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Intestinal malrotation and acute left side appendicitis: an indication for laparoscopic exploration
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Nurses' knowledge and practices in cases of acute and chronic confusion: a questionnaire survey
Get PDFPURPOSE:
This study aimed to describe nurses' knowledge and practices toward patients with acute or chronic confusion.
DESIGN AND METHODS:
A cross-sectional design was used, and 249 nurses engaged in clinical practice fulfilled an online self-report questionnaire.
FINDINGS:
Tools for diagnosing acute confusion/delirium are never used by 57.80% of the nurses. Between 80% and 81% of nursing interventions involve managing patients' physical environment and between 62% and 71% deal with managing communication. Theoretical training in the use of tools for assessing and intervening in cases of confusion was significantly associated with nurses' knowledge and practices.
PRACTICE IMPLICATIONS:
These results suggest the need for increased investment in nurses' training
Novel ABCA3 mutations as a cause of respiratory distress in a term newborn
Get PDFWe report here the case of a term female newborn that developed severe respiratory distress soon after birth. She was found to be a compound heterozygote for both novel mutations in the ABCA3 gene. ABCA3 deficiency should be considered in mature babies who develop severe respiratory distress syndrome
Origem coronária anómala: da suspeita à revascularizac¸ão cirúrgica
Get PDFCongenital anomalies of the coronary arteries are uncommon and can present a diagnostic challenge. The authors present the case of a patient with recurrent chest pain during exertion admitted for acute coronary syndrome. Coronary angiography revealed no coronary lesions but showed that the right coronary artery originated from the anterolateral aortic wall, above the sinuses of Valsalva, leading to suspicion of compression by the pulmonary artery, confirmed by CT angiography. The patient underwent surgical revascularization with a good result. The authors highlight the need to consider compression of an anomalous coronary artery by the pulmonary artery in the differential diagnosis of recurrent chest pain on exertion and acute myocardial infarction without significant coronary stenosis
Chronic granulomatous disease associated with common variable immunodeficiency - 2 clinical cases
Get PDFINTRODUCTION:
Chronic granulomatous disease associated with common variable immunodeficiency (GD-CVID), although well documented, is rare. Granulomatous lesions can affect several organs and are histologically indistinguishable from sarcoidosis.
CLINICAL CASES:
Case 1: A 39-year-old male patient with CVID, asymptomatic although with thrombocytopenia and mediastinal-hilar adenopathies. GD-CVID was diagnosed by bone marrow biopsy. Progressive clinical and radiological improvement was obtained with corticotherapy. Case 2: A 38-year-old male patient with CVID, suffered from asthenia, anorexia, myalgia, lower limbs edemas, and dry cough. He had mediastinal and bilateral hilar adenopathies within which biopsy revealed non-necrotizing granulomatous infiltrate. A spontaneous resolution was detected after 9 months of evolution.
CONCLUSION:
GD-CVID is rare and can mimetize other pathologies, namely, sarcoidosis; it should therefore be publicized and discussed so that it becomes a general clinical knowledge
Treatment planning systems dosimetry auditing project in Portugal
Get PDFBACKGROUND AND PURPOSE:
The Medical Physics Division of the Portuguese Physics Society (DFM_SPF) in collaboration with the IAEA, carried out a national auditing project in radiotherapy, between September 2011 and April 2012. The objective of this audit was to ensure the optimal usage of treatment planning systems. The national results are presented in this paper.
MATERIAL AND METHODS:
The audit methodology simulated all steps of external beam radiotherapy workflow, from image acquisition to treatment planning and dose delivery. A thorax CIRS phantom lend by IAEA was used in 8 planning test-cases for photon beams corresponding to 15 measuring points (33 point dose results, including individual fields in multi-field test cases and 5 sum results) in different phantom materials covering a set of typical clinical delivery techniques in 3D Conformal Radiotherapy.
RESULTS:
All 24 radiotherapy centers in Portugal have participated. 50 photon beams with energies 4-18 MV have been audited using 25 linear accelerators and 32 calculation algorithms. In general a very good consistency was observed for the same type of algorithm in all centres and for each beam quality.
CONCLUSIONS:
The overall results confirmed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy is generally acceptable with no major causes for concern. This project contributed to the strengthening of the cooperation between the centres and professionals, paving the way to further national collaborations