Prevascularized spongy-like hydrogels maintain their angiogenic potential after prolonged hypothermic storage.

The chronic shortage of organs and tissues for transplantation represents a dramatic burden on healthcare systems worldwide. Tissue engineering offers a potential solution to address these shortages, but several challenges remain, with prevascularization being a critical factor for in vivo survival and integration of tissue engineering products. Concurrently, a different challenge hindering the clinical implementation of such products, regards their efficient preservation from the fabrication site to the bedside. Hypothermia has emerged as a potential solution for this issue due to its milder effects on biologic systems in comparison with other cold preservation methodologies. Its impact on prevascularization, however, has not been well studied. In this work, 3D prevascularized constructs were fabricated using adipose-derived stromal vascular fraction cells and preserved at 4 °C using Hypothermosol or basal culture media (α-MEM). Hypothermosol efficiently preserved the structural and cellular integrity of prevascular networks as compared to constructs before preservation. In contrast, the use of α-MEM led to a clear reduction in prevascular structures, with concurrent induction of high levels of apoptosis and autophagy at the cellular level. In vivo evaluation using a chorioallantoic membrane model demonstrated that, in opposition to α-MEM, Hypothermosol preservation retained the angiogenic potential of constructs before preservation by recruiting a similar number of blood vessels from the host and presenting similar integration with host tissue. These results emphasize the need of studying the impact of preservation techniques on key properties of tissue engineering constructs such as prevascularization, in order to validate and streamline their clinical application.

Capture-based targeted sequencing using a T-cell control in myeloid malignancies and idiopathic cytopenias.

We report on a study of next-generation sequencing in 257 patients undergoing investigations for cytopenias. We sequenced bone marrow aspirates using a target enrichment panel comprising 82 genes and used T cells from paired blood as a control. One hundred and sixty patients had idiopathic cytopenias, 81 had myeloid malignancies and 16 had lymphoid malignancies or other diagnoses. Forty-seven of the 160 patients with idiopathic cytopenias had evidence of somatic pathogenic variants consistent with clonal cytopenias. Only 39 genes of the 82 tested were mutated in the 241 patients with either idiopathic cytopenias or myeloid neoplasms. We confirm that T cells can be used as a control to distinguish between germline and somatic variants. The use of paired analysis with a T-cell control significantly reduced the time molecular scientists spent reporting compared to unpaired analysis. We identified somatic variants of uncertain significance (VUS) in a higher proportion (24%) of patients with myeloid malignancies or clonal cytopenias compared to less than 2% of patients with non-clonal cytopenias. This suggests that somatic VUS are indicators of a clonal process. Lastly, we show that blood depleted of lymphocytes can be used in place of bone marrow as a source of material for sequencing.

Shrouded in history: Unveiling the ways of life of an early Muslim population in Santarém, Portugal (8th- 10th century AD).

In around 716 AD, the city of Santarém, Portugal, was conquered by the Berber and Arab armies that swept the Iberian Peninsula and went on to rule the region until the 12th century. Archaeological excavations in 2007/08 discovered an Islamic necropolis (Avenida 5 de Outubro #2-8) that appears to contain the remains of an early Muslim population in Santarém (8th- 10th century). In this study, skeletal material from 58 adult individuals was analysed for stable carbon (δ13Ccol; δ13Cap), nitrogen (δ15N) and sulphur (δ34S) isotope ratios in bones, and stable oxygen (δ18O), carbon (δ13Cen) and radiogenic strontium (87Sr/86Sr) isotopes in tooth enamel. The results of this study revealed a dietary pattern of predominantly C3-plant and domestic C3-fed herbivore consumption during adulthood (δ13Ccol and δ15N, respectively) but a higher proportion of C4-plant input during childhood (δ13Cen) for some individuals-interpreted as possible childhood consumption of millet porridge, a common practice in North Africa-in those with unorthodox burial types (Groups 1 and 2) that was not practiced in the individuals with canonical burials (Group 3). In this first mobility study of a medieval Muslim population in Portugal, δ18ODW values revealed greater heterogeneity in Groups 1 and 2, consistent with diverse origins, some in more humid regions than Santarém when compared to regional precipitation δ18O data, contrasting the more homogenous Group 3, consistent with the local precipitation δ18O range. Ancient DNA analysis conducted on three individuals revealed maternal (mtDNA) and paternal (Y-chromosome) lineages compatible with a North African origin for (at least) some of the individuals. Additionally, mobility of females in this population was higher than males, potentially resulting from a patrilocal social system, practiced in Berber and Arab communities. These results serve to offer a more detailed insight into the ancestry and cultural practices of early Muslim populations in Iberia.

Psychosocial experiences of involuntary definitive childless women: a comparative study based on reproductive status.

STUDY QUESTION: Do involuntary definitive childless women have lower psychosocial adjustment levels than women with infertility diagnoses actively trying to conceive and presumably fertile women? SUMMARY ANSWER: Involuntary definitive childless women have lower levels of sexual functioning than infertile women actively trying to conceive and presumably fertile women, and higher levels of depression than presumably fertile women. WHAT IS KNOWN ALREADY: Involuntary definitive childless defines those who wanted to become parents but were unable to do so. Studies have provided evidence about infertility and its psychosocial consequences, but there is a lack of knowledge about the impact of involuntary definitive childlessness, namely on sexual function, social support, marital satisfaction, and psychological adjustment. STUDY DESIGN, SIZE, DURATION: This associative study was conducted between July 2021 and January 2022 for involuntary definitive childless women and between July 2016 and February 2018 for women with an infertility diagnosis actively trying to conceive as well as presumably fertile women. An online questionnaire announced in social media and gynaecology and fertility clinics was used. The inclusion criteria for all participants were being childless, in a heterosexual relationship and cohabiting for at least 2 years. Specific inclusion criteria for involuntary definitive childless women were: trying to conceive for at least 2 years; not achieving pregnancy because of biological and medical constraints; and not undergoing fertility treatment or being a candidate for adopting a child at time of the study. For women with an infertility diagnosis the inclusion criteria were: actively trying to conceive (naturally or through fertility treatments); having a primary fertility diagnosis; and aged between 22 and 42 years old. For presumably fertile women, the inclusion criteria were: having a parenthood wish in the future; and not knowing of any condition that could prevent them from conceiving. PARTICIPANTS/MATERIALS, SETTING, METHODS: Out of 360 women completing the survey, only 203 were eligible for this study (60 involuntary definitive childless women, 78 women with an infertility diagnosis actively trying to conceive, and 65 presumably fertile women). All participants completed a questionnaire including sociodemographic and clinical data, the Female Sexual Function Index, the 2-Way Social Support Scale, the Relationship Assessment Scale, and Hospital Anxiety and Depression Scale. Binary logistic regression was performed to assess the relation between sexual function, social support, marital satisfaction, anxiety, depression, and reproductive status, adjusting for age, and cohabitation length. Presumably fertile women were used as a reference group. MAIN RESULTS AND THE ROLE OF CHANCE: Women were 34.31 years old (SD = 5.89) and cohabited with their partners for 6.55 years (SD = 4.57). The odds ratio (OR) showed that involuntary definitive childless women had significantly lower sexual function than infertile women actively trying to conceive (OR = 0.88, 95% CI = 0.79-0.99) and presumably fertile women (OR = 34.89, 95% CI = 1.98-614.03), and higher depression levels than presumably fertile women (OR = 99.89, 95% CI = 3.29-3037.87). Women with an infertility diagnosis actively trying to conceive did not differ from presumably fertile women in sexual function, social support, marital satisfaction, anxiety, and depression. LIMITATIONS, REASONS FOR CAUTION: The majority of childless women underwent fertility treatments, and childlessness for circumstantial reasons owing to lack of a partner was not included, therefore these results may not reflect the experiences of all women with an involuntary childless lifestyle. There was a time gap in the recruitment process, and only the definitive childlessness group filled out the questionnaire after the coronavirus disease 2019 pandemic. We did not ask participants if they self-identified themselves with the groups' terminology they were assigned to. WIDER IMPLICATIONS OF THE FINDINGS: Our results emphasize the importance of future research to provide a more comprehensive understanding of the adjustment experiences of childless women and an awareness of the poor adjustment they might experience, highlighting the need to keep following women after unsuccessful treatments. Clinical practitioners must attend to these dimensions when consulting involuntary definitive childless women who might not have gone through treatments but also experience these adverse outcomes. STUDY FUNDING/COMPETING INTEREST(S): This study was partially supported by the Portuguese Foundation for Science and Technology. The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER: N/A.

Prediabetes remission after bariatric surgery: a 4-years follow-up study.

BACKGROUND: Bariatric surgery leads to weight loss and to cardiometabolic risk improvement. Although prediabetes remission after bariatric surgery is biologically plausible, data on this topic is scarce. We aimed to assess prediabetes remission rate and clinical predictors of remission in a 4 year follow up period. METHODS: Observational longitudinal study including patients with obesity and prediabetes who had undergone bariatric surgery in our centre. Prediabetes was defined as having a baseline glycated haemoglobin (A1c) between 5.7% and 6.4% and absence of anti-diabetic drug treatment. We used logistic regression models to evaluate the association between the predictors and prediabetes remission rate. RESULTS: A total of 669 patients were included, 84% being female. The population had a mean age of 45.4 ± 10.1 years-old, body mass index of 43.8 ± 5.7 kg/m2, and median A1c of 5.9 [5.8, 6.1]%. After bariatric surgery, prediabetes remission rate was 82%, 73%, 66%, and 58%, respectively in the 1st, 2nd, 3rd, and 4th years of follow-up. Gastric sleeve (GS) surgery was associated with higher prediabetes remission rate than Roux-en-Y gastric bypass surgery in the 3rd year of follow-up. Men had a higher remission rate than women, in the 1st and 3nd years of follow-up in the unadjusted analysis. Younger patients presented a higher remission rate comparing to older patients in the 3rd year of follow-up. CONCLUSION: We showed a high prediabetes remission rate after bariatric surgery. The remission rate decreases over the follow-up period, although most of the patients maintain the normoglycemia. Prediabetes remission seems to be more significant in patients who had undergone GS, in male and in younger patients.

COVID-19 Lockdown and Impact on 2-Year Weight Loss in a Bariatric Center.

INTRODUCTION: The COVID-19 pandemic has led to a worldwide lockdown, which affected physical exercise habits, as well as having a detrimental effect on psychological health and follow-up visits of patients submitted to bariatric surgery. The aim of this study was to evaluate the impact of COVID-19 lockdown on the 2-year weight loss of patients submitted to bariatric surgery in our center. METHODS: This was an observational study comparing the weight loss of patients who underwent bariatric surgery from January to March 2020 with a control group submitted to surgery between January and March 2017. Percentage of total weight loss (% TWL) and excess weight loss (% EWL) were assessed 6, 12, and 24 months after surgery. RESULTS: A total number of 203 patients were included in this study, 102 had bariatric surgery during the selected period in 2020 and 101 underwent surgery during the same period in 2017. There was no statistically significant difference in weight loss between the 2017 and 2020 groups which was reported as % TWL (mean 27.08 ± 7.530 vs. 28.03 ± 7.074, 33.87 ± 8.507 vs. 34.07 ± 8.979 and 34.13 ± 9.340 vs. 33.98 ± 9.993; p = 0.371) and % EWL (mean 66.83 ± 23.004 vs. 69.71 ± 17.021, 83.37 ± 24.059 vs. 84.51 ± 21.640 and 83.47 ± 24.130 vs. 84.27 ± 23.651; p = 0.506) at 6, 12, and 24 months post-surgery. CONCLUSION: Despite social limitations imposed by the COVID-19 lockdown, we found no significant difference between weight loss at 2 years postoperatively in the 2020 group when compared with a control group who underwent bariatric surgery in 2017. These results show that the outcomes of bariatric surgery during the COVID-19 lockdown were comparable with those recorded before the pandemic, supporting the efficacy of bariatric procedures' metabolic effects during the first 2 years after surgery, regardless of lifestyle habits.

Gender Dysphoria in a Patient With Ovotesticular Disorder of Sex Development.

Ovotesticular disorder of sex development (OT-DSD) is a rare condition characterized by the presence of both ovarian and testicular tissue in the gonads. Management and sex designation of these patients depend on several factors, and an underlying potential for gender dysphoria should be acknowledged. We present a case of a patient diagnosed with 46,XX OT-DSD at 12 months old who was attributed a female sex designation but started manifesting gender dysphoria during adolescence. Gender identity is an important factor to consider on long-term follow-up of OT-DSD patients.

Being Female and in a Romantic Relationship Enhances the Association between Satisfaction with Love Life and Capacity to Love.

This study aims to evaluate if the relation between love life satisfaction, assessed by the satisfaction with love life scale (SWLLS), and capacity to love, assessed by the capacity to love inventory (CTL-I), is moderated by gender and by being or not in a romantic relationship, in a Portuguese sample. To this end, the adaptation and validation of CTL-I for this population were carried out through an exploratory factorial analysis (EFA) followed by a Robust Maximum Likelihood (MLR) confirmatory factorial analysis (CFA). A multi-group analysis for measurement invariance depending on being in a romantic relationship or not was assessed. The model's reliability was also evaluated. The associations between SWLLS and CTL-I were tested by correlations, regressions and moderations. At last, differences between means and distributions concerning sociodemographic variables were determined. The results showed that a good model fit for the Portuguese version of the CTL-I was found, as well as good psychometric properties. Results also showed that satisfaction with love life contributes to explaining the capacity to love and all its dimensions, and that gender and being in a romantic relationship moderate the association between love life satisfaction and the capacity to love. Being female and being in a romantic relationship make the relationship between love life satisfaction and the capacity to love stronger and more meaningful.

Repercusiones de la pandemia de COVID-19 en la formación en enfermería: Scoping Review / Repercussions of the COVID-19 pandemic on Nursing training: A Scoping Review / Repercussões da pandemia COVID-19 na formação em Enfermagem: Scoping Review

Objetivo: mapear el conocimiento producido sobre las repercusiones de la pandemia de COVID-19 en la formación en enfermería. Método: se trata de una scoping review, guiada por las recomendaciones del Joanna Briggs Institute Reviewer's Manual realizada en 15 bases de datos electrónicas y repositorios de tesis y disertaciones. El protocolo de esta revisión fue registrado en Open Science Framework. Los datos fueron analizados y sintetizados en dos categorías de análisis establecidas: aspectos positivos y negativos y estadística descriptiva. Resultados: se identificaron 33 publicaciones, los aspectos positivos más citados fueron el desarrollo de nuevas estrategias de enseñanza adaptadas al entorno virtual y la formación de futuros profesionales en la práctica clínica en el contexto de una crisis sanitaria. Los aspectos negativos se relacionan con cuestiones psicológicas, como el aumento de casos de ansiedad, estrés y soledad en los estudiantes. Conclusión: la evidencia sugiere que la enseñanza a distancia fue una solución de emergencia oportuna para continuar con la formación académica, sin embargo, esta modalidad educativa presentó aspectos positivos y negativos que deben ser repensados para que haya una mejor sistematización de la enseñanza-aprendizaje en otros contextos similares al de la pandemia de COVID-19.

Objective: to map the knowledge produced about the repercussions imposed by the COVID-19 pandemic on Nursing training. Method: this is a Scoping Review, guided by the recommendations set forth in the Joanna Briggs Institute Reviewer's Manual and carried out in 15 electronic databases and theses and dissertations repositories. The protocol was registered at the Open Science Framework. The data were analyzed and synthesized into two pre-established analysis categories: positive and negative repercussions; and descriptive statistics. Results: 33 publications identified, the most cited positive aspects were the development of new teaching strategies adapted to the virtual environment and the training of future professionals in clinical practice in the context of a health crisis. The negative repercussions are related to psychological issues such as increase in the cases of anxiety, stress and loneliness among the students. Conclusion: the diverse evidence suggests that remote teaching was a timely emergency way out for the continuity of academic training; however, this educational modality presented positive and negative aspects that need to be rethought for a better systematization of teaching-learning in other contexts that resemble the COVID-19 pandemic.

Objetivo: mapear o conhecimento produzido sobre as repercussões da pandemia COVID-19 na formação em Enfermagem. Método: trata-se de uma scoping review, guiada pelas recomendações da Joanna Briggs Institute Reviewer's Manual realizada em 15 bases de dados eletrônicas e repositórios de teses e dissertações. O protocolo desta revisão foi registrado em Open Science Framework. Os dados foram analisados e sintetizados em duas categorias de análise estabelecidas: aspectos positivos e negativos e estatística descritiva. Resultados: 33 publicações identificadas, os aspectos positivos mais citados foram o desenvolvimento de novas estratégias de ensino adaptadas ao meio virtual e a capacitação dos futuros profissionais na prática clínica do contexto de crise sanitária. Os aspectos negativos estão relacionados às questões psicológicas, como aumento de casos de ansiedade, estresse e solidão entre os estudantes. Conclusão: as evidências sugerem que o ensino remoto foi uma saída emergencial oportuna para a continuidade da formação acadêmica, contudo, esta modalidade educacional apresentou aspectos positivos e negativos que precisam ser repensados para uma melhor sistematização do ensino-aprendizagem em outros contextos que se assemelhem ao da pandemia da COVID-19.

Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review.

OBJECTIVE: To map the evidence on self-care guidelines for patients in the post-hematopoietic stem cell transplantation (HSCT) period. METHOD: Scoping review supported by Joanna Briggs Institute recommendations, with searches conducted between March and April 2022 in national and international databases and repositories of theses and dissertations. RESULTS: Of the 11 studies that composed the final sample, the guidelines had a social and personal aspect, as post-transplant patients need to follow numerous essential recommendations for the prevention of infections and complications for successful treatment and improved quality of life. CONCLUSION: Knowing the self-care guidelines that must be performed by post-HSCT patients is fundamental for the nursing team to provide the necessary information for care outside the controlled environment of the hospital, in addition to minimizing episodes of infection, death, and increasing the survival and quality of life of transplant recipients.

Intracellular spatially-targeted chemical chaperones increase native state stability of mutant SOD1 barrel.

Amyotrophic lateral sclerosis (ALS) is a progressive neurological disorder with currently no cure. Central to the cellular dysfunction associated with this fatal proteinopathy is the accumulation of unfolded/misfolded superoxide dismutase 1 (SOD1) in various subcellular locations. The molecular mechanism driving the formation of SOD1 aggregates is not fully understood but numerous studies suggest that aberrant aggregation escalates with folding instability of mutant apoSOD1. Recent advances on combining organelle-targeting therapies with the anti-aggregation capacity of chemical chaperones have successfully reduce the subcellular load of misfolded/aggregated SOD1 as well as their downstream anomalous cellular processes at low concentrations (micromolar range). Nevertheless, if such local aggregate reduction directly correlates with increased folding stability remains to be explored. To fill this gap, we synthesized and tested here the effect of 9 ER-, mitochondria- and lysosome-targeted chemical chaperones on the folding stability of truncated monomeric SOD1 (SOD1bar) mutants directed to those organelles. We found that compound ER-15 specifically increased the native state stability of ER-SOD1bar-A4V, while scaffold compound FDA-approved 4-phenylbutyric acid (PBA) decreased it. Furthermore, our results suggested that ER15 mechanism of action is distinct from that of PBA, opening new therapeutic perspectives of this novel chemical chaperone on ALS treatment.

Repercussions of the COVID-19 pandemic on Nursing training: A Scoping Review. / Repercusiones de la pandemia de COVID-19 en la formación en enfermería: Scoping Review.

to map the knowledge produced about the repercussions imposed by the COVID-19 pandemic on Nursing training. this is a Scoping Review, guided by the recommendations set forth in the Joanna Briggs Institute Reviewer's Manual and carried out in 15 electronic databases and theses and dissertations repositories. The protocol was registered at the Open Science Framework. The data were analyzed and synthesized into two pre-established analysis categories: positive and negative repercussions; and descriptive statistics. 33 publications identified, the most cited positive aspects were the development of new teaching strategies adapted to the virtual environment and the training of future professionals in clinical practice in the context of a health crisis. The negative repercussions are related to psychological issues such as increase in the cases of anxiety, stress and loneliness among the students. the diverse evidence suggests that remote teaching was a timely emergency way out for the continuity of academic training; however, this educational modality presented positive and negative aspects that need to be rethought for a better systematization of teaching-learning in other contexts that resemble the COVID-19 pandemic.

mapear el conocimiento producido sobre las repercusiones de la pandemia de COVID-19 en la formación en enfermería. se trata de una scoping review, guiada por las recomendaciones del Joanna Briggs Institute Reviewer's Manual realizada en 15 bases de datos electrónicas y repositorios de tesis y disertaciones. El protocolo de esta revisión fue registrado en Open Science Framework. Los datos fueron analizados y sintetizados en dos categorías de análisis establecidas: aspectos positivos y negativos y estadística descriptiva. se identificaron 33 publicaciones, los aspectos positivos más citados fueron el desarrollo de nuevas estrategias de enseñanza adaptadas al entorno virtual y la formación de futuros profesionales en la práctica clínica en el contexto de una crisis sanitaria. Los aspectos negativos se relacionan con cuestiones psicológicas, como el aumento de casos de ansiedad, estrés y soledad en los estudiantes. la evidencia sugiere que la enseñanza a distancia fue una solución de emergencia oportuna para continuar con la formación académica, sin embargo, esta modalidad educativa presentó aspectos positivos y negativos que deben ser repensados para que haya una mejor sistematización de la enseñanza-aprendizaje en otros contextos similares al de la pandemia de COVID-19.

(1) Mapeó la evidencia científica de las repercusiones de la pandemia en la formación en enfermería. (2) Destacó las repercusiones positivas y negativas de la pandemia en la formación en enfermería. (3) Destacó la importancia de la formación en enfermería en el contexto de la pandemia. (4) Señaló la necesidad de formar docentes para la enseñanza a distancia en enfermería.

mapear o conhecimento produzido sobre as repercussões da pandemia COVID-19 na formação em Enfermagem. trata-se de uma scoping review, guiada pelas recomendações da Joanna Briggs Institute Reviewer's Manual realizada em 15 bases de dados eletrônicas e repositórios de teses e dissertações. O protocolo desta revisão foi registrado em Open Science Framework. Os dados foram analisados e sintetizados em duas categorias de análise estabelecidas: aspectos positivos e negativos e estatística descritiva. 33 publicações identificadas, os aspectos positivos mais citados foram o desenvolvimento de novas estratégias de ensino adaptadas ao meio virtual e a capacitação dos futuros profissionais na prática clínica do contexto de crise sanitária. Os aspectos negativos estão relacionados às questões psicológicas, como aumento de casos de ansiedade, estresse e solidão entre os estudantes. as evidências sugerem que o ensino remoto foi uma saída emergencial oportuna para a continuidade da formação acadêmica, contudo, esta modalidade educacional apresentou aspectos positivos e negativos que precisam ser repensados para uma melhor sistematização do ensino-aprendizagem em outros contextos que se assemelhem ao da pandemia da COVID-19.

Stromal Vascular Fraction Obtained From Subcutaneous Adipose Tissue: Ex-Obese and Older Population as Main Clinical Targets.

INTRODUCTION: Human adipose tissue contains a heterogeneous and synergistic mixture of cells called stromal vascular fraction (SVF) with highly proliferative and angiogenic properties, conferring promising applicability in the field of regenerative medicine. This study aims to investigate if age, body mass index (BMI), history of obesity and massive weight loss, and harvest site are related to SVF cell marker expression. METHODS: A total of 26 samples of subcutaneous adipose tissue were harvested from patients admitted to the Plastic and Reconstructive department in University Hospital Center of São João, Porto, Portugal, for body contouring surgery. The percentage of cells expressing CD31, CD34, CD45, CD73, CD90, and CD105 was assessed and compared with patient's age, BMI, history of obesity and massive weight loss (ex-obese group), and harvest site. RESULTS: In the ex-obese group, a significantly higher number of cells expressing CD90 (P = 0.002) was found. BMI, harvest site, and age appear to have no association with SVF subpopulations. CONCLUSIONS: This study suggests that ex-obese patients have a higher percentage of SVF cells expressing CD90, which correlates with higher proliferative and angiogenic rates. The effect of former obesity and massive weight loss on the expression of CD90 is a new and relevant finding because it makes this population a suitable candidate for reconstructive and aesthetic surgery and other fields of regenerative medicine. The use of SVF appears also promising in older patients because no negative correlation between increasing age and different cell markers expression was found.

Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review / Orientaciones para el autocuidado de pacientes en el post-trasplante de células madre hematopoyéticas: revisión de alcance / Orientações para o autocuidado de pacientes no pós-transplante de células-tronco hematopoéticas: revisão de escopo

ABSTRACT Objective: To map the evidence on self-care guidelines for patients in the post-hematopoietic stem cell transplantation (HSCT) period. Method: Scoping review supported by Joanna Briggs Institute recommendations, with searches conducted between March and April 2022 in national and international databases and repositories of theses and dissertations. Results: Of the 11 studies that composed the final sample, the guidelines had a social and personal aspect, as post-transplant patients need to follow numerous essential recommendations for the prevention of infections and complications for successful treatment and improved quality of life. Conclusion: Knowing the self-care guidelines that must be performed by post-HSCT patients is fundamental for the nursing team to provide the necessary information for care outside the controlled environment of the hospital, in addition to minimizing episodes of infection, death, and increasing the survival and quality of life of transplant recipients.

RESUMEN Objetivo: mapear las evidencias sobre las orientaciones realizadas para el autocuidado de pacientes en el post-trasplante de células madre hematopoyéticas (TCTH). Método: Scoping Review apoyada en las recomendaciones del Instituto Joanna Briggs, con búsquedas entre marzo y abril de 2022 en bases de datos y repositorios de tesis y disertaciones nacionales e internacionales. Resultados: de los 11 estudios que compusieron la muestra final, las orientaciones tenían un carácter social y personal, ya que el paciente en el post-trasplante necesita seguir numerosas recomendaciones imprescindibles para la prevención de infecciones y complicaciones para el éxito del tratamiento y la mejora de la calidad de vida. Conclusión: Conocer las orientaciones para el autocuidado que deben ser realizadas por pacientes en el post-TCTH es fundamental para que el equipo de enfermería proporcione la información necesaria para los cuidados fuera del contexto controlado del ambiente hospitalario, además de minimizar los episodios de infección, muerte y aumentar la sobrevida y calidad de vida de los transplantados.

RESUMO Objetivo: mapear as evidências sobre as orientações realizadas para o autocuidado de pacientes no pós-transplante de células-tronco hematopoéticas (TCTH). Método: Scoping Review apoiada nas recomendações do Joanna Briggs Institute, com buscas entre março e abril de 2022 em bases de dados e repositórios de teses e dissertações nacionais e internacionais. Resultados: dos 11 estudos que compuseram a amostra final, as orientações tinham cunho social e pessoal, visto que o paciente do pós-transplante precisa seguir inúmeras recomendações imprescindíveis para a prevenção de infecções e complicações para o êxito do tratamento e melhoria da qualidade de vida. Conclusão: Conhecer as orientações para o autocuidado que devem ser realizadas por pacientes no pós-TCTH é fundamental para que a equipe de Enfermagem forneça as informações necessárias para os cuidados fora do contexto controlado do ambiente hospitalar, além de minimizar os episódios de infecção, morte e aumentar a sobrevida e qualidade de vida dos transplantados.

Hemothorax After Retroclavicular Approach to the Infraclavicular Region in a Critically Ill Patient: A Case Report.

The retroclavicular approach to the infraclavicular region (RAPTIR) is a recently described locoregional technique for upper limb analgesia that offers advantages over the classic infraclavicular block. RAPTIR is considered an effective and easy-to-perform block associated with few complications and better patient comfort. We present a case of a critically ill patient with thoracic and upper limb trauma. Despite multimodal analgesia, the patient developed delirium and experienced suboptimal pain control. An ultrasound-guided continuous RAPTIR block was performed, resulting in improved pain scores and delirium control. Twenty-four hours post block, the patient presented with dyspnea and chest pain, leading to the diagnosis of hemothorax. Chest computed tomography angiography revealed no vascular damage. The perineural catheter was removed 48 hours after its placement and the patient had a satisfactory recovery without long-term complications. The RAPTIR requires the needle to pass underneath the clavicle's acoustic shadow, putting the structures beneath the clavicle at risk of injury. Cadaver studies have raised concerns about potential vascular complications of the RAPTIR in a noncompressible location. This case highlights, for the first time, a rare but serious complication of the RAPTIR, demonstrating the potential risks of passing the needle through a blind spot.

Criação de uma comunicação interatrial com implante de stent como tratamento paliativo em pacientes com hipertensão arterial pulmonar primária grave ­ avaliação de longo prazo / Creation of an atrial septal defect with stent implantation as a palliative treatment in patients with severe primary pulmonary arterial hypertension ­ long-term evaluation

INTRODUÇÃO E/OU FUNDAMENTOS: A história natural da hipertensão arterial pulmonar primária (HPP) grave culmina em insuficiência cardíaca direita refratária ao tratamento otimizado. A comunicação interatrial (CIA) alivia a sobrecarga direita na HP secundária à cardiopatia congênita de hiperfluxo e é uma alternativa na falência ventricular direita associada a HPP. Avaliamos a segurança e eficácia da criação de uma CIA nestes pacientes, com ênfase no impacto clínico de longo prazo. MÉTODOS: Estudo clínico observacional e retrospectivo de uma coorte de pacientes com HPP e classe funcional (CF) > II, em tratamento otimizado, submetidos a abertura de CIA com stent de 2014-2022. O procedimento se deu através de punção transseptal. Foram avaliados os desfechos: mortalidade, sucesso na criação e manutenção da CIA, complicações e melhora da classe funcional e do teste de caminhada de 6 min. RESULTADOS E CONCLUSÕES: Amostra de 8 pacientes com médias de idade e peso de 29,5±13,0 anos e 71,0±15,5kg. No cateterismo, tinham média basal de pressão atrial direita de 16,9±5,9mmHg e pressão sistólica na artéria pulmonar (PSAP) de 98,8±25,2mmHg. Todos classificados como HAP de alto risco. Imediatamente após o procedimento houve queda da saO2 de 96,7±2,9 para 84,3±1,1% (p<0,01) com uma CIA de diâmetro médio de 6,2±1,1mm. Não houve óbito relacionado ao procedimento. Um paciente apresentou taquicardia supraventricular revertida com cardioversão elétrica e 1 paciente apresentou imagem de trombo aderido ao stent imediatamente após o seu implante, que reverteu após 48h de uso de heparina. O seguimento clínico foi realizado em 100% da série e o seu tempo médio foi de 3,5±1,8 anos. Neste período, a hipoxemia obtida se manteve (queda de 96,7±2,9 para 89,3±2,1%, p0,02). Não houve diferença nos parâmetros ecocardiográficos avaliados (PSAP, TAPSE e onda s'), da CF (mantida em III) ou do teste de caminhada (321,8±105,0 para 304,9±61,0m p0,50). Houve 4 internações por IC grave, com melhora após tratamento inotrópico endovenoso em 1 paciente, que recebeu alta hospitalar e 3 óbitos em decorrência de choque cardiogênico refratário. No entanto, o tempo médio de sobrevida foi de 4,2±0,7 anos (IC 95%: 2,8-5,6), com sobrevida em 5 anos de 60%, superior à média descrita na literatura (32,4%). CONCLUSÃO: A criação da CIA nestes pacientes é segura e eficaz no alívio da hipertensão atrial direita. Apesar de não mostrar diferença nas variáveis clínicas e ecocardiográficas avaliadas, contribuiu para melhora significativa da sobrevida nesta grave condição.

Percepção de gestantes ao acompanhamento pré-natal durante a pandemia da COVID-19 / Pregnant women's perception aboutprenatal monitoring during theCOVID-19 pandemic

Objetivo:Compreender a percepção de gestantes noacompanhamento pré-natal durante a pandemia da COVID-19.Métodos:Estudo analítico com abordagem qualitativa,realizado com onze gestantes atendidas porduas equipes de Estratégia Saúde da Família do município de Colinas, Maranhão. A coleta de dados foi realizada mediante entrevistas semiestruturadas gravadas e após transcritas. Os dados foram processados com o auxílio do softwareIRaMuTeQpor meio da Classificação Hierárquica Descendente e analisados por meio de interpretação de sentidos.Resultados:O processamento dos dados resultou em seis classes que, após a interpretação de sentidos,deram origem àduas categorias: Percepções ao atendimento pré-natal durante a pandemia da COVID-19e Experiências,aprendizados e cuidados na gestação diante da pandemia.Conclusão:A aquisição de medidas para o controle da transmissão do vírus mostrou-segeradora de dificuldades na adesão ao pré-natal, afetando a qualidade do atendimento em questão. O distanciamento social e a redução do tempo de permanência nas consultas afetaram a relação estabelecida entre profissional e gestante, com isso a atenção foi prejudicada.

Objective:To understand pregnant women's perception aboutprenatal monitoring during the COVID-19 pandemic.Methods:An analytical study with a qualitative approach conducted with elven pregnant women assisted bytwo Family Health Strategy teams from the municipality of Colinas, Maranhão. Data collection was carried out by means of semi-structured interviews, which wererecorded and later transcribed. The data were processed with the aid of the IRaMuTeQsoftware program by means of Descending Hierarchical Classification and analyzed through interpretation of meanings. Results:Data processing resulted in six classes which, after interpreting the meanings,gave rise to two categories: Perceptions about prenatal care during the COVID-19 pandemic; and Experiences, lessons learned and care measures in pregnancy during the pandemic.Conclusion:The imposition of measures to control transmission of the virus proved tocreate difficulties in adherence to prenatal care, affecting quality of the assistance provided. Social distancing and reduction in the length of the consultations affected the relationship established between the professionals and the pregnant women, therefore impairing care.

Spongy-like hydrogels prevascularization with the adipose tissue vascular fraction delays cutaneous wound healing by sustaining inflammatory cell influx.

In vitro prevascularization is one of the most explored approaches to foster engineered tissue vascularization. We previously demonstrated a benefit in tissue neovascularization by using integrin-specific biomaterials prevascularized by stromal vascular fraction (SVF) cells, which triggered vasculogenesis in the absence of extrinsic growth factors. SVF cells are also associated to biological processes important in cutaneous wound healing. Thus, we aimed to investigate whether in vitro construct prevascularization with SVF accelerates the healing cascade by fostering early vascularization vis-à-vis SVF seeding prior to implantation. Prevascularized constructs delayed re-epithelization of full-thickness mice wounds compared to both non-prevascularized and control (no SVF) groups. Our results suggest this delay is due to a persistent inflammation as indicated by a significantly lower M2(CD163+)/M1(CD86+) macrophage subtype ratio. Moreover, a slower transition from the inflammatory to the proliferative phase of the healing was confirmed by reduced extracellular matrix deposition and increased presence of thick collagen fibers from early time-points, suggesting the prevalence of fiber crosslinking in relation to neodeposition. Overall, while prevascularization potentiates inflammatory cell influx, which negatively impacts the cutaneous wound healing cascade, an effective wound healing was guaranteed in non-prevascularized SVF cell-containing spongy-like hydrogels confirming that the SVF can have enhanced efficacy.

Waist-to-Hip Ratio and Inflammatory Parameters Are Associated with Risk of Non-Alcoholic Fatty Liver Disease in Patients with Morbid Obesity.

Non-alcoholic fatty liver disease (NAFLD) is associated with several other metabolic disorders, which are typically pro-inflammatory states. Body fat content is an important marker of metabolic health and abdominal fat is associated with harmful cardiometabolic outcomes. We aimed to evaluate the association between the risk of NAFLD (through Fatty Liver Index (FLI), and BMI, AST/ALT ratio, and presence of diabetes (BARD)), and anthropometric parameters, predictors of metabolic status, in patients with morbid obesity, and to evaluate the association of FLI and BARD scores with pro-inflammatory markers. We have retrospectively studied patients with morbid obesity followed in our center. In total, 2184 participants were included, with an average age of 42.8 ± 10.6 years, 84.5% being females. We report a positive association of FLI with waist circumference (ß = 0.10 [0.09 to 0.11], p < 0.01) and waist-to-hip ratio (ß = 8.68 [6.85 to 10.52, p < 0.01]), even after adjusting for age, sex, body mass index, diabetes, and dyslipidemia (p < 0.01 for both adjusted models). The associations of BARD with anthropometric measures were significant only in the non-adjusted model. There was a positive association between both FLI and BARD and C-reactive protein. Our results point towards a positive association between waist-to-hip ratio and the risk of hepatic steatosis, and between pro-inflammatory markers and both hepatic steatosis and fibrosis.