Fluid and Electrolyte Balance During the First Week of Life and Risk of Bronchopulmonary Dysplasia in the Preterm Neonate

BACKGROUND: Early fluid and electrolyte imbalances may be associated with an increased risk of bronchopulmonary dysplasia. OBJECTIVE: We sought to establish an association between fluid and electrolyte balance in the first week of life and the risk of bronchopulmonary dysplasia. METHODS: Clinical charts of 205 neonates <32 weeks gestational age and/or <1,250 g birth weight (admitted to our NICU between 1997 and 2008) were analyzed. Clinical features, fluid and electrolyte balance were analyzed for the first 7 days of life using multivariate models of generalized estimation equations. A p value <0.05 was considered significant in all of the hypothesis tests. RESULTS: The prevalence of bronchopulmonary dysplasia was 22%. Lower gestational age and birth weight, male gender, less frequent use of antenatal steroids, respiratory distress syndrome, use of surfactant, patent ductus arteriosus, duration of invasive ventilation and NICU stay were significantly associated with bronchopulmonary dysplasia. The variation in serum values of potassium, phosphorus and creatinine during the first week of life also revealed an association with bronchopulmonary dysplasia. Higher mean plasma calcium values were associated with spontaneous closure of the patent ductus arteriosus. The use of indomethacin to induce patent ductus arteriosus closure was significantly higher in bronchopulmonary dysplasia patients. CONCLUSIONS: Differences in renal function and tubular handling of potassium and phosphorus are present during the first week of life among preterm neonates who will develop bronchopulmonary dysplasia. The higher rate of patent ductus arteriosus and indomethacin use may influence these differences. Serum levels of calcium also appear to play a role in spontaneous ductus arteriosus closure

O IMAGINÁRIO INTERNACIONAL A PARTIR DA PRIMEIRA PÁGINA: O CONTRIBUTO DA REVISTA SEARA NOVA NA TRANSIÇÃO DA DITADURA PARA A DEMOCRACIA EM PORTUGAL

Fundada em 1921, a revista Seara Nova destaca-se no panorama mediático português não apenas pela sua longevidade. Durante anos, foi um dos símbolos da resistência ao regime ditatorial liderado por António Salazar (1926-1968) e Marcelo Caetano (1968-1974), sobrevivendo a inúmeras censuras e atentados à liberdade de expressão, com uma proposta editorial que noticiava os problemas do país e diversas situações que marcavam a atualidade internacional e com um olhar atento aos países africanos de língua oficial portuguesa. A partir de uma delimitação temporal (1959-1979) e abordando apenas duas temáticas – a cobertura de assuntos da África de língua portuguesa e os acontecimentos internacionais – este artigo observa a mediatização destes assuntos retratados na primeira página da revista Seara Nova. A análise efetuada às 225 edições, ao longo de duas décadas, permite concluir, por exemplo, que os assuntos internacionais ocupavam um espaço diminuto, mas relevante do ponto de vista editorial. O líder cubano Fidel Castro surge como figura mais vezes retratada, ao mesmo tempo que alguns conflitos militares e políticos menos mediáticos, como o Perú, Chile e a República Dominicana também surgem com frequência. A revista esteve, ainda, atenta aos feitos científicos da altura, como a chegada do Homem à Lua, e manifestou sempre um interesse claro pela literatura, com a recusa do Nobel por Sarte, a morte de Albert Camus ou a passagem de Jorge Amado por Portugal, assim como as mudanças de poder nas ex-colónias. Esta investigação sugere, por fim, que a revista sobreviveu ao regime ditatorial e que a transição para a democracia foi relativamente inócua para o tratamento de assuntos internacionais

Memórias coloniais em Reis Ventura e Dulce Maria Cardoso

Reis Ventura, escritor e jornalista residente em Luanda nos anos 50-70 do século XX, redige obras de temática colonial, nomeadamente sobre a comunidade branca em Angola, numa visão eurocêntrica e lusotropical. No pós-independência de Angola, lança a obra Os dias da vergonha, que visa relatar os acontecimentos ocorridos desde a revolução de abril de 1974 até 11 de novembro de 1975. Mais de 40 anos depois do 25 de abril, Dulce Maria Cardoso recorda o “retorno” daquela mesma comunidade branca, no momento da descolonização. Haverá consonâncias entre estas memórias vividas apesar de atores sociais diferentes? Numa leitura das obras de Reis Ventura e Dulce Maria Cardoso, sob a ótica dos conceitos de memória e vestígio, entre o cânone e arquivo, “desmemória” ou esquecimento (Assmann 2016), indaga-se sobre a importância dos testemunhos para a construção da memória coletiva

Improved Survival with Therapeutic Hypothermia after Cardiac Arrest with Cold Saline and Surfacing Cooling: Keep It Simple

Aim. To evaluate whether the introduction of a therapeutic hypothermia (TH) protocol consisting of cold saline infusion and surface cooling would be effective in targeting mild therapeutic hypothermia (32–34°C). Additionally, to evaluate if TH would improve survival after cardiac arrest. Design. Before-after design. Setting. General Intensive Care Unit (ICU) at an urban general hospital with 470 beds. Patients and Methods. Patients admitted in the ICU after cardiac arrest between 2004 and 2009 were included. Effectiveness of the TH protocol to achieve the targeted temperature was evaluated. Hospital mortality was compared before (October 2004–March 2006) and after (April 2006–September 2009) the protocol implementation. Results. Hundred and thirty patients were included, 75 patients were not submitted to TH (before TH group), and 55 were submitted to TH (TH group). There were no significant differences concerning baseline, ICU, and cardiac arrest characteristics between both groups. There was a significant reduction in hospital mortality from 61% (n = 46) in the before TH group to 40% (n = 22) in the TH group. Conclusion. Our protocol consisting of cold saline infusion and surface cooling might be effective in inducing and maintaining mild therapeutic hypothermia. TH achieved with this protocol was associated with a significant reduction in hospital mortality

Identoralidade(s) em Mia Couto

Mia Couto states that “African culture is not a single one but a multicultural network in continuous construction” (COUTO, 2005, p. 79). The idea of a multiple and plural identity is related to the questions of tradition and roots of a people, with the need to “re-construct” rituals and beliefs, fundamental elements for the reconstruction of the identity of a country marked by war. The sixteen-year war with the desolation of the natural and human landscape did not provide a cultural context suitable for oral transmission. The need to rescue “the ancestral Mozambican imagery deeply rooted in orality (MARTINS, 2002), lost or forgotten, remains up-to-date and linked to the question of the definition of identity, of Mozambican cultural identity. Oral tradition helps to recycle and revive the collective memory and traditional culture of the Mozambican people, but orality alone is not enough to combat forgetfulness; it is necessary to write to reinforce and diversify the process of re-creating this tradition. Mia Couto contributes to the recovery of tradition with his stories, creating a space “between places”, in which elements of modernity, through the bias of prosaic-fictional writing, are used to transform, update and invigorate the traditional cultural heritage and thus renew the process of building the collective identity of Mozambique. Through readings of Mia Couto’s short narratives and novels, the intention is to explore how the author uses orality to re-construct the identity of the characters and consequent revitalization of collective cultural memory, analyzing selected texts in which identity and orality merged to portray the Mozambican identity. Reinventing or hearing forgotten voices is coloring and building the new Mozambican cultural identity, giving the anonymous people an opportunity to express themselves, to identify with and to give a life to a cultural project for a future that is always under construction.Mia Couto afirma que “a cultura africana não é uma única mas uma rede multicultural em contínua construção” (COUTO, 2005, p. 79). A ideia de uma identidade múltipla e plural relaciona-se com as questões de tradição e de raízes de um povo, com a necessidade de “refabricar” rituais e crenças, elementos fundamentais para a reconstrução identitária dum país marcado pela guerra. Os dezasseis anos de guerra com a desolação da paisagem natural e humana não proporcionaram um contexto cultural adequado à transmissão oral. A necessidade de resgatar “o imaginário ancestral moçambicano profundamente enraizado na oralidade” (MARTINS, 2002), perdido ou esquecido, permanece atual e ligada à questão da definição da identidade, da moçambicanidade. A tradição oral ajuda a reciclar e reavivar a memória coletiva e a cultura tradicional do povo moçambicano, mas a oralidade em si só não chega para combater o esquecimento; é preciso escrever para reforçar e diversificar o processo de recriação dessa tradição. Mia Couto contribui para o resgate da tradição com as suas estórias, criando um espaço “entre lugares”, em que elementos da modernidade, pelo viés da escrita prosaico-ficcional, são utilizados para transformar, atualizar e dinamizar o património cultural tradicional e assim renovar o processo de construção da identidade coletiva de Moçambique. Através de leituras das narrativas curtas e romances de Mia Couto, pretende-se explorar a forma como o autor utiliza a oralidade para a (re)construção da identidade das personagens e consequente revitalização da memória cultural coletiva, analisando textos selecionados em que a identidade e a oralidade se fundem para retratarem a moçambicanidade neles patente. Assim, reinventar ou ouvir vozes esquecidas é colorir e edificar a nova identidade cultural moçambicana, dando oportunidade ao povo anónimo de se expressar, de se identificar com e de fazer viver um projeto cultural para um futuro sempre em construção

O papel do design gráfico na diferenciação e na diversificação de produtos biológicos: estudo de caso - Biofun, Produtos Biológicos do fundão

Trabalho de Projeto apresentado à Escola Superior de Artes Aplicadas de Castelo Branco do Instituto Politécnico de Castelo Branco e à Faculdade de Arquitetura da Universidade Técnica de Lisboa para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Design Gráfico.Este estudo constitui uma reflexão sobre a importância do design gráfico no crescimento, diferenciação e consolidação comercial de uma empresa por via da influência da marca no comportamento do consumidor. O projeto prende-se pela valorização de um produto de produção biológica - concentrado de fruta, e tem como objetivo apresentar o design como uma estratégia de diferenciação. A produção biológica, privilegia as práticas comuns desenvolvidas para minimizar o impacto humano sobre o equilíbrio natural do meio ambiente, da biodiversidade e do bem-estar animal, com o propósito de desenvolver um modelo agrícola sustentável, que beneficie a terra e a vida que se forma nela. Assim, o objetivo do estudo é valorizar um produto de prática biológica, promovendo-o na sua singularidade. Esta proposta aborda a marca para além da sua capacidade de identificação, mas como um conjunto de características e atributos que definem uma cultura, que traduzem uma história, enfatizando a sua personalidade, os seus valores, qualidades e sensações que o produto tem a capacidade de transmitir. Neste trabalho é proposta uma estratégia para a comercialização de um produto de excelência, que se insere num mercado tradicional.Abstract: This is, mainly, a reflection on the importance of graphic design on the growth, differentiation and commercial consolidation of a company led by the influence of the brand in the consumer's behavior. This project is based on the valorization of an organic product – fruit concentrate, and its aim is to present the design as a differentiation strategy. Organic production emphasizes the common practices developed to minimize the human impact on the natural balance of the environment, biodiversity and animal wellbeing, in order to develop a sustainable agricultural model, which benefits the land and the life that grows in it. Thus, the goal of the study is to value a product of biological practice, promoting it in its singularity. This proposal addresses the brand beyond its ability to identify, but as a set of characteristics and attributes that define a culture, that translate a story, emphasizing the personality, values, qualities and feelings that the product has the ability to transmit. This work proposes a strategy for the commercialization of a product of excellence, which is part of a traditional market

Nzinga Mbandi: from story to myth

The figure of Queen Nzinga Mbandi continues to be appreciated in fictional and/or historical narratives as a myth of postcolonial Angolan identity, allowing a continuous approach as to what concerns the modes of cultural representation. In this article, the works of Manuel Pedro Pacavira, Nzinga Mbandi (1975), Pepetela, A gloriosa família: o tempo dos flamengos (1997) and José Eduardo Agualusa, A Rainha Ginga e de como os africanos inventaram o mundo (2014) will be analyzed, as these authors, in different moments of the recent Angolan history, look at this emblematic figure, drawing on historical information produced by Cavazzi, Cadornega or Jean Louis Castilhon, among others. The works now in analysis reiterate the mythical figure of resistance to the European invaders, which was Nzinga Mbandi, or a strong orientation towards the nationalist exaltation supported by it, an evident strategy which, by the rescue of figures and cultural practices, is defined as a means to affirm negritude

Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre study

Background: The provision of Intensive Care (IC) can lead to a health care provider's physical, psychological and emotional exhaustion, which may develop into burnout. We notice the absence of specific studies regarding this syndrome in Portuguese Intensive Care Units (ICUs). Our main objective is to study the incidence and risk factors of burnout in Portuguese ICUs. Methods: A self-fulfilment questionnaire containing 3 items: (i) socio-demographic data of the study population; (ii) experiences in the workplace; (iii) Maslach Burnout Inventory (MBI) - was applied to evaluate the influence of distinct factors on the prevalence of burnout among physicians and nurses working in ICUs. Results: Three hundred professionals (82 physicians and 218 nurses) from ten ICUs were included in the study, out of a total of 445 who were eligible. There was a high rate of burnout among professionals working in Portuguese ICUs, with 31% having a high level of burnout. However, when burnout levels among nurses and physicians were compared, no significant difference was found. Using multivariate analysis, we identified gender as being a risk factor, where female status increases the risk of burnout. In addition, higher levels of burnout were associated with conflicts and ethical decision making regarding withdrawing treatments. Having a temporary work contract was also identified as a risk factor. Conversely, working for another service of the same health care institution acts as a protective factor. Conclusions: A high rate of burnout was identified among professionals working in Portuguese ICUs. This study highlights some new risk factors for burnout (ethical decision making, temporary work contracts), and also protective ones (maintaining activity in other settings outside the ICU) that were not previously reported. Preventive and interventive programmes to avoid and reduce burnout syndrome are of paramount importance in the future organization of ICUs and should take the above results into account

Application of the Cre-loxP system for multiple gene disruption in the yeast kluyveromyces marxianus

The yeast Kluyveromyces marxianus presents several interesting features that make this species a promising industrial yeast for the production of several compounds. In order to take full advantage of this yeast and its particular properties, proper tools for gene disruption and metabolic engineering are needed. The Cre-loxP system is a very versatile tool that allows for gene marker rescue, resulting in mutant strains free of exogenous selective markers, which is a very important aspect for industrial application. As the Cre-loxP system works in some non-conventional yeasts, namely Kluyveromyces lactis, we wished to know whether it also works in K. marxianus. Here, we report the validation of this system in K. marxianus CBS 6556, by disrupting two copies of the LAC4 gene, which encodes a β-galactosidase activity.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - (CAPES), Brazil;Agência de Inovação - projecto UMINHO/POCI-Zimlac/BI/2/0