The importance of Information and Communication Technologies (ICT) to promote Information, self-care and empowerment among patients with chronic illnesses

In the last decades, there has been some technical-scientific advances in the healthcare domain, enabling us to live longer. This reality is particularly important for people suffering from chronic diseases, because they have to find adequate ways to manage their limitations and healthcare condition. Therefore, self-care promotion is one of the biggest challenges of healthcare, particularly for nurses. At the same time, technologies are increasingly used methods by patients to search for information and knowledge about their diseases. With this paper, we intend to verify in what extent does Information and Communication Technologies (ICT) may help patients with chronic diseases to promote their self-care and to manage their health condition. In this sense, we conducted a systematic literature review, focused in following databases: Medeline, Cinahl, PubMed e SciencHub. The main key-words that were used in this research were: chronic disease, self-care, self-management and information systems. We found results from previous works evidencing that patients with chronic diseases resort online information sources (considered reliable), to acquire information that help their self-efficacy and self-management of health condition. The communication or collaborative tools used are primarily the email, discussion forums, blogs and social media. Online programs of self-management of chronic illness also contribute to a faster communication stream between patients and health professionals, in order to allow feedback and social support, having a positive impact in patients’ behaviors, in terms of their adherence and therapeutic management, and also improving health care demand. Thus, we acknowledge that the use of ICT, using various types of media (smartphone, tablet, notebook, ...), not only promotes health education, self-care and empowerment, but also facilitates the communication between patients and health professionals. So, ICT is a relevant contribution to chronic diseases’ patients, facilitating their lives at different levels, and in particular, providing adequate tools to deal with their situation.info:eu-repo/semantics/acceptedVersio

Innovating in nursing education: A brief review of literature

Nursing education has undergone many changes over the years. The development of new medical technologies challenges the present education systems to prepare nurses for the near future. The adoption and use of Information and Communication Technologies (ICT) is increasingly important for nursing teachers to be up to date with pedagogical advances, and prepare the nursing students with theoretical and technical-practical skills, through simulated situations, close to the reality of hospital units (where they'll be as professionals). The use of ICT in nursing education is essential to facilitate the acquisition of knowledge and, particularly, to promote competences, being a challenge both for teachers and students. Aim: The main goal of this paper is to Identify and analyse the innovation in nursing education, i.e., how nursing teachers use ICT in the teaching-learning process. Methodology: We started with the question research: How do nursing teachers use ICT in the teaching-learning process? Data sources were online databases, including CINHAL, MEDELINE and PUBMED. The selection of the articles for the present review was made according to the titles and the abstracts. The selected papers were analysed using a content analysis method. Results: Findings revealed that the teaching of future nurses in laboratories using advanced technologies, such as mannequins and equipment that provide realistic simulations, and the use of ICT facilities, facilitate the pedagogical process, both in classroom and through e-learning methods. Conclusion: The results from the different articles suggest that ICT promote knowledge for students and these information technologies are crucial in nursing education and a great challenge for the teachers, helping to train professionals prepared to deal with the technological scenarios they will encounter in health institutions.info:eu-repo/semantics/acceptedVersio

What do nursing students expect from ICT in their learning and practice?

The development of science due to the progressive scientific and technological discoveries led to significant changes in the people health care, requiring a more complex and demanding nursing care. Nowadays, in the upbringing of a nurses, they may use several equipment and educational technologies that benefit from information and communication technologies (ICT), whose goal is to facilitate the learning process. Most of the emerging tools provide high-quality learning experiences effectively and economically. The use of ICT supplements traditional instructional methods. The role of nursing education is to prepare the future nurses to work in several environments. So, nursing schools need to prepare nurses to work with different technologies and applications (apps), in a digital world. In this paper, our main goal is understand the importance attributed to ICT in the learning process among nursing students. According to the methodology adopted we performed individual interviews with nursing students. Data were treated through context analyses, after being transcribed and analyzed, using a typical statistical software. Findings revealed that students emphasize the importance of ICT in the academical process the advantages it brings to them as future health professionals. Nursing students most usually use the computer and cell phone with the goal of doing research, gather information and interact with peers, allowing communication but an autonomous study. ICT is understood as means for a quick and easy access to information, facilitating the learning process and contributing to take decisions in the nursing care based upon scientific evidences. It is also central in the communication between nurse and patient, and between health professionals, promoting the continuity of care and support people with chronic diseases. In sum, nursing students consider ICT essential as a facilitator in the research and communication, not only in an academic context (in theoretical and practical classes) but also in health units context.info:eu-repo/semantics/acceptedVersio

Total Tumor Load Assessed by One-Step Nucleic Acid Amplification Assay as an Intraoperative Predictor for Non-Sentinel Lymph Node Metastasis in Breast Cancer

BACKGROUND: This study aimed to determine the relationship between CK19 mRNA copy number in sentinel lymph nodes (SLN) assessed by one-step nucleic acid amplification (OSNA) technique, and non-sentinel lymph nodes (NSLN) metastization in invasive breast cancer. A model using total tumor load (TTL) obtained by OSNA technique was also constructed to evaluate its predictability. METHODS: We conducted an observational retrospective study including 598 patients with clinically T1-T3 and node negative invasive breast cancer. Of the 88 patients with positive SLN, 58 patients fulfill the inclusion criteria. RESULTS: In the analyzed group 25.86% had at least one positive NSLN in axillary lymph node dissection. Univariate analysis showed that tumor size, TTL and number of SLN macrometastases were predictive factors for NSLN metastases. In multivariate analysis just the TTL was predictive for positive NSLN (OR 2.67; 95% CI 1.06-6.70; P = 0.036). The ROC curve for the model using TTL alone was obtained and an AUC of 0.805 (95% CI 0.69-0.92) was achieved. For TTL >1.9 × 105 copies/μL we got 73.3% sensitivity, 74.4% specificity and 88.9% negative predictive value to predict NSLN metastases. CONCLUSION: When using OSNA technique to evaluate SLN, NSLN metastases can be predicted intraoperatively. This prediction tool could help in decision for axillary lymph node dissection.info:eu-repo/semantics/publishedVersio

Coronary arcade: a rare anomaly of the coronary circulation.

Intercoronary communication or 'coronary arcade' is a rare congenital coronary anomaly. We present the case of a 65-year-old man with atypical chest pain for four months. The 12-lead ECG and echocardiogram were normal. Treadmill exercise testing was interrupted at peak exercise due to consecutive salvos of ventricular premature beats, without significant ST-T changes. Coronary angiography showed no significant coronary stenosis, but a connection between the right coronary and circumflex arteries was observed, consistent with coronary arcade. The functional importance of this variant is not clear, but it may cause myocardial ischemia by coronary steal or function as a natural bypass, in which case it may play a protective role in the myocardium if significant atherosclerosis develops

Echocardiographic assessment of a cardiac lymphoma: beyond two-dimensional imaging

Lymphoma is usually recognized as the third most frequent metastatic malignancy involving the heart. In recent years, the incidence of cardiac lymphoma has increased, mainly because of HIV-infected patients. We present a case of secondary cardiac lymphoma in an HIV patient presenting with heart failure. Transthoracic echocardiography showed increased left ventricular (LV) wall thickness and an extensive mass in the right cavities with involvement of the tricuspid annulus (Figure 1). Doppler tissue imaging (DTI) showed reduced systolic and diastolic velocities at mitral and tricuspid annulus, compatible with systolic and diastolic myocardial dysfunction, likely owing to infiltration. After 2 weeks of chemotherapy, repeated exam showed significant reduction of the tumour mass and of the LV wall thickness, as well as normalized systolic and diastolic velocities at mitral and tricuspid annulus, as assessed by DTI. Use of transthoracic echocardiography, mostly two-dimensional imaging, has been described for several years for the diagnosis of cardiac involvement as well as for the assessment of tumour regression in response to chemotherapy. The present case report highlights the potential utility of other echocardiographic modalities, particularly DTI, for the assessment of cardiac lymphoma but also for monitoring the tumour response to adequate therapy

In-depth phenolic characterization of iron gall inks by deconstructing representative Iberian recipes

UIDB/50006/2020 PTDC / QUI-OUT / 29925/2017Iron-gall ink is one of the most important inks in the history of western civilization. The deep black colour results from Fe3+ complexes with phenolic compounds available in gall extracts. Unfortunately, it induces the degradation of both ink and support over time. Furthermore, our knowledge of these complex molecular structures is limited. This work aims to overcome this gap, revealing essential information about the complex structures of these pigments and dyes that will create a breakthrough in the next generation of conservation treatments. It presents the first in-depth phenolic identification and quantification of extracts and inks, prepared with and without gum arabic (an essential additive in medieval recipes). Five representative Iberian recipes were selected and prepared. Their phenolic profile was analysed by HPLC–DAD and HPLC–ESI–MS, which revealed that the phenolic compounds present in higher concentration, in the gall extracts, are pentagalloylglucose and hexagalloylglucose (0.15 ± 0.01–32 ± 3 mg/mL), except for one recipe, in which gallic acid is the main phenolic. The influence of the ingredients is also discussed by deconstructing the recipes: extracts of additives as pomegranate peel and solvents used in the extraction of the galls (vinegar and white wine) were characterized.publishersversionpublishe

Proton pump inhibitors in patients treated with aspirin and clopidogrel after acute coronary syndrome

INTRODUCTION: Clopidogrel is an antiplatelet agent converted to its active metabolite by cytochrome P-450 isoenzymes. Numerous drugs are known to inhibit P-450 isoenzymes, including proton pump inhibitors (PPIs), which are often associated with aspirin and clopidogrel to prevent adverse gastrointestinal effects. In vitro studies first showed that PPIs reduced the antiplatelet effect of clopidogrel, while recent clinical studies have raised concerns that the addition of a PPI to clopidogrel in acute coronary syndrome (ACS) patients could actually increase the risk of recurrent cardiovascular events. OBJECTIVE: The aim of this study was to evaluate whether the prescription of a PPI conferred a worse prognosis in patients discharged with aspirin and clopidogrel treatment after ACS. METHODS: A total of 876 patients admitted with ACS and discharged with aspirin and clopidogrel, with a planned duration of at least six months, from January 2004 to March 2008, were reviewed. Patients were classified in two groups according to whether or not a PPI was prescribed at discharge. The PPIs considered were those mainly metabolized by cytochrome P-450 2C19. We excluded patients with insufficient information available on either prescription or clinical records that could allow clearly confirm or exclude exposure to a PPI. Primary end points were six-month all-cause mortality and the composite of death, myocardial infarction and unstable angina at six months. RESULTS: Of the 802 patients considered for further analysis, 274 (34.2%) individuals were medicated with a PPI in addition to dual antiplatelet therapy. Patients taking PPIs were older, more often had renal insufficiency and less often had a history of coronary revascularization and smoking. They more often presented with Killip class >I and lower hemoglobin concentration on admission. There were no significant differences between the two groups in terms of medical treatment (during hospital stay and at discharge) or invasive procedures. By multivariate analysis, independent and positive predictors of PPI prescription were older age and lower hemoglobin concentration on admission. Patients taking PPIs had a slightly higher prevalence of six-month mortality (6.5% vs. 3.9%) and of the composite end point (12.9% vs. 9.2%), although without statistical significance. By multivariate analysis including potential confounding variables, the prescription of a PPI on top of aspirin and clopidogrel was still n ot associated with a worse prognosis. CONCLUSIONS: In the present study, PPI precription in addition to aspirin and clopidogrel after ACS was not associated with a worse six-month prognosis