Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report

Persistent left superior vena cava (PLSVC) is the most frequent thoracic venous anatomical variant in the general population. Isolated PLSVC, without formation of the right superior vena cava, is described in 10% of cases of PLSVC only. While it can be associated with congenital heart disease, arrhythmias, and premature death, adult patients with PLSVC are mostly asymptomatic, and the diagnosis is usually accidental. We present the case of a 72-year-old male with end-stage renal disease who was started on urgent hemodialysis through a temporary non-tunneled femoral central venous catheter (CVC) in the SLED (slow low-efficiency dialysis) modality and later remained dependent on hemodialysis. At this stage, placement of a tunneled CVC in the right internal jugular vein was necessary and fluoroscopy guidance was not available. There were no complications during the procedure, but postoperative conventional chest radiography revealed an inadequate positioning of the CVC tip in the left hemithorax, crossing the midline. Subsequently, the diagnosis of PLSVC was obtained by performing a thoracic angio-CT scan, confirming CVC tip positioning inside the PLSVC, and also excluded the presence of cardiac defects or additional anatomical variations of the great vessels of the thorax. Early evaluation for the creation of autologous vascular access was started under our care, and there were no mechanical or other complications associated with hemodialysis sessions during early follow-up after discharge.info:eu-repo/semantics/publishedVersio

Differential responses of the antioxidant defence system and ultrastructure in a salt-adapted potato cell line

Changes in lipid peroxidation and ion content and the possible involvement of the antioxidant system in salt tolerance at the cellular level was studied in a potato (Solanum tuberosum L.) callus line grown on 150 mM NaCl (salt-adapted) and in a non-adapted line exposed to 150 mM NaCl (salt-stressed). Salinity reduced the growth rate and increased lipid peroxidation in salt-stressed line, which remained unaltered in the adapted line. Na+ and Cl− content increased due to salinity in both lines, but the adapted line displayed greater K+/Na+ ratio than the stressed one. Total superoxide dismutase (SOD, EC 1.15.1.1), ascorbate peroxidase (APX, EC 1.11.1.11), and glutathione reductase (GR, EC 1.6.4.2) activities decreased in both salt-exposed lines; catalase (CAT, EC 1.11.1.6) activity did not change in the adapted line, but decreased in the stressed cell line. Salinity caused the suppression of one GR isoform, while the isozyme patterns of SOD, APX, and CAT were not affected. Ascorbate and reduced glutathione increased in both salt-exposed calli lines. α-Tocopherol increased as a result of salt exposure, with higher levels found in adapted calli. Electron microscopy showed that neither the structural integrity of the cells nor membrane structure were affected by salinity, but plastids from adapted cells had higher starch content. The results suggest that the enzymic and non-enzymic components of the antioxidant system are differentially modulated by salt. Different concentrations of antioxidant metabolites are more relevant to the adaptive response to salinity in potato calli than the differences in activity of the antioxidant enzymes.info:eu-repo/semantics/acceptedVersio

Dados, diagnósticos e intervenções de enfermagem centrados na pessoa que vive com ostomia: protocolo scoping review

Introduction: The building of an ostomy generates changes that trigger a health/disease transition. Nurses play a major role in adapting to the new condition. It is important to formalize nursing knowledge that supports nurses’ decision-making in order to incorporate it into information systems that promote evidence-based nursing practice. Objetive: Continuously map the nursing knowledge involved in the process of care planning, focusing on the person living with an ostomy. Methods: Joanna Briggs Institute's scoping review guidance and, the Cochrane Collaboration's guidance on living systematic reviews will be followed to meet the review's objective. Two independent reviewers will evaluate the relevance of the articles, the extraction and synthesis of the data. Studies published in English, Spanish and Portuguese from 2009 onwards, searched in MEDLINE (PubMed), CINAHL (EBSCO), Scopus, JBI Library of Systematic Reviews and Cochrane Central Register of Controlled Trials, OpenGrey, RCAAP and Dart-Europa will be included. Results: It is expected to map the data, diagnoses and nursing interventions centered on the person living with an ostomy, allowing the formalization of the knowledge involved in the design of nursing care for this population group. Conclusion: This scope review will show trends that will support nurses' decision making in order to improve the quality of clinical practice.Introdução: A confeção de uma ostomia gera mudanças que desencadeiam uma transição saúde/doença. Os enfermeiros desempenham um papel importante na adaptação à nova condição. Importa formalizar o conhecimento de enfermagem que suporta a tomada de decisão do enfermeiro, para incorporá-lo em sistemas de informação que promovam uma prática de enfermagem baseada em evidências. Objetivo: Mapear continuamente o conhecimento de enfermagem envolvido no processo de conceção de cuidados, centrado na pessoa que vive com ostomia. Métodos: Serão seguidas as orientações do Joanna Briggs Institute para revisões de escopo e da Cochrane para revisões sistemáticas vivas para se atingir o objetivo da revisão. Dois revisores independentes avaliarão a relevância dos artigos, extração e síntese dos dados. Serão incluídos estudos publicados em inglês, espanhol e português a partir de 2009, pesquisados na MEDLINE (PubMed), CINAHL (EBSCO), Scopus, JBI Library of Systematic Reviews e Cochrane Central Register of Controlled Trials, OpenGrey, RCAAP e Dart-Europa. Resultados: Espera-se mapear os dados, diagnósticos e intervenções de enfermagem centrados na pessoa que vive com ostomia, permitindo formalizar o conhecimento envolvido na conceção de cuidados de enfermagem a este grupo populacional. Conclusão: Esta revisão de escopo mostrará tendências que subsidiarão a tomada de decisão do enfermeiro, a fim de melhorar a qualidade da prática clínica.info:eu-repo/semantics/publishedVersio

Developmental Disabilities and Socioeconomic Outcomes in Young Adulthood

We assessed the associations between developmental disabilities and indicators of socioeconomic outcomes (i.e., educational attainment, employment status, occupation type, subjective perception of socioeconomic status [SES], income, and wage rate) among young U.S. adults aged 24–33 years

The development of a portal to the Municipal Botanical Garden of Bauru by the application of participative Design concepts and the use of bamboo

Em 2018, o projeto de extensão universitária MUDAdesign, em parceria com o Jardim Botânico Municipal de Bauru, desenvolveu um projeto de portal para uma trilha ecológica no Jardim Botânico de Bauru. O projeto aplicou conceitos do design participativo e o emprego de bambu in natura da espécie Dendrocalamus asper. A demanda deste projeto surgiu com o intuito de dar maior visibilidade ao acesso para a trilha e estimular sua visitação. O objetivo do artigo é apresentar o desenvolvimento do processo projetivo e as etapas de construção do artefato em questão. A metodologia aplicada é composta pela formulação de diretrizes de projeto, visitas técnicas, atividades participativas, definição de materiais e desenvolvimento de projeto com enfoque na aplicação de conceitos do design participativo. Este enfoque foi de grande importância para um adequado processo projetivo e produtivo do produto.In 2018, the universitary extension project MUDAdesign, in a partnership with the Municipal Botanical Garden of Bauru, developed a project of a portal for an ecologic trail in the local of the Botanical Garden of Bauru. The project applied concepts of the participative design and the use of in natura bamboo from the Dendrocalamus asper species. The demmand of this project aims to give more visibility to the access to the trail and to stimulate its visitation. The objective of this article is to presente the development od the projective process and the construction steps of the artifact. The applied methodology is composed by the formulation of the guidelines of the projct, technical visits, participative activities, definition of materials and the development of the project focusing o the application of the participative design concepts. This focus had a great importance for anappropriate projective and productive process of the produc

Programas e respostas à saùde do idoso em Portugal

The aging process starts at birth and we know that health is not a random issue, it is related to choices, the environment in which we live and the access to health that we have. Aging is diverse, but professionals tend to generalize care. There are inadequate policies, inadequate services, accessibility to conditioned care and inadequate nursing consultations. It is essential to analyze the documents issued by health structures and reflect on a practice of consultation directed at the elderly. The objective of this study is to address the pertinence and applicability of the National Program for the Health of Older Persons, the World Report on Aging and Health, the National Strategy for Active and Healthy Aging and the proposal for the National Health Plan for Dementia, presenting a critical reflection on their implication in the care of the elderly. From the analysis carried out, we conclude that Portuguese decisionmaking does not reflect the implementation of measures at the same pace as other EU countries. It is urgent and pertinent to create a program exclusively for the elderly, which values the periodic evaluation of users, allowing the early identification of changes and, on the other hand, develop an individual personalized care plan for each one. The Biomedical paradigm must be broken, and it is essential to carry out a structured Nursing Consultation for the Elderly, using the five-point evaluation: careful clinical evaluation; physical assessment; mental assessment; functional assessment and; social evaluation. In decision-making, the implementation of programs at various levels of prevention must be paramount, in order to promote health status and improve the quality of life of the elderly.O processo de envelhecimento inicia-se à nascença e sabemos que a saúde não é uma questão aleatória, relaciona-se com escolhas, com o meio no qual se vive e com o acesso à saúde que se dispõe. O envelhecimento é diversificado, mas os profissionais tendem a generalizar os cuidados. Verificam-se políticas inadequadas, serviços desajustados, acessibilidade aos cuidados condicionada e consultas de Enfermagem desadequadas. É primordial que se analisem os documentos emanados pelas estruturas da saúde e se reflita numa prática de consulta direcionada para o idoso. O objetivo deste estudo é abordar a pertinência e aplicabilidade do Programa Nacional para a Saúde das Pessoas Idosas, do Relatório Mundial de Envelhecimento e Saúde, da Estratégia Nacional para o Envelhecimento Ativo e Saudável e da proposta para o Plano Nacional de Saúde para as Demências, apresentando uma reflexão crítica sobre a implicação destas na prática de cuidados ao idoso. Da análise efetuada, concluímos que a tomada de decisão Portuguesa não reflete a implementação de medidas ao mesmo ritmo de outros países da UE. É urgente e pertinente a criação de um programa em exclusivo para as pessoas idosas, que valorize a realização periódica de avaliações dos utentes, permitindo a identificação precoce de alterações e, por outro lado, desenvolva um plano individual de cuidados personalizados a cada um deles. O paradigma Biomédico deve ser quebrado sendo essencial que se realize uma Consulta de Enfermagem ao Idoso estruturada, com recurso à avaliação de cinco vertentes: avaliação clínica cuidada; avaliação física; avaliação mental; avaliação funcional e; avaliação social. Na tomada de decisão, deve ser primordial a implementação de programas aos vários níveis de prevenção, no sentido de promover o estado de saúde e melhoria da qualidade de vida dos idosos.&nbsp

Oral cleft prevention programa (OCPP)

Background: Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted. Methods/design: This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P), on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P) randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg) to that of a historical control group. The study has been approved by IRBs (ethics committees) of all involved sites. Results will be disseminated through publications and presentations at scientific meetings. Discussion: The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study provides an opportunity for huge savings in not only money but the overall quality of life. This may help establish more specific clinical guidelines for oral cleft prevention so that the intervention can be better tailored for at-risk women

Nursing knowledge on skin ulcer healing: a living scoping review protocol

Objective: This review aims to continuously map the nursing knowledge on skin ulcer healing in any context of care. Introduction: Chronic wounds are an increasing concern for society and health care providers. Pressure ulcers and venous ulcers, among others, have devastating effects on morbidity and quality of life and require a systematic approach. The nursing process is an important method that allows a better organization and overall care quality for a systematic and continuous professional approach to nursing management of skin ulcers. The integration of this nursing knowledge in informatics systems creates an opportunity to embed decision-support models in clinical activity, promoting evidence-based practice. Inclusion criteria: This scoping review will consider articles on nursing data, diagnosis, interventions, and outcomes focused on people with skin ulcers in all contexts of care. This review will include quantitative, qualitative, and mixed methods study designs as well as systematic reviews and dissertations. Methods: JBI’s scoping review guidance, as well as the Cochrane Collaboration’s guidance on living reviews, will be followed to meet the review’s objective. Screening of new literature will be performed regularly, with the review updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and PEDro. Searches for unpublished studies will include OpenGrey and Reposito´ rios Cientı´ficos de Acesso Aberto de Portugal. Studies published in English and Portuguese since 2010 will be considered for inclusion.info:eu-repo/semantics/publishedVersio

Nursing knowledge of people with paresis of voluntary muscles: a living scoping review protocol

Objective: This review aims to continuously map the nursing knowledge about people with paresis of voluntary muscles in any context of care. Introduction: Muscle paresis is a condition that significantly impacts quality of life. Nurses have a crucial role in managing this condition, particularly paresis of voluntary movement muscles. However, nursing knowledge about patients with paresis of voluntary muscles is dispersed, hampering the integration of evidence within the structure of information systems. Mapping how the nursing process components are identified is the first step in creating a Nursing Clinical Information Model for this condition, capable of integrating evidence into information systems. Inclusion criteria: This scoping review will consider studies focusing on the nursing process regarding people with paresis of voluntary muscles in all care contexts. The review will include quantitative, qualitative, and mixed-methods study designs, systematic reviews, clinical guidelines, dissertations, and theses. Methods: The review process will follow JBI's scoping review guidance, as well as the Cochrane Collaboration's guidance on living reviews. Screening of new literature will be performed regularly, with the review being updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched will include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, and the Cochrane Central Register of Controlled Trials. Searches for unpublished studies will include OpenGrey and Repositorios Cientificos de Acesso Aberto de Portugal. Studies published in English and Portuguese from 1975 will be considered for inclusion.info:eu-repo/semantics/publishedVersio

Etnoconhecimento dos pescadores artesanais de Santo Amaro - Maranhão: aspectos relacionados à pesca e biologia da ictiofauna de valor comercial na região

Com um extenso litoral e uma pesca essencialmente artesanal, o Maranhão possui uma diversidade de recursos pesqueiros que vêm sendo explorados nos últimos anos. Associado a essa atividade, o conhecimento tradicional dos pescadores sobre a ictiofauna local torna-se fundamental para o estabelecimento de medidas de conservação e sustentabilidade dos estoques pesqueiros a longo prazo. Objetivo: Verificar o etnoconhecimento dos pescadores sobre os aspectos reprodutivos da ictiofauna de importância comercial do município de Santo Amaro no Maranhão. Material e Métodos: Os questionários aplicados e as entrevistas transcritas realizadas com os pescadores mostraram um pouco do perfil e do conhecimento tradicional deles sobre a dinâmica reprodutiva das principais espécies de peixes que ocorrem na região. Resultados: Observou-se que pesca é a principal atividade desenvolvida na região e os participantes demonstraram profundo conhecimento que julgam ser essenciais para a conservação e preservação dos estoques pesqueiros de forma consciente e sustentável. Conclusão: As informações contidas nessa investigação é uma fonte alternativa valiosa, pois adicionam novos saberes ao status do conhecimento sobre a temática