Nutcracker Syndrome: A Cause of Hematuria and Low Back Pain in Young Patients.

Nutcracker syndrome is a clinical condition in which there is compression of the left renal vein in its path between the abdominal aorta and the superior mesenteric artery. This phenomenon can cause abdominal or low back pain and hematuria. It is a rare clinical entity, although probably underdiagnosed. The diagnosis is essentially clinical and based on imaging, but necessarily a diagnosis of exclusion. We present the case of a 21-year-old boy who came to the Emergency Department with hematuria and low back pain. After exhaustive study and exclusion of other possible clinical entities, the diagnosis was confirmed to be nutcracker syndrome. Despite its usually benign expression, this entity should not be forgotten in the diagnostic process of cases of hematuria and low back pain, especially in young patients.

Aprendizagem do cuidar a família na comunidade: Usabilidade do Modelo Dinâmico de Avaliação e Intervenção Familiar / Learning to care for the family in the community: Usability of the Dynamic Model of Family Assessment and Intervention / Aprendizaje del cuidado a la familia en la comunidad: Usabilidad del Modelo Dinámico de Evaluación e Intervención Familiar

Resumo Enquadramento: O Modelo Dinâmico de Avaliação e Intervenção Familiar é mobilizado no processo de ensino aprendizagem dos estudantes da licenciatura em enfermagem, como orientador no processo de cuidados às famílias na comunidade. Objetivo: Analisar as dimensões valorizadas pelos estudantes do curso de licenciatura em enfermagem, no desenvolvimento de competências na avaliação e intervenção familiar. Metodologia: Estudo exploratório-descritivo com 350 estudantes da licenciatura em Enfermagem. Uso de formulário para identificar aspetos valorizados na utilização do modelo referencial teórico e operativo em ensino clínico. Análise de conteúdo com categorização a priori e a posteriori. Cumpridos os pressupostos éticos. Resultados: Identificam-se cinco dimensões: Clareza (mais valorizada); Simplicidade; Generalidade; Consequências deriváveis (frequência de nomeação intermédia) e Precisão empírica (menos valorizada). Emerge interligação entre etapas do processo de cuidados e modelo como instrumento de mudança e referencial na tomada de decisão no contexto clínico. Conclusão: As dimensões confirmam a importância atribuída pelos estudantes à estrutura e sentido na aprendizagem dos cuidados à família sendo preditivas da aprendizagem integrada, entre teoria e prática em enfermagem.

Abstract Background: The Dynamic Model of Family Assessment and Intervention is used in the teaching-learning process of undergraduate nursing students to guide the process of caring for families in the community. Objective: To analyze the dimensions valued by undergraduate nursing students in the development of family assessment and intervention skills. Methodology: An exploratory-descriptive study was conducted with 350 undergraduate nursing students. A form was used to identify aspects valued in using the theoretical and operational model in clinical teaching. Data were subjected to content analysis, with a priori and a posteriori categorization. All ethical assumptions were met. Results: Five dimensions were identified: Clarity (most valued); Simplicity; Generality; Derivable consequences (intermediate frequency), and Empirical precision (least valued). Interconnection emerges between stages of the care process and the model as an instrument of change and reference in decision-making in clinical settings. Conclusion: The dimensions confirm the importance attributed by students to the structure and meaning in learning about family care and are predictors of integrated learning between nursing theory and practice.

Resumen Marco contextual: El Modelo Dinámico de Evaluación e Intervención Familiar se articula en el proceso de enseñanza-aprendizaje de los estudiantes del grado en Enfermería, como guía en el proceso de cuidados a las familias en la comunidad. Objetivo: Analizar las dimensiones valoradas por los estudiantes del grado en Enfermería en el desarrollo de competencias en la evaluación e intervención familiar. Metodología: Estudio exploratorio-descriptivo con 350 estudiantes del grado en Enfermería. Se utilizó un formulario para identificar los aspectos valorados en el uso del modelo referencial teórico y operativo en la enseñanza clínica. Análisis de contenido con categorización a priori y a posteriori. Se cumplieron todos los supuestos éticos. Resultados: Se identifican cinco dimensiones, Clareza (más valorada); Simplicidad; Generalidad; Consecuencias derivables (frecuencia intermedia) y Precisión empírica (menos valorada). Surge interconexión entre etapas del proceso de cuidados y modelo como instrumento de cambio y referencia para la toma de decisiones en el contexto clínico. Conclusión: Las dimensiones confirman la importancia atribuida por los estudiantes a la estructura y el significado en el aprendizaje de los cuidados a la familia, y son predictivas del aprendizaje integrado entre la teoría y la práctica en enfermería.

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience in Portugal.

Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals' education and training. This study intended to measure nursing students' perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students' adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students' adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience: Development and Validation of a Scale in Four European Countries.

Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries.

A Case of Cervical Lymphadenopathy After Vaccination Against COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic has caused a major global healthcare crisis, and the fields of science and medicine have been engaged in a massive effort to control and prevent the resultant deaths and morbidity. Researchers and pharmaceutical companies have developed in record time vaccines against COVID-19 that are intended to be safe and effective; however, the short validation time has been a challenge for doctors and epidemiologists, especially in light of the increase in reports emerging from various parts of the world about the adverse effects of the new vaccines. Portugal's national regulatory authority, the National Authority of Medicines and Health Products (INFARMED), has recently granted approval for Pfizer-BioNTech (Pfizer Inc., New York, NY; BioNTech SE, Mainz, Germany) and Moderna (Moderna, Inc, Cambridge, MA) COVID-19 vaccines, and they are being rolled out to be administered among the general population. In light of this, it is important for breast surgeons, family doctors, hematologists, and radiologists to consider the effects of recent COVID-19 vaccination history as a possible cause in the differential diagnosis for patients with unilateral cervical adenopathy. The objective of this report is to present a case that involves an adverse reaction involving acute-onset cervical lymphadenopathy in a female patient that coincided with her vaccination against COVID-19, even though cervical lymphadenopathy had not been previously reported as a potential side effect of the COVID-19 vaccination. We discuss the case of a Portuguese physician with a family history of breast cancer, who developed right cervical lymphadenopathy after receiving the first dose of the COVID-19 vaccine. Lymph node growth and ultrasound changes observed in the patient over the weeks, and a lack of information on the COVID-19 vaccine's adverse effects, prompted an in-depth study to understand its etiology.

Adult pancreatoblastoma - Case report and review of literature.

Most cases of pancreatoblastoma, a rare malignant epithelial tumor of the pancreas, are seen in the pediatric population. The rarity of pancreatoblastoma, the similar radiologic findings to those seen in other pancreatic lesions, and its histopathologic heterogeneity, make its preoperative diagnosis in adults a real challenge. We report ultrasound, computed tomography and magnetic resonance imaging correlative findings of a histologically proven pancreatoblastoma in a 37-year-old woman. Pancreatoblastoma should be considered in the differential diagnosis of a pancreatic mass presenting uncommon imaging features.

Tubular Carcinoma of the Breast: Advantages and Limitations of Breast Tomosynthesis.

Tubular carcinoma of the breast is a rare variant of invasive ductal carcinoma. We report a case of 42-year-old asymptomatic female with a histopathological proven multifocal tubular carcinoma, studied by mammography, Tomosynthesis, Ultrasound, and Magnetic Resonance. Herein, we discuss the advantages and limitations of Tomosynthesis, an emerging imaging technique, in this particular case.

The anatomical compartments and their connections as demonstrated by ectopic air.

Air/gas outside the aero-digestive tract is abnormal; depending on its location, it is usually called emphysema, referring to trapped air/gas in tissues, or ectopic air/gas. It can be associated to a wide range of disorders, and although it usually is an innocuous condition, it should prompt a search for the underlying aetiology, since some of its causes impose an urgent treatment. In rare instances, it may itself represent a life-threatening condition, depending on the site involved and how quickly it evolves. Abnormal air/gas beyond viscera and serosal spaces, reaches its location following some anatomic boundaries, such as fascia, which may help search the source; however if the air pressure exceeds the strength of the tissues, or the time between the aggression and the imaging is too long, the air/gas is almost everywhere, which may hinder its cause. Good knowledge of the anatomic spaces and how they connect between them facilitates the quick detection of the cause. Teaching points • Ectopic air can be depicted on conventional radiographs; but CT is more sensitive and accurate • Visceral and retropharyngeal spaces directly communicate with mediastinum • Renal fascia is a single multilaminated structure, which contains potential space.

Solid pseudopapillary tumor of the pancreas: a rare and probably misdiagnosed neoplasm.

Solid Pseudopapillary Tumor of the pancreas is a rare nonfunctioning tumor. It is considered a low-grade malignancy that is apparently curable with surgical complete excision in most instances. We present a case of solid pseudopapillary pancreatic tumor that represented a challenge to the radiologists. This case highlights its possible various appearances and the need to the radiologist to be familiar with them.