Relação da hemoglobina, RDW, neutrófilos, linfócitos e NLR e o tempo de internamento em cirurgia cólica e/ou rectal oncológica : um estudo retrospetivo

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018Introdução | As complicações pós-operatórias de cirurgia cólica e/ou rectal são frequentes e podem ser responsáveis pelo aumento do tempo de internamento pós-operatório. Diversos factores de risco, contribuem para um aumento do tempo de internamento pós-operatório através do aumento do número de complicações. Variações dos valores séricos de hemoglobina (Hb), red cell distribution width (RDW), neutrófilos, linfócitos e índice de relação neutrófilo-linfócito (NLR) podem ser reflexo de um aumento do número de complicações pós-operatórias e, consequentemente, do tempo de internamento. O presente estudo teve como objetivo avaliar os valores pré-operatórios de Hb, RDW, neutrófilos, linfócitos e NLR enquanto preditores de prolongamento do tempo de internamento pós-operatório e ocorrência de óbito em adultos submetidos a cirurgia de ressecção cólica e/ou rectal do foro oncológico. Material e Métodos | Análise retrospetiva dos valores de Hb, RDW, neutrófilos, linfócitos, NLR, tempo de internamento e óbito de doentes adultos submetidos a resseção colo-rectal, entre julho de 2014 e outubro de 2017 (39 meses). Resultados | A análise de 250 doentes demonstrou uma correlação positiva entre o RDW e um tempo de internamento ≥ 9 dias em doentes submetidos a cirurgia de urgência com realização de anastomose (AUC 0.740; p-value 0.017). Verificou-se uma correlação positiva entre o valor de RDW e a ocorrência de óbito em doentes submetidos a cirurgia de urgência sem realização de anastomose (AUC 0.790; p-value 0.008). Verificou-se uma correlação positiva entre o valor total de linfócitos e um tempo de internamento ≥ 9 dias nos doentes submetidos a cirurgia electiva sem realização de anastomose. Conclusão | RDW é um potencial preditor de prolongamento do tempo de internamento em doentes submetidos a cirurgia de urgência com realização de anastomose e de óbito em doentes submetidos a cirurgia de urgência sem realização de anastomose. O valor total de linfócitos é um potencial preditor de prolongamento do tempo de internamento em doentes submetidos a cirurgia electiva sem realização de anastomose.Introduction | Postoperative complications of oncologic colic and/or rectal surgery are frequent and may be responsible for an increase in postoperative hospital length of stay. Variations in the serum levels of hemoglobin (Hb), red cell distribution width (RDW), neutrophils, lymphocytes and neutrophil-lymphocyte ratio (NLR) may be a reflection of an increase in the number of postoperative complications and, consequently, time of hospitalization. The present study aimed to evaluate the preoperative values of Hb, RDW, neutrophils, lymphocytes and NLR as predictors of prolonged postoperative hospital length of stay and death in adults submitted to oncologic colic and/or rectal resection surgery. Methods | Retrospective analysis of Hb, RDW, neutrophils, lymphocytes, NLR, length of hospital stay and death of adult patients submitted to colic and/or rectal resection for neoplasia between july 4, 2014 and october 16, 2017 (total of 39 months). Results | The analysis of 250 patients showed a positive correlation between RDW and a hospital length of stay ≥ 9 days in patients undergoing emergency surgery with anastomosis (AUC 0.740; p-value 0.017). There was a positive correlation between the value of RDW and the occurrence of death in patients undergoing emergency surgery without anastomosis (AUC 0.790; p-value 0.008). There was a positive correlation between total lymphocyte count and hospital length of stay ≥ 9 days in patients undergoing elective surgery without anastomosis. Conclusions | RDW is a potential predictor of augmented length of stay in patients undergoing emergency surgery with anastomosis and death in patients undergoing emergency surgery without anastomosis. The total value of lymphocytes is a potential predictor of augmented length of stay in patients undergoing elective surgery without anastomosis

a protocol for a scoping review

Funding Information: This work was supported by Fundação para a Ciência e Tecnologia, I.P. through Comprehensive Health Research Centre (CHRC), National School of Public Health from NOVA University of Lisbon and under the grant UI/BD/150875/2021. Publisher Copyright: © 2022 BMJ Publishing Group. All rights reserved.Introduction Health organisations should support healthcare workers who are physically and psychologically affected by patient safety incidents (second victims). There is a growing body of evidence which focuses on second victim support interventions. However, there is still limited research on the elements necessary to effectively implement and ensure the sustainability of these types of interventions. In this study, we propose to map and frame the key factors which underlie an effective implementation of healthcare worker support interventions in healthcare organisations when healthcare workers are physically and/or emotionally affected by patient safety incidents. Methods and analysis This scoping review will be guided by the established methodological Arksey and O'Malley framework, Levac and Joanna Briggs Institute (JBI) recommendations. We will follow the JBI three-step process: (1) a preliminary search conducted on two databases; (2) the definition of clear inclusion criteria and the creation of a list of search terms to be used in the subsequent running of the search on a larger number of databases; and (3) additional searches (cross-checking/cross-referencing of reference lists of eligible studies, hand-searching in target journals relevant to the topic, conference proceedings, institutional/organisational websites and networks repositories). We will undertake a comprehensive search strategy in relevant bibliographic databases (PubMed/MEDLINE, Embase, CINHAL, Web of Science, Scopus, PsycInfo, Epistemonikos, Scielo, Cochrane Library and Open Grey). We will use the Mixed Methods Appraisal Tool V.2018 for quality assessment of the eligible studies. Our scoping review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. Ethics and dissemination This study will not require ethical approval. Results of the scoping review will be published in a peer-review journal, and findings will be presented in scientific conferences as well as in international forums and other relevant dissemination channels. Trial registration number 10.17605/OSF.IO/RQAT6. Preprint from medRxiv available: doi: https://doi.org/10.1101/2022.01.25.22269846.publishersversionpublishe

The effect of an intermittent protocol on strength performance in female football players: an exploratory study

Football is a sport that involves a combination of continuous and intermittent effort. Therefore, players need to be able to recover quickly between moments of high intensity to continue to perform at a high level of output throughout the entire match. The present study aimed to evaluate the effect of an intermittent exercise protocol on the rate of high-intensive force production through the countermovement test (CMJ) in elite Portuguese female soccer players. The sample consisted of 12 players from the first division of women's football in Portugal (Age = 18.1 ± 0.9 years; Weight = 60.10 ± 5.8 Kg; Height = 1.63 ± 4.8 cm; BMI = 22.48 ± 1.5 kg/m2). The players performed an intermittent exercise protocol on a cycle ergometer, lasting 8 minutes, in which each minute corresponded to 40 seconds of high-intensity (4W/kg, based on the player's body weight) and 20 seconds of low-intensity (75W). Before and after the protocol, the players performed the CMJ. Through the results obtained, it was possible to observe that players presented a significant decrease in the height of the CMJ between the two moments (before- 29.92 ± 3.55cm vs after- 26.92 ± 4.05cm; p < 0.01). The present study allowed us to conclude that intermittent exercise protocol promoted a negative influence on CMJ performance

Phenotype of BTK‐lacking myeloid cells during prolonged COVID‐19 and upon convalescent plasma

© 2022 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.XLA patient with 7-month course of COVID-19 with persistent plasma SARS-CoV-2 load revealed a sustained non-inflammatory profile of myeloid cells in association with contained severity of disease, arguing in favor of the use of BTK inhibitors in SARS-COV-2 infection.This work was funded by the following grants from Fundação para a Ciência e a Tecnologia (FCT), Portugal, through “Apoio Especial Research4COVID-19,” project numbers 125 and 803. André M. C. Gomes and Guilherme B. Farias received Fellowships funded by FCT (Doctorates4COVID-19, 2020.10202.BD), and Janssen-Cilag Farmacêutica, respectively.info:eu-repo/semantics/publishedVersio

Genetic diversity and population structure of Cynara cardunculus L. in southern Portugal

Cynara cardunculus L. is a cardoon species native to the Mediterranean region, which is composed of three botanical taxa, each having distinct biological characteristics. The aim of this study was to examine wild populations of C. cardunculus established in Portugal, in order to determine their genetic diversity, geographic distribution, and population structure. Based on SSR markers, 121 individuals of C. cardunculus from 17 wild populations of the Portuguese Alentejo region were identified and analysed. Ten SSRs were found to be efficient markers in the genetic diversity analysis. The total number of alleles ranged from 9 to 17 per locus. The expected and observed means in heterozygosity, by population analysed, were 0.591 and 0.577, respectively. The wild population exhibited a high level of genetic diversity at the species level. The highest proportion of genetic variation was identified within a geographic group, while variation was lower among groups. Geographic areas having highest genetic diversity were identified in Alvito, Herdade da Abo´boda, Herdade da Revilheira and Herdade de São Romão populations. Moreover, significant genetic differentiation existed between wild populations from North-Alentejo geographic locations (Arraiolos, E´ vora, Monte da Chamine´ ) and Centro Hortofrutı´cola, compared with other populations. This study reports genetic diversity among a representative number of wild populations and genotypes of C. cardunculus from Portugal. These results will provide valuable information towards future management of C. cardunculus germplasm.info:eu-repo/semantics/publishedVersio

Síndrome de Meigs: revisão de literature / Meigs syndrome: literature review

Introdução: A síndrome de Meigs é uma doença rara caracterizada pela presença de ascite e derrame pleural associado à neoplasia ovariana benigna. O CA-125 pode estar em níveis normais ou aumentados, fomentando dúvidas sobre a gênese benigna da massa. Objetivos: O objetivo desse estudo é revisar sobre a síndrome de Meig, compreendendo-a em sua totalidade. Métodos: Os bancos de dados Pubmed, UpToDate, Diretrizes e protocolos hospitalares foram pesquisados eletronicamente utilizando os descritores síndrome de Meigs, tumor ovariano e tumores ginecológicos nos idiomas inglês e português. Discussão e Conclusão: O diagnóstico é essencialmente clínico, porém, pode ser complementado pelos exames de imagem e pelos marcadores séricos. A ressecção da tumoração ovárica, tão somente, é suficiente para resolução espontânea da síndrome.

Functional Scalability and Replicability Analysis for Smart Grid Functions: The InteGrid Project Approach

The evolution of the electrical power sector due to the advances in digitalization, decarbonization and decentralization has led to the increase in challenges within the current distribution network. Therefore, there is an increased need to analyze the impact of the smart grid and its implemented solutions in order to address these challenges at the earliest stage, i.e., during the pilot phase and before large-scale deployment and mass adoption. Therefore, this paper presents the scalability and replicability analysis conducted within the European project InteGrid. Within the project, innovative solutions are proposed and tested in real demonstration sites (Portugal, Slovenia, and Sweden) to enable the DSO as a market facilitator and to assess the impact of the scalability and replicability of these solutions when integrated into the network. The analysis presents a total of three clusters where the impact of several integrated smart tools is analyzed alongside future large scale scenarios. These large scale scenarios envision significant penetration of distributed energy resources, increased network dimensions, large pools of flexibility, and prosumers. The replicability is analyzed through different types of networks, locations (country-wise), or time (daily). In addition, a simple replication path based on a step by step approach is proposed as a guideline to replicate the smart functions associated with each of the clusters

Assessment of the Implementation of the International Health Regulations during the COVID-19 Pandemic: Portugal as a Case Study

Introduction: The International Health Regulations (IHR) were developed to prepare countries to deal with public health emergencies. The spread of SARS-CoV-2 underlined the need for international coordination, although few attempts were made to evaluate the integrated implementation of the IHR’s core capacities in response to the COVID-19 pandemic. The aim of this study was to evaluate whether IHR shortcomings stem from non-compliance or regulatory issues, using Portugal as a European case study due to its size, organization, and previous discrepancies between self-reporting and peer assessment of the IHR’s core capacities. Methods: Fifteen public health medical residents involved in contact tracing in mainland Portugal interpreted the effectiveness of the IHR’s core capabilities by reviewing the publicly available evidence and reflecting on their own field experience, then grading each core capability according to the IHR Monitoring Framework. The assessment of IHR enforcement considered efforts made before and after the onset of the pandemic, covering the period up to July 2021. Results: Four out of nine core IHR capacities (surveillance; response; risk communication; and human resource capacity) were classified as level 1, the lowest. Only two were graded level 3 (preparedness; and laboratory), the highest. The remaining three) (national legislation, policy & financing; coordination and national focal point communication; and points of entry) were classified as level 2. Conclusion: Portugal exemplifies the extent to which implementation of the IHR was not fully achieved, which has resulted in the underperformance of several core capacities. There is a need to improve preparedness and international cooperation in order to harmonize and strengthen the global response to public health emergencies, with better political, institutional, and financial support

Estudo de conservação sob atmosfera controlada na qualidade da cereja cv. Satin

A cereja é muito apreciada e apresenta um tempo de comercialização muito curto devido a ser um fruto altamente perecível. Técnicas de conservação pós-colheita são essenciais para manter a qualidade da cereja até serem consumidas. Baixas temperaturas são utilizadas para retardar o processo de deterioração da fruta e como complemento a aplicação de atmosferas controladas permite retardar o processo de amadurecimento e envelhecimento. A diminuição de oxigénio e o aumento de dióxido de carbono e azoto inibe o amadurecimento, mantendo o sabor e a qualidade da fruta. Neste trabalho experimental, cerejas da cultivar Satin foram conservadas em câmaras de refrigeração no produtor e nas instalações do CATAA com equipamento de atmosferas controladas. Quatro atmosferas controladas com diferentes combinações de oxigénio e dióxido de carbono foram testadas e o seu efeito na qualidade das cerejas foi avaliado. Ao longo do tempo de conservação as cerejas foram analisadas a diferentes níveis: qualidade (peso, dureza, cor e sólidos solúveis totais), microbiológico e organolético. Os resultados de temperatura e humidade no produtor e no CATAA, foram comparados e indicam que ambas as situações apresentam ótimas condições de conservação. No entanto, complementar a conservação com atmosferas controladas sugere que a qualidade da cereja é mantida por mais tempo, através da minimização do envelhecimento e processo de amadurecimento.info:eu-repo/semantics/publishedVersio