The physicianelderly patient relationship: challenges and perspectives

O objetivo deste artigo é expor os desafios e perspectivas da relação médico-paciente idoso. Nas relações interpessoais, inerentes ao exercício profissional da medicina, é a qualidade do encontro que determina sua eficiência. Assim, na formação e na identificação do bom profissional, a relação médico-paciente idoso é fundamental na promoção da qualidade do atendimento. Os mé dicos devem privilegiar sentimentos e valores dos pacientes idosos e de seus familiares, estimu lando a tomada das decisões necessárias em conjunto, ou seja, a democratização da relação médi co-paciente, resgatando sua humanização. Esta proposta aspira ao nascimento de uma nova imagem deste profissional responsável pela efetiva promoção da saúde, ao considerar o paciente idoso em sua integridade física, psíquica e social, e não somente do ponto de vista biológico.The aim of this article was to discuss challenges and perspectives in the physician-elderly patient relationship. In interpersonal relations, inherent to medical practice, it is the quality of the encounter that determines its efficiency. Thus, in training and identifying good medical professionals, the physician-elderly patient relationship is essential for promoting quality of care. Physicians should prioritize the feelings and values of elderly patients and their families, encouraging the necessary joint decision-making, that is, democratization of the physician-patient relations hip, reclaiming its humanization. This proposal aspires to the birth of a new image for these professionals, who are responsible for effective health promotion, by considering elderly patients in their physical, psychological, and social entirety, and not merely from the biological point of view

Silk fibroin-based hydrogels and scaffolds for osteochondral repair and regeneration

Osteochondral lesions treatment and regeneration demands biomimetic strategies aiming physicochemical and biological properties of both bone and cartilage tissues, with long-term clinical outcomes. Hydrogels and scaffolds, appeared as assertive approaches to guide the development and structure of the new osteochondral engineered tissue. Moreover, these structuresalone or in combination with cells and bioactive molecules, bring the mechanical support after in vitro and in vivo implantation. Moreover, multilayered structures designed with continuous interfaces, furnish appropriate features of the cartilage and subchondral regions, namely microstructure, composition, and mechanical properties. Owing the potential as scaffolding materials, natural and synthetic polymers, bioceramics, and composites, have been employed. Particularly, significance is attributed to the natural-based biopolymer silk ï¬ broin from the Bombyx mori silkworm, considering its unique mechanical and biological properties. The significant studies on silk fibroin-based structures, namely hydrogels and scaffolds, towards bone, cartilage, and osteochondral tissue repair and regeneration are overviewed herein. The developed biomimetic strategies, processing methodologies, and final properties of the structures are summarized and discussed in depth.s The authors thank to the project FROnTHERA (NORTE-01-0145- FEDER-000023), supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). The financial support from the Portuguese Foundation for Science and Technology to Hierarchitech project (M-ERA-NET/0001/2014), for the fellowship grant (SFRH/ BPD/113806/2015) and for the fund provided under the program Investigador for J. M. Oliveira (IF/00423/2012 and IF/01285/2015) are also greatly acknowledged.info:eu-repo/semantics/publishedVersio

Injectable Gels for Dental and Craniofacial Applications

The use of injectable scaffolds is considered a promising approach in craniofacial tissue regeneration, as they can be introduced with minimally invasive surgery, thus reducing the risk of surgery complications and improving postoperative recovery. In this chapter, comprehensive descriptions of chemically and physically cross-linked hydrogels that can be used as injectable scaffolds for dental and craniofacial application are presented. Nanocomposite hydrogels, in which nano-sized particles may serve as reinforcing agents and impart functionality to the hydrogels, are also discussed. Special attention is given to peptide amphiphiles which can self-assemble into supramolecular configuration mimicking the extracellular matrix (ECM) structure. Finally, injectable microspheres and different techniques of fabrication are discussed in this chapter