Design of Molecularly Imprinted Polymers Using Supercritical Carbon Dioxide Technology.

The design and development of affinity polymeric materials through the use of green technology, such as supercritical carbon dioxide (scCO2), is a rapidly evolving field of research with vast applications across diverse areas, including analytical chemistry, pharmaceuticals, biomedicine, energy, food, and environmental remediation. These affinity polymeric materials are specifically engineered to interact with target molecules, demonstrating high affinity and selectivity. The unique properties of scCO2, which present both liquid- and gas-like properties and an accessible critical point, offer an environmentally-friendly and highly efficient technology for the synthesis and processing of polymers. The design and the synthesis of affinity polymeric materials in scCO2 involve several strategies. Commonly, the incorporation of functional groups or ligands into the polymer matrix allows for selective interactions with target compounds. The choice of monomer type, ligands, and synthesis conditions are key parameters of material performance in terms of both affinity and selectivity. In addition, molecular imprinting allied with co-polymerization and surface modification are commonly used in these strategies, enhancing the materials' performance and versatility. This review aims to provide an overview of the key strategies and recent advancements in the design of affinity polymeric materials using scCO2.

Biomolecular Fishing: Design, Green Synthesis, and Performance of l-Leucine-Molecularly Imprinted Polymers.

Biopurification is a challenging and growing market. Despite great efforts in the past years, current purification strategies still lack specificity, efficiency, and cost-effectiveness. The development of more sustainable functional materials and processes needs to address pressing environmental goals, efficiency, scale-up, and cost. Herein, l-leucine (LEU)-molecularly imprinted polymers (MIPs), LEU-MIPs, are presented as novel biomolecular fishing polymers for affinity sustainable biopurification. Rational design was performed using quantum mechanics calculations and molecular modeling for selecting the most appropriate monomers. LEU-MIPs were synthesized for the first time by two different green approaches, supercritical carbon dioxide (scCO2) technology and mechanochemistry. A significant imprinting factor of 12 and a binding capacity of 27 mg LEU/g polymer were obtained for the LEU-MIP synthesized in scCO2 using 2-vinylpyridine as a functional monomer, while the LEU-MIP using acrylamide as a functional monomer synthesized by mechanochemistry showed an imprinting factor of 1.4 and a binding capacity of 18 mg LEU/g polymer, both systems operating at a low binding concentration (0.5 mg LEU/mL) under physiological conditions. As expected, at a higher concentration (1.5 mg LEU/mL), the binding capacity was considerably increased. Both green technologies show high potential in obtaining ready-to-use, stable, and low-cost polymers with a molecular recognition ability for target biomolecules, being promising materials for biopurification processes.

Positive impact of the Therasuit method on gross motor function of children with autism spectrum disorder: Case series.

The Therasuit method is a valuable physiotherapeutic method to improve the gross motor function of children with neuromotor disorders. This series of case studies investigates the effect of the Therasuit method on the gross motor function of children with autism spectrum disorder (ASD). Therasuit method is a therapeutic intervention that involves the use of a therapeutic suit attached to a cage to stimulate gross motor skills, muscle strengthening, stretching, task training, and balance, which is a positive intervention for other neurodevelopmental disorders. The study was conducted with nine male children (42.1 + 4.1 months old) with ASD who received the Therasuit protocol for 4 weeks (20 sessions). The Gross Motor Function Measure (GMFM-88) was used to assess the children's gross motor function before and after the Therasuit method intervention. In dimension B, several skills showed improvement, including transfer to sitting, lean forward and return, trunk rotation without support, and transfer from sitting to all four stances. In dimension C, an increase was observed in skills such as being prone to all four stance transfers and reaching above the shoulders. In dimension D, maximum scores were achieved in skills such as pulling to stand on a large bench without assistance. The dimensions with the greatest impairment were D and E, corresponding to gross motor skills in orthostasis and dynamic skills in orthostasis, respectively. The findings suggest that the Therasuit method is a promising resource for treating motor impairments in children with ASD. However, further studies with a larger sample size, an adequate control condition, and random assignment of participants would be needed to provide stronger evidence of the method's effectiveness in this population.

Case report: Arteriovenous graft for hemodialysis using abdominal vessels.

The improvement of dialysis therapy and clinical support has increased the life expectancy of patients with end stage renal disease (ESRD) over the last years. However, in Brazil, the renal transplant rate cannot follow this growth. This fact, in association with the unavailability of adequate healthcare services in the country, substantially enlarges the use of dual lumen catheters and, consequently, access-related complications. The result is a high rate of patients with access failure, which brings a challenge: how to maintain dialysis in this group? This case report describes a non-conventional surgical approach to create a definite access using abdominal vessels, in an end stage vascular access patient.

When a Histologic Diagnosis Becomes Factitious: A Case of Munchausen Syndrome.

Recurrent episodes of hypoglycemia are uncommon in non-diabetic patients. The workup investigation must confirm hypoglycemia and distinguish between endogenous versus exogenous hyperinsulinism. Simultaneous measurements of plasma glucose, insulin, C-peptide, and a screen for oral hypoglycemic agents should be performed. According to the results, further imaging studies may be necessary. A 43-year-old woman suffering from recurrent hypoglycemia presented to the emergency room (ER) with a hypoglycemic coma. She has had multiple episodes of documented hypoglycemia for the last 13 years. The case was initially investigated, and laboratory studies revealed endogenous hyperinsulinism. Screening for sulfonylureas, anti-insulin and anti-insulin receptor antibodies were negative. Body imaging and positron emission tomography (PET) with 68Ga-DOTANOC did not show evidence of an insulinoma. The patient was submitted to a pancreatectomy, which revealed nesidioblastosis in the histologic examination. Since then, the patient became hyperglycemic but the insulin doses were progressively reduced until new episodes of hypoglycemia recurred and the insulin was stopped. Again, inappropriately high levels of insulin were found at the time of hypoglycemic episodes. Computed tomography (CT) and PET scans did not find evidence of an insulinoma. A C-peptide was later found to be negative and insulin ampoules were found in her possession, making a diagnosis of a factitious disorder. Although rare, factious disorders are frequently overlooked and challenging to diagnose. Since they are very resource and time-consuming, self-inflicted illnesses should always be considered and ruled out beforehand.

Structural and histochemical aspects in leaves of six species of Anemia (Anemiaceae) occurring in rocky outcrops.

Rocky outcrops are known for low humidity, rainfall and high solar radiation, factors that limit the development of some vegetables. However, some species of the genus Anemia occurring in these environments. Thus, understanding the anatomical characters present in these vegetables are important for botanical and biodiversity knowledge in rock fields. We described the leaf anatomy of six species of Anemia to identify characters adapted to rocky outcrops for ferns. Herbarium samples were rehydrated. Field-collected leaves, were also sampled, the material was subjected to standard anatomical study by light microscopy, and secretions were evaluated by histochemical of the secondary compounds, with ruthenium red, tannic acid, ferric chloride, lugol, Sudan black B, vanillin/hydrochloric acid, Dragendorff's reagent and ponceau xylidine. Histochemical tests were positive for phenolic compounds, alkaloids, polysaccharides, and proteins in A. buniifolia, A. oblongifolia, A. presliana, and A. trichorhiza. Our findings revealed that several structural and histochemical characters of Anemia with trichomes, conical stegmatas, phenolic compounds, mucilages and alkaloids are related to reducing water loss, providing an adaptive value to species in extreme environments, such as rocky outcrops, in addition to new data relevant to the group taxonomy, such as the presence of amphistomatic leaves in A. trichorhiza.

Wilson's Disease: First Report of Two Combined Mutational Variants in a Portuguese Patient.

Wilson's disease is a rare autosomal recessive condition. A defect on the copper carrier protein ATP7B prevents the excretion of copper, which then accumulates in several organs. The prognosis of Wilson's disease is favourable if the diagnosis is made early. The Leipzig criteria standardized phenotypic classification and diagnostic criteria, thus simplifying the diagnostic approach. A search for ATP7B mutations is not necessary for diagnostic purposes and studies of genotype-phenotype correlation have not produced any conclusive evidence so far. More information is needed to reliably assess the prognosis for each patient. Here we describe a young patient with a combination of two mutational variants: c.3402del and c.3061-12T>A. To our knowledge, this is the first report of this compound heterozygote genotype. LEARNING POINTS: Wilson's disease should be suspected in a young patient with subacute liver failure.The diagnostic approach to Wilson's disease can be difficult as there are a great variety of clinical scenarios.Further studies on matching genotypic variations with clinical phenotypes could improve the diagnosis and treatment of these patients.

Morbimortality and Six-Month Survival Among Elderly Patients Treated With Noninvasive Mechanical Ventilation in an Intermediate Care Unit: A Retrospective Evaluation.

BACKGROUND: Noninvasive mechanical ventilation (NIMV) has been established as a successful therapeutic option for patients with acute respiratory failure (ARF) with a specific etiology. OBJECTIVES: This study evaluated the morbimortality of patients with ARF treated with NIMV in a medical intermediate care unit (UCINT) to identify factors associated with higher in-hospital mortality, six-month mortality, and three- and six-month hospital readmission rates. METHODS: This retrospective cohort study included elderly patients admitted for ARF and treated with NIMV in the UCINT between 2015 and 2019. RESULTS: In the sample of 102 patients, the median age was 84.2 (±5.5) years, and 57% were women. In total, 28% were on long-term oxygen therapy, and 68% had a do-not-resuscitate order. At admission, the median Charlson comorbidity index and Barthel index of activities of daily living were 7 [6; 8] and 30 [20; 57,5], respectively. The simplified acute physiology score II was 39.1±10.7, and 92% of patients had type 2 ARF. Median days on NIMV and days in UCINT were 10 [6; 16] and 6 [3; 10], respectively. The main conditions requiring UCINT admission for NIMV were heart failure, pneumonia, and exacerbation of the chronic obstructive pulmonary disease. The NIMV failure rate was 7%. At discharge, the average Barthel index was 35 [10; 55]. The in-hospital mortality rate was 23%. DISCUSSION:  Older age, higher simplified acute physiology score II, higher Charlson comorbidity index, and higher number of days on NIMV were associated with higher in-hospital mortality. Long-term oxygen therapy was associated with higher three-month mortality. A higher Barthel index at the time of hospital discharge was associated with a higher six-month readmission rate. CONCLUSION: NIMV can be used successfully in elderly patients and less studied ARF etiologies, such as pneumonia.

Bone Marrow Granulomatosis in Acute Q Fever.

Reported cases of Q fever in people living in urban areas after occasional contact with farm animals or infected pets such as dogs and cats have been increasing. The diagnosis of Q fever is usually laborious due to unspecific and variable clinical manifestations. The most common clinical presentation is an influenza-like illness with varying degrees of pneumonia and hepatitis. Acute hepatitis is more frequent than pneumonia in countries where the disease is endemic, such as in Portugal. We report a case of acute Q fever with hepatic and bone marrow involvement presented as fever of unknown origin (FUO) in a 56-year-old sportive hunter man. Typical fibrin ring granulomas (doughnut granulomas) were found in the bone marrow biopsy and were essential for the diagnosis. Bone marrow involvement is considered a rare manifestation of Q fever. Coxiella infection activates a granulomatous inflammatory response that can lead to persistent immune cell activation. Doughnut granulomas are not pathognomonic but they are highly specific for the diagnosis of Q fever.

Reflexões sobre o acolhimento de profissionais de saúde na pandemia / Reflections about the psychological attention of health workers in the pandemic / Reflexiones sobre la acogida de trabajadores sanitarios en la pandemia

O presente artigo tem como objetivo, por meio de um relato de experiência, compartilhar reflexõesa respeito das ações de um projeto de extensão realizado em 2020 com o intuito de fortalecer trabalhadores de saúde durante a pandemia da Covid-19. Estudantes de psicologia, psicólogos residentes e uma docente participaram da experiência,oferecendo acolhimento psicológico a treze trabalhadoras de instituições públicas de saúde, em sua maioria profissionais da enfermagem, que buscaram o projeto por demanda espontânea. Durante os encontros, estimulou-se a análise do cotidiano do trabalho e dos mecanismos de enfrentamento individuais e coletivos, metodologia baseada na Ergologia. Os temas convergentes nos acolhimentos foram: senso de responsabilidade, sentimento deculpa e sofrimento no trabalho; risco de contaminação, distanciamento social e estigmas; gestão do trabalho e humanização do cuidado. Por fim, considera-se a importância do projeto para o suporte e reflexão crítica das trabalhadoras sobre os processos de trabalho. (AU)

This article aims, through an experience report, at sharing reflections on the actions that were part of an extra-curricular project carried out in 2020 with the goal of strengthening health workers during the Covid-19 pandemic. Psychology students, resident psychologists and a professor took part in the experience, offering psychological care to thirteen workers from public health institutions, mostly nursing professionals, who sought the project on a spontaneous demand. During the sessions, the analysis of the day-to-day work and of individual and collective coping mechanisms was stimulated, a methodology based on Ergology. The converging themes that emerged in the sessions were: sense of responsibility, feeling of guilt and suffering at work; risk of contamination, social distance, and stigmas; work management and humanization of care. Finally, the importance of the project is considered both for the psychological attention and critical reflection of the workers about the labor processes. (AU)

Este artículo tiene como objetivo compartir reflexiones, a través de un relato de experiencia, sobre las acciones de un proyecto de extensión realizado en 2020 con la finalidad de fortalecer a los trabajadores de la salud durante la pandemia Covid-19. Participaron estudiantes de psicología, psicólogas residentes y una profesora, que ofrecieron atención psicológica a trece trabajadoras de instituciones públicas de salud, en su mayoría profesionales de enfermería, que buscaron el proyecto por demanda espontánea. Durante los encuentros se incentivó el análisis del trabajo diario y los mecanismos de afrontamiento individuales y colectivos, metodología basada en la Ergología. Los temas convergentes fueron: sentido de responsabilidad, sentimiento de culpa y sufrimiento en el trabajo; riesgo de contaminación, distancia social y estigmas; y gestión del trabajo y humanización del cuidado. Finalmente, se considera la importancia del proyecto para la recepción y reflexión crítica de las trabajadoras sobre los procesos de trabajo. (AU)

Low-field magnetic resonance imaging characteristics of multifocal vertebral lesions in dogs.

BACKGROUND: There is a lack of information regarding magnetic resonance imaging (MRI) features of polyostotic vertebral lesions in dogs. The aim of this retrospective study was to identify and differenciate low-field MRI features of aggressive versus benign multifocal vertebral diseases in dogs. METHODS: MRI examinations from 49 dogs with polyostotic vertebral lesions were reviewed. Images were evaluated for vertebral intensity changes, expansile lesions, new bone formation, cortical bone interruption, paravertebral musculature changes, lymphadenomegaly, spinal cord compression and spinal cord signal changes. RESULTS: Twenty-nine dogs with non-aggressive bone lesions and 20 dogs with aggressive vertebral lesions were included. Non-aggressive lesions had variable T2-weighted fast spin-echo (T2W) signal intensity and the majority displayed low signal intensity on short tau inversion recovery (STIR). Aggressive lesions predominantly had high T2W and STIR signal intensity, with variable signal intensity on T1-weighted spin-echo and contrast enhancement. Aggressive lesions were associated with spinal pain (p < 0.01), new bone formation (p = 0.02), spinal cord compression (p < 0.01) and lymphadenomegaly (p < 0.01). Cortical interruption (p < 0.01) and paravertebral musculature changes (p < 0.01) were the strongest indicative imaging features for aggressive lesions. CONCLUSION: Spinal pain, spinal cord compression, new bone formation, lymphadenomegaly and especially cortical interruption and paravertebral musculature signal intensity changes were the best discriminators for differentiating malignant from benign vertebral lesions.

Evaluation of reduction of external load of total phosphorus and total suspended solids for rehabilitation of urban lakes.

Urban lakes provide important services to cities, but they suffer from en-vironmental problems, mainly resulting from degradation of the watershed. Rehabilitation of degraded lakes is based on the recovery of water quality and reduction of external pollution, the latter usually taking priority. The Lagoa da Pampulha (LP) is an artificial lake located in Belo Horizonte, Minas Gerais - Brazil, that has suffered eutrophication and silting for decades and has been undergoing rehabilitation for some years. The objective of this study was to evaluate the importance of sanitary, environmental and urban improvements implemented in the LP watershed. For this purpose, total phosphorus (TP) and total suspended solid (TSS) loads transported to LP, between 2016 and 2017, obtained from hydrological and water quality monitoring data, were estimated. Additionally, simulations were carried out using the Storm Water Management Model (SWMM) to evaluate TP and TSS loads in hypothetical scenarios. The conservative scenario proposed a reduction of 50 % in sanitary sewage discharge to water courses and an increase of 30 % and 10 % in the urban area and non-vegetated soil, respectively, in the watershed. In an op-timistic scenario, a reduction of 95 % in sewage discharge and a reduction of 50 % in non-vegetated soils was proposed. According to the results obtained, between October 2016 and September 2017, about 38 tons of TP and 3000 tons of TSS were transported into LP. The results of the SWMM simulations indicated high loads entering the lake, ranging from about 23,000 to 13,000 ton/year for TP and from 3200 to 2400 ton/year for TSS, in actual and optimistic scenario respectively. Despite presenting significant reductions, of up to 60 % for TP and 25 % for TSS, the loads transported to LP remained high even in the most optimistic scenario, indicating that implementation of the evaluated improvements only not sufficient to guarantee rehabilitation of the lake, and must be associated with other measures.

MIP Synthesis and Processing Using Supercritical Fluids.

Supercritical fluid technology provides a clean and straightforward way for the preparation of high affinity polymeric materials. Molecularly Imprinted Polymers (MIPs) as dry, free-flowing powders are obtained in a one-step synthetic route yielding molecular recognition materials for several applications. Herein, we describe the experimental procedures involved in the scCO2-assisted MIP development: synthesis, template desorption, impregnation, and membrane preparation. MIP applications are described putting in evidence the advantages of MIP development using supercritical fluid technology.

Convergence-Retraction Nystagmus in a Dog With Presumptive Ischemic Encephalopathy Following Acute Cervicothoracic Myelopathy.

A 6.5-year-old male neutered Trailhound was admitted for hyperacute, nonprogressive, left-sided hemiparesis. Physical and neurologic examination revealed nonpainful, left-sided poorly ambulatory hemiparesis, decreased left-sided postural reactions and thoracic limbs hyporeflexia. Neuroanatomic localisation was consistent with a left-sided C6-T2 myelopathy. Haematology and biochemistry revealed nonspecific abnormalities. Magnetic resonance imaging of the neck revealed a focal intramedullary lesion at the level of C6-C7 vertebrae compatible with acute hydrated noncompressive nucleus pulposus extrusion or ischemic myelopathy. During the second day of hospitalization, the dog developed convergence-retraction nystagmus, up-gaze palsy and eyelid retraction (Collier's sign) compatible with dorsal midbrain syndrome. Magnetic resonance imaging of the brain revealed a focal lesion compatible with dorsal midbrain ischemic infarct. Further clinicopathologic testing, thoracic and abdominal imaging were unremarkable. Ischemic encephalopathy of unknown etiology was additionally diagnosed. Physiotherapy was performed therapeutically. At 1-year follow-up the dog was normal. This is an unusual report of a dog with myelopathy followed by ischemic encephalopathy with manifestation of convergence-retraction nystagmus in the absence of vestibular signs. This saccadic intrusion is a characteristic clinical manifestation of a dorsal midbrain syndrome localization. The importance of a complete differential diagnoses list formation in a dog with ischemic encephalopathy which leads to a thorough diagnostic investigation plan is highlighted. Moreover, this report contributes to the enrichment of the clinical reasoning veterinary literature on convergence-retraction nystagmus. To the authors' knowledge, this is the second case report (fourth dog) to describe convergence-retraction nystagmus in dogs as a manifestation of dorsal midbrain syndrome.

Drug-Induced Aseptic Meningitis Following Spinal Anesthesia.

Meningitis is a very uncommon complication of spinal anesthesia, and drug-induced aseptic meningitis (DIAM) is even rarer. We present two cases of DIAM following spinal anesthesia with bupivacaine and ropivacaine, respectively. The patients presented shortly after the procedure with typical meningitis symptoms. Since CSF (cerebrospinal fluid) analysis could not initially exclude bacterial meningitis, they were started on empirical antibiotics. CSF was subsequently found to be negative for viruses and bacteria in both cases, and antibiotics were promptly stopped. Both patients improved rapidly and without neurological sequelae. While it remains a diagnosis of exclusion, it is important to be aware of DIAM as recognition of the condition can lead to shorter admission times and avoid unnecessary use of antibiotics. LEARNING POINTS: A diagnosis of DIAM should be considered when a patient who recently underwent spinal anesthesia is admitted with symptoms and CSF compatible with meningitis.Clinical and laboratory findings (including CSF analysis) cannot distinguish between bacterial meningitis and DIAM.A negative CSF culture and rapid recovery confirm the diagnosis and stopping antibiotics at this point is effective.

Chlamydia-induced curvature of the host-cell plasma membrane is required for infection.

During invasion of host cells, Chlamydia pneumoniae secretes the effector protein CPn0678, which facilitates internalization of the pathogen by remodeling the target cell's plasma membrane and recruiting sorting nexin 9 (SNX9), a central multifunctional endocytic scaffold protein. We show here that the strongly amphipathic N-terminal helix of CPn0678 mediates binding to phospholipids in both the plasma membrane and synthetic membranes, and is sufficient to induce extensive membrane tubulations. CPn0678 interacts via its conserved C-terminal polyproline sequence with the Src homology 3 domain of SNX9. Thus, SNX9 is found at bacterial entry sites, where C. pneumoniae is internalized via EGFR-mediated endocytosis. Moreover, depletion of human SNX9 significantly reduces internalization, whereas ectopic overexpression of CPn0678-GFP results in a dominant-negative effect on endocytotic processes in general, leading to the uptake of fewer chlamydial elementary bodies and diminished turnover of EGFR. Thus, CPn0678 is an early effector involved in regulating the endocytosis of C. pneumoniae in an EGFR- and SNX9-dependent manner.

Promoção de estilos de vida saudável e qualidade do sono aos profissionais de saúde, em contexto hospitalar / Promoting healthy lifestyles and sleep quality to health professionals in hospital settings

Este relatório de estágio encontra-se inserido no plano curricular do 10º Curso de Mestrado em Enfermagem na Área de Especialização em Enfermagem Comunitária e tem como objetivo espelhar o percurso efetuado ao longo das Unidades Curriculares Opção II e Estágio com Relatório, com base na metodologia do planeamento em saúde de Imperatori e Giraldes (1993). O local de estágio que serviu de base para a realização deste relatório foi o Serviço de Saúde Ocupacional de um Centro Hospitalar de Lisboa, ressalvando o papel fundamental que a Enfermagem do Trabalho desempenha na promoção de saúde dos trabalhadores, bem como na prevenção dos riscos a que estes são expostos diariamente. As competências em planeamento em saúde do Enfermeiro Especialista em Enfermagem Comunitária podem ser uma mais-valia nesta área tão específica. De acordo com a evidência, as Doenças Crónicas Não Transmissíveis são uma preocupação constante a nível mundial, sendo a adoção de estilos de vida saudável e uma boa qualidade do sono, elementos fulcrais para minimizar os seus efeitos. Para o diagnóstico de situação foram aplicados, com as devidas autorizações, o questionário Estilo de Vida Fantástico e o Índice de Qualidade de Sono de Pittsburg. A priorização das necessidades realizou-se de acordo com o Método de Hanlon adaptado e os diagnósticos priorizados foram, de forma decrescente: sono comprometido, status nutricional comprometido, atividade psicomotora comprometida, coping comprometido e status emocional comprometido. As intervenções incidiram na promoção da qualidade do sono dos profissionais com o projeto "Dormir melhor…para melhor viver", englobando componentes do estilo de vida, como os hábitos alimentares saudáveis e a prática adequada de atividade física. O referencial teórico adotado foi o Modelo de Promoção da Saúde de Pender, Murdaugh e Parsons (2015), pois enquadra-se nos objetivos do projeto. Este referencial conduziu o planeamento de intervenções junto da população, com intuito de capacitação da mesma, para melhorar os domínios de estilo de vida alterados. As estratégias tiveram por base a promoção da saúde através do uso de cartazes, folhetos e de sessões de educação para a saúde. Finda a intervenção, foi efetuada a avaliação da eficácia das medidas implementadas.

This internship report is inserted in the curricular plan of the 10th Master's Course in Nursing in the Community Nursing Specialization Area and aims to mirror the path taken along the Curriculum Units Option II and Internship with Report, based on the methodology of the health planning by Imperatori e Giraldes (1993). The internship location that served as the basis for this report was the Occupational Health Service of a Hospital Center in Lisbon, emphasizing the fundamental role that Occupational Nursing plays in the promotion of workers' health, as well as in the prevention of risks to that these are exposed daily. The skills in health planning of the Specialist Nurse in Community Nursing can t be an asset in this specific area. According to the evidence, Chronic Noncommunicable Diseases are a constant concern worldwide, with the adoption of healthy lifestyles, including quality of sleep, a key element to mitigate their effects. For the diagnosis of the situation, the Fantastic Lifestyle questionnaire and the Pittsburg Sleep Quality Index were applied, with the proper authorizations. The prioritization of needs was carried out according to the adapted Hanlon Method and the prioritized diagnoses were, in decreasing form: impaired sleep, impaired nutritional status, impaired psychomotor activity, impaired coping and impaired status. The interventions focused on promoting the sleep quality of professionals, with the projecto "Dormir melhor…para melhor viver", encompassing lifestyle components, such as healthy eating habits and adequate physical activity.The theoretical framework adopted was the Health Promotion Model of Pender, Murdaugh e Parsons (2015), as it fits the objectives of the project. This reference led to the planning of interventions with the population, with the aim of training them, to improve the altered lifestyle domains. The strategies were based on health promotion through the use of posters, leaflets and health education sessions. After the intervention, the evaluation was carried out to assess the effectiveness of the implemented measures.

Técnica de Imaginación Guiada en el manejo de la ansiedad materna durante el embarazo: revisión integradora / A Técnica de Imaginação Guiada na gestão da ansiedade materna durante a gravidez: revisão integrativa / Guided Imagery Technique on managing maternal anxiety during pregnancy: integrative review

Este artículo describe la importancia de la Técnica de Imaginacion Guiada en el manejo de la andiedad materna durante el embarazo.Objetivos: Conocer la evidencia científica sobre la influencia de la Técnica de Imaginacion Guiada en el manejo de la ansiedad materna durante el embarazo.Metodologia: Revisión integradora de la literatura realizada en la base de datos The Cochrane Library y en la plataforma EBSCO Host. Se obtuvieron 30 artículos, de los cuales se incluyeron 10 artículos en el estudio.Resultados/Discusión: Del análisis de la evidencia científica resultaron los siguientes temas: ansiedad; manejo del estrés y su impacto fisiológico; relajación y bienestar; adhesión a la Técnica de Imaginacion Guiada; percepción positiva del embarazo; dificultades en el uso de la Técnica de Imaginacion Guiada. Conclusión: La Técnica de Imaginacion Guiada parece promover la relajación y el bienestar de las mujeres, así como los niveles más bajos de ansiedad y de malestar percibidos durante el embarazo

Este artigo descreve a importância da Técnica de Imaginação Guiada na gestão da ansiedade materna durante a gravidez.Objetivo: Conhecer a evidência científica sobre a influência da Técnica de Imaginação Guiada na gestão da ansiedade materna durante a gravidez.Método: Revisão integrativa da literatura realizada na base de dados The Cochrane Library e através da plataforma EBSCO Host. De um total de 30 artigos obtidos, foram incluídos no estudo 10 artigos.Resultados/Discussão: Da análise da evidência científica resultaram as seguintes temáticas: ansiedade, gestão do stress e impacto fisiológico; relaxamento e bem-estar; adesão à Técnica de Imaginação Guiada; perceção positiva da gravidez; dificuldades na sua utilização.Conclusão: A Técnica de Imaginação Guiada parece promover o relaxamento e bem-estar da mulher, assim como diminuir os níveis de ansiedade e desconfortos percecionados durante a gravidez

This article describes the importance of the Guided Imagery Technique for the management of maternity associated anxiety during pregnancy. Goal: To understand the scientific evidence regarding the Guided Imagery Technique for the management of maternity associated anxiety during pregnancy. Method: Integrative revision of the literature from the Cochrane Library database, using the platform EBSCO Host. From a total of 30 articles on the subject, 10 were included on this articleResults/Discussion: The scientific evidence analysis translates on the following topics: anxiety, stress management and physiological impact; relaxation and well-being; adherence to the Guided Imagery Technique; positive perception of the pregnancy; difficulties to its use. Conclusion: The Guided Imagery Technique seems to promote the relaxation and well being of the women and also, aids with the reduction of anxiety levels and perceived discomfort during pregnancy

Sarcoidose ocular: a nossa realidade nos últimos seis anos / Ocular sarcoidosis: our reality for the past six years

RESUMO Introdução: Na sarcoidose, as manifestações oculares são comuns e podem constituir a manifestação inicial da doença ou mesmo a única. O objetivo deste trabalho foi analisar os parâmetros demográficos, manifestações clínicas, terapêutica e principais complicações oculares em doentes com sarcoidose ocular. Métodos: Estudo descritivo e retrospectivo que incluiu doentes com o diagnóstico de sarcoidose ocular, observados nas consultas de Inflamação Ocular e de Doenças Auto-Imunes do Hospital Prof. Doutor Fernando Fonseca, no período entre 2009 e 2015. Resultados: Foram identificados 11 doentes com o diagnóstico de sarcoidose ocular, com predomínio do sexo feminino (54,5%) e caucasianos. A média da idade ao diagnóstico foi de 45±14 anos. A sarcoidose manifestou-se de forma exclusivamente ocular em 36% dos casos. O envolvimento ocular foi a manifestação inicial em 90,9% dos casos. Identificaram-se 9 casos de uveíte, 1 de esclerite anterior nodular e 1 de queratite intersticial. O tratamento com corticoterapia tópica foi realizado em 100% dos casos, sendo o tratamento único em apenas 1 doente. Nos restantes, foi necessário associar corticoterapia oral. Em 4 desses doentes, pela gravidade da doença e atingimento binocular, utilizou-se também corticoterapia pulsada endovenosa. O tratamento adjuvante imunossupressor mais frequentemente utilizado foi o metotrexato (45%). Um doente necessitou de terapia biológica com infliximabe para controle da doença. Conclusão: A manifestação ocular mais comum foi a uveíte, com predomínio da panuveíte. O tratamento mais utilizado e com maior taxa de controle da doença foi a corticoterapia sistêmica em associação com o metotrexato.

ABSTRACT Purpose: In sarcoidosis, ocular manifestations are common and can be the initial or even the only clinical manifestation. The aim of this study was to analyze the demographic parameters, clinical manifestations, treatment and the major ocular complications in patients with ocular sarcoidosis. Methods: We conducted a descriptive and retrospective study that included patients with the diagnosis of ocular sarcoidosis, followed by inflammatory ophthalmology and immune-mediated disease consults at the Prof. Doutor Fernando Fonseca Hospital, between 2009 and 2015. Results: Eleven patients with the diagnosis of ocular sarcoidosis were identified, with a predominance of females (54,5%) and Caucasians. The average age at diagnosis was 45 ± 14 years. Sarcoidosis was exclusively ocular in 36%. The first manifestation of sarcoidosis was eye disease in 90.9 % of cases. Nine cases of uveitis, one of nodular scleritis and one of interstitial keratitis were observed. Topical corticoid treatment was applied in 100% of cases, with only one achieving remission of the disease. Oral corticoid treatment was necessary in 10 cases, four of which needed a high dose methylprednisolone induction. Methotrexate was the adjunctive immunosuppressive treatment of choice in 45% of cases. There was one refractory case for conventional immunosuppressive therapy, having achieved remission with biologic agent infliximab. Conclusion: Uveitis was the commonest ocular manifestation, and there was a predominance of panuveitis. Systemic corticoid and methotrexate were the most used immunosuppressive treatments for maintaining the controlled stated of the disease.