ABSTRACT Preschool-age children who stutter can experience negative attitudes and beliefs about oneself. This information is essential to the assessment and intervention in speech and language therapy. However, there is only translated into European Portuguese (EP) the instrument Scale of Children’s Atittudes (A-19), by Guitar and Grims (1977). The aim of this research is the translation, adaptation, and content validation of the assessment instrument Preschooler Awareness of Stuttering Survey (PASS), developed by Abbiati et al. (2013), from English to EP. A cross-sectional descriptive qualitative methodology was used and the methodological procedures of translation, back-translation and panel of experts (Sousa & Rojjanasrirat, 2011) were implemented. In the translation phase, differences were noted between the original and the translated version regarding the semantic and idiomatic equivalences of different concepts and expressions (Borsa et al., 2012). It was also verified the need to include new information to enhance the comprehension of the instrument application. In the back-translation, it was noted the use of synonyms of concepts/expressions of the original version, keeping the same type of sentence structure. The panel of experts focused on the conceptual equivalence of the items of the instrument's record sheets. It was considered that the concepts remained preserved, the items understandable, and the translation of the instrument appropriate to the intended target population. The continuation of this research aims to provide speech therapists with a new instrument to assess preschool-age children who stutter, contributing to a reliable assessment that enhances therapeutic intervention according to the characteristics and needs of each child.

RESUMEN Los niños que tartamudean en edad preescolar pueden experimentar actitudes y creencias negativas sobre uno mismo. Esta información es esencial para la evaluación e intervención en la terapia del habla y lenguaje. Sin embargo, solo se tradujo al portugués europeo (PE) el instrumento Scale of Children’s Atittudes (A-19), de Guitar e Grims (1977). El objetivo de esta investigación es la traducción, adaptación y validación de contenido del instrumento de evaluación Prechooler Awareness of Stuttering Survey (PASS), desarrollado por Abbiati et al. (2013), del inglés al PE. Se utilizó una metodología cualitativa descriptiva transversal e se implementaron los procedimientos metodológicos de traducción, retrotraducción y panel de expertos (Sousa & Rojjanasrirat, 2011). En la fase de traducción se verificaron diferencias entre la versión original y la versión traducida en cuanto a las equivalencias semánticas e idiomáticas de diferentes conceptos y expresiones (Borsa et al., 2012). También se verificó la necesidad de incluir nueva información para mejorar la comprensión de la aplicación del instrumento. En la retrotraducción, se observó el uso de sinónimos para los conceptos/expresiones la versión original, manteniendo el mismo tipo de estructura oracional. El panel de expertos se centró en la equivalencia conceptual de los elementos de las hojas de registro del instrumento. Se consideró que los conceptos permanecieron preservados, los ítems entendibles y la traducción del instrumento apropiada para la población objetivo prevista. La continuación de esta investigación tiene como objetivo proporcionar a los logopedas un nuevo instrumento para evaluar a los niños que tartamudean en edad preescolar, contribuyendo a una evaluación confiable que mejora la intervención terapéutica de acuerdo con las características y necesidades de cada niño.

Reações emocionais negativas e mudanças de autoperceção poderão ser experienciadas por crianças que gaguejam em idade pré-escolar. Estas informações são essenciais à avaliação e à intervenção em terapia da fala. Contudo, apenas existe traduzido para o português europeu (PE) o instrumento Scale of Children’s Atittudes (A-19). O objetivo deste trabalho passa pela tradução, adaptação e validação do conteúdo do instrumento de avaliação Preschooler Awareness of Stuttering Survey (PASS), do inglês para o PE. Utilizou-se uma metodologia qualitativa descritiva transversal e os procedimentos empregues foram: tradução, retrotradução e realização de painel de peritos. Na tradução verificaram-se diferenças entre a versão original e a versão traduzida quanto às equivalências semântica e idiomática de conceitos e expressões. Além disso, verificou-se a necessidade de incluir nova informação para promover a compreensão da aplicabilidade do instrumento. Na retrotradução, constatou-se a utilização de sinónimos dos conceitos/expressões da versão original, mantendo-se o mesmo tipo de estrutura frásica. O painel de peritos focou-se na equivalência concetual dos itens das folhas de registo do instrumento. Considerou-se que os conceitos se mantiveram preservados, os itens compreensíveis e a tradução do instrumento adequada à população-alvo pretendida. A continuação desta investigação pretende fornecer aos terapeutas da fala um novo instrumento que auxilie a avaliação de crianças que gaguejam em idade pré-escolar, contribuindo para uma avaliação fidedigna que potencie a intervenção terapêutica de acordo com as características e necessidades de cada criança.

Abstract Factor X deficiency ranks among the rarest coagulopathies and has a variable presentation spectrum. We intend to present a proposal for anesthesia protocol for individuals with the coagulopathy. The excision of an ovarian neoplasm was proposed for a 26-year-old, female, ASA II patient, with congenital Factor X deficiency. Physical examination and lab tests were normal, except for Prothrombin Time (PT) 22.1s (VR: 8-14s), International Normalized Ratio (INR) 1.99 (VR: 0.8-1.2) and Activated Partial Thromboplastin Time (aPTT) 41.4s (VR: 25-37s). We concluded that a history of bleeding should always be investigated, along with a pre-anesthetic coagulation study.

Simultaneous kidney pancreas transplantation, if feasible, is the treatment of choice for the management of end-stage renal disease in patients with type 1 diabetes. This intervention can offer glycemic control and might also stabilize or even reverse some of the metabolic complications of diabetes. Chronic kidney disease has become a critical problem in orthotopic liver transplantation due to multiple risk factors, including post-transplant diabetes mellitus and immunosuppression. This has a major impact on graft and patient survival. In this paper we present the case of a 42-year-old man submitted to a simultaneous pancreas kidney transplant after a successful liver transplantation 18 years earlier. The surgical procedure was uneventful, and the patient was discharged 18 days after admission. The case findings support that simultaneous pancreas and kidney transplantation is an effective method for the treatment of chronic kidney disease in patients with diabetes and a previous liver transplant.

Typhlitis is a clinical entity rare in adults, reported in immunosuppressed patients. It is a life-threatening condition that occurs in neutropenic patients due to compromised integrity of the bowel wall and its exact pathogenesis is not completely understood. We report a 35-year-old man with a post deceased donor renal and pancreas transplantation status who presented fever and febrile neutropenia. Three days after admission he presented hematochezia with a hemoglobin drop. Colonoscopy revealed "ileum mucosa with multiforme ulcers" and since no other etiology was found, typhlitis was considered. He gradually improved with support treatment and was able to be managed non-operatively. To our knowledge, there are only six other reports of typhlitis in kidney transplant recipients.

Human immunodeficiency virus infection is a multisystemic disease which causes kidney disease in a variable proportion of infected patients. AA amyloidosis, in turn, is an unusual complication related to HIV infection and also an infrequent cause of kidney disease; in this setting AA amyloidosis usually results from chronic skin infections related to intravenous use of recreational drugs. We report the case of a 43-year-old woman, native of the Ivory Coast, with active HIV 1 infection diagnosed 11 years ago, currently in the Centers for Disease Control and Prevention’s stage C3, out of antiretroviral therapy for non-adherence and with persistent positive viral load, admitted to the nephrology department for nephrotic syndrome. The patient denied any other relevant clinical history, including chronic or recurrent inflammatory or infectious disease or use or abuse of recreational drugs. Urine sediment and renal function were both normal as was renal ultrasound. Other opportunistic infections were excluded. The renal biopsy revealed deposition of amorphous substance, Congo red positive, in the vascular walls and a positive immunofluorescence for serum amyloid A, confirming the diagnosis of renal amyloidosis. The patient was started on antiretroviral and symptomatic therapy, with clinical improvement. The clinical diagnosis of renal amyloidosis secondary to HIV can be challenging, as it requires the exclusion of other possible aetiologies, but should be considered in the differential diagnosis of renal disease in HIV patients. This case illustrates the importance of the renal biopsy in such cases in which the diagnosis can be improperly set up if based only on clinical data.

Coxiella burnetii (C. burnetii) causes a zoonotic disease - Q fever. This bacterium is highly resistant to harsh environmental conditions and causes an uncharacteristic clinical syndrome. Q fever may be acute or chronic and renal manifestations of the disease are more common in the chronic forms. It is reported a case of a 83 -year old woman, with previous normal renal function and a medical history of arterial hypertension and osteoarthritis. She presented with leg oedema, acute kidney injury (serum creatinine 4.14 mg/dl), and an urine protein-to-creatinine ratio of 9.14 gr/gr. A diagnosis of acute kidney injury with nephrotic syndrome was admitted. The lab work revealed a decrease in serum complement levels (C3, C4), and elevated serum levels of β2 -microglobulin and IgM anticardiolipin. Renal ultrasound showed bilateral cysts, so a renal biopsy could not be performed. During hospital stay, renal function worsened with oliguria and the patient needed transient haemodialysis. The renal function gradually recovered but the nephrotic syndrome (ratio 18gr/gr) persisted, with a thrombotic complication (deep vein thrombosis and pulmonary emboli). She presented a fever of unknown origin (FUO) and was treated with several antibiotic courses, eventually becoming afebrile. She was discharged with a serum creatinine 0,89mg/dL and a proteinuria of 18g/24H. By then, we had obtained the result of a positive serology for C. burnetii, so doxycycline was started and proteinuria (0,3gr/gr) remitted. Currently, the patient remains with high levels of C. burnetii antibodies and is still under treatment with doxycycline. The authors report a case of acute Q fever manifested by recurrent fever and acute kidney injury with nephrotic syndrome. This case illustrates a rare aetiology of nephrotic syndrome with acute kidney injury