Abstract Obesity has been associated with poorer reproductive outcomes after ART treatments, affecting the quality of embryos, endometrial receptivity, and the risk of gestational complications. The decision to delay IVF/ICSI treatments to promote weight loss must be carefully considered, especially in older women. Future research should focus on weight loss interventions tailored to patients’ age and BMI, with longitudinal studies to assess the effects of these interventions. Promoting healthy lifestyles and controlled weight loss is essential, but risks and benefits must be carefully weighed to optimize reproductive treatments.

Resumo A obesidade tem sido associada a piores desfechos reprodutivos após tratamentos de PMA, afetando a qualidade embrionária, a recetividade endometrial e o risco de complicações gestacionais. A decisão de adiar tratamentos de FIV/ICSI para promover a perda de peso deve ser considerada nas mulheres mais velhas. A investigação futura deve focar-se em estudos longitudinais para avaliar os efeitos de intervenções de perda de peso adaptadas à idade e ao IMC. A promoção de estilos de vida saudáveis e a perda de peso controlada são essenciais, mas os riscos e benefícios devem ser cuidadosamente ponderados para otimizar os tratamentos reprodutivos.

Aim Hyposalivation and dry mouth affect the quality of life in patients with Head and Neck Cancer, who did the treatment with radiotherapy. Thus this study has the objective to evaluate the dosimetric relationship between 3D radiotherapy and changes in salivary flow, xerostomia and quality of life in patients with head and neck cancer according to the volume of the irradiated parotid gland. Methods 23 patients with cancer in the head and neck area and in need of 3D radiotherapy were followed up during radiotherapy treatment, and the parotid gland (PG) design was also performed in radiotherapy planning. Questionnaires were carried out to determine xerostomia and quality of life, while the salivary flow was determined through calculations regarding the collection and weighing of saliva. Such data were collected in three moments: before the beginning of the radiotherapy treatment (D0), in the middle of the treatment (D1) and at the end of it (D2). The numerical variables are represented by measures of central tendency and measures of dispersion. Results when associating the salivary flow, the xerostomia questionnaire and the OHIP-14, a statistically significant difference was found (p-value <0.001), as well as when comparing some volumes of irradiated PG with the OHIP-14. However, no relationship was found between dosimetric data, xerostomia and hyposalivation. Conclusion patients undergoing 3D radiotherapy for malignant neoplasms in the head and neck region had decreased salivary flow, increased complaints of dry mouth and decreased quality of life. However, it was not possible to establish a statistically significant correlation between these findings and the volumes of irradiated parotids. Cancer D 2 (PG planning saliva moments D0, D0 , (D0) D1 (D1 D2. D2 . (D2) dispersion OHIP14, OHIP14 OHIP 14, 14 OHIP-14 pvalue p value <0.001, 0001 <0.001 0 001 <0.001) OHIP14. 14. However hyposalivation parotids (D0 (D (D2 OHIP1 1 OHIP-1 000 <0.00 00 OHIP- <0.0 <0. <0 <

RESUMEN Objetivo: evaluar la evidencia de validez de un video educativo sobre actividad sexual segura después del síndrome coronario agudo. Método: estudio en tres fases: elaboración de un vídeo; análisis de validez de contenido por 11 expertos; y análisis de validez basado en procesos de respuesta de siete personas con enfermedad coronaria. Se calculó el índice de validez de contenido (CVR) con valores críticos para la segunda fase de 0,63 y para la tercera de 1,0. Resultados: el video abordó la importancia de retomar la actividad sexual y posiciones que consuman menos energía, signos de alerta clínica, la importancia de adherirse al tratamiento y un ambiente acogedor para la práctica sexual. Se obtuvo un CVR por encima del valor crítico con un total de 4 minutos y 41 segundos. Conclusión: el video educativo reúne evidencia adecuada de validez de contenido y puede ser utilizado como herramienta para pacientes post síndrome coronario agudo. Objetivo agudo Método fases vídeo 1 expertos coronaria (CVR 063 0 63 0,6 10 1,0 Resultados energía clínica segundos Conclusión 06 6 0, 1,

RESUMO Objetivo: avaliar as evidências de validade de um vídeo educativo sobre atividade sexual segura após síndrome coronariana aguda. Método: estudo em três fases: desenvolvimento de um vídeo; análise da validade de conteúdo por 11 especialistas; e análise da validade baseada nos processos de resposta por sete pessoas com doença coronariana. Calculou-se a razão de validade de conteúdo (CVR) com valores críticos para a segunda fase de 0,63 e para a terceira de 1,0. Resultados: o vídeo abordou a importância da retomada da atividade sexual e das posições que consomem menos energia, sinais clínicos de alerta, importância da adesão ao tratamento e do ambiente acolhedor para prática sexual. Obteve-se um CVR acima do valor crítico com um total de 4 minutos e 41 segundos. Conclusão: o vídeo educacional reúne adequadas evidências de validade de conteúdo, podendo ser utilizado como uma ferramenta para pacientes após síndrome coronariana aguda. Objetivo aguda Método fases 1 especialistas Calculouse Calculou se (CVR 063 0 63 0,6 10 1,0 Resultados energia alerta Obtevese Obteve segundos Conclusão 06 6 0, 1,

ABSTRACT Objective: to assess validity evidence of an educational video on safe sexual activity after acute coronary syndrome. Method: study in three phases: video development; content validity analysis by 11 experts; and analysis of validity based on response processes by seven people with coronary disease. The content validity ratio (CVR) was calculated with critical values for the second phase of 0.63 and for the third of 1.0. Results: the video addressed the importance of resuming sexual activity and positions that consume less energy, clinical warning signs, the importance of adhering to treatment and a welcoming environment for sexual practice. A CVR above the critical value was obtained with a total of 4 minutes and 41 seconds. Conclusion: the educational video brings together adequate content validity evidence and can be used as a tool for patients after acute coronary syndrome. Objective syndrome Method phases development 1 experts disease (CVR 063 0 63 0.6 10 1.0 Results energy signs practice seconds Conclusion 06 6 0. 1.

Abstract Breast involvement in the context of systemic sarcoidosis is rare and may mimic a malignant lesion. Imaging studies contribute to the detection of breast lesions but are not useful in establishing a definitive diagnosis. Thus, malignancy must be excluded by histological biopsy in order to confirm the early diagnosis. We report a case of breast involvement by sarcoidosis in a 63-year-old woman with known systemic sarcoidosis. Mammography shows multiple oval masses with microlobulated edges and high density, without microcalcifications. Ultrasonographically, they correlated to solid hypoechoic masses with microlobulated contours, in both breasts, findings that were considered suspicious for malignancy. Breast Magnetic Resonance Imaging (MRI) showed multiple bilateral enhancing masses. Histological examination confirmed breast involvement by sarcoidosis.

Resumo O envolvimento mamário no contexto de sarcoidose sistémica é raro e pode mimetizar uma lesão maligna. Os estudos de imagem contribuem para a deteção de lesões mamárias mas não são úteis no estabelecimento de um diagnóstico definitivo. Assim, a malignidade deve ser excluída por biópsia histológica de forma a confirmar precocemente o diagnóstico. Reporta-se um caso de envolvimento mamário pela sarcoidose numa mulher de 63 anos com sarcoidose sistémica conhecida. A mamografia mostra múltiplos nódulos ovalados, de bordos microlobulados e elevada densidade, sem microcalcificações associadas. Ecograficamente correspondiam a nódulos sólidos hipoecogénicos, de contornos microlobulados, em ambas as mamas, achados que foram considerados suspeitos de malignidade. A Ressonância Magnética mamária realizada mostrou múltiplas massas bilaterais com realce de contraste endovenoso. O exame histológico confirmou o envolvimento mamário pela sarcoidose.

ABSTRACT Purpose: The purpose of this study was to evaluate the long-term outcomes of patients with trichiasis treated with a modified interlamellar oral mucosa graft surgery technique using fibrin glue. Methods: A prospective study was conducted at the Oculoplastic Department of Ouro Verde Hospital Complex. Patients with recurrent trichiasis without entropion who did not respond to conventional therapy, underwent intermarginal lamellar splitting of the eyelid and oral mucous graft insertion with fibrin glue replacing sutures. They were then evaluated at 1-day, 1-week, 1-month, 6-month, and 4-year follow-ups. Graft adherence, symptom resolution, esthetic satisfaction, overall patient satisfaction, and trichiasis recurrence were assessed at 6-month and 4-year follow-ups. Results: Fifteen patients (a total of 19 eyes) were included, of whom 10 (66.7%) were female and 5 (33.3%) were male. The mean age was 75.4 ± 10.5 years (range, 54-98 years). Acquired trichiasis was the main cause. Of the patients with acquired trichiasis, 12 (86.7%) had chronic blepharitis, 2 (13.3%) had an undetermined cause, and one (6.7%) had trachomatous trichiasis. Most cases involved only one eyelid segment (89.4%) and =5 lashes (84.2%; minor trichiasis). No adverse reactions from the fibrin glue were reported and no sutures were required after graft placement. At 6 months, no graft failures occurred, 17 eyes of 13 patients (89.4%) showed good graft adherence, 2 eyes of 2 patients (10.5%) showed partial graft adherence, and 2 eyes of 1 patient (10.5%) had trichiasis recurrence. At 4-year follow-up, no graft failure occurred, 3 patients (3 eyes) were lost to follow-up, and 2 eyes of 2 patients (14.2%) had trichiasis recurrence. The 4-year cumulative success rate was 78.9%. Conclusions: The modified interlamellar surgery with fibrin glue showed a good long-term success rate. This technique reduces surgical time, facilitates smaller graft insertion, and therefore, should be considered for recalcitrant minor trichiasis without entropion.> Purpose longterm long term Methods Complex therapy 1day, 1day day day, 1-day 1week, 1week week week, 1-week 1month, 1month month month, 1-month 6month, 6month 4year year 4 followups. followups follow ups. ups follow-ups adherence resolution satisfaction Results included 66.7% 667 66 7 (66.7% 33.3% 333 33 (33.3% male 754 75 75. 105 10. range, range (range 5498 54 98 54-9 years. . years) cause 86.7% 867 86 (86.7% blepharitis 13.3% 133 (13.3% 6.7% 67 (6.7% 89.4% 894 89 (89.4% = 84.2% 842 84 (84.2% trichiasis) placement months occurred 10.5% (10.5% followup, followup up, up follow-up ( 14.2% 142 14 (14.2% 789 78 9 78.9% Conclusions time therefore entropion. 66.7 (66.7 33.3 (33.3 549 54- 86.7 8 (86.7 13.3 (13.3 6.7 (6.7 89.4 (89.4 84.2 (84.2 (10.5 14.2 (14.2 78.9 66. (66. 33. (33. 86. (86. 13. (13. 6. (6. 89. (89. 84. (84. (10. 14. (14. 78. (66 (33 (86 (13 (6 (89 (84 (10 (14 (8 (1

RESUMO Objetivo: O objetivo deste estudo foi avaliar os resultados a longo prazo da técnica cirúrgica modificada de enxerto interlamelar de mucosa oral usando cola de fibrina para o tratamento de triquíase. Métodos: Um estudo prospectivo foi realizado no Departamento de Óculo-plástica do Complexo Hospital Ouro Verde. Pacientes com triquíase recorrente sem entrópio, que não responderam à terapia convencional, foram submetidos à cirurgia com separação intermarginal das lamelas das pálpebras e inserção de enxerto de mucosa oral usando cola de fibrina, substituindo a sutura. Pacientes foram avaliados 1 dia, 7 dias, 1 mês, 6 meses e 4 anos após a cirurgia. A aderência do enxerto, resolução dos sintomas, satisfação estética, satisfação geral do paciente e recorrência de triquíase foram avaliados aos 6 meses e aos 4 anos. Resultados: Quinze pacientes (total de 19 olhos) foram incluídos, dos quais 10 (66.7%) eram do sexo feminino e 5 (33.3%) do sexo masculino. A média de idade foi 75.4 ± 10.5 anos (intervalo 54-98 anos). Triquíase adquirida foi a principal causa, da qual 12 pacientes apresentaram blefarite crônica (86.7%), 2 pacientes com causa indeterminada (13.3%) e 1 paciente com triquíase tracomatosa (6.7%). A maioria dos casos envolveu apenas um segmento da pálpebra (89.4%) e com =5 cílios (84.2%; triquíase menor). Nenhuma reação adversa foi reportada com o uso da cola de fibrina e nenhum caso necessitou de sutura após inserção do enxerto. Aos 6 meses, não houve nenhuma falha de enxerto, 17 olhos de 13 pacientes (89.4%) apresentaram boa aderência de enxerto, 2 olhos de 2 pacientes (10.5%) mostraram aderência parcial do enxerto e 2 olhos de 1 paciente (10.5%) apresentaram recorrência da triquíase. Aos 4 anos, não houve nenhuma falha de enxerto, 3 olhos de 3 pacientes tiveram perda de seguimento e 2 olhos de 2 pacientes (14.2%) apresentaram recorrência da triquíase. A taxa de sucesso acumulativa após 4 anos foi de 78.9%. Conclusão: A cirurgia modificada de enxerto interlamelar de mucosa oral usando cola de fibrina mostrou uma boa taxa de sucesso a longo prazo. Esta técnica reduz o tempo cirúrgico, facilita a inserção de enxertos menores e, portanto, deve ser considerada em triquíase menor sem entrópio resistente ao tratamento convencional. Objetivo Métodos Óculoplástica Óculo plástica Verde convencional dia dias mês sintomas estética Resultados total incluídos 66.7% 667 66 (66.7% 33.3% 333 33 (33.3% masculino 754 75 75. 105 10. intervalo 5498 54 98 54-9 . anos) 86.7%, 867 86.7% , 86 (86.7%) 13.3% 133 (13.3% 6.7%. 67 6.7% (6.7%) 89.4% 894 89 (89.4% = 84.2% 842 84 (84.2% menor. menor) 10.5% (10.5% 14.2% 142 14 (14.2% 789 78 9 78.9% Conclusão cirúrgico portanto 66.7 (66.7 33.3 (33.3 549 54- 86.7 8 (86.7% 13.3 (13.3 6.7 (6.7% 89.4 (89.4 84.2 (84.2 (10.5 14.2 (14.2 78.9 66. (66. 33. (33. 86. (86.7 13. (13. 6. (6.7 89. (89. 84. (84. (10. 14. (14. 78. (66 (33 (86. (13 (6. (89 (84 (10 (14 (6 (3 (86 (1 (8 (

Abstract Introduction Prodromal characteristics of psychosis have been described for more than a century. Over the last three decades, a variety of studies have proposed methods to prospectively identify individuals (and youth in particular) who are at high risk of developing a psychotic disorder. These studies have validated various screening instruments and made them available in several languages. Here, we describe the translation into Brazilian Portuguese and cross-cultural adaptation of two such screening tools – the Prodromal Questionnaire-16 (PQ-16) and the Prevention through Risk Identification, Management, and Education (PRIME)-Screen. Method Two bilingual native speakers of Brazilian Portuguese translated the questionnaires from English. A native English speaker then performed back-translations into English. These back-translated versions were submitted to the original authors. They provided feedback and later approved the final versions. Results After translation and cross-cultural adaptation, no items needed to be changed in the adapted PQ-16 and four items were revised in the PRIME-Screen. After the peer-review process, we included two suggestions in the PQ-16 to facilitate use of the tool in our cultural and social contexts. The PRIME-Screen did not need further changes. Conclusion These new instruments can help screen Brazilian Portuguese-speaking patients who are at risk of psychosis in primary care. century decades particular disorder languages Here crosscultural cross Questionnaire16 Questionnaire 16 Questionnaire-1 PQ16 PQ (PQ-16 Identification Management PRIMEScreen. PRIMEScreen PRIME Screen. Screen (PRIME)-Screen backtranslations back translations backtranslated authors PQ-1 peerreview peer review process contexts changes Portuguesespeaking speaking care Questionnaire1 1 Questionnaire- PQ1 (PQ-1 PQ- (PQ- (PQ

Abstract Background: Adolescence is a period of significant biological, psychological and social changes. Characterized by constant emotional conflicts and cycles of disorganization-reorganization of the identity, it is a phase of enormous vulnerability to the circumstances of the surrounding environment that will influence the future of the emerging adult: identity development and certainty about oneself is closely related to better functioning in multiple domains. The COVID-19 pandemic and the social isolation adopted as a public health measure had a significant impact on the lives of adolescents: on routines, sleep, peer relationships, and school performance, adding challenges to the already complex quotidian. Objectives: This review describes the pandemic's impact in adolescents' daily routines, sleep, screen use, academic life, physical activity, relationships, and behaviors assumed by adolescents in a family context. Methods: The authors performed a literature narrative overview synthesizing the relevant findings from searches on Pubmed® and Google Scholar® Development/Conclusion: Individual characteristics and family relationships are fundamental in the capability of adolescents to deal cope with the adversity imposed by the COVID-19 pandemic. The impact of restrictive measures in this population should be taken into account by political and public health authorities when instituting preventive measures of confinement and lockdown to mitigate social isolation and allow developing adaptive strategies during adolescence

Resumo Introdução: A adolescência é um período de significativas mudanças biológicas, psicológicas e sociais. Pautada por constantes conflitos emocionais e ciclos de desorganização-reorganização da identidade, é uma fase de enorme vulnerabilidade às circunstâncias do meio envolvente, suscetível de condicionar o futuro do indivíduo. A pandemia de COVID-19 e a instituição do isolamento social enquanto medida de saúde pública tiveram grande impacto na vida dos adolescentes: nas rotinas, no sono, no relacionamento com os pares e no desempenho escolar, acrescentando desafios ao já complexo quotidiano. Objetivos: O objetivo deste estudo é descrever o impacto da pandemia nas rotinas diárias, sono, uso de ecrãs, vida académica, atividade física, relações interpessoais e comportamentos assumidos pelo adolescente em contexto familiar. Métodos: Os autores realizaram uma revisão narrativa da literatura sintetizando os achados relevantes de buscas no Pubmed® e no Google Scholar®. Desenvolvimento/Conclusão: As características individuais e as relações familiares são fundamentais na capacidade dos adolescentes de lidarem com as adversidades impostas pela pandemia do COVID-19. A análise do impacto das medidas restritivas permite que as autoridades políticas e de saúde pública as instituam mitigando o isolamento social ou desenvolvendo estratégias adaptativas para a população dessa faixa etária.

Resumo Introdução: A atual pandemia mundial por COVID-19 tem vindo a causar um impacto considerável não apenas na saúde, mas também na economia das sociedades, enfatizando a insegurança alimentar como um importante problema de saúde pública. Objetivo: Caracterizar o cenário de insegurança alimentar em Portugal durante a pandemia por COVID-19 e explorar as características sociodemográficas relacionadas. Metodologia: Trata-se de um estudo transversal, que utiliza dados de um inquérito online, realizado entre novembro de 2020 a fevereiro de 2021, incluindo 882 residentes em Portugal com idade igual ou superior a 18 anos. Recolheram-se dados sociodemográficos e de situação de segurança alimentar, sendo que esta última foi avaliada por meio da escala “United States Household Food Security Survey Module: Six-Item Short Form.” Foram calculados modelos de regressão logística brutos e ajustados (covariáveis: escolaridade, perceção de rendimento familiar e situação perante o trabalho durante a pandemia de COVID-19). Foram estimados Odds Ratio (OR) e respetivos intervalos de confiança a 95% (IC). Resultados: A maioria dos participantes era do sexo feminino (71,3%), com média de idade de 36,8 anos (DP 11,0). A prevalência de insegurança alimentar foi de 6,8%. Indivíduos com menor escolaridade (≤12 anos de estudo; OR 2,966; IC 95% 1,250-7,042), e aqueles que estavam e permaneceram desempregados desde o início da pandemia (OR 2,602; IC 95% 1,004-6,742) apresentaram maior odds de pertencer a um agregado familiar com insegurança alimentar, independentemente da escolaridade, situação perante o trabalho durante a pandemia por COVID-19 e perceção de rendimento familiar. Além disso e, independentemente da escolaridade e da situação perante o trabalho durante a pandemia por COVID-19, foi observado menor odds de pertencer a um agregado familiar com insegurança alimentar, aqueles que relataram perceção de rendimento familiar confortável (OR 0,007; IC 95% 0,001-0,062) comparativamente aqueles que perceberam o seu rendimento familiar como insuficiente. Conclusões: Estes resultados destacam os grupos populacionais que estão em maior risco de insegurança alimentar durante a atual pandemia por COVID-19. Estratégias eficazes de saúde pública devem ser desenvolvidas com o objetivo de endereçar a insegurança alimentar durante esta crise, especialmente entre os grupos de maior risco.

Abstract Introduction: The current worldwide COVID-19 pandemic has been having a considerable impact not only on health but also on the economy of societies, emphasizing food insecurity as a significant public health concern. Aim: The objective of this study was to characterize the scenario of food insecurity in Portugal during the COVID-19 pandemic and explore its related sociodemographic characteristics. Methodology: This is a cross-sectional study, using data from an online survey, performed from November 2020 until February 2021, including 882 residents aged 18 years or older in Portugal. Data on sociodemographics and food security status were collected, the latter was evaluated using the United States Household Food Security Survey Module: Six-Item Short Form. Crude and adjusted logistic regression models were performed (covariates: education, household income perception, and the working status during the COVID-19 pandemic). The odds ratio (OR) and respective 95% confidence intervals (CI) were estimated. Results: Most participants were women (71.3%), with a mean age of 36.8 years (SD 11.0). Food insecurity prevalence was 6.8%. Less-educated individuals (≤12 years of schooling; OR 2.966; 95% CI 1.250-7.042), and those who were and remained unemployed since the beginning of the pandemic (OR 2.602; 95% CI 1.004-6.742) had higher odds of belonging to a food-insecure household, regardless of education, working status during the COVID-19 pandemic, and household income perception. Moreover, lower odds of belonging to a food-insecure household were observed among those reporting a comfortable household income (OR 0.007; 95% CI 0.001-0.062) than those who perceived their household income as insufficient, independently of education and the working status during the COVID-19 pandemic. Conclusions: These findings highlight the population groups that are at a greater risk of food insecurity during the current COVID-19 pandemic. Effective public health strategies should be developed aiming to address food insecurity during this crisis, especially among the higher risk groups.

Abstract The Croton urucurana Baill species is known in Brazil as “sangra d’água” and is popular due to its medicinal properties. For better processing of herbal medicines, it is essential that efficient drying and storage techniques are developed and that compounds are preserved. Therefore, this study aimed to select models through multivariate cluster analysis applying Akaike (AIC) and Bayesian information criteria (BIC) to describe Croton urucurana leaves drying kinetics at different temperatures (40-70 °C). The initial moisture content in Croton urucurana leaves was 1.791, 1.841, 2.196 and 2.144 kg water kg dry matter-1, and 8.25, 7.75, 4.25 and 2 hours were required to reach hygroscopic equilibrium, with a final moisture content of 0.134, 0.105, 0.065 and 0.0601 kg water kg dry matter-1, at 40, 50, 60 and 70 °C, respectively. The models with the greatest similarity to the experimental data were Diffusion Approximation; Cavalcanti Mata; Two-term; Two-term Exponential; Modified Henderson & Pabis; Logarithmic; Midilli; Page and Verma. The multivariate cluster technique associated with AIC and BIC criteria during model selection is a great applicability tool to help decision-making when evaluating the drying plant leaves. The Cavalcanti Mata mathematical model was selected to represent the drying kinetics.

Abstract The identification of anti NMDA-Receptor encephalitis made it possible to recognise that some patients with rapidly progressive psychiatric symptoms, cognitive impairment, seizures, movement disorders, or coma of unknown cause, had an autoimmune disease.There are a female predominance, affecting young adults. with diverse clinical presentation and frequent association with tumours (ovarian teratoma).In the acute stage of the disease, many patients need to be hospitalised for at least 3-4 months, including admission to an Intensive Care Unit, followed by several months of physical and behavioural rehabilitation The first management should focus on immunotherapy and the detection and subsequent removal of tumour.

THE POISONOUS GARDEN: THE CHEMISTRY BEHIND THE INTOXICATION BY DOMESTIC ORNAMENTAL PLANTS. In times of the COVID-19 pandemic, despite the fact families have spent more time together, the job demands and commitments that adults have now brought into their homes may mean their attention has been taken away from their children. This, combined with the absence of older family members or domestic helpers that assist in looking after the children has left them potentially more exposed to domestic accidents. Data from the National Toxic-Pharmacological Information System indicate that two-thirds of domestic intoxications with plants (usually the ornamental ones) occur in children. These accidents can be caused either by inhalation, contact with the skin, eyes and mucous membranes, as well as by ingestion. The toxicity of ornamental plants is due to the presence of substances such as oxalic acid and its highly irritating salts, alkaloids, glycosides, flavonoids, and toxic terpenes, among several other classes of secondary metabolites. In the present study, we carried out a survey of the main ornamental plants used in the country and analyzed the toxic substances that can cause numerous conditions from dermatitis in milder cases to death in more severe cases.

Abstract Overview and Aims: In vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) show discouraging results in poor ovarian responders. We aim to characterize low prognosis women, stratifying them according to POSEIDON criteria -based on ovarian reserve markers and response in previous cycles. Study Design: data base retrospective study Population: women undertaking an IVF/ICSI cycle between May/2012 and December/2017 in our public centre. Methods: all women undertaking IVF/ICSI cycles with registered antimullerian hormone levels and antral follicule count (the ovarian reserve markers considered in POSEIDON criteria) were divided in 4 groups -women with normal ovarian reserve markers but low response in previous cycle (<35 years-G1; ≥35 years-G2) and women with at least one low ovarian reserve marker (<35 years-G3; ≥35years-G4). Ovarian reserve markers, previous ovarian response, socio-demographic features, type/etiology of infertility, number of oocytes collected, clinical pregnancy and delivery rates per cycle/ovarian puncture(OP)/transfer were determined. Ovarian response (categorized into optimal/non-optimal based on the number of oocytes collected), clinical pregnancy and delivery rates of the 4 groups were compared to population non-POSEIDON(PNP). X 2 test was used. Significance was set at p-value<0.05. Results: 1789 cycles were analysed; 49.6%(887/1789) of them met POSEIDON criteria - n=86(G1), n=129(G2); n=180(G3); n=492(G4). 85.7% of those reaching OP had a non-optimal response. G4 showed the worse pregnancy and delivery rates, significantly lower than PNP. The highest rates of pregnancy and delivery were verified in a subgroup of G2, except for delivery/cycle; no difference was observed between G1/G2 and PNP. Most women were Portuguese, Caucasian, normal weighted, non-smokers and presented primary infertility. Male factor was the most frequently identified cause. Conclusion: POSEIDON criteria showed high positive predictive value of having a non-optimal response. Results may help managing expectations of women undergoing IVF/ICSI with similar characteristics. Exclusion from POSEIDON group should not be considered reassuring due to low negative predictive value.

Resumen Marco contextual: Las experiencias personales y en la enseñanza clínica influyen en el modo en que los estudiantes de enfermería se enfrentan a la muerte. Objetivo: Evaluar las actitudes de los estudiantes de Enfermería hacia la muerte y los cuidados al final de la vida. Metodología: Estudio descriptivo. Los datos se recogieron mediante un cuestionario en línea. Participaron un total de 158 estudiantes de la licenciatura de Enfermería. Los datos cuantitativos se analizaron con el programa IBM SPSS Statistics. Se realizaron análisis estadísticos descriptivos y exploratorios de los datos mediante pruebas paramétricas y no paramétricas. Resultados: Los estudiantes mostraron una mayor proximidad a las actitudes de neutralidad, miedo y cercanía hacia la muerte, y una menor proximidad a las actitudes de evitación y huida. Con respecto a los cuidados al final de la vida, los estudiantes que ya han realizado la enseñanza clínica tienen actitudes positivas. Conclusión: Es importante utilizar metodologías de enseñanza/aprendizaje que permitan a los estudiantes exponer sus experiencias con la muerte y los cuidados al final de la vida en la enseñanza clínica.

Resumo Enquadramento: As vivências pessoais e em ensino clínico influenciam o modo como os estudantes de enfermagem lidam com a morte. Objetivo: Avaliar as atitudes dos estudantes de enfermagem perante a morte e os cuidados em fim de vida. Metodologia: Estudo descritivo. Os dados foram recolhidos através de um questionário online. Participaram 158 estudantes do curso de licenciatura em Enfermagem. Os dados quantitativos foram analisados com recurso ao programa IBM SPSS Statistics. Foram realizadas análises estatísticas descritivas e exploratórias dos dados através de testes paramétricos e não paramétricos. Resultados: Os estudantes evidenciam maior proximidade com atitudes de neutralidade, medo e aproximação perante a morte e menos proximidade com atitudes de evitamento e escape. Relativamente aos cuidados em fim de vida, os estudantes que já realizaram ensino clínico apresentam atitudes positivas. Conclusão: É importante utilizar metodologias de ensino/aprendizagem que permitam ao estudante expor as suas experiências com a morte e com os cuidados em fim de vida em ensino clínico.

Abstract Background: Personal and clinical experiences influence how nursing students cope with death. Objective: To assess nursing students’ attitudes towards death and end-of-life care. Methods: Descriptive study. Data were collected through an online questionnaire. The sample consisted of 158 undergraduate nursing students. Quantitative data were analyzed using IBM SPSS Statistics software. Descriptive statistics and exploratory data analysis were performed through parametric and non-parametric tests. Results: Students tend more to attitudes of neutral acceptance, fear of death, and approach acceptance and less to attitudes of avoidance and escape. Regarding end-of-life care, students who had already completed clinical training showed positive attitudes. Conclusion: Teaching and learning methodologies should be used to allow students to expose their experiences with death and end-of-life care in clinical training.