Oxygen Therapy in Advanced Disease: Do You Know the Evidence?

A dispneia é um dos sintomas que tem mais impacto tanto para o doente com doença avançada, como para o profissional de saúde com a responsabilidade de o acompanhar. Sem prejuízo de se dever aprofundar a evidência disponível sobre as indicações e eficácia da oxigenoterapia, é já vasta a informação que suporta a evidência de que o uso de oxigénio com intenção paliativa deve ser prescrito de forma criteriosa pois, à semelhança de qualquer outro tratamento, tem efeitos secundários associados e pode causar malefícios. O artigo que se apresenta é uma revisão bibliográfica das mais recentes matérias publicadas neste âmbito, com o objetivo de contribuir para melhorar a prática clínica no contexto do tratamento dos doentes em fim de vida.info:eu-repo/semantics/publishedVersio

Lanthanum-based perovskites obtained in molten nitrates or nitrites

International audienceLanthanum-based perovskites, LaMO3 (where M = Mn, Fe, Co, Ni), have been synthesised from lanthanum precursors and corresponding 3d transition metal salts in molten alkali metal nitrates or nitrites. The reactivity of eight precursors in three molten salts of different basicity was analysed. Single phase orthorhombic LaMnO3.11, and orthorhombic LaFeO3 have been obtained in molten NaNO2 at 723 K, for 2 h. LaCoO3 is also formed in molten nitrite, but an increase of basicity, by adding Na2O2, was necessary to obtain LaNiO3. The reaction systems were investigated by thermal analysis. X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX) and specific surface area measurements (BET method) were used to characterise the synthesised nanopowders

Determination of poly(?-caprolactone) solubility parameters: Application to solvent substitution in a microencapsulation process

International audienc

Crianças como Prestadoras de Cuidados

Quando se fala de crianças prestadoras de cuidados, tende a considerar estar-se perante algo pouco frequente e relevante. Contudo, uma breve revisão da literatura existente em vários países - Reino Unido, Austrália e Canadá - revela que esta é uma realidade reconhecida há já alguns anos. Só no Reino Unido existem 175 000 crianças identificadas como prestadoras de cuidados, 2,1% do total das crianças (Becker e Becker, 2008). A previsível evolução da população (aumento da esperança de vida, aumento do número de famílias monoparentais, aumento das famílias nucleares com um elemento doente e outro que sustenta a casa, bem como o aumento das doenças crónicas) indica que em 2020 as necessidades de prestação de cuidados terão de ser cobertas por um número de indivíduos superior à população activa, tornando por isso previsível que uma crescente fatia dessas mesmas necessidades seja coberta por crianças (Siskowski, 2006). Uma vez que em Portugal a investigação acerca desta problemática é inexistente, e que de um modo geral continua o desconhecimento dos profissionais de saúde sobre estas crianças, as suas necessidades e a melhor forma de as satisfazer (Banks et al., 2002), tornase urgente despertar os enfermeiros para a mesma, envolvendo-os simultaneamente no seu estudo. Pretendemos, por isso, partir para a análise do tema desenvolvendo um estudo que identifique quem são estes prestadores de cuidados, quais os cuidados que prestam e quais as suas necessidades, tentando ainda verificar qual o papel dos enfermeiros junto destas crianças e das suas famílias. Da revisão da literatura realizada, partimos com a consciência que esta terá de ser uma realidade relevante na prática de enfermagem, sendo fundamental perceber a relação enfermeiro/doente/criança prestadora de cuidados, bem como conhecer as suas necessidades e responsabilidades.When discussing the issue of young caregivers, it is always assumed that such a practice is unlikely to take place. A brief review of the related literature in several countries – United Kingdom, Australia and Canada – shows however that this is a recognized reality for several years now. The United Kingdom alone has 175.000 children identified as caregivers (2,1% of total children) (Becker & Becker, 2008). The foreseen evolution in population trends (increase in life expectancy, increase in the number of monoparental families, increase in the number of nuclear families with a sick member and another one supporting the household, the increased incidence of chronic diseases) indicates that in 2020 the needs for caregiving will have to be covered by a number of persons higher than total active population, i.e., a bigger share of those needs will have to be covered by young caregivers (Siskowski, 2006). Since Portuguese research on this subject is inexistent, and knowledge about these children, their needs and the best way to satisfy them is still unknown to most health professionals (Banks et al., 2002), it becomes urgent to lift up nurses’ awareness and to involve them in its study and research. We though aim to undertake the analysis of this topic by developing a study aimed at identifying who these young caregivers are, what types of care they are actually supplying, and what their needs are, trying at the same time to identify the roles played by nurses close to these young caregivers and their families. From the undertaken literature review, we acknowledge that this is an issue worthy of attention and relevant to the field of nursing, and that it is of extreme importance to understand the interactions between the nurses / patients / young caregivers, as well as their needs and responsibilities.info:eu-repo/semantics/publishedVersio

POEMS Syndrome: a Rare Cause of Adrenal Insufficiency in a Young Male

Summary: POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes) is a rare multisystemic disease. Clinical presentation is variable, the only mandatory criteria being polyneuropathy and monoclonal gammapathy in association with one major and one minor criterion. Primary adrenal insufficiency is rarely reported. We describe a case of a 33-year-old patient, in whom the presenting symptoms were mandibular mass, chronic sensory-motor peripheral polyneuropathy and adrenal insufficiency. The laboratory evaluation revealed thrombocytosis, severe hyperkalemia with normal renal function, normal protein electrophoresis and negative serum immunofixation for monoclonal protein. Endocrinologic laboratory work-up confirmed Addison's disease and revealed subclinical primary hypothyroidism. Thoracic abdominal CT showed hepatosplenomegaly, multiple sclerotic lesions in thoracic vertebra and ribs. The histopathologic examination of the mandibular mass was nondiagnostic. Bone marrow biopsy revealed plasma cell dyscrasia and confirmed POEMS syndrome. Axillary lymphadenopathy biopsy: Castleman's disease. Gluco-mineralocorticoid substitution and levothyroxine therapy were started with clinical improvement. Autologous hematopoietic cell transplantation (HCT) was planned, cyclophosphamide induction was started. Meanwhile the patient suffered two ischemic strokes which resulted in aphasia and hemiparesis. Cerebral angiography revealed vascular lesions compatible with vasculitis and stenosis of two cerebral arteries. The patient deceased 14 months after the diagnosis. The young age at presentation, multiplicity of manifestations and difficulties in investigation along with the absence of serum monoclonal protein made the diagnosis challenging. We report this case to highlight the need to consider POEMS syndrome in differential diagnosis of peripheral neuropathy in association with endocrine abnormalities even in young patients. Learning points: POEMS syndrome is considered a 'low tumor burden disease' and the monoclonal protein in 15% of cases is not found by immunofixation. Neuropathy is the dominant characteristic of POEMS syndrome and it is peripheral, ascending, symmetric and affecting both sensation and motor function. Endocrinopathies are a frequent feature of POEMS syndrome, but the cause is unknown. The most common endocrinopathies are hypogonadism, primary hypothyroidism and abnormalities in glucose metabolism. There is no standard therapy; however, patients with disseminated bone marrow involvement are treated with chemotherapy with or without HCT.info:eu-repo/semantics/publishedVersio

El sistema de traducción automática castellano-catalán interNOSTRUM Alacant

Este artículo describe interNOSTRUM, un sistema de traducción automática (TA) castellano-catalán actualmente en desarrollo que alcanza una gran velocidad mediante el uso de tecnología de estados finitos (lo que permite su integracion en navegadores de internet) y obtiene una precisión razonable utilizando una estrategia de transferencia morfológica avanzada (lo que permite producir rápidamente borradores de traducciones listos para una postedición ligera)

Fractionating stem cells secretome for Parkinson's disease modeling: Is it the whole better than the sum of its parts?

Human mesenchymal stem cells (hMSCs) secretome has been have been at the forefront of a new wave of possible therapeutic strategies for central nervous system neurodegenerative disorders, as Parkinson's disease (PD). While within its protein fraction, several promising proteins were already identified with therapeutic properties on PD, the potential of hMSCs-secretome vesicular fraction remains to be elucidated. Such highlighting is important, since hMSCs secretome-derived vesicles can act as biological nanoparticles with beneficial effects in different pathological contexts. Therefore, in this work, we have isolated hMSCs secretome vesicular fraction, and assessed their impact on neuronal survival, and differentiation on human neural progenitors' cells (hNPCs), and in a 6-hydroxydopamine (6-OHDA) rat model of PD when compared to hMSCs secretome (as a whole) and its protein derived fraction. From the results, we have found hMSCs vesicular fraction as polydispersity source of vesicles, which when applied in vitro was able to induce hNPCs differentiation at the same levels as the whole secretome, while the protein separated fraction was not able to induce such effect. In the context of PD, although distinct effects were observed, hMSCs secretome and its derived fractions displayed a positive impact on animals' motor and histological performance, thereby indicating that hMSCs secretome and its different fractions may impact different mechanisms and pathways. Overall, we concluded that the use of the secretome collected from hMSCs and its different fractions might be active modulators of different neuroregeneration mechanisms, which could open new therapeutical opportunities for their future use as a treatment for PD.Prémios Santa Casa Neurociências Prize Mantero Belard for Neurodegenerative Diseases Research (MB-28-2019). This work was supported by the European Regional Development Fund (FEDER), through the Competitiveness Internationalization Operational Programme (POCI), and by National funds, through the Foundation for Science and Technology (FCT), under the scope of projects UIDB/50026/2020; UIDP/50026/2020 and POCI-01-0145-FEDER-029751. This article has also been developed under the scope of the project NORTE-01-0145-FEDER-000023, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER). This work has been funded by ICVS Scientific Microscopy Platform, member of the national infrastructure PPBI - Portuguese Platform of Bioimaging (PPBI–POCI-01-0145-FEDER-022122)info:eu-repo/semantics/publishedVersio

Enhanced neuronal differentiation by dynamic piezoelectric stimulation

Abstract Electroactive smart materials play an important role for tissue regenerative applications. Poly(vinylidene fluoride) (PVDF) is a specific subtype of piezoelectric electroactive material that generates electrical potential upon mechanical stimulation. This work focuses on the application of piezoelectric PVDF films for neural differentiation. Human neural precursor cells (hNPCs) are cultured on piezoelectric poled and non-poled -PVDF films with or without a pre-coating step of poly-d-lysine and laminin (PDL/L). Subsequently, hNPCs differentiation into the neuronal lineage is assessed (MAP2+ and DCX+) under static or dynamic (piezoelectric stimulation) culture conditions. The results demonstrate that poled and coated -PVDF films induce neuronal differentiation under static culture conditions which is further enhanced with mechanical stimulation. In silico calculations of the electrostatic potential of different domains of laminin, highlight the high polarity of those domains, which shows a clear preference to interact with the varying surface electric field of the piezoelectric material under mechanical stimulation. These interactions might explain the higher neuronal differentiation induced by poled -PVDF films pre-coated with PDL/L under dynamic conditions. Our results suggest that electromechanical stimuli, such as the ones induced by piezoelectric -PVDF films, are suitable to promote neuronal differentiation and hold great promise for the development of neuroregenerative therapies.Fundação para a Ciência e a Tecnologia, Grant/Award Numbers: POCI-01-0145-FEDER-029206, POCI-01-0145-FEDER-031392, PTDC/MED-NEU/31417/2017, UIDB/50026/2020, UIDP/50026/2020, NORTE-01-0145-FEDER-029968, POCI-01-0145-FEDER-029751, POCI-01-0145-FEDER-032619, UID/FIS/04650/2020, PTDC/EMD-EMD/28159/2017, PTDC/BTM-MAT/28237/2017, PTDC/QUI-OUT/32243/2017, LA/P/0058/2020, UIDB/04539/2020, UIDP/04539/2020, POCI-01-0145-FEDER-031356, DSAIPA/DS/0118/2020; Santa Casa da Misericórdia de Lisboa, Grant/Award Numbers: MC-04-17, MC-18-21; Basque Government Industry Departments; Spanish State Research Agency; European Regional Development Fund, Grant/Award Number: PID2019-106099RB-C43/AEI; Northern Portugal Regional Operational Program, Grant/Award Numbers: NORTE-01-0145-FEDER-000023, NORTE-01-0145-FEDER-000013; Portuguese Platform of Bioimaging, Grant/Award Number: PPBI-POCI-01-0145-FEDER-022122; ICVS Scientific Microscopy Platform; Portuguese Foundation for Science and Technology, Grant/Award Number: PD/BDE/143150/2019info:eu-repo/semantics/publishedVersio