Evaluation of patients' discomfort regarding regional anesthesia: 8AP6‐7

Background and Goal of Study: Regional anesthesia may cause physical and psychological discomfort. 50% of patients scheduled for urologic procedures undergo regional anesthesia, and their comfort represents a concern to the anesthesiologist. This study aims to: 1. identify factors related to patients’ discomfort regarding regional anesthesia(position for anesthesia and surgery procedures, puncture site pain, room temperature, audio-visual perception, sensitive/motor blockade); 2. Evaluate patients’ satisfaction with anesthesia. Materials and Methods: Af ter approval from the Hospital Ethics Committee all patients over 18years old, scheduled for urologic surgery, understanding Portuguese and anesthetized with spinal anesthesia were included. Patients in day case surgery or with incomplete medical records were excluded. We performed a questionnaire(with closed ended questions) in the first 24 hours af ter surgery and consulted anesthesia records. We asked yes or no questions, used a 1-10 scale to evaluate pain and a 1-4 scale to evaluate satisfaction. Because there isn’t a valid questionnaire in the literature to evaluate what we aimed to, we created one based on multiple articles1,2. Results and Discussion: 50patients were included; mean age 65 years old (min.32, max.89); 78% males and 70% ASAII. 75%denied discomfort during positioning for back puncture and 58% referred cold during anesthesia or surgery. One person was uncomfortable in the surgical position and no one considered being awake uncomfortable; sensitive/motor blockade was uncomfortable for 22%. Spinal was more painful than the venous puncture for32%; for 50%venous puncture was more painful and for 18%pain was similar. Patients were satisfied or very satisfied with the anesthetic technique and would choose the same technique in the future in 98% of cases. Conclusion: Although this questionnaire is not validated, it allowed us to understand that cold during anesthesia/surgery is a problem for most patients but this is easily solved. It also showed us that most patients are not uncomfortable with positioning during procedures, being awake and not feeling the legs.Interestingly only about one third of the patients thought that the back puncture was more painful than the venous puncture. In general we consider spinal anesthesia a good choice for these patients and we are satisfied that patients don’t find it uncomfortable and are also satisfie

Compliance to radiation therapy of head and neck cancer patients and impact on treatment outcome

The aims of the study were to evaluate head and neck cancer (HNC) patient's compliance to the planned radiation therapy (RT) using the department policy established in 2005 at IPOCFG and to estimate the impact on treatment outcome due to failure in receiving RT as prescribed.info:eu-repo/semantics/publishedVersio

Biological dose-escalated definitive radiation therapy in head and neck cancer

To compare treatment outcome of patients with head and neck (HN) tumours treated with definitive radiation therapy that, mainly owing to differences in the fractionation scheme used with simultaneous integrated boost techniques, resulted in a different biological dose. Methods: 181 patients with HN cancer, prescribed to about 70.2Gy in the primary tumour, were included in this study. Population cohort was divided into Group ,70 and Group $70 when the mean dose converted to a 2 Gy fractionation in the primary tumour was less or higher than 70.2Gy, respectively. The probability of local control (LC), locoregional control (LRC), disease-free survival (DFS) and overall survival (OS) was determined for both groups. The incidence of acute and late complications was compared between the two groups. Results: At 24 months for Groups ,70 and$70, LC was 83.2% and 87.5%, LRC was 79.5% and 81.6%, DFS was 56.3% and 66.8% and OS was 63.9% and 71.5% p5ns, respectively. The incidence of acute dysphagia, odynophagia and pain, and late mucositis was significantly higher in Group $70 than in Group ,70. The rate of xerostomia, dysphonia, radiodermatitis, alopecia, dental complications, hypoacusia and weight loss was comparable between the two groups. Conclusion: The biological dose escalation was safe, but an increase in the incidence of the acute side effects: dysphagia, odynophagia and pain and late mucositis, was obtained. Advances in knowledge: Despite the significant biological dose escalation, within the range of doses delivered to this cohort, no clear dose–response effect was observe

Higher pain intensity, depression, and being 75 Years or Older are associated with lower Levels of self-reported physical activity in older adults with pain attending primary care

Objective: This study investigated whether pain characteristics (intensity, frequency, duration and number of pain sites), depression, age, sex and comorbidities are associated with lower levels of selfreported physical activity in older adults with pain at the primary healthcare setting.Methods: A total of 504 participants aged 60 years of age and over were assessed for: socio-demographics, comorbidities, pain, depression, and physical activity. Associations between these variables were investigated using ordinal logistic regression.Results: Reporting severe pain or worst imaginable pain, being older (≥ 75 years), and feeling depressed were significantly associated with lower physical activity in the univariate (OR = 2.33, 2.93, 2.31, and 2.23, respectively) and multivariate models (Adj OR = 2.21, 2.47, 2.49, and 1.97, respectively).Conclusions: Interventions aiming to increase physical activity for older adults in primary care should consider the needs of those reporting higher pain intensity, feeling depressed and who are 75 years or older

The national inventory of geological heritage: methodological approach and results

A existência de um inventário nacional de património geológico é fundamental para se poderem implementar estratégias de geoconservação. Este trabalho apresenta a metodologia usada no desenvolvimento do mais completo inventário de geossítios, realizado até ao momento em Portugal, assim como os principais resultados obtidos. O inventário vai integrar o Sistema de Informação do Património Natural e o Cadastro Nacional dos Valores Naturais Classificados, ambos geridos pelo Instituto de Conservação da Natureza e da Biodiversidade.The existence of a national inventory of the geological heritage is of paramount importance for the implementation of a geoconservation strategy. This paper presents the methodological approach used to produce the most complete geosites inventory in Portugal, so far, and the obtained results. This inventory will be uploaded into the National Database of Natural Heritage managed by the Portuguese authority for nature conservation.Este trabalho é apoiado pela Fundação para a Ciência e a Tecnologia, através do financiamento plurianual do CGUP e do projecto de investigação “Identificação, caracterização e conservação do património geológico: uma estratégia de geoconservação para Portugal” (PTDC/CTE-GEX/64966/2006).info:eu-repo/semantics/publishedVersio

Sugarcane (Saccharum X officinarum): A Reference Study for the Regulation of Genetically Modified Cultivars in Brazil

Global interest in sugarcane has increased significantly in recent years due to its economic impact on sustainable energy production. Sugarcane breeding and better agronomic practices have contributed to a huge increase in sugarcane yield in the last 30 years. Additional increases in sugarcane yield are expected to result from the use of biotechnology tools in the near future. Genetically modified (GM) sugarcane that incorporates genes to increase resistance to biotic and abiotic stresses could play a major role in achieving this goal. However, to bring GM sugarcane to the market, it is necessary to follow a regulatory process that will evaluate the environmental and health impacts of this crop. The regulatory review process is usually accomplished through a comparison of the biology and composition of the GM cultivar and a non-GM counterpart. This review intends to provide information on non-GM sugarcane biology, genetics, breeding, agronomic management, processing, products and byproducts, as well as the current technologies used to develop GM sugarcane, with the aim of assisting regulators in the decision-making process regarding the commercial release of GM sugarcane cultivars

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio