 22 se incluyeron en el análisis. Resultados: La mayoría de los factores de riesgo para el desarrollo de complicaciones no se puede modificar. Entre los sensibles a la intervención del enfermero se encuentran la educación pre y posoperatoria, la marcación del lugar del estoma y el seguimiento después del alta hospitalaria. Conclusión: El reconocimiento de factores de riesgo asociados al desarrollo de complicaciones del estoma permite al enfermero, por un lado, identificar previamente los indicadores de vulnerabilidad en sus pacientes y, por otro lado, intervenir de forma más efectiva.info:eu-repo/semantics/publishedVersio

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Evaluation of T3B fingerprinting for identification of clinical and environmental Sporothrix species

In this study, PCR fingerprinting using the universal primer T3B was applied to distinguish among clinical and environmental species of the Sporothrix complex, Sporothrix brasiliensis, S. globosa, S. mexicana, S. pallida, S. luriei and S. schenckii sensu stricto. The T3B fingerprinting generated clearly distinct banding patterns, allowing the correct identification of all 43 clinical and environmental isolates at the species level, what was confirmed by partial calmodulin gene sequence analyses. This technique is reproducible and provides the identification of all species of the Sporothrix complex with sufficient accuracy to be applied in clinical mycology laboratories as well as in epidemiological studies in order to obtain a better understanding of the epidemiology of sporotrichosis.This study was approved by the Research Ethics Committee of IPEC/Fiocruz. Financial support for this work was provided by FAPERJ (Grant Proc. E-26/111.619/2008). R.M.Z.O. is in part supported by CNPq 350338/2000-0. M.M.E.O. was supported in part by a grant from CAPES 2445/11-5 and CAPES-PNPD for his work at CBMA, Universidade do Minho, Braga, PT.info:eu-repo/semantics/publishedVersio

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

Science has a critical role to play in guiding more sustainable development trajectories. Here, we present the Sustainable Amazon Network (Rede Amazonia Sustentavel, RAS): a multidisciplinary research initiative involving more than 30 partner organizations working to assess both social and ecological dimensions of land-use sustainability in eastern Brazilian Amazonia. The research approach adopted by RAS offers three advantages for addressing land-use sustainability problems: (i) the collection of synchronized and co-located ecological and socioeconomic data across broad gradients of past and present human use; (ii) a nested sampling design to aid comparison of ecological and socioeconomic conditions associated with different land uses across local, landscape and regional scales; and (iii) a strong engagement with a wide variety of actors and non-research institutions. Here, we elaborate on these key features, and identify the ways in which RAS can help in highlighting those problems in most urgent need of attention, and in guiding improvements in land-use sustainability in Amazonia and elsewhere in the tropics. We also discuss some of the practical lessons, limitations and realities faced during the development of the RAS initiative so far.Keywords: Social–ecological systems, Tropical forests, Land use, Interdisciplinary research, Sustainability, Trade-off

Biologia floral de Hedychium coronarium Koen. (Zingiberaceae).

No presente trabalho foi estudada a biologia floral de Hedychium coronarium Koen., que ocorre em localidades de brejos e na beira de estradas, na cidade de Teresópolis (RJ), no período compreendido entre novembro de 2003 a julho de 2004. A floração segue o padrão anual assincrônico em nível populacional e ocorre nos meses de janeiro a abril, sendo a frutificação de março a maio. As flores são brancas, zigomorfas, hermafroditas nectaríferas, têm antese noturna e emitem um forte odor perceptível à longa distância. Os estaminódios constituem a “unidade de atração” para os visitantes florais. O androceu é composto de um único estame fértil e os grãos de pólen têm “pollenkitt”. O estigma é verde, úmido, côncavo e com pêlos uniformes ao seu redor. A espécie é auto-incompatível, com índices baixos de formação de frutos sob condições naturais. As flores de H. coronarium são importantes fontes de recursos para a fauna da região, oferecendo néctar e pólen como recompensa

Biologia floral de Hedychium coronarium Koen. (Zingiberaceae).

No presente trabalho foi estudada a biologia floral de Hedychium coronarium Koen., que ocorre em localidades de brejos e na beira de estradas, na cidade de Teresópolis (RJ), no período compreendido entre novembro de 2003 a julho de 2004. A floração segue o padrão anual assincrônico em nível populacional e ocorre nos meses de janeiro a abril, sendo a frutificação de março a maio. As flores são brancas, zigomorfas, hermafroditas nectaríferas, têm antese noturna e emitem um forte odor perceptível à longa distância. Os estaminódios constituem a “unidade de atração” para os visitantes florais. O androceu é composto de um único estame fértil e os grãos de pólen têm “pollenkitt”. O estigma é verde, úmido, côncavo e com pêlos uniformes ao seu redor. A espécie é auto-incompatível, com índices baixos de formação de frutos sob condições naturais. As flores de H. coronarium são importantes fontes de recursos para a fauna da região, oferecendo néctar e pólen como recompensa

Dois casos de poliembrionia em Clusiaceae: Clusia criuva Cambess. e Clusia fluminensis Planch. & Triana

Ensaios de germinação com sementes de Clusia criuva Cambess. e de Clusia fluminensis Planch. & Triana, espécies dioicas, arbóreas, presentes na restinga de Maricá, Rio de Janeiro, revelaram altos percentuais germinativos, 99,2% (n = 140) para C. criuva e 100% (n = 75) para C. fluminensis. Entre as sementes germinadas foi observada a ocorrência de poliembrionia num percentual de 2,1% para C. criuva e de 2,7% para C. fluminensis