ABSTRACT Introduction: Optimal fluid balance in peritoneal dialysis requires adequate urinary and peritoneal water and sodium removal and restriction of dietary sodium intake (<2 g/day). We aim to study the relationship between sodium intake, blood pressure control and medication burden in peritoneal dialysis patients. Methods: Observational, cross-sectional study of chronic peritoneal dialysis patients followed in our hospital in March 2022. We estimated patient’s sodium intake according to the equations proposed by Kim et al. Mean ambulatory blood pressure was categorized in controlled, stage one, stage two and stage three hypertension. A qualitative evaluation of sodium intake was done by asking patients about their compliance with a low-salt diet. Results: Eighty-two patients: mostly men, with a mean age of 54.1±14.7 years and dialysis vintage of 26.2±18.7 months. Most patients were on continuous ambulatory peritoneal dialysis (63.4%) and the mean weekly Kt/V was 2.2±0.4. A percentage of 85.4% of our patients had residual diuresis, averaged at 1257±867 mL/day. Mean dietary sodium intake was 3.5±1.1 g; it was higher in men and patients with uncontrolled hypertension, regardless of age, dialysis vintage and other comorbidities. We found a strong correlation between dietary sodium intake and residual diuresis, systolic blood pressure, diastolic blood pressure and the number of anti-hypertensive drugs. Patients with a sodium intake ≥ 3.3 g had higher risk of uncontrolled BP and higher medication burden. Qualitative evaluation of this sub-population revealed that only 2.3% (n=1) admitted non-compliance with a low-sodium diet. Conclusion: We found a strong correlation between estimated dietary sodium consumption, blood pressure control and medication burden. Most importantly, there was a striking difference between patient’s perception of sodium consumption and the actual results. Our results highlight the importance of dietary salt restriction in blood pressure control and reinforce the need for a dietary consultation in peritoneal dialysis patients.

ABSTRACT Introduction: Sleep disorders affect up to 70% of peritoneal dialysis (PD) patients and appear to have significant negative effects on their quality of life (QoL). We compared life and sleep quality between patients on automated PD (APD) and continuous ambulatory PD (CAPD). Material and Methods: Cross-sectional study in chronic PD patients followed in our Dialysis Unit in February 2022. We evaluated sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) and QoL with EUROHIS-QOL-8. Results: Fifty-two patients, mostly men (65.4%, n=32), with a mean age of 52.7±14.2 years and PD vintage of 24.3±17.1 months. Our sample had similar distribution between APD and CAPD; we found no difference between groups regarding demographic data, PD-related quality parameters or prevalence of previous sleep disturbances. Mean QoL index was 69.9%±9.3% and similar between APD and CAPD patients; EUROHIS-QOL-8 negatively correlated with the scores on ESS (p=0.004) and PSQI (p=0.011). Regarding sleep quality, the mean ESS was 8.8±4.2 and PSQI was 7.6±3.6. APD patients had similar scores on ESS, but higher prevalence of severe daytime sleepiness (ESS≥18) (p=0.04) and higher scores on PSQI (p=0.002). Within the PSQI, sleep’ latency (p=0.003), duration (p=0.002) and efficiency (p=0.013) were the most affected parameters. Higher PSQI scores also correlated with worse blood pressure control; a cut-off value for PSQI of 6 was found to increase the risk of uncontrolled hypertension. Conclusion: In our series, APD patients had worse global sleep quality (PSQI) when compared to ACPD patients. This difference was mainly due to worse sleep latency, duration and efficiency. The assessment of the quality of life showed no difference between groups, however there was a clear link between quality of life and sleep quality.

Abstract Background Pancreaticoduodenectomy is associated with high morbidity. Many preoperative variables are risk factors for postoperative complications, but they are primarily non-modifiable. It is not clear whether an intraoperative goal-directed fluid regimen might be associated with fewer postoperative surgical complications compared to current conservative, non-goal-directed fluid practices. We hypothesize that the use of Systolic Volume Variation (SVV)-guided intraoperative fluid administration might be beneficial. Methods Data from 223 patients who underwent pancreaticoduodenectomy in our institution between 2015 and 2019 were reviewed. Patients were classified into two groups based on the use of intraoperative use of SVV to guide the administration of fluids. The decision to use SVV or not was made by the attending anesthesiologist. Subjects were classified into SVV-guided intraoperative fluid therapy (SVV group) and non-SVV-guided intraoperative fluid therapy (non-SVV group). Uni and multivariate regression analyses were conducted to determine if SVV-guided fluid therapy was significantly associated with a lower incidence of postoperative surgical complications, such as Postoperative Pancreatic Fistula (POPF), Delayed Gastric Emptying (DGE), among others, after adjusting for confounders. Results Baseline, demographic, and intraoperative characteristics were similar between SVV and non-SVV groups. In the multivariate analysis, the use of SVV guidance was significantly associated with fewer postoperative surgical complications (OR = 0.48; 95% CI 0.25-0.91; p= 0.025), even after adjusting for significant covariates, such as perioperative use of epidural, pancreatic gland parenchyma texture, and diameter of the pancreatic duct. Conclusions VV-guided intraoperative fluid administration might be associated with fewer postoperative surgical complications after pancreaticoduodenectomy.

Abstract The COVID-19 pandemic has put serious pressure on healthcare institutions, becoming one of the main concerns of the scientific society, and in general, since it has consequences for all levels of care. As knowledge about the virus evolves, so do the choices, generating inconsistencies, difficulties and the need for change and adaptation. Thus, it is urgent to provide guidance to health professionals and families of children with oncological disease on the adaptations of health services, protecting the health and safety of the team, children and families. This article addresses the response of the Pediatric Service of Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) to the current pandemic context, as a reference center for the treatment of children with cancer, in order to continue the provision of quality and excellent medical and nursing care, meeting the specific needs of children and their families.

Resumo A pandemia COVID-19 colocou uma séria pressão nas instituições de saúde, tornando-se uma das principais preocupações da sociedade científica, e no geral, uma vez que acarreta consequências a todos os níveis do cuidar. À medida que os conhecimentos sobre o vírus evoluem, geram-se inconsistências e dificuldades, havendo necessidade de mudança e adaptação. Assim, torna-se urgente a orientação dos profissionais de saúde e das famílias de crianças com doença oncológica sobre as adaptações dos serviços de saúde, protegendo a saúde e a segurança da equipa multidisciplinar, crianças e famílias. No presente artigo será abordada a resposta do Serviço de Pediatria do Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) ao atual contexto pandémico, enquanto centro de referência para o tratamento de crianças com cancro, de forma a dar continuidade à prestação de cuidados médicos e de Enfermagem de qualidade e excelência, indo de encontro às necessidades específicas das crianças e das suas famílias.

Abstract Objective To evaluate the effect of the association between external and internal tooth bleaching on color changes in dentin and enamel, individually or recombined, previously stained with triple antibiotic paste (TAP). Methodology Forty enamel-dentin specimens from bovine incisors were separated into ten blocks according to similarity in their whiteness index (WID). Three specimens within each block were stained by dentin exposure to TAP, and the remaining specimen was used as control to estimate color changes. Specimens were sectioned to separate tissues, and dentin and enamel colors were measured individually and after being recombined. Alterations in color (CIEDE2000 - ΔE00) and translucency parameter (TP) resulting from staining were estimated by color difference between stained and control specimens. The contribution of each tissue to the color change (CTCC) was also calculated. Non-sectioned stained specimens were bleached by applying sodium perborate on dentin, associated or not with 35% hydrogen peroxide on enamel. Color changes caused by bleaching procedures were estimated and data were analyzed using the paired t-test or Two-way repeated measures ANOVA. Results TAP caused more pronounced changes in dentin, but enamel color was also affected. Both protocols presented a similar ΔE00, and dentin showed the greater color change. After exposure to TAP, we observed a reduction in WID; WID values were the same for bleached and control specimens regardless of protocol. We found no significant effect of substrate and bleaching technique on TP. Enamel played a more critical role in color changes caused by either staining or bleaching procedures. Conclusion Enamel color played a greater role on tooth color changes than dentin. External and internal bleaching association did not improve bleaching effect on specimens stained with TAP.

Resumo À semelhança dos surtos de SARS-CoV-1, em 2003-2004 e de MERS, em 2012, a pandemia de SARS-CoV-2 apresentou, desde o seu início, relatos de transmissão frequente da doença a profissionais de saúde (PS). O nosso Centro Hospitalar identificou o seu primeiro caso confirmado de COVID-19 a 9 de março de 2020, num paciente hospitalizado há 6 dias. O primeiro caso de COVID-19 confirmado num PS ocorreu 3 dias depois, numa enfermeira com vínculo epidemiológico provavelmente relacionado com o primeiro paciente confirmado. O primeiro objetivo do nosso estudo é descrever e caracterizar o impacto dos primeiros 3 meses da pandemia de SARS-CoV-2 no Centro Hospitalar Universitário Lisboa Norte (CHULN). O nosso segundo objetivo é relatar o desempenho do Serviço de Saúde Ocupacional (SSO) do CHULN em relação ao impacto da pandemia no CHULN HCW e sua adaptação ao longo da evolução epidemiológica nacional, regional e institucional. Durante os primeiros três meses, foram ra streados 2.152 PS (o que representa 29,8% da população total de PS), agrupados em cem clusters distintos, cada um dos quais variando entre 2 e 98 PS. A profissão rastreada mais prevalente foi a de enfermeiro (n = 800; 37,2%) seguido do médico (n = 634; 29,5%). A principal fonte de infecção identificada (simultaneamente, geradora de procedimentos de triagem de clusters) esteve relacionada com outros colegas de trabalho (n = 1.216; 56,5%). Uma fonte originada num paciente ou uma fonte combinada de paciente e colega de trabalho foram responsáveeis por apenas 559 (26%) e 43 (2%) dos casos, respectivamente. Os nossos resultados preliminares demonstram uma taxa de infecção mais baixa entre os profissionais de saúde do que as comumente encontradas na literatura. A principal fonte de infecção parecia estar relacionada com colegas de trabalho e não com o paciente. Novas estratégias preventivas deverão que ser implementadas para controlar a propagação do SARS-CoV-2 em contexto profissional.

Abstract As with the SARS-CoV-1 outbreak in 2003-2004 and the MERS outbreak in 2012, there were early reports of frequent transmission to healthcare workers (HCW) in the SARS-CoV-2 pandemic. Our hospital center identified its first COVID-19 confirmed case on March 9, 2020, in a 6-day hospitalized patient. The first confirmed COVID-19 case in a HCW happened 3 days later, in a nurse with a probable epidemiological link related to the first confirmed patient. Our study’s first objective is to describe and characterize the impact of the first 3 months of the SARS-CoV-2 pandemic on the Centro Hospitalar Universitário Lisboa Norte (CHULN). Our second objective is to report the performance of the CHULN Occupational Health Department (OHD) and the impact of the pandemic on CHULN HCW and its adaptation across national, regional, and institutional epidemiological evolution. Over the first 3 months, 2,152 HCW were screened (which represent 29.8% of the total HCW population), grouped in 100 separate identifiable clusters, each one ranging from 2 to 98 HCW. The most prevalent profession screened were nurses (n = 800; 37.2%) followed by doctors (n = 634; 29.5%). The main source of potential infection and cluster generating screening procedures was co-worker related (n = 1,216; 56.5%). A patient source or a combined patient co-worker source was only accountable for 559 (26%) and 43 (2%) of cases, respectively. Our preliminary results demonstrate a lower infection rate among HCW than the ones commonly found in the literature. The main source of infection seemed to be co-worker related rather than patient related. New preventive strategies would have to be implemented in order to control SARS-CoV-2 spread.

Resumo O nódulo mamário pode ser benigno ou maligno, sendo que este último pode ser primário da mama ou metastático. Quando a neoplasia primária é desconhecida, o diagnóstico e orientação terapêutica podem ser bastante difíceis. Apresentamos o caso de uma doente com cancro gástrico, estadio IV, em que a primeira apresentação foi um nódulo da mama. A incidência rara de tal apresentação clínica justifica o relato deste caso e destaca a importância de existência de equipas multidisciplinares na abordagem do doente oncológico.

Abstract A breast lump can be benign or malignant, the late one can be primary or metastatic. When the primary neoplasm is unknown the diagnosis, management and treatment maybe quite difficult. We present a case of stage IV gastric cancer, where the first complaint was a breast lump. The rare incidence of such clinical presentation justifies reporting this case and highlights the importance of multidisciplinary teams in the management of cancer patients.

Abstract The Cognitive Telephone Screening Instrument (COGTEL) has shown to be a brief, reliable, and valid instrument to assess cognitive functioning in adults in face-to-face procedures as well as over the phone. So far, no psychometric evaluation exists on its use in adolescents. The present study set out to evaluate the psychometric properties of the face-to-face application of the COGTEL in adolescents in the school context and to analyse the association with school grades. We assessed cognitive performance using COGTEL in face-to-face assessments of 170 adolescents, with retests after 6 months for test-retest reliability. Predictive validity was assessed using school grades. Test-retest reliability for the COGTEL was good (ICC = .77; p < .001). The partial correlation controlling for age between COGTEL and school grades was medium and positive (r = .40; p < .001). School grades alone explained 42% and 36% of the variance in the COGTEL total score in elementary and secondary students, respectively. The present study suggests that COGTEL is a reliable and valid instrument to assess cognitive functioning in adolescents, with the advantage of feasibility in multiple contexts.

Resumo O Instrumento de Rastreio Cognitivo por Telefone (COGTEL) tem demostrado ser um instrumento fiável, válido e breve para avaliar o funcionamento cognitivo em adultos, quer por telefone, quer de forma presencial. Até à data, não foram estudadas as suas características psicométricas para uso em adolescentes. O presente estudo teve por objetivo avaliar as propriedades psicométricas do COGTEL em adolescentes no contexto escolar, através da aplicação presencial, e analisar a associação dos scores com as notas escolares. O desempenho cognitivo foi avaliado em 170 adolescentes, usando o COGTEL em entrevistas presenciais, com um reteste após 6 meses para avaliar a fiabilidade teste-reteste. A validade preditiva foi avaliada com base nas notas escolares. A fiabilidade teste-reteste para o COGTEL foi boa (ICC = 0.77; p < .001). As correlações parciais, controlando pelo efeito da idade, entre o score total do COGTEL e as notas escolares foram moderadas e positivas (r = .40; p < .001). As notas escolares, individualmente, explicaram 42% e 36% da variância total no score total do COGTEL, em alunos do ensino básico e secundário, respetivamente. O presente estudo sugere que o COGTEL é um instrumento fiável e válido para avaliar o funcionamento cognitivo em adolescentes, com a vantagem de ser aplicável em múltiplos contextos.

ABSTRACT Sleep plays a fundamental role in the growth and development of newborns, with their deprivation having many negative effects. The environment of the neonatal intensive care units (NICU) presents itself as disturbing and harmful for the neonatal sleep. Objective Map the existing scientific evidence regarding the strategies promoting newborn’s sleep in the NICU setting. Methodology Scoping review based on the methodology proposed by the Joanna Briggs Institute, using the following search engines and databases: MEDLINE via PubMed, CINHAL Plus with Full Text and Nursing & Allied Health Collection: Comprehensive via EBSCO-HOST, Academic Search Complete, ScienceDirect and Directory of Open Access Journals via B-ON, LILACS, RCAAP and SciELO. As search limiters, there were defined articles published in the last 5 years (until February 2019), available in Portuguese or in English and in full text. Results A total of 186 results were listed, and the final sample included 9 studies that responded to the review objective based on the selected inclusion criteria. The sleep-promoting strategies identified refer to the management of the environment in the NICU, the concentration of Nursing care respecting the newborn’s sleep-wake cycle, and non-pharmacological interventions such as proper positioning, physical restraint, non-nutritive sucking, Yakson technique, gentle human touch, kangaroo mother care, massage, calm auditory stimuli and remolding mattress. Conclusion Given the importance of sleep in the newborn’s development, the nurse’s role is crucial through the implementation of protective and promoting sleep strategies, especially in the NICU.

RESUMO O sono tem um papel fundamental no crescimento e desenvolvimento dos recém-nascidos, com a sua privação a apresentar inúmeros efeitos negativos. O ambiente das unidades de cuidados intensivos neonatais (UCIN) apresenta-se como perturbador e nocivo do sono neonatal. Objetivo Mapear a evidência científica existente quanto às estratégias promotoras do sono do recém-nascido em contexto de UCIN. Método Scoping review baseada na metodologia proposta pelo Joanna Briggs Institute, com recurso aos seguintes motores de busca e bases de dados: MEDLINE via PubMed, CINHAL Plus with Full Text e Nursing & Allied Health Collection: Comprehensive via EBSCO-HOST, Academic Search Complete, ScienceDirect e Directory of Open Access Journals via B-ON, LILACS, RCAAP e SciELO. Definidos como limitadores artigos publicados nos últimos 5 anos (até fevereiro de 2019), disponíveis em português ou inglês e em texto integral. Resultados Foram localizados 186 registos, tendo a amostra final incluído 9 estudos que responderam ao objetivo da revisão com base nos critérios de inclusão definidos. As estratégias promotoras do sono identificadas remetem para a gestão do ambiente na UCIN, concentração dos cuidados de Enfermagem respeitando o ciclo de sono-vigília dos recém-nascidos, posicionamento adequado, contenção, sucção não-nutritiva, técnica de Yakson, toque humano suave, canguru materno, massagem, estímulos auditivos calmos e colchão modelador. Conclusão Dada a importância do sono no desenvolvimento dos recém-nascidos, é fulcral o papel do Enfermeiro através da adoção de estratégias protetoras e promotoras deste, especialmente em contexto de UCIN.

RESUMEN El sueño desempeña un papel fundamental en el crecimiento y desarrollo de los recién nacidos, su privación presenta numerosos efectos negativos. El ambiente de las unidades de cuidados intensivos neonatales (UCIN) se presenta como perturbador y nocivo del sueño neonatal. Objetivo Mapear la evidencia científica existente en cuanto a las estrategias promotoras del sueño de los recién nacidos en contexto de UCIN. Metodología Scoping review basada en la metodología propuesta por el Joanna Briggs Institute, utilizando los siguientes motores de búsqueda y bases de datos: MEDLINE via PubMed, CINHAL Plus with Full Text e Nursing & Allied Health Collection: Comprehensive via EBSCO-HOST, Academic Search Complete, ScienceDirect e Directory of Open Access Journals via B-ON, LILACS, RCAAP e SciELO. Definido como limitadores artículos publicados en los últimos 5 años (hasta febrero de 2019), disponibles en portugués o inglés y en texto completo. Resultados Se localizaron 186 registros, y la muestra final incluyó 9 estudios que respondieron al objetivo de la revisión sobre la base de los criterios de inclusión definidos. Las estrategias promotoras del sueño identificadas remiten a la gestión del ambiente en la UCIN, concentración de los cuidados de enfermería respetando el ciclo de sueño / vigilia de los recién nacidos, posicionamiento adecuado, contención, succión no nutritiva, técnica de Yakson, toque humano suave, canguro materno, masaje, estímulos auditivos tranquilos y colchón modelador. Conclusión Dada la importancia del sueño en el desarrollo de los recién nacidos, es fundamental el papel del Enfermero a través de la adopción de estrategias protectoras y promotoras de éste, especialmente en contexto de UCIN.

Overview and Aims: Patient satisfaction when using health services is an indicator often used for quality measurement. This study aims to analyze the complaints to assess the reasons for displeasure in the care provided as a way to recognize patients as active agents in the improvement of health services. Study design, Population, Methods: An observational, descriptive, retrospective study was performed through the acquisition of complaints made by the users of the service in the patient's office of the Hospital Center between 2008-2016. The data obtained were analyzed qualitatively and quantitatively. Results: A total of 91 complaints were identified in the nine years of the study, corresponding to an average complaint rate of 0.2‰. The propensity to complain was similar over time, with predominance of complaints in their own name and concerning the area of obstetrics (compared to gynaecology). Complaints addressed to health professionals refer, mainly, to doctors or medical acts. The prevalent typology of complaints refers to the domain of relationships predominantly in communication, followed by those related to institutional management. The situations of the clinical domain that encompass the quality and safety of the care provided was a reason for complaint in 27% of the situations. Conclusions: From the analysis of the complaints we believe that these are predictive of deficiencies found later, so that they offer a signal in real time of a service quality. In situations of frustration of users' expectations, it seems to be important to bet on the best information regarding rights and duties in health care.

Resumo O objetivo deste estudo foi investigar a associação da fadiga percebida com a composição corporal e a qualidade muscular (força, espessura e torque específico) em mulheres adultas jovens. Cinquenta e uma mulheres foram avaliadas quanto a fadiga percebida, a composição corporal, a força muscular de extensão de joelho, a espessura muscular e a qualidade muscular. A versão curta do Questionário Internacional de Atividade Física foi aplicada para classificar as voluntárias como ativas ou inativas.Para examinar a relação entre a fadiga percebida e as variáveis dependentes, a correlação de Pearson foi executada. A fadiga percebida apresentou relação significativa (p < 0,05) com o peso corporal (r = 0,469), IMC (r = 0,369), massa gorda (r = 0,469), percentual de gordura (r = 0,396) e pico de torque relativo (r = -0,378). Adicionalmente, mulheres inativas apresentaram maior (p < 0,05) peso corporal, índice de massa corporal, massa gorda, percentual de gordura e fadiga percebida, comparadas com mulheres ativas. A fadiga percebida se relaciona com o peso corporal e com a gordura corporal, mas não com a força muscular ou com a qualidade muscular. Além disso, mulheres fisicamente ativas tem uma menor fadiga percebida, peso corporal e gordura corporal do que mulheres fisicamente inativas. Esses resultados sugerem que a gordura corporal exerce um papel importante na fadiga percebida e que a atividade física pode atenuar esse sintoma.

Abstract The purpose of this study was to investigate the association of perceived fatigue with body composition and muscle quality (strength, thickness and specific torque) in young adult women. Fifty-one healthy women (31.98 ± 6.88 years) were assessed regarding perceived fatigue, body composition, knee extensors muscle strength, muscle thickness, and muscle quality. The short version of International Physical Activity Questionnaire was applied to classify subjects as active or inactive. To examine the relationship between perceived fatigue and dependent variables, the Pearson’s correlation was performed. Perceived fatigue was significantly correlated (p < 0.05) with body weight (r = 0.469), body mass index (r = 0.369), fat mass (r = 0.469), percent body fat (r = 0.396), and relative peak torque (r = -0.378). Additionally, inactive women had significantly greater (p < 0.05) body weight, body mass index, fat mass, percent body fat, and perceived fatigue than active women. Perceived fatigue is related to body weight and fat mass, but not to muscle strength or muscle quality. Moreover, physically active women showed lower perceived fatigue, body weight, and body fat compared to physically inactive women. These results suggest that body fat may play a role in perceived fatigue and physical activity could attenuate such symptom.

Resumo Neste artigo pretende-se compreender a epidemia de gripe pneumónica de 1918-1919 em Coimbra, a partir das informações contidas nas páginas de um periódico local. Por meio da análise rigorosa e sistemática da Gazeta de Coimbra consegue-se inferir a perceção que uma burguesia urbana teve desta catástrofe sanitária, considerada a maior do século XX. Guiados pelo editor do jornal, numa perspetiva não oficial dos fatos, é possível vislumbrar as reações às primeiras notícias da epidemia, nomeadamente os temores da população frente à informação veiculada, mas também a resposta das autoridades e da sociedade civil. Crítico em muitos aspetos, censura abertamente a inércia de várias instituições da cidade, como a Câmara Municipal, a Faculdade de Medicina da Universidade e a Misericórdia.

Abstract This article investigates the 1918-1919 influenza epidemic in Coimbra using information found in the pages of a local newspaper. Rigorous and systematic analysis of the Gazeta de Coimbra reveals the urban bourgeoisie’s perception of this health disaster, considered the most severe in the twentieth century. Guided by the newspaper’s editor though an unofficial view of the facts, the reader can glimpse reactions to the first news of the epidemic, particularly the population’s fears related to this information, but also the response from authorities and civil society. The newspaper is critical in many aspects, openly censuring inaction by several institutions of the city such as the city council, the medical school at the University of Coimbra, and the Misericórdia charitable institution.

Fetal umbilical intra-abdominal vein varix is a rare congenital malformation characterized by focal dilatation of the umbilical vein. It's clinical significance is unclear and is usually an isolated finding, in some cases it may be associated with other fetal anomalies, chromosomal defects or fetal death. The authors report a case of pregnant woman at 25 weeks of gestation with a fetus affected by dilatation of an intraabdominal portion of the umbilical vein, with a favorable progress and outcome.

Resumo Um protocolo específico de Drop Jumps (DJs), com 100 saltos, tem sido amplamente utilizado para induzir o dano muscular. Entretanto, este protocolo tem falhado em mostrar uma queda relevante em indivíduos treinados. Objetivou-se avaliar o desempenho muscular após dois protocolos de DJs com diferentes volumes em indivíduos treinados. Dezoito homens treinados em força e/ou potência (4,92 ± 2,78 anos de treinamento) foram aleatoriamente designados em um dos dois grupos: DJ100 (cinco séries de 20 DJs) ou DJ140 (sete séries de 20 DJs), com 2 minutos entre as séries. Os DJs foram executados de uma caixa de 60 cm de altura. Após a aterrisagem, os voluntários executaram um salto vertical máximo. O inchaço muscular aumentou significativamente em ambos os grupos (p < 0,001). O torque isométrico máximo (TIM) reduziu significativamente tanto no DJ100 (p = 0,005) quanto no DJ140 (p < 0,001). O TIM não apresentou diferenças entre grupos no momento pré (p = 0,815). Entretanto, no momento pós, o TIM foi significativamente inferior no DJ140 em relação ao DJ100 (p = 0,043). O salto com contra movimento (SCM) reduziu significativamente no DJ140 (p = 0,001), mas não no DJ100 (p = 0,802). No momento pós, o SCM foi significativamente inferior no DJ140 em relação ao DJ100. O DJ140 induziu uma queda maior na força isométrica em relação do DJ100, e somente o DJ140 reduziu significativamente o desempenho no salto. Esses resultados demonstraram que indivíduos bem treinados requerem um grande volume DJs para reduzir substancialmente o desempenho muscular.

Abstract A specific drop jumps (DJs) protocol (using 100 jumps) has been largely used to induce muscle damage. However, it failed to show relevant drop in performance in well-trained individuals. Trained subjects may require a protocol with greater volume to induce decrease of muscle performance. The aim of this study was to assess muscle performance after two DJs damaging protocols with different volumes in well-trained individuals. Eighteen strength and/or power-trained males (4.92 ± 2.78 years of training experience) were randomly assigned into one of two groups: DJ100 (five sets of 20 DJs) or DJ140 (seven sets of 20 DJs), with 2-min of rest interval. DJs were performed from a 60-cm box. After landing, the volunteers performed a maximal vertical rebound jump. Muscle swelling increased significantly on both DJ100 and DJ140 (p < 0.001). Maximal isometric torque (MIT) decreased significantly on both DJ100 (p = 0.005) and DJ140 (p < 0.001). MIT showed no between-group difference on pre-assessment (p = 0.815). However, on post-assessment, MIT was significantly lower on DJ140 than DJ100 (p = 0.043). Countermovement jump (CMJ) decreased significantly on DJ140 (p = 0.001), but not on DJ100 (p = 0.802). There was no between-group difference on pre-assessment (p = 0.978). However, on post-assessment, CMJ was significantly lower on DJ140 than DJ100 (p = 0.038). DJ140 induced greater drop in isometric strength than DJ100 and only DJ140 significantly reduced jump performance. These results demonstrated that well-trained individuals require a great volume of DJs to reduce substantially muscle performance.

ABSTRACT Objective: To define the safe transition process from hospital to community of patients with chronic mental disorders and their families. Method: This was an action research study included in the constructivist paradigm. The participants in the study were nurses from a psychiatry service and from primary healthcare services. Results: After the identification of causes of continuity fragmentation, the following items emerged from the participants’ speeches: a) two criteria categories for safe transition (those associated with health status, dependence level, and self-care capacity of patients, and those associated with knowledge and competence level of informal caregivers); b) the design of an algorithm to facilitate clinical decision-making. Final considerations: In order to promote adherence to therapeutic treatment in the hospital-community transition, treatment plans must include patients and their families, and improve communication networks and support among care levels.

RESUMEN Objetivo: Definir el proceso de transición segura del hospital a la comunidad de la persona con enfermedad mental crónica y su familia. Método: Estudio de investigación-acción, inserto en el paradigma constructivista. Participaron los enfermeros de un servicio de psiquiatría y de atención primaria de salud. Resultados: Luego de identificarse las causas de fragmentación de la continuidad, surgieron del discurso de los participantes: a) Dos categorías de criterios para la transición segura (los asociados a condición de salud, grado de dependencia y capacidad de autocuidado del paciente, y los asociados al conocimiento y nivel de competencia del cuidador informal); b) El diseño de un algoritmo para facilitar la toma de decisión clínica. Consideraciones finales: Para estimular la adhesión al régimen terapéutico en la transición hospital-comunidad, el proyecto terapéutico debe incluir a la persona y a su familia, y mejorar las redes de comunicación y soporte entre niveles de cuidado.

RESUMO Objetivo: Definir o processo de transição segura do hospital para a comunidade da pessoa com doença mental crônica e sua família. Método: Este é um estudo de investigação-ação, inserido no paradigma construtivista. Teve como participantes os enfermeiros de um serviço de psiquiatria e dos cuidados de saúde primários. Resultados: Após a identificação das causas da fragmentação da continuidade, emergiram do discurso dos participantes: a) duas categorias de critérios para a transição segura (os associados à condição de saúde, ao grau de dependência e à capacidade de autocuidado do cliente e os associados ao conhecimento e ao nível de competência do cuidador informal); b) o desenho de um algoritmo para facilitar a tomada de decisão clínica. Considerações finais: Para promover a adesão ao regime terapêutico na transição hospital-comunidade, o projeto terapêutico tem de incluir a pessoa e a sua família e melhorar as redes de comunicação e suporte entre níveis de cuidado.