TRANSESOPHAGEAL RIGHT UPPER PULMONARY LOBECTOMY - IN VIVO PORCINE EXPERIMENTAL STUDY

TRANSESOPHAGEAL RIGHT UPPER PULMONARY LOBECTOMY - IN VIVO PORCINE EXPERIMENTAL STUDY João Moreira-Pinto, MD1,2,3; Aníbal Ferreira, MD1,2,4; Alice Miranda, DVM1,2; Carla Rolanda, MD, PhD1,2,4; Jorge Correia-Pinto, MD, PhD1,2,5 1Surgical Sciences Research Domain, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; 2ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal; 3Pediatric Surgery division, Centro Hospitalar do Porto, Porto, Portugal; 4Department of Gastroenterology, Hospital de Braga, Braga, Portugal; 5Pediatric Surgery division, Hospital de Braga, Braga, Portugal. Background and Study Aims Video-assisted thoracoscopic surgery (VATS) has been widespread as the better approach to carry out pulmonary lobectomy. Natural Orifice Transluminal Endoscopic Surgery (NOTES) is being assessed as an alternative to the transthoracic endoscopic surgery. We designed this study to test the feasibility of peroral transesophageal right upper pulmonary lobectomy with the assistance of a single transthoracic trocar. Material and Methods In ten anesthetized pigs (35-45 Kg), we performed right upper pulmonary lobectomy using a forward viewing single-channel gastroscope (introduced perorally) and an operative thoracoscope with a 5 mm working channel (introduced through a single-transthoracic 10 mm port) (Karl Storz). After introducing the gastroscope throughout an oroesophageal overtube into the esophagus, a 1 cm transverse esophagotomy was carried out in the upper third using an ESD-knife under thoracoscope control. Anatomic dissection of the right upper hilum was performed using flexible (gastroscope) and rigid (thoracoscope) instruments. After individual dissection, right upper pulmonary arteries, veins and correspondent bronchus were independently stapled using a 45-mm long, linear endostapler (EndoPath®, Ethicon Endo-Surgery) introduced through the oroesophageal overtube. After completing the lobe resection using an endoscopic snare with cautery, the specimen was extracted retrogradely through the mouth. The esophagotomy was stitched and tied using Endo Stitch™ (Covidien) and a long knot-pusher, which were handled through the oroesophageal overtube. Results Esophagotomy was performed safely in all animals. Dissection of the right upper lobe hilum elements (arteries, veins and bronchus) was also carried out in all animals without significant problems. Oroesophageal handling of the endostapplers for independent ligation of the hilum elements under transthoracic imaging was surprisingly feasible, reasonably easy to perform and reliable in 7 cases. In two cases ligation of the vessels was en bloc. In one case, severe hemorrhage occurred from incomplete vein ligation, although we could control it using electrocoagulation. Esophagotomy closure was feasible but its reliability was not tested in survival studies. All but one animal were kept alive until the end of the acute experiment when they were sacrificed. Conclusions Transesophageal right upper pulmonary lobectomy using single transthoracic trocar assistance is feasible and it may represent a step towards scarless pulmonary lobectomy. Additional survival studies are necessary to test the reliability of this procedure. Apresentador: João Moreira-Pinto, Médico Interno de Cirurgia Pediátrica, CHP

Thinness in the pursuit for social safeness: An integrative model of social rank mentality to explain eating psychopathology

Pinto-Gouveia, J., Ferreira, C., & Duarte, C. (2014). Thinness in the pursuit for social safeness: An integrative model of social rank mentality to explain eating psychopathology. Clinical Psychology and Psychotherapy, 21(2), 154-165. doi: 10.1002/cpp.1820.The current study tests a model based on social rank mentality investigating whether women who feel inferior and believe others see them negatively, and feel under pressure to compete to avoid social inferiority, present increased body dissatisfaction and drive for thinness; and whether these associations are mediated by distinct emotional regulation processes. The predictions from the model proposed were examined through path analyses, in a sample of 125 women from the general population and 102 patients with eating disorders. Results showed that the path model explained 51% of body dissatisfaction variance and 61% of drive for thinness and allowed us to confirm that social ranking variables increased drive for thinness through higher levels of self-criticism and lower levels of self-compassion. The findings suggest that the nuclear eating disorders’ features arise as a result of a more self-critical and less compassionate attitude with the self, in the context of a mentality focused on social ranking and competition

Drive for thinness as a women's strategy to avoid inferiority

Ferreira, C., Pinto-Gouveia, J., & Duarte, C. (2013). Drive for thinness as a women's strategy to avoid inferiority. International Journal of Psychology and Psychological Therapy, 13(1), 15-29. http://www.ijpsy.com/volumen13/num1/344.htmlThe emphasis on the need to achieve and be successful, and the contextual competitive dynamics in Western societies, may explain the increase of distinct forms of psychopathology. This study examined sex differences relative to the expression and consequences of feeling under pressure to compete to avoid a threatening social position. Also, we tested whether insecure striving moderates the impact of a low social rank on drive for thinness, in women. In this cross-sectional study self-report measures of insecure striving and secure non-striving, social comparison, depression, anxiety and stress, and eating disorders symptomatology were completed by a sample of 245 male and 429 female students. For both men and women, the need to strive is associated with general psychopathological symptoms (depression, anxiety and stress). Furthermore, insecure striving was a significant moderator between a low social rank and the endorsement of the importance of thinness and dieting behaviours in women. These findings support the hypothesis that drive for thinness arises as a competitive weapon to assure a secure place in the social world

Reviving käthe seidel’s legacy to University of Minho

Site da conferência internacional: http://www.wetconf10.adp.pt/home_p.htmIn the 80’s Prof. Käthe Seidel was in Portugal by invitation of the University of Minho (UM). The relationship established led to the donation of Seidel’s laboratory to UM, to create a Limnological Laboratory. Some institutional and personal reasons rendered this unviable and until now, Seidel’s legacy at UM is resumed to some German bibliography, equipment and unpublished work. Prof. Kickuth was Seidels’ disciple. His technology is based on a rooted emergent macrophyte system of horizontal subsurface flow that relied on optimized substrate planted with Phragmites. Aiming to determine the efficiency of Kickuth’s process and to understand the role of the biotic communities presented on these optimized substrates, mensal sampling campaigns were made in a Constructed Wetland (CW) located in the North of Portugal. The sampling campaigns began on January 2005. Inlet (IN) and outlet (OUT) wastewater simple samples and substrate samples were taken from one of the two CW’s beds. In situ determinations of temperature, pH and redox potential were recorded, and IN and OUT wastewater samples were analysed for BOD5, COD and TSS; estimated densities of some microbiological communities were assessed by the recovery of colony formed units (CFU/ml) on solid culture media, using the spread technique. The results obtained show a very good efficiency on organic load removal (values of 80-90%) accompanied by higher values in percent removal of the estimated heterotrofics CFU/ml. The total and fecal coliforms removal was also high (90-100%). The substrate’s biodiversity characterized by optical microscopy allowed the identification of both protozoa and metazoa (mainly nematodes and annelids). The sampling and quantification methodologies of the biota taxa aren’t optimized. As the knowledge of this “black box” effective function may contribute to increase the credibility of these sustainable systems, it seems pertinent to proceed with these studies.Instituto da Água, Águas de Portugal, EPAL, Somague, Caixa Geral de Depósitos, Alves Ribeiro S.A., Fundação Calouste Gulbenkian, Acciona, Câmaras Municipais de: Alcochete, Lisboa, Odemira, Évora, Beja, Sintra Loures; Serviços Municipalizados de águas e saneamento de: Loures e Sintra; Empressa Municipal de água e saneamento de Beja, Cafés Delta, Galp e EDP-energias de Portuga

Shame, Self-Criticism, Perfectionistic Self-Presentation and Depression in Eating Disorders

Costa, J., Marôco, J., Pinto-Gouveia, J., & Ferreira, C. (2016). Shame, Self-Criticism, Perfectionistic Self-Presentation and Depression in Eating Disorders. International Journal of Psychology and Psychological Therapy, 16(3), 317-328. http://www.ijpsy.com/volumen16/num3/449.htmlThe complexity of eating disorder (ED) manifestations has increased the interest in understanding the mechanisms underlying the eating psychopathology and it is now widely accepted that there are multiple risk pathways for both the development and maintenance of eating psychopathology. This study examined the association between external shame and depression. We also investigated the possible mediation effect of self-criticism in the relation between shame and depression. Further to that, the current cross-sectional study inspected whether this mediation exists for different conditional values of perfectionistic self-presentation. One hundred and twenty one women diagnosed with eating disorder according to the Eating Disorder Examination (EDE 16.0D) completed a battery of self-report questionnaires to assess external shame, self-criticism, perfectionistic self-presentation and depression. A mediated-moderation analysis was performed. Results showed that the path from external shame to self-criticism depends on the level of perfectionistic self-presentation whereas the effect of self-criticism on depression is constant. Thus, there is an interaction between external shame and perfectionistic self-presentation on self-criticism which, in turn, affects depression. The internalization of an ideal-self sets up a standard that once compared to the actual self, displays negative self-evaluations and feelings that individuals see as reflecting a bad, inferior and flawed self. In this context, a perfectionistic self-presentation is used to create positive images on the minds of others. Although this style of organization is an adaptive way to deal with specific social contexts once it functions as a buffer in the relationship between shame and self-criticism, perfectionistic self-presentation seems to be a useless strategy since it does not prevent them from depression. Implications for future research are discussed

The LSTS open-source communication and autonomy software: enabling networked vehicle systems to find track, and sample dynamic features of the ocean

Peer Reviewe

A necessidade de competir para evitar a inferioridade: Estudos de validação da versão portuguesa da SAIS

Ferreira, C., Duarte, C., & Pinto-Gouveia, J. (2011). A necessidade de competir para evitar a inferioridade: Estudos de validação da versão portuguesa da SAIS. Psychologica, 54, 5 - 34. doi:10.14195/1647-8606_54_1A Striving to Avoid Inferiority Scale (SAIS; Gilbert et al., 2007) avalia as crenças acerca da necessidade de competir ou lutar/esforçar-se para evitar a inferioridade. Numa amostra de 2411 sujeitos da população geral, verificou-se uma estrutura de dois factores para a SAIS parte um – striving inseguro e non-striving seguro – e SAIS parte três –procura e evitamento de competição. Nas três partes encontraram-se valores elevados de consistência interna, e correlações item-total moderadas a altas. Comprovou-se a validade de constructo através da análise de correlações com medidas de ranking social, vinculação ao grupo social, perfeccionismo e sintomatologia ansiosa, depressiva e stress. Verificou-se uma boa estabilidade temporal. Esta é uma medida útil na avaliação da patologia do comportamento alimentar, discriminando entre uma amostra clínica de 91 doentes com perturbação alimentar e uma amostra de 102 participantes da população normal. Os resultados são discutidos considerando-se a literatura existente

Thromboprophylaxis With Apixaban in Patients Undergoing Major Orthopedic Surgery: Meta-Analysis and Trial-Sequential Analysis

Background: Venous thromboembolism (VTE) is a potentially fatal complication of orthopedic surgery, and until recently, few antithrombotic compounds were available for postoperative thromboprophylaxis. The introduction of the non–vitamin K antagonists oral anticoagulants (NOAC), including apixaban, has extended the therapeutic armamentarium in this field. Therefore, estimation of NOAC net clinical benefit in comparison with the established treatment is needed to inform clinical decision making. Objectives: Systematic review to assess the efficacy and safety of apixaban 2.5 mg twice a day versus low-molecular-weight heparins (LMWH) for thromboprophylaxis in patients undergoing knee or hip replacement. Data sources: MEDLINE, Embase, and CENTRAL were searched from inception to September 2016, other systematic reviews, reference lists, and experts were consulted. Study eligibility criteria, participants, and intervention: All major orthopedic surgery randomized controlled trials comparing apixaban 2.5 mg twice daily with LMWH, reporting thrombotic and bleeding events. Data extraction: Two independent reviewers, using a predetermined form. Study appraisal and synthesis methods: The Cochrane tool to assess risk bias was used by two independent authors. RevMan software was used to estimate pooled risk ratio (RR) and 95% confidence intervals (95% CI) using random-effects meta-analysis. Trial sequential analysis (TSA) was performed in statistical significant results to evaluate whether cumulative sample size was powered for the obtained effect. Overall confidence in cumulative evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group methodology. Results: Four studies comparing apixaban 2.5 mg twice daily with LMWH were included, with a total of 11.828 patients (55% undergoing knee and 45% hip replacement). The overall risk of bias across studies was low. In comparison with LMWH (all regimens), apixaban showed a significantly lower risk of VTE events and overall mortality combined (RR: 0.63, 95% CI: 0.42-0.95, I2 = 84%, n = 8346), but not of major VTE events (RR: 0.62, 95% CI: 0.32-1.19, I2 = 63%, n = 9493), or of symptomatic VTE events and VTE-related mortality combined (RR: 1.14, 95% CI: 0.68-1.90, I2 = 0%, n = 11 879). Trial sequential analysis showed that the risk reduction obtained for VTE and mortality was based on underpowered cumulative sample size and effect dimension. Subgroup analysis according to LMWH regimens showed that apixaban reduced the risk of VTE events and overall mortality, and major VTE events, when compared with LMWH once daily, without differences between apixaban and LMWH twice daily. Conclusions: There is low to moderate evidence that in patients undergoing knee or hip replacement, apixaban seems equally effective and safe to LMWH twice a day. When compared with LMWH once a day, apixaban seems a superior thromboprophylaxis option. However, the results are underpowered which precludes definite answers regarding the true net clinical benefit of apixaban versus LMWH in this clinical context

Desenvolvimento de uma Escala de Comparação Social através da Aparência Física: Estudo exploratório da estrutura factorial e das propriedades psicométricas numa amostra feminina da população geral

Ferreira, C., Pinto-Gouveia, J., & Duarte, C. (2011). Desenvolvimento de uma Escala de Comparação Social através da Aparência Física: Estudo exploratório da estrutura factorial e das propriedades psicométricas numa amostra feminina da população geral. Psychologica, 54, 309-330. doi: 10.14195/1647-8606_54_1