Prevention of the development of skin injuries resulting from surgical positioning in the prone position and lithotomy position

O presente documento foi elaborado no âmbito do Estágio de Natureza Profissional integrado no plano de estudos do Primeiro Mestrado em Enfermagem Médico-cirúrgica na Área de Enfermagem à Pessoa em Situação Perioperatória da Escola Superior de Enfermagem do Porto, no período letivo 2022/2023. Pretende documentar, descrever e analisar, as atividades desenvolvidas e o contributo da componente clínica para o desenvolvimento pessoal e profissional, no âmbito da aquisição e desenvolvimento de competências de enfermagem especializadas, tanto no que diz respeito às competências comuns do enfermeiro especialista como às competências de enfermagem especializadas na Área de Enfermagem à Pessoa em Situação Perioperatória, nomeadamente nos domínios da prática profissional, ética e legal, prestação e gestão de cuidados, bem como no da investigação, analisando o nível de concretização dos objetivos e as competências desenvolvidas. O Estágio de Natureza Profissional desenvolveu-se em contexto clínico no Bloco Operatório Central e Bloco Operatório de Especialidades de um Hospital da Região Norte. Foi neste contexto que se foram aprofundando competências, nomeadamente clínicas, num quadro de aplicação e de partilha de experiências e de conhecimentos, num percurso contínuo de aprendizagem. Este contexto foi escolhido, principalmente, pela oportunidade de vivenciar experiências da prática profissional diferentes do contexto de trabalho habitual, que é a área da cirurgia oncológica. Procurou-se, ao longo deste percurso, a concretização do máximo de experiências clínicas através das quais houve oportunidade de desenvolvimento de aprendizagens profissionais diferenciadas. Refletindo sobre a segurança e qualidade dos cuidados, nomeadamente a segurança da pessoa em situação perioperatória, na realização de um posicionamento seguro e no estabelecimento de procedimentos relativos à mobilização e ao posicionamento cirúrgico que garantam o conforto e previnam complicações, foi desenvolvido o projeto na área da “Prevenção de lesões na pele decorrentes do posicionamento cirúrgico em decúbito ventral e posição litotómica”. Concretizou-se através da avaliação dos clientes que necessitavam destes posicionamentos para a realização dos procedimentos cirúrgicos, com recurso à aplicação da Escala de Avaliação de Risco Para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico ELPO-PT, e implementação de intervenções de enfermagem mediante essa avaliação. No que diz respeito à componente de investigação, foi realizada uma “scoping review”, de acordo com a metodologia do Joanna Briggs Institute, sobre esta temática, que permitiu aumentar o conhecimento baseado na melhor evidência nesta área, assim como inferir dados, diagnósticos e intervenções de enfermagem, e efetuar um padrão de documentação dos cuidados para clientes submetidos a estes posicionamentos cirúrgicosThis document was prepared within the scope of the Professional Internship integrated into the study plan of the First Master's Degree in Medical-Surgical Nursing in the Area of Nursing for People in Perioperative Situations at the Escola Superior de Enfermagem do Porto, in the academic period 2022/2023. It aims to document, describe and analyze the activities developed and the contribution of the clinical component to personal and professional development, within the scope of the acquisition and development of specialized nursing skills, both with regard to the common skills of the specialist nurse and the skills of specialized nurses in the area of Nursing for People in Perioperative Situations, namely in the areas of professional, ethical and legal practice, provision and management of care, as well as research, analyzing the level of achievement of objectives and the skills developed. The Professional Internship took place in a clinical context in the Central Operating Room and Specialties Operating Room of a Hospital in the Northern Region. It was in this context that skills were deepened, particularly clinical ones, within a framework of application and sharing of experiences and knowledge, in a continuous learning path. This context was chosen mainly for the opportunity to experience professional practice experiences that are different from the usual work context, which is the area of oncological surgery. Throughout this journey, we seek to achieve as many clinical experiences as possible, through which there was an opportunity to develop differentiated professional learning. Reflecting on the safety and quality of care, namely the safety of the person in the perioperative situation, in carrying out safe positioning and in establishing procedures related to mobilization and surgical positioning that guarantee comfort and prevent complications, the project was developed in the area “Prevention of skin injuries resulting from surgical positioning in the prone position and lithotomy position”. It took place through the assessment of clients who needed these positions to carry out surgical procedures, using the Risk Assessment Scale for the Development of Injuries Resulting from Surgical Positioning ELPO-PT and implementing nursing interventions based on this assessment. With regard to the research component, a “scoping review” was carried out in accordance with the Joanna Briggs Institute methodology on this topic, which allowed increasing knowledge based on the best evidence in this area, as well as inferring data, diagnoses and nursing interventions and provide a standard of care documentation for clients undergoing these surgical placement

Doença de Menkes: relato de caso com comprometimento da substância branca cerebral

Menkes disease is a rare X-linked disorder related to a defect in the copper metabolism. According to the current literature, the most frequent neuroimaging findings are cortical atrophy, chronic subdural effusion or hygroma, and vascular abnormalities. White matter lesions may be present before other features of the disease and may evolve into atrophy. We hereby report a case of Menkes disease with typical history and progression, and an early phase imaging study with important white matter abnormalities, which could have lead to diagnostic difficulties.A doença de Menkes é patologia ligada ao X relacionada a defeito no metabolismo de cobre. De acordo com literatura atual, os achados mais frequentes em exames de neuroimagem são atrofia cortical, efusão de subdural crônica ou higroma, e alterações vasculares. Lesões em substância branca podem estar presentes antes das alterações clinicas da doença e podem evoluir para atrofia. Apresentamos relato de caso da doença de Menkes com história e evolução típica, descrevendo os achados de neuroimagem na fase inicial da doença que revelaram sinais importantes de comprometimento da substância branca que poderiam conduzir a dúvidas diagnósticas.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Setor de Neurologia InfantilUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Setor de Doenças Metabólicas HereditáriasUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Diagnóstico por ImagemUNIFESP, EPM, Setor de Neurologia InfantilUNIFESP, EPM, Setor de Doenças Metabólicas HereditáriasUNIFESP, EPM, Depto. de Diagnóstico por ImagemSciEL

A national e-Delphi towards the measurement of safe medication practices in Portuguese hospitals

Objectives To determine the face and content validity of items for measuring safe medication practices in Portuguese hospitals. Methods 128 items were drafted from content analysis of existing questionnaires and the literature, employing preferred terms of the WHO International Classification for Patient Safety (Portuguese version). A two-round e-Delphi was convened, using a purposive multidisciplinary panel. Hospital-based experts were asked to rate the relevance of items on a 7-point Likert scale and to comment on their clarity and completeness. Results The response rate was similar in both rounds (70.3% and 73.4%, respectively). In the first round 91/128 (71.1%) items reached the predefined level of positive consensus. In the second round 23 additional items reached positive consensus, as well as seven items newly derived by the panel. Conclusions Most items have face and content validity, indicating relevance and clarity, and can be included in a future questionnaire for measuring safe medication practices in Portuguese hospitals

The current role of nuclear medicine in breast cancer

Breast cancer is the most common cancer in females worldwide. Nuclear medicine plays an important role in patient management, not only in initial staging, but also during follow-up. Radiopharmaceuticals to study breast cancer have been used for over 50 years, and several of these are still used in clinical practice, according to the most recent guideline recommendations. In this critical review, an overview of nuclear medicine procedures used during the last decades is presented. Current clinical indications of each of the conventional nuclear medicine and PET/CT examinations are the focus of this review, and are objectively provided. Radionuclide therapies are also referred, mainly summarising the methods to palliate metastatic bone pain. Finally, recent developments and future perspectives in the field of nuclear medicine are discussed. In this context, the promising potential of new radiopharmaceuticals not only for diagnosis, but also for therapy, and the use of quantitative imaging features as potential biomarkers, are addressed. Despite the long way nuclear medicine has gone through, it looks like it will continue to benefit clinical practice, paving the way to improve healthcare provided to patients with breast cancer.</p

Usuários dos serviços de saúde com diabetes mellitus: do conhecimento à utilização dos direitos à saúde

Se trata de un estudio descriptivo de abordaje cualitativo, con el objetivo de analizar el conocimiento de los usuarios de los servicios de salud con diabetes mellitus (DM) acerca de sus derechos. Participaron 12 personas con DM atendidas en un centro universitario del interior paulista en 2008, por medio de entrevista abierta. El análisis de contenido temático de los datos posibilitó identificar dos categorías: el (des)conocimiento de los usuarios de los servicios de salud con diabetes sobre sus derechos y el ejercicio no consciente de sus derechos por las personas con DM. Fue posible constatar que, a pesar de los avances legalmente alcanzados por las políticas públicas, la mayoría de los usuarios de los servicios de salud con DM desconoce sus derechos, a pesar de que utilizan los beneficios provenientes de la legislación, de manera no consciente. Se resalta como punto fundamental proveer informaciones completas y suficientes para que la persona pueda tomar la mejor decisión en relación a su tratamiento, preservando su autonomía en los servicios de salud.Estudo descritivo de abordagem qualitativa, e teve como objetivo analisar o conhecimento dos usuários dos serviços de saúde com diabetes mellitus (DM), acerca dos seus direitos. Participaram 12 pessoas com DM, atendidas em um centro universitário do interior paulista, em 2008, por meio de entrevista aberta. A análise de conteúdo temática dos dados possibilitou identificar duas categorias: o (des)conhecimento dos usuários dos serviços de saúde com diabetes sobre seus direitos e o exercício não consciente dos seus direitos pelas pessoas com DM. Foi possível constatar que, apesar dos avanços legalmente alcançados pelas políticas públicas, a maioria dos usuários dos serviços de saúde com DM desconhece seus direitos, embora utilize, de maneira não consciente, os benefícios advindos da legislação. Ressalta-se como ponto fundamental prover informações completas, suficientes para que a pessoa possa tomar a melhor decisão em relação ao seu tratamento, preservando sua autonomia, nos serviços de saúde.This descriptive study with qualitative approach analyzes the knowledge of individuals with diabetes mellitus (DM) concerning their health rights. Open interviews were conducted with 12 individuals with DM in a university center in the interior of Sao Paulo, Brazil. Content analysis enabled the identification of two categories: the users (lack of) knowledge concerning their rights and the unaware exercise of their rights. The results revealed that despite the legal advancements achieved in public policies, most users with DM are unaware of their rights, although they use the benefits that accrue from law in an unconscious way. Providing complete and sufficient information is essential so that individuals are able to make the best decision in relation to their treatment, preserving their autonomy

Chemometric approaches to evaluate the substitution of synthetic food dyes by natural compounds: The case of nanoencapsulated curcumin, spirulina, and hibiscus extracts

Finding natural food coloring options from plant-based sources to substitute artificial dyes is a challenging task because natural dyes often present low water-solubility, not very vibrant hues, and instability due to interactions with food ingredients. Chemometric approaches can be used to evaluate color differences and patterns resulting from natural and synthetic dyes when applied to food systems. Here, the Mixture Design and the Principal Component Analysis (PCA) were applied to evaluate the substitution of the following artificial food dyes: yolk yellow, apricot yellow, strawberry red, and tartrazine by natural dyes (water-soluble curcumin, yellow shade; Hibiscus sabdariffa extract, red shade; Spirulina platensis extract, blue/green shade), in three food simulated systems (phosphate buffer, pH 6.9; yogurt, pH 4.0 and citrate buffer, pH 3.0). The color parameters L*, a*, b*, C* and °h were determined and color difference (ΔE*) with artificial dyes resulted in 11 empirical models. PCA yielded a clear map for the identification of the closely matches natural/artificial dyes for the food simulated systems in three subregions. Furthermore, the antioxidant capacity of the natural dyes was determined by OxHLIA and TBARS. It was possible to make an assessment guide that may be useful for other food systems and dyes.Authors thank to CNPq (Chamada Universal– MCTI/CNPq Nº 28/2018, Process 421541/2018–0) and Fundação Araucária (convênio 039/2019) for the financial support. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. Authors thank to Central Analítica Multiusuário da UTFPR Campo Mourão (CAMulti-CM) by the color analysis. Authors are grateful to the Foundation for Science and Technology (FCT, Portugal) for financial support through national funds FCT/MCTES to the CIMO (UIDB/00690/2020). L. Barros and C. Pereira thank the national funding by FCT, P.I., through the institutional scientific employment program-contract for their contracts.info:eu-repo/semantics/publishedVersio

Wood smoke exposure of Portuguese wildland firefighters: DNA and oxidative damage evaluation

Portugal is among the European Union countries most devastated by forest fires each year. In the last three decades, more than 3.8 million hectares of forest were burned. Wildland firefighters are exposed to a variety of hazards, including many toxic combustion products that may lead to deleterious health effects. Epidemiological studies showed a positive association between firefighting and several chronic diseases, including cancer. Results from biomonitoring studies in firefighters, particularly concerning genotoxicity evaluation, constitute a valuable tool for investigating important occupational hazards. Thus, the aim of this study was to assess genotoxicity in a group of wildland firefighters using the comet assay for DNA damage and oxidative stress. Both parameters were increased in firefighters compared to controls, but significance was only found for basal DNA damage. No significant influence was found regarding major confounding variables on the genotoxic endpoints studied, with the exception of age. Data obtained provide preliminary information on human health effects of wildland firefighting exposure at genetic and molecular levels. These findings may also provide new important data to serve as public awareness to the potential adverse health risks involving wildland firefighting. Implementation of security and hygiene measures in this sector as well as good practices campaigns may be crucial to decrease risk.info:eu-repo/semantics/publishedVersio

Synthesis and characterization of novel hydroxy- and aminobisphosphonates

Bisphosphonates (BPs) are a family of drugs that are successfully used in the treatment of various calcium-related disorders such as Pagetμs disease, osteoporosis and bone metastases. In addition, functional BPs have been also used in the treatment of metal intoxication and as novel ligands for well-defined radioactive metal complexes that can be used in imagiology, scintigraphy and radiotherapy applications [1,2]. The indazole derivatives are pharmacologically important compounds and the indazole ring system forms the basis of a number of drug molecules. Condensed pyrazoles are also known as pharmacophoric elements in numerous active compounds. However, in comparison with other heteroaromatic compounds, the chemistry of indazole and condensed pyrazoles remains less studied [3]. The present work is to extend the previous studies in indazolebisphosphonates [4] in order to obtain new BPs derived from indazole and condensed pyrazole with potential biological/therapeutical activities. Herein, we report the synthesis and characterization of a series of new 1-hydroxybisphosphonates (1) and aminobisphosphonates (2) (substituted at different C- or N-positions of the indazole ring - N-1, C-5, C-6, C-7

Práticas de leitura nos anos iniciais: uma experiência de estágio no ensino fundamental

The present text aims to present some of the discussions carried out from the study developed through the curricular component Research and Internship III, of the Pedagogy course. This proposed to analyze the experiences and perceptions about reading practices in a class of the 2nd year of Elementary School. It took place through a qualitative approach, for which participant observation and the development of an action plan in the context of the classroom were used as instruments for data production, based on the observed aspects and the demands pointed out by the teachers of the gang. The internship was carried out in a school of the Municipal Network of Guanambi-BA. The results point to the need for innovation in pedagogical reading practices. For this, it is understood that it is necessary to stimulate the way in which reading is presented to children, giving them the opportunity to know and interpret different textual genres.O presente texto tem por objetivo apresentar algumas das discussões realizadas a partir do estudo desenvolvido por meio do componente curricular Pesquisa e Estágio III, do curso de Pedagogia. Esse se propôs a analisar as experiências e as percepções acerca das práticas de leitura em uma turma do 2° ano do Ensino Fundamental. Se deu por meio de uma abordagem qualitativa, para a qual foram utilizados como instrumentos de produção de dados a observação participante e o desenvolvimento de um plano de ação no contexto da sala de aula, a partir dos aspectos observados e das demandas apontadas pelas docentes da turma. O estágio foi realizado em uma escola da Rede Municipal de Guanambi-BA. Os resultados apontam para a necessidade de inovação das práticas pedagógicas de leitura. Para isso, compreende-se que é preciso dinamizar a forma como se é apresentada a leitura às crianças, dar a elas a oportunidade de conhecer e interpretar diferentes gêneros textuais

Atentando para as singularidades humanas na atenção à saúde por meio do diálogo e acolhimento

Objetivou-se compreender como os trabalhadores de saúde se posicionam frente ao seu principal objeto de trabalho – o usuário – sujeito e autor da sua história de vida. Pesquisa qualitativo-exploratória. Participaram 11 profissionais de enfermagem em Unidade Básica de Saúde, por meio de um instrumento semi-estruturado nos meses de março e abril de 2008. As falas resultaram em dois temas convergentes: Atentando para as singularidades humanas na atenção à saúde; Diálogo e acolhimento como possibilidades interativas. Evidenciou-se que a atenção à saúde vem ampliando os debates pela valorização da singularidade humana por meio do diálogo e acolhimento como possibilidades interativas