Abstract Background-Pulmonary arterial hypertension (PAH) increases afterload in the right ventricle (RV), inducing adverse ventricular remodelling. Objective- This study explored the protective effects of thyroid hormones and grape juice on serum biomarkers and proteins related to intermediary metabolism in the RV in a model of PAH. Methods- PAH was induced in Wistar rats via the administration of monocrotaline (60 mg/kg i.p.) and they were subsequently treated with organic grape juice (GJ) and thyroid hormones (TH), administered separately or in combination. Results: The RV systolic diameter significantly increased (20%) in the PAH group compared to the control group (P = 0.002). Total CK, LDH, and ALT levels were reduced (~50%) (P<0.001) in the PAH+TH+GJ group as compared to PAH group. Glucose, albumin, triglyceride, and total cholesterol levels were reduced (~50%) (P<0.001) in the PAH group; however, these parameters returned to baseline in the PAH+GJ group. Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) protein expression increased two-fold (P<0.001) and PDH protein levels were reduced (~25%) in the PAH+TH+GJ group compared to the PAH group (P<0.001). Conclusion: The data suggest that serum biomarkers can help in the evaluation of this disease, and that this therapeutic approach can attenuate maladaptive remodelling in the PAH model. BackgroundPulmonary Background Pulmonary (PAH RV, , (RV) Objective Methods 60 (6 mgkg mg kg i.p. ip i p GJ (GJ TH, TH (TH) combination Results 20% 20 (20% P 0.002. 0002 0.002 . 0 002 0.002) CK LDH ~50% 50 (~50% P<0.001 P0001 001 (P<0.001 PAHTHGJ Glucose albumin triglyceride however PAHGJ proliferatoractivated proliferator activated 1alpha alpha 1 PGC1α PGCα PGC 1α α (PGC-1α twofold two fold ~25% 25 (~25% P<0.001. Conclusion disease (RV 6 ( i.p (TH 2 (20 000 0.00 00 ~50 5 (~50 P<0.00 P000 (P<0.00 ~25 (~25 (2 0.0 ~5 (~5 P<0.0 P00 (P<0.0 ~2 (~2 0. ~ (~ P<0. P0 (P<0. P<0 (P<0 P< (P<

Abstract Climate change is humanity’s 21st century biggest challenge. Due to the higher rates of soil sealing, its effects and consequences are expected to be more severe in cities. To mitigate climate change effects or adapt cities to them, several approaches can be adopted, namely by adopting nature-based solutions, such as blue and green infrastructures. During the course of Study and Behaviour of Soils, of the undergraduate degree in Sustainable City Management, taught at the Institute of Engineering of the Polytechnic Institute of Coimbra (ISEC-IPC), students are faced with the need to present solutions to solve an urban problem by implementing a green solution. Students are involved in a co-creation process to carry out this academic activity. This project-based learning methodology is seen as an active learning process, and its three stages are fully described in this paper. Students’ perceptions, academic results and assiduity are compared and contrasted to enhance the benefits of such an approach in geotechnical education. Results show that not only are students more willing to participate in class, reducing absenteeism, but students’ final project results increased when compared with a more traditional pedagogical approach. Also, based on the survey, it is possible to conclude that the co-creation approach allows the development of transversal skills and competencies, and such a learning process should be implemented more often during the undergraduate degree. humanitys humanity s st challenge sealing them adopted naturebased nature infrastructures Soils Management ISECIPC, ISECIPC ISEC IPC , (ISEC-IPC) solution cocreation co creation activity projectbased paper perceptions education class absenteeism Also survey competencies (ISEC-IPC

Abstract Background Adverse remodeling of lung vessels elevates pulmonary pressure and provokes pulmonary arterial hypertension (PAH). PAH results in increased right ventricle (RV) afterload, causing ventricular hypertrophy and the onset of heart failure. There is no specific treatment for maladaptive RV remodeling secondary to PAH. Objectives This study aims to explore two therapeutic approaches, grape juice (GJ) and thyroid hormones (TH), on PAH-induced oxidative stress and cardiac functional changes. Methods Parameters of echocardiography related to lung vessel resistance (AT/ET ratio), RV contractility (TAPSE), and RV diastolic function (E/A peaks ratio) were evaluated. Also, total ROS, lipid peroxidation, antioxidant enzymes, calcium handling proteins, pro-oxidant and antioxidant protein expression were measured. Values of p<0.05 were considered statistically significant. Results Both GJ and TH treatments demonstrated reductions in pulmonary resistance (~22%) and improvements in TAPSE (inotropism ~11%) and AT/ET ratio (~26%) (p<0.05). There were no changes amongst groups regarding the E/A peak ratio. Although ROS and TBARS were not statistically significant, GJ and TH treatments decreased xanthine oxidase (~49%) levels and normalized HSP70 and calcium handling protein expression (p<0.05). However, only TH treatment ameliorated diastolic function (~50%) and augmented NRF2 immunocontent (~48%) (p<0.05). Conclusions To the best of our knowledge, this study stands as a pioneer in showing that TH administered together with GJ promoted functional and biochemical improvements in a PAH model. Moreover, our data suggest that GJ and TH treatments were cardioprotective, combined or not, and exhibited their beneficial effects by modulating oxidative stress and calcium-handling proteins. . (PAH) (RV afterload failure approaches (GJ TH, , (TH) PAHinduced induced ATET AT ET ratio, TAPSE, (TAPSE) EA E A evaluated Also peroxidation enzymes proteins prooxidant pro oxidant measured p005 p 0 05 p<0.0 significant ~22% 22 (~22% inotropism ~11% 11 ~26% 26 (~26% p<0.05. (p<0.05) ~49% 49 (~49% HSP HSP7 However ~50% 50 (~50% NRF ~48% 48 (~48% knowledge model Moreover cardioprotective calciumhandling (PAH (TH (TAPSE p00 p<0. ~22 2 (~22 ~11 1 ~26 (~26 (p<0.05 ~49 4 (~49 ~50 5 (~50 ~48 (~48 p0 p<0 ~2 (~2 ~1 (p<0.0 ~4 (~4 ~5 (~5 p< ~ (~ (p<0. ( (p<0 (p< (p

Resumo Fundamento A remodelação adversa dos vasos pulmonares eleva a pressão pulmonar e provoca hipertensão arterial pulmonar (HAP). A HAP resulta em aumento da pós-carga do ventrículo direito (VD), causando hipertrofia ventricular e consequente insuficiência cardíaca. Não existe um tratamento específico para o remodelamento desadaptativo do VD secundário à HAP. Objetivos Este estudo tem como objetivo explorar duas abordagens terapêuticas, o suco de uva (SU) e os hormônios tireoidianos (HT), no tratamento do estresse oxidativo induzido pela HAP e nas alterações funcionais cardíacas. Métodos Parâmetros ecocardiográficos relacionados à resistência dos vasos pulmonares (relação TA/TE), contratilidade do VD (ESPAT) e função diastólica do VD (relação dos picos E/A) foram avaliados. Além disso, foram medidos ROS totais, peroxidação lipídica, enzimas antioxidantes, proteínas de manipulação de cálcio, expressão de proteínas pró-oxidantes e antioxidantes. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados Ambos os tratamentos, com SU e HT, demonstraram uma redução na resistência pulmonar (~22%), além de melhorias na ESPAT (inotropismo ~11%) e na relação TA/TE (~26%) (p<0,05). Não houve alterações entre os grupos na relação do pico de E/A. Embora ROS e TBARS não tenham sido estatisticamente significativos, os tratamentos com SU e HT diminuíram os níveis de xantina oxidase (~49%) e normalizaram a expressão de HSP70 e proteínas de manipulação de cálcio (p<0,05). No entanto, apenas o tratamento com HT melhorou a função diastólica (~50%) e aumentou o imunoconteúdo de NRF2 (~48%) (p<0,05). Conclusões Até onde sabemos, este estudo é pioneiro ao mostrar que o HT administrado em conjunto com o SU promoveu melhorias funcionais e bioquímicas em um modelo de HAP. Além disso, nossos dados sugerem que os tratamentos com SU e HT se mostraram cardioprotetores, sejam combinados ou não, e exibiram seus benefícios ao modular o estresse oxidativo e as proteínas de manipulação do cálcio. . (HAP) póscarga pós carga VD, , (VD) cardíaca terapêuticas (SU (HT) cardíacas TA/TE, TATE TA TE TA/TE) (ESPAT E/A EA E avaliados disso totais lipídica antioxidantes próoxidantes pró oxidantes p005 p 0 05 p<0,0 significativos ~22%, 22 ~22% (~22%) inotropismo ~11% 11 ~26% 26 (~26% p<0,05. (p<0,05) ~49% 49 (~49% HSP HSP7 entanto ~50% 50 (~50% NRF ~48% 48 (~48% sabemos cardioprotetores (HAP (VD (HT p00 p<0, 2 ~22 (~22% ~11 1 ~26 (~26 (p<0,05 ~49 4 (~49 ~50 5 (~50 ~48 (~48 p0 p<0 ~2 (~22 ~1 (~2 (p<0,0 ~4 (~4 ~5 (~5 p< ~ (~ (p<0, ( (p<0 (p< (p

RESUMO Objetivo: Descrever a elaboração e validação de um protocolo para atendimento de pacientes suspeitos ou com Coronavirus Disease-19 (COVID-19) em hemodiálise. Método: Estudo metodológico conduzido de março a agosto/2020 em hospital do sul do Brasil. O estudo envolveu diagnóstico situacional, revisão da literatura, elaboração do protocolo e validação de conteúdo (abrangência, clareza e pertinência). Participaram da validação dez profissionais da equipe multidisciplinar com experiência no atendimento de pacientes com doença renal e um órgão oficial fiscalizatório de enfermagem. Obteve-se 100% de consenso entre os especialistas. Resultados: Foram elaborados: “Fluxo de atendimento para pacientes constituído de seis “etapas” e “Plano gerencial para centros de diálise”. A validação permitiu aprimorar e refinar o conteúdo atendendo preceitos de normas sanitárias, segurança e diretrizes clínicas. Considerações finais: A elaboração e validação do protocolo podem padronizar e nortear a prática clínica, promovendo a continuidade e a segurança no cuidado, podendo ser utilizado em outros centros.

ABSTRACT Objective: To describe the elaboration and validation of a protocol for the care of suspected patients with Coronavirus Disease-19 (COVID-19) undergoing hemodialysis. Method: A methodological study conducted from March to August 2020 at a hospital in southern Brazil. The study involved situational diagnosis, literature review, protocol elaboration and content validation (scope, clarity and relevance). Ten professionals from the multidisciplinary team with experience in caring for patients with kidney disease and an official Nursing supervisory body participated in the validation. 100% consensus was reached among the experts. Results: The following were elaborated: “Flow of patient care consisting of six stages” and “Management plan for dialysis centers”. The validation allowed improving and refining the content, complying with the precepts of health standards, safety and clinical guidelines. Final considerations: The elaboration and validation of the protocol can standardize and guide the clinical practice, promoting continuity and safety in care, and can be used in other centers.

RESUMEN Objetivo: Describir la elaboración y validación de un protocolo para la atención de pacientes sospechosos o con Coronavirus Disease-19 (COVID-19) en hemodiálisis. Método: estudio metodológico realizado de marzo a agosto / 2020 en un hospital del sur de Brasil. El estudio incluyó diagnóstico situacional, revisión de la literatura, elaboración de protocolos y validación de contenido (alcance, claridad y relevancia). En la validación participaron diez profesionales del equipo multidisciplinar con experiencia en el cuidado de pacientes con enfermedad renal y un órgano de control oficial de enfermería. Se alcanzó un consenso del 100% entre los expertos. Resultados: Fueron elaboraron: "Flujo de atención al paciente en seis etapas" y "Plan de gestión para centros de diálisis". La validación permitió mejorar y afinar el contenido, cumpliendo con los preceptos de las normas de salud, seguridad y guías clínicas. Consideraciones finales: La elaboración y validación del protocolo puede estandarizar y orientar la práctica clínica, promoviendo la continuidad y seguridad en la atención, pudiendo ser utilizado en otros centros.

Objective: To describe the elaboration and validation of a protocol for the care of suspected patients with Coronavirus Disease-19 (COVID-19) undergoing hemodialysis.Method: Methodological study conducted from March to August 2020 at a referral hospital in southern Brazil. The study involved situational diagnosis, literature review, protocol elaboration and content validation (scope, clarity and relevance). Ten professionals from the multidisciplinary team with experience in caring for patients with kidney disease and an official nursing supervisory body participated in the validation. 100% consensus was reached among experts.Results: The following were elaborated: “Flow of patient care composed of six stages and” and “Management plan for dialysis centers”. The validation allowed to improve and refine the content, complying with the precepts of health standards, safety and clinical guidelines.Final considerations: The elaboration and validation of the protocol can standardize and guide clinical practice, promoting continuity and safety in care, and can be used in other centers.

Objetivo: Describir la elaboración y validación de un protocolo para la atención de pacientes sospechosos o con Coronavirus Disease-19 (COVID-19) en hemodiálisis.Método: studio metodológico realizado de marzo a agosto / 2020 en un hospital del sur de Brasil. El estudio incluyó diagnóstico situacional, revisión de la literatura, elaboración de protocolos y validación de contenido (alcance, claridad y relevancia). En la validación participaron diez profesionales del equipo multidisciplinar con experiencia en el cuidado de pacientes con enfermedad renal y un órgano de control oficial de enfermería. Se alcanzó un consenso del 100% entre los expertos.Resultados: Fueron elaboraron: "Flujo de atención al paciente en seis etapas" y "Plan de gestión para centros de diálisis". La validación permitió mejorar y afinar el contenido, cumpliendo con los preceptos de las normas de salud, seguridad y guías clínicas.Consideraciones finales: La elaboración y validación del protocolo puede estandarizar y orientar la práctica clínica, promoviendo la continuidad y seguridad en la atención, pudiendo ser utilizado en otros centros.

Objetivo: Descrever a elaboração e validação de um protocolo para atendimento de pacientes suspeitos ou com Coronavirus Disease-19 (COVID-19) em hemodiálise.Método: Estudo metodológico conduzido de março a agosto/2020 em hospital do sul do Brasil. O estudo envolveu diagnóstico situacional, revisão da literatura, elaboração do protocolo e validação de conteúdo (abrangência, clareza e pertinência). Participaram da validação dez profissionais da equipe multidisciplinar com experiência no atendimento de pacientes com doença renal e um órgão oficial fiscalizatório de enfermagem. Obteve-se 100% de consenso entre os especialistas.Resultados: Foram elaborados: “Fluxo de atendimento para pacientes constituído de seis “etapas” e “Plano gerencial para centros de diálise”. A validação permitiu aprimorar e refinar o conteúdo atendendo preceitos de normas sanitárias, segurança e diretrizes clínicas. Considerações finais: A elaboração e validação do protocolo podem padronizar e nortear a prática clínica, promovendo a continuidade e a segurança no cuidado, podendo ser utilizado em outros centros.

Abstract The enzyme acetylcholinesterase participates in the end of cholinergic transmission and it has been shown that its activity is increased in some diseases that affect the brain, including Alzheimer disease. The objective of this study was to investigate the effect of purple grape juice consumption with or without high-fat diet in the gestational and lactation period on acetylcholinesterase activity and oxidative stress parameters in the hippocampus of female descendants. During pregnancy and lactation, 40 female Wistar rats received a control diet or a high-fat diet, with half of them receiving grape juice. After lactation, the female descendants received water and control diet in ad libitum until euthanasia on the 120 postnatal day. Hippocampus from were removed for analysis of AChE activity, protein oxidation and lipid peroxidation. It was observed that high-fat diet consumption during the pregnancy increased the AChE activity and the grape juice reduced this activity in descendants. The same was observed in protein oxidation, the descendants from high-fat diet had significantly highest values, and grape juice decreased the levels. We conclude that dietary choices during pregnancy can alter the acetylcholinesterase levels and grape juice is an important alternative to improve this function in adulthood.

A displasia broncopulmonar (DBP) é multifactorial. Prematuridade, doença da membrana hialina, oxigénio, ventilação mecânica, inflamação e canal arterial são alguns dos factores na sua patogénese. Objectivo: Avaliar a prevalência da DBP e seus factores de risco em cinco unidades portuguesas, para implementar boas práticas no tratamento deste doentes. Material e métodos: 256 recém-nascidos (RN) com idade gestacional (IG) <30 semanas e/ou peso <1250 g internados em cinco unidades portuguesas, entre 2004 e 2006, foram estudados. Foi recolhida a informação clínica dos processos. A DBP foi definida como a necessidade de oxigénio às 36 semanas de idade pós-conceptional. Resultados: A prevalência da DBP foi de 12,9%. O seu risco diminuiu de 46% por semana de IG e de 39% por 100g de peso. O risco de DBP foi maior entre os RN com baixo peso (OR adj = 0,73, 95% CI=0,57-0,95), doença da membrane hialina grave (OR adj = 9,85, 95% CI=1,05-92,35), com sépsis (OR adj = 6,22, 95% CI=1,68-23,02), com maior duração de ventilação (42 vs 3 dias, respectivamente nos RN com e sem DBP, p<0,001) e maior duração de FiO2>0,30 (85 vs 5 dias, respectivamente nos doentes com e sem DBP, p<0,001). Comentários: Os factores de risco de DBP mais relevantes foram o baixo peso, a doença da membrana hialina grave, a duração da ventilação mecânica e da oxigenoterapia e a sépsis. A implementação das boas práticas para reduzir a lesão pulmonar nos RN deve ser dirigida para melhorar as práticas que reduzem estes factores de risco.

The pathogenesis of bronchopulmonary dysplasia (BPD) is clearly multifactorial. Specific pathogenic risk factors are prematurity, respiratory distress, oxygen supplementation, mechanical ventilation (MV), inflammation, patent ductus arteriosus (PDA), etc. Aim: To evaluate BPD prevalence and to identify risk factors for BPD in five Portuguese Neonatal Intensive Care Units in order to develop better practices the management of these newborns. Material and methods: 256 very low birth weight infants with gestational age (GA) <30 weeks and/or birthweight (BW) <1250 g admitted in five Portuguese NICUs, between 2004 and 2006 were studied. A protocol was filled in based on clinical information registered in the hospital charts. BPD was defined as oxygen dependency at 36 weeks of postconceptional age. Results: BPD prevalence was 12.9% (33/256). BPD risk decreased 46% per GA week and of 39% per 100g BW. BPD risk was significantly higher among newborns with low BW (adj OR= 0.73, 95% CI=0.57- 0.95), severe hyaline membrane disease (adj OR= 9.85, 95% CI=1.05-92.35), and those with sepsis (adj OR=6.22, 95% CI=1.68-23.02), those with longer duration on ventilatory support (42 vs 3 days, respectively in BPD and no BPD patients, p<0.001) and longer duration of FiO2>0.30 (85 vs 5 days, respectively in BPD and no BPD patients, p<0.001). Comments: The most relevant risk factors were low birth weight, severe hyaline membrane disease, duration of respiratory support and oxygen therapy, and nosocomial sepsis. The implementation of potentially better practices to reduce lung injury in neonates must be addressed to improve practices to decrease these risk factors.

Neste trabalho descrevemos as malformações e co-morbidades observadas em pacientes com síndrome de Turner (ST). Foi realizado um estudo retrospectivo, avaliando os prontuários de 60 pacientes cujo diagnóstico de ST foi confirmado através do cariótipo, desde a fase pré-natal até a idade de 49 anos. As pacientes encontram-se com idades entre 1 e 50 anos e foram evoluídas num período de 4 meses a 29 anos. Trinta e uma apresentavam o cariótipo 45XO, 24 eram mosaico e 5 apresentavam o padrão 46Xi, (i,Xq). Todas tinham baixa estatura e algum tipo de estigma. Cinco (8,3%) não apresentavam outras malformações congênitas e eram saudáveis; 55 (91,6%) apresentavam doenças associadas, sendo que em 23 (38,3%) foram detectadas doenças endócrinas, em 16 (26,6%) otorrinolaringológicas, 15 (25%) cardiológicas, 14 (23,3%) nefrológicas e 6 (10%) gastrointestinais. Entre as doenças endócrinas mais comuns, observamos hipotireoidismo (36,6%), seguido de osteoporose (18,3%) e hiperlipemia (11,6%). As doenças otorrinolaringológicas mais comuns foram as infecções (otite média e amigdalite); das doenças cardiológicas, as valvulopatias (principalmente aorta bicúspide), das nefrológicas as duplicações do sistema coletor e rotações renais e das gastrointestinais foram observados dois casos de divertículo de Meckel. Encontramos maior prevalência de malformações cardíacas nas pacientes com cariótipo 45XO, embora sem significância estatística quando considerados os demais cariótipos. Concluímos que, devido à alta ocorrência de doenças nesta síndrome, estas devem ser acompanhadas periodicamente em diferentes especialidades.

A retrospective study was held on data of 60 patients with Turner's Syndrome (TS), aiming to report the most prevalent diseases in this syndrome. Diagnosis was confirmed by kariotype from the prenatal period to the age of 49 years. At the time of the study the age of the patients ranged from 1 to 50 years, and they were observed during 4 months to 29 years. Thirty-one patients presented 45XO kariotype, 24 were mosaic and 5 were 46Xi, (i,Xq). All presented with low stature and some stigmas. Five (8.3%) did not present other diseases and are currently healthy. In 55 (91.6%) the following associate diseases were observed: 23 (38.3%) had endocrine, 16 (26.6%) ear, throat and nose, 15 (25%) cardiologic, 14 (23.3%) renal and 6 (10%) gastrointestinal diseases. The most common endocrine diseases were hypothyroidism (36.6%), osteoporosis (18.3%) and hyperlipidemia (11.6%). The most frequent ear, nose and throat diseases were infections (media otitis and tonsillitis). Congenital diseases of the aorta valve (bicuspid aorta valve) and double collecting systems with renal rotation were the most prevalent cardiac and renal diseases, respectively. Two patients had a diagnosis of Meckel's diverticulum. Although congenital diseases were more common in 45XO patients, no statistical significant difference was found concerning the prevalence of the diseases on other karyotypes. We conclude that special support must be given to patients with TS, with periodical assistance by multiple specialists.

Os autores descrevem o caso de paciente portadora de leucemia mielóide aguda que apresentou como primeira manifestação da doença, infiltração leucêmica conjuntival. São feitas considerações a respeito das manifestações sistêmicas e oftalmológicas e atualização desta doença.

The authors present a case of acute myelogenous leukemia whose first symptom was infiltration of the conjunctiva. The clinical and ophthalmologic characteristics are discussed and reviewed.