Hemangioma Cavernoso da Supra-Renal

INTRODUÇÃO: O hemangioma cavernoso da glândula supra-renal é um tumor benigno, raro, com menos de uma centena de casos reportados na literatura. É caracterizado na sua constituição por formações vasculares dilatadas e delimitadas por células endoteliais. Apresenta-se caracteristicamente como um incidentaloma e o seu diagnóstico é habitualmente estabelecido apenas no pós-operatório. CASO CLÍNICO: Doente de 73 anos referenciada por nódulo de 45mm da glândula supra-renal esquerda diagnosticado incidentalmente no seguimento de lesão quística renal. A avaliação imagiológica por TC revelou nódulo sólido de 45x28mm na glândula supra-renal esquerda. Realizou estudo para avaliar a autonomia do nódulo, e que revelou uma hipersecreção adrenérgica. Colocada a hipótese diagnóstica de feocromocitoma e proposta para cirurgia ablativa. Foi submetida a suprarrenalectomia esquerda laparoscópica, que decorreu sem intercorrências. O resultado histológico da peça operatória revelou um hemangioma cavernoso da supra-renal. DISCUSSÃO / CONCLUSÃO: A forma de apresentação mais comum do hemangioma cavernoso da supra-renal é a de um incidentaloma, implicando o diagnóstico diferencial com os vários tipos de lesões ocupando espaço deste órgão. Este facto associado à falta de especificidade dos exames pré-operatórios e à raridade da patologia compromete a acuidade diagnóstica. No presente caso, assim como na maioria dos reportados na literatura, esta patologia foi somente estabelecida no pós-operatório através do resultado anátomo-patológico

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

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

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

Pneumoperitoneum in Peritoneal Dialysis Patients

O Pneumoperitoneu no doente em diálise peritoneal é uma complicação rara, no entanto deve ser tida em atenção de forma a evitar uma laparotomia desnecessária que possa comprometer esta opção dialítica. Os autores qpresentam o cado de uma doente de 70 anos de idade com insuficiência renal crónica, em diálise peritoneal há 21 meses, sem qualquer complicação ou sinal de peritonite. Admitida no serviço de urgência com dor epigástrica súbita. À observação, um abdómen timpanizado, sem alterações na porção externa do cateter de Tenckhoff. Analiticamente sem leucocitose. O Rx Abdominal demonstrou a existência de pneumoperitoneu. A TC abdominal confirmou uma pneumoperitoneu generalizado mas predominante no andar supramesocólico, sem extravasamento de contraste oral e com o cateter de diálise bem posicionado no quadrante inferior esquerdo. Procedeu-se à aspiração do pneumoperitoneu através de um técnica asséptica em posição de Trendlenburg, com confirmação radiológica da resolução do mesmo. Constatou-se recorrência do penumoperitoneu no dia seguinte, apesar da doente permanecer assintomática, pelo que se procedeu à remoção do cateter, sem recorrência do pneumoperitoneu.info:eu-repo/semantics/publishedVersio

Renewable energy systems: Industrial and home best practise case studies

The use of renewable energies and energy efficiency improvement systems is sometimes constrained by the investment needed for devices and its installation. However, governments have developed policies to reduce the initial costs to end-users. The increasing number of renewable energy systems can help in the reduction of the global dependency on fossil energy sources, and simultaneously can help to ensure that the carbon dioxide emissions quota is not exceeded, aiming a reduction of the green-house effect. In this sense, this paper presents two best practise case studies. One of them is in the industrial context and other in the residence context, concerning the use of renewable energy systems and energy efficiency improvement strategies. The best practice case study in industrial context involves the renewable energy systems design in an automotive sector factory, making use of solar thermal panels and energy efficiency measures. The non-industrial case study covers the analysis of the energy efficiency improvement using a thermal energy recovery system from hot water used in daily baths or showers. The direct benefits (savings) and indirect (impacts) are analysed for both case studies.info:eu-repo/semantics/publishedVersio

Surface and porous characterisation of activated carbons made from a novelbiomass precursor, the esparto grass

In the work now reported the production of activated carbons from a novel precursor, esparto grass, by activation with carbon dioxide is presented. The results show that the materials produced have interesting properties, namely BET apparent surface area and pore volume up to 1122 m(2) g(-1) and 0.46 cm(3) g(-1), respectively. The activated carbons have basic characteristics with point of zero charge between 9.25 and 10.27 and show a very fascinating structure, as shown by the SEM images. (C) 2012 Elsevier B.V. All rights reserved.The authors are grateful to the Fundacao para a Ciencia e Tecnologia (Portugal) and the European Regional Development Fund (FEDER) through the Operational Programme for Competitiveness Factors (COMPETE) and QREN for financial support through Project PTDC/CTM/66552/2006 (FCOMP-01-0124-FEDER-007142) and under the Strategic Project PEst-OE/QUI/UI0619/2011 (CQE/UE).Valente Nabais, J.; Laginhas, C.; Ribeiro Carrott, MML.; Carrott, PJM.; Crespo Amorós, JE.; Nadal Gisbert, AV. (2013). Surface and porous characterisation of activated carbons made from a novelbiomass precursor, the esparto grass. Applied Surface Science. 265:919-924. doi:10.1016/j.apsusc.2012.11.164S91992426

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

Modelling the transport of lactic acid, sodium chloride and reducing sugars in carrot slices submerged in brines - Part I. Univariate approach

The transport phenomena pertaining to the independent diffusion of lactic acid and sodium chloride from a brine into carrot slices submerged therein, and of reducing sugars in the opposite direction, were experimentally studied at various temperatures and initial concentrations of salt and acid in the brine. The data sets obtained at each combination of temperature and initial concentration of the brine were independently fit to three analytical models derived from just principles on three alternative mechanisms postulated for the time-variation of the diffusivity. Incremental sum of squares analyses have shown that the diffusion of acid and salt into the carrots is well described by a constant diffusivity, whereas the diffusion of reducing sugars out of the carrots is well described by a diffusivity undergoing a sigmoidal variation with time. This sigmoidal variation may be explained by the assumption that the bursting of the carrot cells is simultaneously proportional to the fraction of intact cells and the fraction of burst cells of the carrot material. The analysis developed is relevant because it allows an approximate prediction of the rates of acid and salt intake, as well as the release rates of reducing sugars, pertaining to bried carrot slices, the basic processes that occur during manufacture of lactic acid carrot pickles

Strain field analysis of cancellous bone under compression by image correlation

Experimental mechanical analysis of cancellous bone has been performed to capture the global strain field of specimens under compression. One major objective is to assess the test procedure and obtain the cancellous bone mechanical properties. Now a day, several techniques are available for the experimental measurement of the field displacement. Among them, the Cross-Correlation is one of most simple’s techniques and can be applied to several studies cases. Based on the correlation of random speckle pattern between two images, the spatial displacement fields can be accessed. A simple digital camera or video recorder can be used without special light to capture the surface intensity pattern in each instant. If several images are taken during a test loading, the displacement field can be fallowed and subsequently the strain can be obtain by the spatial differentiation. Because of random surface pattern, the image can be divided in small areas, each of them pattern independent. By cross-correlating each of one between the two images, the relative displacement is obtained