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Introduction and Objectives: Digital health (DH) is a broad concept, bringing together technology and healthcare, that is playing an increasingly important role in the daily routine of healthcare professionals (HCPs) and promises to contribute to the prevention and treatment of cardiovascular disease. There are no solid data on the position of Portuguese HCPs toward the implementation of DH in cardiovascular medicine. This national cross-sectional study aims to provide a snapshot of DH implementation in Portuguese cardiovascular HCP routines and to identify both expectations and barriers to its adoption. Methods: An 18-question survey was created specifically for this study and distributed to 1174 individuals on the Portuguese Society of Cardiology mailing list. Results: We collected 117 valid responses (response rate 10%). Almost all participants had smartphones and laptops, and two-thirds had tablets. Electronic medical information systems were the most used DH tool (84% of respondents) and were considered the most important for improving cardiovascular care. Implantable technologies (sensors and devices), telemedicine and social media were used by more than two out of three respondents and considered «very important» or «extremely important» by most of them. Most participants showed positive expectations regarding the impact of DH in cardiovascular medicine: 78% agreed that DH could improve health outcomes, 64% that it promotes health literacy and 63% that it could decrease healthcare costs. The top-rated barriers were patients’ inability to use smartphones, limited access to electronic devices, and lack of legal regulation of DH. Conclusion: Most Portuguese cardiovascular HCPs had at least three electronic devices (mainly smartphones, laptops and tablets) and showed positive expectations regarding DH's current and future impact on cardiovascular medicine. Patient DH literacy, technology adoption, and DH regulation were identified as the most important barriers to increasing the adoption of DH tools in cardiovascular medicine. Resumo: Introdução e objetivos: A saúde digital é um conceito amplo, que junta a tecnologia aos cuidados de saúde, desempenhando um papel cada vez mais importante na prática clínica diária dos profissionais de saúde e promissor na prevenção e tratamento de doenças cardiovasculares. Não existem dados consistentes que avaliem a posição dos profissionais de saúde portugueses em relação à implementação da saúde digital na medicina cardiovascular. Por conseguinte, este estudo visa compreender o panorama geral da implementação da saúde digital na rotina diária dos profissionais de saúde cardiovascular em Portugal e identificar tanto as expectativas como os obstáculos à sua adoção. Métodos: Um inquérito de 18 perguntas foi construído para as necessidades específicas deste estudo e distribuído a 1174 potenciais respondedores da mailing list da Sociedade Portuguesa de Cardiologia. Resultados: Foram obtidas 117 respostas válidas (taxa de resposta ao inquérito de 10%). Quase todos os respondedores tinham um smartphone e um computador portátil e dois terços tinham um tablet. Os sistemas eletrónicos de informação médica foram a ferramenta mais utilizada (84% dos inquiridos) e considerada a mais relevante para melhorar os cuidados de saúde cardiovasculares. Mais de dois terços dos inquiridos relataram utilizar tecnologias implantáveis (sensores ou dispositivos), telemedicina e as redes sociais e todas estas ferramentas foram consideradas «muito relevantes» ou «totalmente relevantes» pela maioria. A maior parte dos respondedores demonstrou expectativas positivas relativamente ao impacto da saúde digital na medicina cardiovascular: 78% concordaram que esta pode melhorar os outcomes em saúde, 64% que promove a literacia em saúde e 63% que pode diminuir os custos dos cuidados de saúde. A incapacidade dos pacientes de utilizar smartphones, o acesso limitado a dispositivos eletrónicos e a falta de regulamentação legal da saúde digital foram as barreiras mais cotadas. Conclusão: Globalmente, a maioria dos profissionais de saúde cardiovascular em Portugal tinha pelo menos três dispositivos eletrónicos (principalmente smartphones, computadores portáteis e tablet) e mostrou expectativas positivas relativamente ao impacto atual e futuro da saúde digital na medicina cardiovascular. A literacia e a adoção de tecnologia relacionada com a saúde digital pelos pacientes, bem como a falta de regulamentação jurídica, foram identificados como os obstáculos mais importantes para aumentar a adoção de ferramentas de saúde digital na medicina cardiovascular.

Abstract This paper examines how humans judge the capabilities of artificial intelligence (AI) to evaluate human attributes, specifically focusing on two key dimensions of human social evaluation: morality and competence. Furthermore, it investigates the impact of exposure to advanced Large Language Models on these perceptions. In three studies (combined N = 200), we tested the hypothesis that people will find it less plausible that AI is capable of judging the morality conveyed by a behavior compared to judging its competence. Participants estimated the plausibility of AI origin for a set of written impressions of positive and negative behaviors related to morality and competence. Studies 1 and 3 supported our hypothesis that people would be more inclined to attribute AI origin to competence-related impressions compared to morality-related ones. In Study 2, we found this effect only for impressions of positive behaviors. Additional exploratory analyses clarified that the differentiation between the AI origin of competence and morality judgments persisted throughout the first half year after the public launch of popular AI chatbot (i.e., ChatGPT) and could not be explained by participants' general attitudes toward AI, or the actual source of the impressions (i.e., AI or human). These findings suggest an enduring belief that AI is less adept at assessing the morality compared to the competence of human behavior, even as AI capabilities continued to advance.

Introduction and objectives: Three-dimensional (3D) model simulation provides the opportunity to manipulate real devices and learn intervention skills in a realistic, controlled, and safe environment. To ensure that simulators provide a realistic surrogate to real procedures they must undergo scientific validation. We aimed to evaluate the 3D-printed simulator SimulHeart® for face and content validity to demonstrate its value as a training tool in interventional cardiology (IC). Methods: Health professionals were recruited from sixteen Portuguese IC units. All participants received a 30-minute theoretical introduction, 10-minute demonstration of each task and then performed the intervention on a 3D-printed simulator (SimulHeart®). Finally, a post-training questionnaire focusing on the appearance of the simulation, simulation content, and satisfaction/self-efficacy was administered. Results: We included 56 participants: 16 “experts” (general and interventional cardiologists), 26 “novices” (cardiology residents), and 14 nurses and allied professionals. On a five-point Likert scale, the overall mean score of face validity was 4.38±0.35 and the overall mean score of content validity was 4.69±0.32. There was no statistically significant difference in the scores provided by “experts” and “novices”. Participants reported a high level of satisfaction/self-efficacy with 60.7% considering it strongly improved their skills. The majority (82.1%) “agreed” or “strongly agreed” that after the simulation they felt confident to perform the procedure on a patient. Conclusion: The 3D-printed simulator (SimulHeart®) showed excellent face and content validity. 3D simulation may play an important role in future IC training programs. Further research is required to correlate simulator performance with clinical performance in real patients. Resumo: Introdução e objetivos: A simulação de modelos tridimensionais (3D) proporciona a oportunidade de manipular dispositivos reais e aprender competências de intervenção num ambiente realista, controlado e seguro. Para garantir que os simuladores fornecem uma comparação realista, estes devem ser submetidos a validação científica. O nosso objetivo foi avaliar o simulador 3D SimulHeart® quanto à validade de aparência e conteúdo, para demonstrar o seu valor como ferramenta formativa em cardiologia de intervenção (CI). Métodos: Recrutamos profissionais de saúde de 16 unidades de CI portuguesas. Todos os participantes receberam uma introdução teórica de 30 minutos, 10 minutos de demonstração e de seguida tentaram realizar a intervenção num simulador 3D Simulheart. Por fim, foi aplicado um questionário pós-formação com foco na aparência da simulação, conteúdo da simulação e satisfação/autoeficácia. Resultados: Incluímos 56 participantes: 16 «especialistas» (cardiologistas gerais e de intervenção), 26 «novatos» (internos de cardiologia) e 14 enfermeiros e profissionais aliados. A pontuação média geral da validade de aparência foi de 4,38±0,35, e a pontuação média geral da validade de conteúdo foi de 4,69 ± 0,32, numa escala Likert de cinco pontos. Não houve diferenças estatisticamente significativas nas pontuações de «especialistas» e «novatos». Os participantes relataram um alto nível de satisfação/autoeficácia sendo que 60,7% consideraram que melhoraram fortemente as suas competências. A maioria (82,1%) «concordou» ou «concordou totalmente>» que após a simulação se sentiram confiantes para realizar o procedimento num paciente. Conclusão: O simulador 3D (SimulHeart®) apresentou excelente validade de aparência e de conteúdo. A simulação 3D pode desempenhar um papel importante nos programas formativos em cardiologia de intervenção. Mais estudos são necessários para correlacionar o desempenho no simulador com o desempenho clínico em pacientes reais.

As it is an infrequent etiology, the diagnosis of perianal tuberculosis is challenging, especially in the absence of a pulmonary focus. TB should be considered in the differential diagnosis of perianal ulcers, fistulas, abscesses, mainly in non-healing and recurrent anal lesions. Treatment with anti-TB agents can provide complete recovery. Furthermore, these lesions are often diagnosed later after complete histopathological and mycobacterial results, where the benefit of avoiding morbid multiple surgeries by effective anti-TB treatment is lost.

We report a 61-year-old male patient without personal history of thyroid carcinoma or radiation exposure. In 2011, he presented with a cervical mass whose biopsy diagnosed a papillary thyroid carcinoma (PTC) in a lymph node metastasis (LNM). Total thyroidectomy with lymphadenectomy of central and ipsilateral compartment was performed. Histopathology identified a 2 mm follicular variant of PTC and LNM in 25/25 lymph nodes. The patient was treated with 150 mCi of radioactive iodine (RAI), followed by levothyroxine suppressive therapy. In 2016, a retrotracheal mass was diagnosed, suggesting local recurrence; patient was submitted to surgical excision and RAI therapy (120 mCi). Due to seizures, in 2019, a brain CT was performed that diagnosed brain metastases. The patient underwent debulking of the main lesion. Histopathology analysis confirmed a metastatic lesion with variated morphology: classical PTC and follicular pattern and hobnail and tall cell features. Molecular analysis revealed BRAFV600E in LNM at presentation and BRAFV600E and TERT promoter (TERTp) mutations in the recurrent LNM and brain metastasis. Based upon this experience we review the reported cases of subcentimetric PTC with brain metastases and discuss the molecular progression of the present case.

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Introduction and objectives: Social media (SoMe) has a flourishing role in cardiovascular (CV) medicine as a facilitator of academic communication not only during conferences and congresses, but also by scientific societies and journals. However, there is no solid data illustrating the use of SoMe by CV healthcare professionals (CVHP) in Portugal.Hence, the main goal of this national cross-sectional survey was to accurately characterize SoMe use by Portuguese CVHPs. Methods: A 35-item questionnaire was specifically developed for this study, approved by the Digital Health Study Group of the Portuguese Society of Cardiology (SPC), and sent, by e-mail, to the mailing list of the SPC (including 1293 potential recipients). Results and conclusion: There were 206 valid answers. Fifty-two percent of respondents were female and 58% were younger than 44 years of age with almost two out of three participants being physicians. Ninety-two percent of the survey participants reported that they are currently using SoMe; LinkedIn was the most common platform used for professional purposes. Sixty-four percent believed SoMe had had a positive impact on their clinical practice; 77% and 49% had used SoMe for acquiring and sharing information related to COVID-19, respectively.In conclusion, the majority of Portuguese CVHPs that participated in this survey are actively using SoMe, with a greater participation of those

Gallstone ileus, a rare complication of cholelithiasis, is caused by an impaction of gallstones within the gastrointestinal tract leading to mechanical intestinal obstruction. Here in, we describe a case of gallstone ileus in a 62-year-old woman successfully treated with enterolithotomy. The patient was discharged home after an uneventful post-operative period. Gallstone ileus is an uncommon complication of gallstones and a rare cause of intestinal obstruction, with often delayed presentation and non-specific symptoms. The preferred approach is enterolithotomy. Elective cholecystectomy after the acute episode is controversial.

Abstract Superior mesenteric artery syndrome designates compression of the third part of the duodenum between the superior mesenteric artery and the aorta. This condition has a low incidence, being more common in thin young women. Nutcracker syndrome is compression of the left renal vein between the superior mesenteric artery and the aorta. Both entities are rare, and their coexistence has been reported in a few cases. Conservative treatment targeting weight gain is sufficient in most cases. An association between the superior mesenteric artery syndrome and acute pancreatitis has rarely been reported. We intend to describe the case of an 18-year-old girl who was admitted to the emergency room with epigastric pain and emesis. Our investigation revealed acute acalculous pancreatitis. During work-up, we discovered superior mesenteric artery syndrome and a compressed left renal vein. The patient is on conservative treatment, and her symptoms have improved.

IntroductionTactile information processing requires the integration of sensory, motor, and cognitive information. Width discrimination has been extensively studied in rodents, but not in humans.MethodsHere, we describe Electroencephalography (EEG) signals in humans performing a tactile width discrimination task. The first goal of this study was to describe changes in neural activity occurring during the discrimination and the response periods. The second goal was to relate specific changes in neural activity to the performance in the task.ResultsComparison of changes in power between two different periods of the task, corresponding to the discrimination of the tactile stimulus and the motor response, revealed the engagement of an asymmetrical network associated with fronto-temporo-parieto-occipital electrodes and across multiple frequency bands. Analysis of ratios of higher [Ratio 1: (0.5–20 Hz)/(0.5–45 Hz)] or lower frequencies [Ratio 2: (0.5–4.5 Hz)/(0.5–9 Hz)], during the discrimination period revealed that activity recorded from frontal-parietal electrodes was correlated to tactile width discrimination performance between-subjects, independently of task difficulty. Meanwhile, the dynamics in parieto-occipital electrodes were correlated to the changes in performance within-subjects (i.e., between the first and the second blocks) independently of task difficulty. In addition, analysis of information transfer, using Granger causality, further demonstrated that improvements in performance between blocks were characterized by an overall reduction in information transfer to the ipsilateral parietal electrode (P4) and an increase in information transfer to the contralateral parietal electrode (P3).DiscussionThe main finding of this study is that fronto-parietal electrodes encoded between-subjects’ performances while parieto-occipital electrodes encoded within-subjects’ performances, supporting the notion that tactile width discrimination processing is associated with a complex asymmetrical network involving fronto-parieto-occipital electrodes.

Abstract Previous research has mostly approached face recognition and target identification by focusing on face perception mechanisms, but memory mechanisms also appear to play a role. Here, we examined how the presence of a mask interferes with the memory mechanisms involved in face recognition, focusing on the dynamic interplay between encoding and recognition processes. We approach two known memory effects: (a) matching study and test conditions effects (i.e., by presenting masked and/or unmasked faces) and (b) testing expectation effects (i.e., knowing in advance that a mask could be put on or taken off). Across three experiments using a yes/no recognition paradigm, the presence of a mask was orthogonally manipulated at the study and the test phases. All data showed no evidence of matching effects. In Experiment 1, the presence of masks either at study or test impaired the correct identification of a target. But in Experiments 2 and 3, in which the presence of masks at study or test was manipulated within participants, only masks presented at test-only impaired face identification. In these conditions, test expectations led participants to use similar encoding strategies to process masked and unmasked faces. Across all studies, participants were more liberal (i.e., used a more lenient criterion) when identifying masked faces presented at the test. We discuss these results and propose that to better understand how people may identify a face wearing a mask, researchers should take into account that memory is an active process of discrimination, in which expectations regarding test conditions may induce an encoding strategy that enables overcoming perceptual deficits.

Objectives In ST-segment elevation myocardial infarction (STEMI), time delay between symptom onset and treatment is critical to improve outcome. The expected transport delay between patient location and percutaneous coronary intervention (PCI) centre is paramount for choosing the adequate reperfusion therapy. The “Centro” region of Portugal has heterogeneity in PCI assess due to geographical reasons. We aimed to explore time delays between regions using process mining tools. Methods Retrospective observational analysis of patients with STEMI from the Portuguese Registry of Acute Coronary Syndromes. We collected information on geographical area of symptom onset, reperfusion option, and in-hospital mortality. We built a national and a regional patient's flow models by using a process mining methodology based on parallel activity-based log inference algorithm. Results Totally, 8956 patients (75% male, 48% from 51 to 70 years) were included in the national model. Most patients (73%) had primary PCI, with the median time between admission and treatment

A 61-year-old man was diagnosed with an exudative pleural effusion with raised amylase and bilirubin levels. The patient had no previous history of acute pancreatitis or trauma and no clinical or radiological signs of chronic pancreatitis. On thoracoabdominal computed tomography, a pancreatic pseudocyst with a pancreaticopleural fistula was identified. Endoscopic retrograde cholangiopancreatography identified a ductal disruption site in the body of the pancreas. Pancreatic sphincterotomy and stent placement in the duct of Wirsung, combined with medical management, allowed fistula closure, pseudocyst reabsorption, and no relapse of the pleural effusion. The relevance of this case lies not only in its rarity but also as it highlights the importance of a multidisciplinary approach in such uncommon conditions. Optimal management of this condition is debatable due to the absence of prospective studies comparing medical, endoscopic, and surgical approaches.

Atrial fibrillation (AF) is a common cardiac arrhythmia characterized by irregular and rapid electrical activity in the atria, leading to ineffective contraction and poor blood flow. More than 90% of the left atrial (LA) thrombi that cause thromboembolic events during atrial fibrillation (AF) develop in the left atrial appendage (LAA). AF modifies the hemodynamics of the left atrium, which can result in thrombosis of the LAA, systemic embolism, and stroke. The current options to reduce thromboembolic events are oral anticoagulation, surgical LAA exclusion, or percutaneous LAA occlusion. However, the mechanism underlying thrombus development in the LAA remains poorly understood. Computational fluid dynamics (CFD) analysis can be used to better understand the risk of thrombus formation and subsequent embolic events. CFD enables the simulation and visualization of blood flow patterns within the heart, including complex structures such as the LAA. Using CFD, researchers can analyze the hemodynamics of blood flow, identify areas of stagnation or turbulence, and predict the risk of thrombus formation. The correlation between blood flow dynamics, atrial fibrillation, and the risk of stroke has been highlighted by CFD studies investigating the underlying mechanism of thrombus formation in the LAA. This review study intends to provide a comprehensive overview of the factors involved in thrombus formation and their implications for clinical practice by synthesizing the insights acquired from these CFD studies.

The lipid composition of the brain is well regulated during development, and the specific temporospatial distribution of various lipid species is essential for the development of optimal neural functions. Dietary lipids are the main source of brain lipids and thus contribute to the brain lipidome. Human milk is the only source of a dietary lipids for exclusively breastfed infant. Notably, it contains milk fat globule membrane (MFGM) enriched in polar lipids (PL). While early life is a key for early brain development, the interplay between dietary intake of polar lipids and spatial dynamics of lipid distribution during brain development is poorly understood. Here, we carried out an exploratory study to assess the early postnatal temporal profiling of brain lipidome between postnatal day (PND) 7 and PND 50 using matrix-assisted laser desorption ionization as a mass spectrometry imaging (MALDI-MSI) in an in vivo preclinical model. We also assessed the effect of chronic supplementation with PL extracted from alpha-lactalbumin-enriched whey protein concentrate (WPC) containing 10% lipids, including major lipid classes found in the brain (37% phospholipids and 15% sphingomyelin). MALDI-MSI of the spatial and temporal accretion of lipid species during brain development showed that the brain lipidome is changing heterogeneously along time during brain development. In addition, increases in 400+ PL supplement-dependent lipids were observed. PL supplementation had significant spatial and temporal effect on specific fatty esters, glycerophosphocholines, glycerophosphoethanolamines, and phosphosphingolipids. Interestingly, the average levels of these lipids per brain area tended to be constant in various brain structures across the age groups, paralleling the general brain growth. In contrast, other lipids, such as cytidine diphosphate diacylglycerol, diacylglycerophosphates, phosphocholines, specific ether-phosphoethanolamines, phosphosphingolipids, glycerophosphoinositols, and glycerophosphoserines showed clear age-dependent changes uncoupled from the general brain growth. These results suggest that the dietary PL supplementation may preferentially provide the building blocks for the general brain growth during development. Our findings add to the understanding of brain-nutrient relations, their temporospatial dynamics, and potential impact on neurodevelopment.

The number and complexity of percutaneous interventions for the treatment of structural heart disease has increased in clinical practice in parallel with the development of new imaging technologies, in order to render these interventions safer and more accurate. Complementary imaging modalities are commonly used, but they require additional mental reconstruction and effort by the interventional team.The concept of fusion imaging, where two different modalities are fused in real time and on a single monitor, aims to solve these limitations. This is an important tool to guide percutaneous interventions, enabling a good visualization of catheters, guidewires and devices employed, with enhanced spatial resolution and anatomical definition. It also allows the marking of anatomical reference points of interest for the procedure.Some studies show decreased procedural time and total radiation dose with fusion imaging; however, there is a need to obtain data with more robust scientific methodology to assess the impact of this technology in clinical practice.The aim of this review is to describe the concept and basic principles of fusion imaging, its main clinical applications and some considerations about the promising future of this imaging technology. Resumo: O número e a complexidade das intervenções percutâneas no tratamento de doenças cardíacas estruturais têm vindo a aumentar na prática clínica, estando associado ao desenvolvimento de novas tecnologias de imagem para intervenções mais precisas e seguras. Modalidades de imagem complementares são comumente utilizadas, contudo exigem um esforço de reconstrução mental por parte da equipa de intervenção.O conceito de imagem de fusão, onde duas modalidades de imagem são fundidas em tempo real e num só monitor, vem colmatar essas limitações. Esta é uma importante ferramenta para a monitoração das intervenções percutâneas pela associação da correta visualização dos cateteres, fios-guia e dispositivos utilizados a uma melhor resolução espacial e definição anatómica. Permite também a marcação de pontos de referência com interesse anatómico para o procedimento.Alguns estudos revelam a diminuição da duração de procedimento e da dose total de radiação; contudo, persiste a necessidade de obtenção de dados com metodologia científica mais robusta para aferir o impacto desta tecnologia na prática clínica.Esta revisão pretende abordar o conceito e os princípios básicos da imagem de fusão, as suas principais aplicações clínicas, bem como algumas considerações acerca do futuro promissor desta tecnologia de imagem.

Abstract Background A key strategy for the primary prevention of cardiovascular disease (CVD) is the use of risk prediction algorithms. We aimed to investigate the predictive ability of SCORE (Systematic COronary Risk Estimation) and PCE (Pooled Cohort Equations) systems for atherosclerotic CVD (ASCVD) risk in Portugal, a low CVD risk country, at the 10-year landmark and at a longer, 15-year follow-up. Methods The SCORE and PCE 10-year risk estimates were calculated for 455 and 448 patients, respectively. Discrimination was assessed by Harrell’s C-statistic. Calibration was analyzed by standardized incidence ratios (SIR). Results During the 10-year follow-up, 7 fatal ASCVD events (the SCORE outcome) and 32 any ASCVD events (the PCE outcome) occurred. The SCORE system showed good discrimination (C-statistic 0.83), while the PCE showed poor discrimination (C-statistic 0.62). Calibration was similar for both systems, according to SIR: SCORE, 0.3 (95% CI 0.1–0.7); PCE, 0.5 (95% CI 0.4–0.7). Globally, both 10-year fatal ASCVD risk and any ASCVD risk were overestimated in the overall population and men. However, the risk was underestimated by both systems in women. Despite an overestimation of 15-year fatal ASCVD by SCORE, the 15-year any ASCVD observed incidence was 1.8 times the 10-year incidence among men and 1.4 times among women. This acceleration of CVD risk was more relevant in the lowest classes of ASCVD risk. Conclusion In this prospective, contemporary, Portuguese cohort, the SCORE had better discriminatory power and similar calibration compared to PCE. However, both risk scores underestimated 10-year ASCVD risk in women.

Introduction and Aims: Cardiac allograft vasculopathy (CAV) is one of the most significant complications after orthotopic heart transplantation. We aimed to investigate the incidence and predictors of CAV in a large cohort of orthotopic heart transplantation patients. Methods: We conducted a retrospective analysis on a prospective cohort of 233 patients who underwent transplantation between November 2003 and May 2014. Baseline clinical data and invasive coronary angiograms (n=712) performed as part of the follow-up program were analyzed by two independent investigators. Results: We included 157 male and 45 female patients with a median age of 66 years. A third of patients had previous ischemic heart disease, 30% peripheral arterial disease, 37% hypertension and 47% dyslipidemia, and 17% were smokers. Acute moderate or severe rejection occurred in 42 patients during the first year. Over a median follow-up of 2920 days, 18% were diagnosed with CAV, with an incidence of 2.91 cases per 100 person-years. Predictors of CAV were previous ischemic heart disease (HR 2.32, 95% CI 1.21-4.45, p=0.01), carotid artery disease (HR 2.44, 95% CI 1.27-4.71, p

Early life nutrition critically impacts post-natal brain maturation and cognitive development. Post-natal dietary deficits in specific nutrients, such as lipids, minerals or vitamins are associated with brain maturation and cognitive impairments. Specifically, polar lipids (PL), such as sphingolipids and phospholipids, are important cellular membrane building blocks and are critical for brain connectivity due to their role in neurite outgrowth, synaptic formation, and myelination. In this preclinical study, we assessed the effects of a chronic supplementation with a source of PL extracted from an alpha-lactalbumin enriched whey protein containing 10% lipids from early life (post-natal day (PND) 7) to adulthood (PND 72) on adult motor skills, anxiety, and long-term memory. The motor skills were assessed using open field and rotarod test. Anxiety was assessed using elevated plus maze (EPM). Long-term object and spatial memory were assessed using novel object recognition (NOR) and Morris water maze (MWM). Our results suggest that chronic PL supplementation improved measures of spatial long-term memory accuracy and cognitive flexibility in the MWM in adulthood, with no change in general mobility, anxiety and exploratory behavior. Our results indicate memory specific functional benefits of long-term dietary PL during post-natal brain development.

Background: The urgent need for mechanical ventilators to support respiratory insufficiency due to SARS-CoV-2 led to a worldwide effort to develop low-cost, easily assembled, and locally manufactured ventilators. The ATENA ventilator project was developed in a community-based approach targeting the development, prototyping, testing, and decentralized manufacturing of a new mechanical ventilator.Objective: This article aims to demonstrate ATENA's adequate performance and safety for clinical use.Material: ATENA is a low-cost ventilator that can be rapidly manufactured, easily assembled, and locally produced anywhere in the world. It was developed following the guidelines and requirements provided by European and International Regulatory Authorities (MHRA, ISO 86201) and National Authorities (INFARMED). The device was thoroughly tested using laboratory lung simulators and animal models.Results: The device meets all the regulatory requirements for pandemic ventilators. Additionally, the pre-clinical experiences demonstrated security and adequate ventilation and oxygenation, in vivo.Conclusion: The ATENA ventilator had a good performance in required tests in laboratory scenarios and pre-clinical studies. In a pandemic context, ATENA is perfectly suited for safely treating patients in need of mechanical ventilation.

As obras subterrâneas encontram-se associadas aos aproveitamentos hidroelétricos nos seus elementos principais: na barragem, contribuindo na satisfação das exigências de comportamento estrutural e hidráulico-operacional, e na central e circuito hidráulico, como elementos fundamentais do sistema hidráulico que possibilita a produção de energia. Neste artigo, são focadas obras subterrâneas realizadas, ao longo de um século, nos grandes aproveitamentos hidroelétricos de Portugal, dando-se destaque às obras consideradas mais relevantes pelo seu layout ou pelas suas características específicas. Nas obras mais recentes, é dada relevância a aspetos relacionados com análises numéricas, segurança, monitorização estrutural e ambiental, estratégias e métodos construtivos.

Introduction. Splenic artery aneurisms (SAA) are the third most common aneurysms, with reported incidences up to 10.4%. There is a higher prevalence in women, and most are incidental findings on imaging studies. Symptomatic or SAA larger than 20 mm and aneurysms in pregnant or in women of childbearing age are indications for surgery, because of the increased risk of rupture. Treatment options include endovascular, laparoscopic, and open surgical approaches. Presentation of Case. A 50-year-old female patient with nonspecific abdominal pain performed a computed tomography scan and angiography, which revealed a 24×20×19 mm SAA. After a multidisciplinary discussion, selective laparoscopic excision of the aneurysm was performed, with spleen preservation. Perioperative course was uneventful, and the patient remained asymptomatic. Discussion. A multidisciplinary discussion is of major importance in guaranteeing the optimal treatment for any given visceral aneurysm. Not all SAA are amenable to endovascular treatment, and laparoscopic surgery has mostly replaced open procedures. Laparoscopic ligation and resection of the SAA with splenic preservation offers permanent treatment, with a low morbidity and short hospital stay. Conclusion. Selective laparoscopic aneurysm resection is a safe and effective approach, with good short- and long-term results, allowing permanent treatment of SAA while maintaining splenic function.

Dislocation of the pisiform is a rare injury, with only few cases reported in the literature. This condition, in association with terrible triad injury of the elbow, is an even more rare occurrence. We report a case of a 51-years-old right-handed female patient who suffered from a dislocation of the left pisiform in association with terrible triad injury of the elbow, after a ground level fall. It was performed a reinsertion of the coronoid process and radial collateral ligaments with anchors, radial head arthroplasty, and closed reduction and internal fixation of the pisiform with Kirschner wire. At the end of follow-up, the patient had satisfactory range of movement of the wrist and elbow, and no residual pain. This rare injury to the wrist is demanding in diagnostics and treatment. However, with a correct diagnosis and appropriate treatment, an excellent clinical outcome can be achieved.

Introduction: Virtual reality simulation is a topic of discussion as a complementary tool to traditional laparoscopic surgical training in the operating room. However, it is unclear whether virtual reality training can have an impact on the surgical performance of advanced laparoscopic procedures. Our objective was to assess the ability of the virtual reality simulator LAP Mentor to identify and quantify changes in surgical performance indicators, after LAP Mentor training for digestive anastomosis. Material and Methods: Twelve surgeons from Centro Hospitalar de São João in Porto (Portugal) performed two sessions of advanced task 5: anastomosis in LAP Mentor, before and after completing the tutorial, and were evaluated on 34 surgical performance indicators. Results: The results show that six surgical performance indicators significantly changed after LAP Mentor training. The surgeons performed the task significantly faster as the median ‘total time’ significantly reduced (p < 0.05) from 759.5 to 523.5 seconds. Significant decreases (p < 0.05) were also found in median ‘total needle loading time’ (303.3 to 107.8 seconds), ‘average needle loading time’ (38.5 to 31.0 seconds), ‘number of passages in which the needle passed precisely through the entrance dots’ (2.5 to 1.0), ‘time the needle was held outside the visible field’ (20.9 to 2.4 seconds), and ‘total time the needle-holders’ ends are kept outside the predefined operative field’ (88.2 to 49.6 seconds). Discussion: This study raises the possibility of using virtual reality training simulation as a benchmark tool to assess the surgical performance of Portuguese surgeons. Conclusion: LAP Mentor is able to identify variations in surgical performance indicators of digestive anastomosis.

RESUMO: A neoplasia da próstata na sua forma avançada tem geralmente metastização óssea ou para gânglios pélvicos. O envolvimento de gânglios supraclaviculares é raro (0,4-1% de todos os casos) [1] e a sua apresentação como adenopatia supraclavicular é ainda mais rara, com apenas alguns casos descritos na literatura [2,3]. Neste contexto, apresentamos o caso de um homem de 62 anos, saudável, com tumefação de novo na fossa supraclavicular esquerda, sem sintomas associados. Após a investigação estabeleceu-se o diagnóstico de adenocarcinoma da próstata em fase avançada, com metastização disseminada. Alertamos para uma forma rara de apresentação de adenocarcinoma da próstata e discutimos a abordagem diagnóstica em casos de adenopatias isoladas. ABSTRACT: Prostate cancer in its advanced form usually metastasizes to the bone or pelvic ganglia. The involvement of the supraclavicular lymph nodes is rare (0.4% to 1% of all cases)1. Its presentation as a supraclavicular lymphadenopathy is even more unusual with only a few cases described in the literature2-7. In this context, we describe the case of a 62 year old man presenting with a left supraclavicular mass without any other signs or associated symptoms. After all the workup, we established the diagnosis of widely metastasized prostate adenocarcinoma. We bring forward this case as an example of a rare form of presentation of prostate cancer and we use it as a base for discussing an approach to isolated peripheral lymphadenopathy.

Games have long been considered as a means to support effective learning, motivate learners and accelerate their learning. Several successful studies using game-based learning are reported in the literature. However, there appears to be a research gap on systematically evaluating accelerated learning in game environments. The main research question we address in this paper is how can we evaluate accelerated learning in game-based learning environments? The main contribution of this paper will be a framework for evaluating accelerated learning in games (ALF). We will illustrate the use of this framework by describing studies conducted in the Norwegian industrial project ALTT (Accelerate Learning Through Technology), aimed at capacity building in the aluminium industry, where we have co-designed a game for accelerating learning about the electrolysis process for extracting aluminium and heat balance in the aluminium production cells.

Designing games for learning in the workplace is challenging in many ways. Within the process industry, the aluminium production cells are harsh environments that are difficult to instrument and pose domain related challenges, which make effective training difficult to achieve. In particular, cognitive challenges arise due to the slow nature of the physical process that disconnects the operators' actions and causality. The complex chemical process demands a high level of understanding of the parameters and their complex interdependencies. Additional challenges are related to representing an appropriate level of detail and precision of the workplace, including integration with existing tools. This paper describes the digital simulation game designed and developed for the operators in aluminium plants to master the cognitive skills required for Heat Balance in the aluminium production cells. A co-design process was adopted from the initial inception of the idea, development and evaluation. The paper will discuss and present the co-creation artefacts used, namely a paper prototype, hybrid prototype of the game along with the output from iterative development cycles. This work is conducted within the research and innovation project, Accelerated Learning for Technology Transfer, with the Norwegian company Hydro.

Background. The apolipoprotein E (APOE) polymorphisms are associated with cardiovascular (CV) disease, but its interaction with type 2 diabetes mellitus (T2DM) long-term incidence is unknown. We investigated the association between APOE genotype and long-term (i) CV events and (ii) T2DM incidence in a Southern European primary prevention cohort. Methods. We assessed individual APOE genotypes in a total of 436 patients followed at a lipid clinic, with a 15-year median follow-up time. We collected data on major CV events (CV death, myocardial infarction, and stroke) and T2DM development. Results. No differences were found regarding major CV event incidence among the different APOE genotypes. However, after excluding 39 patients with a prior history of T2DM, APOE2 carriers displayed a higher incidence of T2DM during follow-up (42.2%) than APOE3 (27.1%) and APOE4 (28.7%) carriers. The age-, sex-, triglycerides-, and statin usage-adjusted OR for T2DM incidence in APOE2 carriers was 1.8 (95%CI 1.1-2.9, p=0.03), compared with wild-type APOE3. To address the role of statins as a confounder, we analyzed T2DM incidence in statin-treated patients. Statin-treated APOE2 carriers also had a higher T2DM incidence (57.9%), in comparison with APOE3 homozygotes (31.6%) and APOE4 carriers (32.5%). After adjustment for confounding, APOE2 carriers on statins displayed a similar twofold increase in T2DM risk compared to APOE3 homozygotes (OR 2.1, 95%CI 1.1-4.0, p=0.03). Conclusion. Our findings suggest a twofold increase in T2DM incidence in APOE2 carriers. This may prompt for a specific glucose dysmetabolism follow-up that might be tailored on the APOE genotype.

Smart Cities have often been associated with an extensive ICT infrastructure supporting citizens to learn. A Human Smart City focuses on its citizens and the human infrastructure they create being key actors of city making processes with a special attention on service design, development and delivery. A Human Smart City leverages technology to enhance citizen engagement and social innovation, thus activating learning processes driven by the experimental nature of smart solutions’ design process. In this paper, we describe the case of MyNeighbourhood, an European project centred on the concept of Human Smart Cities and aimed at engaging neighbourhoods within four pilot cities. Four European municipalities engaged with their citizens to co-design services and foster a sense of identity and ownership in their neighbourhoods. The project focussed on sharing experiences across the neighbourhoods and the pilots with the aim of learning from each other. The experiences from this project show learning processes at different levels: individuals, groups and, in some cases, institutional. The focus of this paper is on neighbourhoods and cities that learn and innovate and on the opportunities and implications for cities.

The field of three-dimensional printing applied to patient-specific simulation is evolving as a tool to enhance intervention results. We report the first case of a fully simulated percutaneous coronary intervention in a three-dimensional patient-specific model to guide treatment.An 85-year-old female presented with symptomatic in-stent restenosis in the ostial circumflex and was scheduled for percutaneous coronary intervention. Considering the complexity of the anatomy, patient setting and intervention technique, we elected to replicate the coronary anatomy using a three-dimensional model. In this way, we simulated the intervention procedure beforehand in the catheterization laboratory using standard materials. The procedure was guided by optical coherence tomography, with pre-dilatation of the lesion, implantation of a single drug-eluting stent in the ostial circumflex and kissing balloon inflation to the left anterior descending artery and circumflex. Procedural steps were replicated in the real patient's treatment, with remarkable parallelism in angiographic outcome and luminal gain at intracoronary imaging.In this proof-of-concept report, we show that patient-specific simulation is feasible to guide the treatment strategy of complex coronary artery disease. It enables the surgical team to plan and practice the procedure beforehand, and possibly predict complications and gain confidence. Resumo: O campo da impressão tridimensional aplicado à simulação específica de doente está a evoluir como uma ferramenta para aperfeiçoar os resultados das intervenções terapêuticas. Pretendemos descrever o primeiro caso de simulação completa de intervenção coronária percutânea, num modelo tridimensional específico de doente, para guiar o procedimento.Uma doente de 85 anos com reestenose intra-stent sintomática no óstio da artéria circunflexa foi referenciada para intervenção coronária percutânea. Considerando a complexidade da anatomia, o contexto clínico e a técnica de intervenção, decidimos reproduzir a anatomia coronária com o uso de um modelo tridimensional. Desse modo, simulámos antecipadamente a intervenção no laboratório de hemodinâmica com material habitual. O procedimento foi guiado por tomografia de coerência óptica, com pré-dilatação da lesão, implantação de um stent farmacoativo na circunflexa ostial e insuflação kissing balloon na descendente anterior e circunflexa. As etapas do procedimento foram reproduzidas no tratamento real, com um paralelismo notável nos resultados angiográficos e ganho luminal avaliado por imagem intracoronária.Com esta prova de conceito, demonstramos que a simulação específica de doente é exequível para guiar a estratégia de tratamento de doença coronária complexa, possibilitando o planeamento antecipado do procedimento, possivelmente prevendo complicações e adquirindo mais confiança. Keywords: 3D printing, Percutaneous coronary intervention, Simulation training, Palavras-chave: Impressão 3D, Intervenção coronária percutânea, Treino em simulação

Extra-articular, transverse, distal phalangeal fractures that involve the physis, are termed Seymour fractures. They are frequently associated with an avulsion of the nail and a laceration of the nail bed. For this type of fractures, sur-gical intervention is needed to explore the fracture site for soft tissue interposition. Its failure may result in several complications. The authors report an adult Seymour-type fracture, which developed an infection due to interposition of the germinal matrix of the nail complex on the fracture site. The purposes of this article are to demonstrate that this rare fracture can also occur in adults, highlight the importance of treating this injury with the basic principles of open fracture treatment, and evidence one of its complications if not well treated.

Introduction – Aging can be related with autonomy loss and decline of individual’s functional capacity impairing everyday chores execution leading to repercussions in life quality. Purpose – Review of the current literature available regarding the repercussions of aging on the binocular and attentional Visual Field and the influence of the binocular visual field in the elderly, regarding reading, writing and walking. Methodology – This study is a meta-analysis, based in a review of the contents of 37 scientific articles, which were subsequently organized in an observation grid and a comparative chart. Outcomes – In 32.43% (n=12) of the articles authors state that it is possible that aging diminishes the extension of the binocular and attentional visual field. Repercussions of the decrease of the binocular visual field extension, without attentional factor on daily activities, are referred in 54.05% (n=20) of the articles. Among those, 40.53% (n=15) established a relationship between the binocular visual field and the performance in reading, writing or walking. In 45.95% (n=17) of the articles the authors related binocular visual field with attentional factor and in 10.81% (n=4) of them established the same connection. Discussion/Findings – Aging causes a decrease in the visual field, particularly in the peripheral vision. This decrease impacts in reading, writing and walking capacities, which can be greatly affected in the presence of a diminished visual attention.

Aims – The convergence insufficiency (CI) interferes with the ability to perform near activities. This study aims to investigate visual attention deficits in higher education students with CI. Methods – A cross-sectional study was developed. Forty-four students (n=44), from ESTeSL, with ages between 18 and 24 years old participated. The students were distributed in two groups, one with Normal Binocular Vision (NBV) and the other with CI. In CI group were included students with reduced: near point of convergence (NPC) and/or near fusional amplitude of convergence (C’). The bells cancellation test was used to evaluate visual attention. Results – Thirty-two students (n=32) were included in the NBV group (23 females and 9 males) and 12 were included in the CI group (11 females and 1 male). The average number of identified bells for the visual attention test was 34.6 for the NBV group and 34.3 for the CI group. The average time to complete the test was 167,9s and 198,3s for the NBV and CI groups respectively. A mild positive correlation between the NPC and the average time was found (r≈0.63). A weak positive correlation between the average number of identified bells and C’ (r≈0.16) was observed. On the other hand, weak negative correlations were found between the NPC and the average number of identified bells (r≈-0.48) and between the average time and C’ (r≈-0.05). Discussion/Conclusion – The NBV group presents a higher average of identified bells than the CI. The students from the CI group took more time to complete the test when compared to the NBV group. These results point to a possible decreasing of visual attention induced by CI.

Aim: To test the hypothesis that shading of the fruiting zone of the plants might reduce yield losses caused by excessive exposure to sun while avoiding the most damaging effects associated with reduced radiation. Methods and results: A number of grapevine rows were shaded with a double layered white plastic netting on their south-facing side, from the ground to about 20 cm above the cluster zone. Data on meteorological conditions, plant growth, plant water availability, yield components and must characteristics were recorded during three growing seasons. Shading significantly increased yield but did not alter significantly the must characteristics. Conclusion: Partial shading of the grapevine canopy reduced yield losses attributable to excessive radiation. The must obtained from shaded berries had a lower concentration of anthocyanins, and the wines made from these musts had a lighter colour which may be detrimental to their quality. Significance and impact of the study: The study highlights the effects of solar radiation on the composition of grape musts and suggests a potentially cost-effective method to control excessive radiation in vineyards.

Studer's neobladder lithiasis is a rare but important long term complication of this orthotopic bladder substitute technique. We report a case of a 45 year-old male patient, submitted to a radical cystoprostatectomy with a Studer's orthotopic neobladder 4 years before, presenting bad compliance to recommended urinary habits, increased production of mucus and high post voiding residue. CT scan and urethrocystography showed a distended pouch with 2 major sacculations with narrow communication and a stone in each sacculation. A minimally invasive endoscopic technique was successfully used in the treatment of the 2 small calculus.

Spatial information on vineyard soil properties can be useful in precision viticulture. In this paper a combination of high resolution soil spatial information of soil electrical resistivity (ER) and ancillary topographic attributes, such as elevation and slope, were integrated to assess the spatial variability patterns of vegetative growth and yield of a commercial vineyard (Vitis vinifera L. cv. Tempranillo) located in the wine-producing region of La Rioja, Spain. High resolution continuous geoelectrical mapping was accomplished by an Automatic Resistivity Profiler (ARP) on-the-go sensor with an on-board GPS system; rolling electrodes enabled ER to be measured for a depth of investigation approximately up to 0.5, 1 and 2 m. Regression analysis and cluster analysis algorithm were used to jointly process soil resistivity data, landscape attributes and grapevine variables. ER showed a structured variability that matched well with trunk circumference spatial pattern and yield. Based on resistivity and a simple terrain attribute uniform management units were delineated. Once a spatial relationship to target variables is found, the integration of point measurement with continuous soil resistivity mapping is a useful technique to identify within-plots areas of vineyard with similar status.

In the present study, we used a preclinical model of induced lipolytic enzyme insufficiency, and hypothesized that the use of monoacylglycerols (MAG) will enhance their bioavailability and delivery to the tissues. Experimental diets containing 20% lipids were fed to rats for 21 days with or without Orlistat. The control diet of fish oil (FO), a source of EPA and DHA, was tested against: structured (A) vanillin acetal of sn-2 MAG (Vanil + O) and (B) diacetyl derivative of sn-2 MAG (Acetyl + O) and (C) free MAG (MAG + O). FA profiles with an emphasis on EPA and DHA levels were determined in plasma, red blood cells (RBC), liver, spleen, brain and retina. We observed significant reduction of lipid absorption when rats co-consumed Orlistat. As expected, the FO groups with and without Orlistat showed the biggest difference. The Vanil + O, Acetyl + O and MAG + O groups, demonstrated higher levels of EPA (5.5 ± 1.9, 4.6 ± 1.6 and 5.6 ± 0.6, respectively) in RBC compared with FO + O diets (3.3 ± 0.2, 2.6 ± 0.2). Levels of EPA incorporation, in plasma, were similar to those obtained for RBC, and similar trends were observed for the collected tissues and even with DHA levels. These observations with two MAG derivatives providing the fatty acid esterified in the sn-2 position, show that these molecules are efficient vehicles of EPA in malabsorption conditions which is in line with our hypothesis. Free MAG, characterized as having exclusively sn-1(3) isomers of EPA, demonstrated better absorption efficiencies and accretion to tissues when compared to structured MAG. The study demonstrated that structured and free MAG can be used efficiently as an enteral vehicle to supply bioactive fatty acids such as EPA and DHA in lipid malabsorption where diminished lipolytic activity is the underlying cause.

Aims: An experiment was set up to evaluate the visual assessment of « shoot tip stage » as a method to estimate the water status of vineyards and its utility in vineyard management. The specific objectives were (1) determining the functional relationship of shoot tip stage (S) with leaf water potential (Ψl) at solar noon, a more traditional method for evaluating vine water stress, and (2) testing its performance and simplicity in field conditions. Materials and results: A field study was first conducted in 2009 in a vineyard located in the La Rioja wine producing region (Spain). Ψl and S measurements were performed at four different phenological stages and the data were collected in a completely randomized design. The relationship between the two parameters was established by multiple linear regression analyses and was validated with data collected in another vineyard during the next year. Conclusion: The calculated shoot tip stage can be used reliably to estimate vineyard water status and to manage vineyard irrigation. Significance and impact of the study: The shoot tip method is fast and non-destructive, it does not require any special skill or equipment, it is independent of weather conditions, and the calculations are simple.

Introdução: A satisfação com a profissão médica tem sido apontada como um fator essencial para a qualidade assistencial, o bemestar dos doentes e a estabilidade dos sistemas de saúde. Estudos recentes têm vindo a enfatizar um crescente descontentamento dos médicos, principalmente como consequência das alterações das relações laborais. Objetivos: Avaliar a perceção dos médicos de formação específica em Portugal, sobre as expectativas e grau de satisfação com a profissão, especialidade e local de formação; razões da insatisfação e intenção de emigrar. Material e Métodos: Estudo transversal. A colheita de dados foi efetuada entre Maio e Agosto de 2014 através de um Inquérito online sobre a “Satisfação com a Especialidade”. Resultados: De uma população total de 5788 médicos, foram obtidas 804 respostas (12,25% do total de médicos internos). Desta amostra, 77% das respostas correspondem a internos dos três primeiros anos de formação. Verificou-se que 90% dos médicos se encontram satisfeitos com a especialidade, tendo-se encontrado também níveis elevados de satisfação com a profissão (85%) e local de formação (86%). Por outro lado, constatou-se que estes diminuíam com a progressão ao longo dos anos de internato. A avaliação global sobre o panorama da prática médica foi negativa e 65% dos médicos responderam que consideram emigrar após conclusão do internato. Conclusão: Os médicos internos em Portugal apresentam níveis positivos de satisfação com a sua profissão. No entanto, a sua opinião sobre o panorama da Medicina e os resultados relativos à intenção de emigrar alertam para a necessidade de tomada de medidas para inverter este cenário.

Introdução – A insuficiência de convergência (IC) pode desencadear alterações da atenção visual. Pretende-se investigar se existem alterações na atenção visual em estudantes do ensino superior com IC. Metodologia – Estudo quantitativo, comparativo e correlacional. Participaram 44 estudantes com idades compreendidas entre os 18 e os 24 anos. Formaram-se dois grupos, um com Visão Binocular Normal (VBN) e outro com IC. O grupo com IC incluiu os indivíduos que apresentaram alterações no ponto próximo de convergência (PPC) e/ou na convergência para perto (C’). Para avaliar a atenção visual utilizou-se o teste de cancelamento de sinos. Resultados – O grupo com VBN foi composto por 32 indivíduos (23 do género feminino) e o grupo com IC por 12 indivíduos (11 do género feminino). No teste de atenção visual verificou-se que o número médio de sinos identificados foi de 34,6 para o grupo com VBN e de 34,3 no grupo com IC. O tempo médio de realização do teste foi de 167,9s e de 198,3s para os grupos de VBN e IC, respetivamente. Observou-se uma correlação moderada positiva entre o PPC e o tempo médio de realização do teste (r≈0,63) e uma correlação fraca positiva entre o número médio de sinos identificados e a C’ (r≈0,16). Por outro lado, a correlação entre o PPC e o número médio de sinos identificados (r≈-0,48) foi fraca negativa e entre a C’ e o tempo médio (r≈-0,05) foi ínfima negativa. Discussão/Conclusões – O grupo com VBN apresenta um número médio de sinos identificados superior ao grupo com IC. Verifica-se ainda que o grupo com IC demorou mais tempo na realização do teste, comparativamente com o grupo com VBN. Estes resultados apontam para uma possível relação entre a IC e a diminuição da atenção visual.

Introdução – O envelhecimento pode estar relacionado com a perda de autonomia e declínio da capacidade funcional dos indivíduos, o que tende a comprometer a execução de tarefas do quotidiano e consequentemente leva a repercussões na qualidade de vida, afetando-a de forma negativa. Objetivos – Rever a bibliografia atualmente disponível no que respeita às repercussões do envelhecimento no campo visual binocular e atencional e à influência do campo visual binocular na leitura, escrita e marcha/locomoção em idosos. Metodologia – Este estudo é uma revisão de literatura. Procedeu-se à análise de 37 artigos científicos, que posteriormente foram organizados numa grelha de observação e numa tabela comparativa. Resultados – Dos artigos analisados, 32,43% (n=12) apontam para uma diminuição da extensão do campo visual binocular e atencional relacionada com o envelhecimento. Repercussões da diminuição da extensão do campo visual binocular sem fator atencional nas atividades quotidianas são referidas em 54,05% (n=20) dos artigos. Neste grupo de artigos 40,53% (n=15) apontam para a existência de uma relação entre o campo visual binocular com o desempenho na leitura, escrita ou marcha/locomoção. Do total de artigos analisados, dos 45,95% (n=17) que descrevem o campo visual binocular com fator atencional, 10,81% (n=4) apontam para a mesma relação. Discussão/Conclusões – O envelhecimento provoca um decréscimo no campo visual binocular, sendo este mais acentuado na periferia. Este decréscimo, na presença de uma atenção visual diminuída, influencia o desempenho na leitura, escrita e marcha/locomoção.

Introdução: As manobras de controlo vascular hepático utilizadas durante cirurgia de fígado estão normalmente associadas a lesão de isquemia-reperfusão, que pode resultar em disfunção renal aguda. O modelo murino tem sido utilizado para estudo desta lesão. Os hidroxietilamidos têm reconhecidas propriedades anti-inflamatórias e melhoram a microcirculação. Os de terceira geração, nomeadamente o 130/0.4, têm melhor perfil de segurança que hidroxietilamidos anteriores. Objetivos: Avaliação da lesão renal em modelo murino de lesão de isquemia-reperfusão hepática parcial normotérmica e investigação do efeito do hidroxietilamido 130/0.4 nessa lesão. Métodos: Distribuíram-se aleatoriamente 72 ratos Wistar do sexo masculino por seis grupos de características idênticas (n = 12 x 6). Em três deles, os de isquemia-reperfusão, clampou-se o pedículo vascular dos lobos hepáticos esquerdo e mediano, induzindo isquemia parcial (70%), e removeu-se o clampe 60 minutos depois (grupos IR + HEA e IR + SH, com administração de hidroxietilamido ou soro fisiológico hipertónico (7,5%) no momento da reperfusão, respetivamente, e grupo IR, sem fluidoterapia). Os grupos de controlo foram operados e tratados segundo o mesmo protocolo, mas sem indução de isquemia (sham + HEA, sham + SH e sham). Após 120 minutos de reperfusão nos grupos de isquemia-reperfusão e 180 minutos de cirurgia nos grupos de controlo colheu-se sangue da artéria aorta para doseamento de creatinina, ureia e alanina aminotransferase e retiraram-se amostras renais e hepáticas para análise histopatológica. Resultados: Como já publicado pelo nosso grupo, o modelo de lesão de isquemia-reperfusão hepática parcial apresentou lesão hepática. No presente trabalho, o grupo IR teve concentrações médias de creatinina, ureia e score histopatológico superiores ao grupo sham (p < 0,05). A creatininémia e uremia foram significativamente inferiores tanto no grupo IR + HEA (23,08 μmol/L e 8,38 mmol/L, respetivamente) como no grupo IR + SH (26,59 μmol/L e 7,82 mmol/L) relativamente ao grupo IR (40,101 μmol/L e 11,25 mmol/L). Não se encontrou diferença significativa entre os grupos IR + HEA e IR + SH (marcadores séricos e histopatologia). Conclusões: O modelo de lesão de isquemia-reperfusão hepática foi eficaz na produção de lesão renal. Tanto o hidroxietilamido 130/0.4 como o soro fisiológico hipertónico foram protetores renais neste contexto e não lesaram o rim no controlo. Justificam-se mais estudos para complementar as implicações clínicas da administração de hidroxietilamido 130/0.4 em cirurgia hepática.

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Studies showed that specific probiotics provide therapeutic benefits in inflammatory bowel disease. In vitro evidence suggested that Lactobacillus paracasei also called ST11 (CNCM I-2116) is a potent strain with immune modulation properties. However, little is known about its capacity to alleviate inflammatory symptoms in vivo In this context, the main objective of this study was to investigate the role of ST11 on intestinal inflammation using the adoptive transfer mouse model of experimental colitis. Rag2-/- recipient mice were fed with ST11 (109 CFU/day)a month prior toinduce colitis by adoptive transfer of naive T cells. One month later, in clear contrast to nonfed mice, weight loss was significantly reduced by 50% in ST11-fed mice. Further analysis of colon specimens revealed a significant reduction neutrophil infiltration and mucosal expression of IL1β, IL-6, and IL12 proinflammatory cytokines, whereas no consistent differences in expression of antibacterial peptides or tight junction proteins were observed between PBS and ST11-fed mice. All together, our results demonstrate that oral administration of ST11 was safe and had a significant preventive effect on colitis. We conclude that probiotics such as Lactobacillus paracasei harbor worthwhile in vivo immunomodulatory properties to prevent intestinal inflammation by nutritional approaches.