Resumen Marco contextual: La crisis provocada por la pandemia de la COVID-19 produjo cambios en la vida académica de los estudiantes de educación superior, que pueden afectar su bienestar psicológico. Objetivo: Analizar la relación entre las estrategias de afrontamiento utilizadas y el bienestar psicológico en estudiantes de enfermería durante la cuarentena por la COVID-19. Metodología: Estudio transversal, descriptivo-correlacional, con una muestra de 136 estudiantes. La recopilación de datos se realizó en línea mediante la Escala de Medición de la Manifestación del Bienestar Psicológico y el Brief COPE. Resultados: Los estudiantes de los últimos cursos utilizan con más frecuencia la estrategia de afrontamiento apoyo instrumental (p = 0,015) y emocional (p = 0,009), y también tienen mayores niveles de bienestar psicológico (p = 0,012). Los cambios en los ingresos familiares se asocian con el bienestar psicológico (p = 0,024), así como con las estrategias de afrontamiento religión (r = 0,36; p ≤ 0,01), reinterpretación positiva (r = 0,47; p ≤ 0,01) y estado de ánimo (r = 0,37; p ≤ 0,01). Conclusión: Las estrategias de afrontamiento adoptadas por los estudiantes parecen estar relacionadas con el bienestar psicológico durante la cuarentena.

Resumo Enquadramento: A crise pandémica da COVID-19 acarretou mudanças na vida académica dos estudantes do ensino superior, o que poderá afetar o seu bem-estar psicológico. Objetivo: Analisar a relação entre estratégias de coping utilizadas e o bem-estar psicológico em estudantes de enfermagem durante a quarentena pela COVID-19. Metodologia: Estudo transversal, descritivo-correlacional, utilizando uma amostra de 136 estudantes. Colheita de dados online, com recurso à Escala de Medida de Manifestação de Bem-estar Psicológico e à Brief COPE. Resultados: Os estudantes dos últimos anos de curso utilizam mais frequentemente a estratégia de coping suporte instrumental (p = 0,015) e emocional (p = 0,009), apresentam ainda, maiores níveis de bem-estar psicológico (p = 0,012). As alterações no rendimento familiar estão associadas ao bem-estar psicológico (p = 0,024), assim como as estratégias de coping religião (r = 0,36; p ≤ 0,01), reinterpretação positiva (r = 0,47; p ≤ 0,01) e humor (r = 0,37; p ≤ 0,01). Conclusão: As estratégias de coping adotadas pelos estudantes parecem estar relacionadas com o bem-estar psicológico durante a quarentena.

Abstract Background: The COVID-19 pandemic crisis has brought about changes in the lives of higher education students that may influence their psychological well-being. Objective: To analyze the association between nursing students’ coping strategies and their psychological well-being during the COVID-19 quarantine. Methodology: Cross-sectional, descriptive-correlational study using a convenience sample of 136 students. Data were collected online using the Portuguese version of the Échelle de Mesure des Manifestations du Bien-être Psychologique and the Brief COPE. Results: Students in the last years of their undergraduate studies used the instrumental support (p = 0.015) and emotional support (p = 0.009) coping strategies more often and had higher levels of psychological well-being (p = 0.012). Psychological well-being is associated with household income changes (p = 0.024), as well as with religion (r = 0.36; p ≤ 0.01), positive reframing (r = 0.47; p ≤ 0.01), and humor (r = 0.37; p ≤ 0.01) coping strategies. Conclusion: Students’ coping strategies seem to be associated with their psychological well-being during the COVID-19 quarantine.

Abstract A 72-year-old woman was admitted for acute heart failure. The echocardiography revealed moderate depression of the left ventricular ejection fraction. Coronary disease was excluded by coronarography. Cardiac magnetic resonance showed predominantly left ventricular septal hypertrophy and severe depression of the left ventricular systolic function. There was also a bright, multifocal and patchy late gadolinium enhancement with subendocardial, mesocardial and subepicardial involvement, suggestive of sarcoidosis. Biochemical study, thoracic computed tomography and positron emission tomography were inconclusive for extra-cardiac sarcoidosis. Therefore, an endomyocardial biopsy was performed. The procedure was complicated by the development of complete atrioventricular block, requiring implantation of a cardiac resynchronization pacing device. A few days after device implantation, the patient developed fever. The echocardiography revealed extensive vegetations, and thus the diagnosis of a device-associated infective endocarditis was made. Even though antibiotic therapy was promptly started, the patient ended up dying. Biopsy results revealed lymphocytic myocarditis. This case is paradigmatic because it shows how the etiologic diagnosis of dilated cardiomyopathy can be challenging. Non-invasive diagnostic exams may not provide a definite diagnosis, requiring an endomyocardial biopsy. However, the benefits versus risks of such procedure must always be carefully weighted.

Resumo Fundamento: Existem muitos escores de risco (ERs) aprovados na predição de um pior prognóstico em síndromes coronárias agudas (SCAs). Recentemente, a Revista Portuguesa de Cardiologia propôs o ER ProACS. Objetivo: Aplicar vários ERs validados, bem como o ProACS em pacientes internados por SCA. Avaliar o desempenho de cada ER em predizer mortalidade hospitalar e a ocorrência de mortalidade por todas as causas ou SCA não fatal em um ano de acompanhamento e compará-los com o ProACS. Métodos: Estudo retrospectivo de SCA. Os seguintes ERs foram aplicados: GRACE, ACTION Registry-GWTG, PURSUIT, TIMI, EMMACE, SRI, CHA2DS2-VASc-HS, C-ACS e ProACS. Curvas ROC foram criadas para determinar o poder preditivo de cada ER e diretamente comparadas com a do ProACS. Resultados: Os escores ProACS, ACTION Registry-GWTG e GRACE mostraram estatística-C de 0,908, 0,904 e 0,890, respectivamente, em predizer mortalidade hospitalar, mostrando melhor desempenho em pacientes com infarto do miocárdio com elevação do segmento ST. Os demais ERs mostraram desempenho satisfatório, com estatística-C acima de 0,750, com exceção de CHA2DS2-VASc-HS e C-ACS, que mostraram baixa performance. Todos os ERs apresentaram baixo desempenho em predizer um pior prognóstico em longo prazo, com estatística-C abaixo de 0,700. Conclusão: O ProACS é um escore de risco facilmente obtido para estratificação precoce de mortalidade intra-hospitalar. Ao avaliar todos os ERs, ProACS, ACTION Registry-GWTG e GRACE mostraram o melhor desempenho, com alta capacidade de predizer um pior prognóstico. O ProACS mostrou superioridade estatisticamente significativa em comparação aos outros ERs. Portanto, o ProACS mostrou-se capaz de combinar simplicidade no cálculo do escore com bom desempenho em predizer um pior prognóstico.

Abstract Background: Multiple risk scores (RS) are approved in the prediction of worse prognosis in acute coronary syndromes (ACS). Recently, the Portuguese Journal of Cardiology has proposed the ProACS RS. Objective: Application of several validated RS, as well as ProACS in patients, admitted for ACS. Evaluation of each RS's performance in predicting in-hospital mortality and the occurrence of all-cause mortality or non-fatal ACS at one-year follow-up and compare them to the ProACS RS. Methods: A retrospective study of ACS was performed. The following RS were applied: GRACE, ACTION Registry-GWTG, PURSUIT, TIMI, EMMACE, SRI, CHA2DS2-VASc-HS, C-ACS and ProACS. ROC Curves were created to determine the predictive power for each RS and then were directly compared to ProACS. Results: The ProACS, ACTION Registry-GWTG and GRACE showed a c-statistics of 0.908, 0.904 and 0.890 for predicting in-hospital mortality, respectively, performing better in ST-segment elevation myocardial infarction patients. The other RS performed satisfactorily, with c-statistics over 0.750, apart from the CHA2DS2-VASc-HS and C-ACS which underperformed. All RS underperformed in predicting worse long-term prognosis revealing c-statistics under 0.700. Conclusion: ProACS is an easily obtained risk score for early stratification of in-hospital mortality. When evaluating all RS, the ProACS, ACTION Registry-GWTG and GRACE RS showed the best performance, demonstrating high capability of predicting a worse prognosis. ProACS was able to demonstrate statistically significant superiority when compared to almost all RS. Thus, the ProACS has showed that it is able to combine simplicity in the calculation of the score with good performance in predicting a worse prognosis.