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  • Ryberg Gylling posted an update 3 days, 1 hour ago

    Percutaneous coronary intervention is a coronary revascularization procedure that may rarely result in thromboembolic events. Although infrequent, ophthalmological complications of percutaneous interventions include a wide range of clinical presentations, with differing severity and outcomes. In this case report, an 83-year-old woman, with multiple cardiovascular risk factors, presents with horizontal diplopia after a percutaneous transluminal coronary angioplasty. After ophthalmological evaluation and a head computed tomography scan, the diagnosis of isolated ischemic internuclear ophthalmoplegia was established. After six months of follow-up, the patient showed complete recovery of her symptoms and ocular movements. We discuss the post-percutaneous intervention ophthalmic complications that, although uncommon, must be recognized by health care providers.Candida auris was first described as a new species back in 2009. Although it differs markedly from other Candida species, this species can be misidentified as other yeasts in the routine microbiology laboratories. Therefore, its identification to species level should be confirmed by reference laboratories. Candida auris exhibits potential to cause invasive infections, and frequently shows a multidrugresistance pattern, and it is associated with high mortality rates. Outbreaks caused by Candida auris and associated with health care institutions have been reported in several countries around the world, including some European countries, such as the United Kingdom and Spain. In Portugal, to our knowledge, there are no known infections or colonization cases caused by Candida auris. This species can survive in the environment for several weeks and once introduced into the hospital environment, the risk of transmission is high, requiring strict infection control measures in order to prevent transmission. This paper intends to raise the awareness of the emergence of this fungal species, as well as to discuss the consequences of this situation.

    Lower limb amputees present a high risk of falling. This study aims to characterise fall history in unilateral lower limb amputees that are autonomous in the community, identifying differences between transfemoral and transtibial amputees and assessing fear of falling between fallers and non-fallers.

    Descriptive, cross-sectional study of consecutive community-dwelling unilateral lower limb adult amputees of any aetiology, attending outpatient consultation in a Portuguese Physical and Rehabilitation Medicine central and university hospital department.

    a prior 12 week individualised rehabilitation program for prosthesis training; regular prosthesis use for more than one year with autonomous gait; and a Functional Independence Measure® score equal to or greater than 100. Injury severity was classified according to the National Database of Nursing Quality Indicators® injury falls measure. In order to assess walking performance over short distances and fear of falling we used the 10-meter walk test and the Falls Efficacy Scale, respectively.

    In a sample of 52 lower limb amputees, mainly men (80.8%) and of traumatic aetiology (63.5%), with a mean age of 57.21 ± 11.55 years, 36.5% reported at least one fall in the previous 12 months, all classified as minor injuries. Transfemoral amputees (n = 23) presented a higher number of falls (2.22 ± 3.23, p = 0.025) and lower gait velocity (0.77 ± 0.26 m per second, p < 0.001). Regarding fear of falling, we found no significant differences between fallers and non-fallers.

    The prevalence of falls was low and of minor severity. Transfemoral amputees fell more often and were slower. There were no reported differences in fear of falling between groups.

    This paper contributes information about Portuguese lower limb amputees, whose studies are scarce and are rarely dedicated to falling.

    This paper contributes information about Portuguese lower limb amputees, whose studies are scarce and are rarely dedicated to falling.

    Acute kidney injury is a frequent complication after transcatheter aortic valve implantation with great impact on morbidity and mortality. It is important to identify modifiable risk factors in order to develop preventive strategies. The aim of the study is to determine acute kidney injury incidence, risk factors and impact in patients that underwent transcatheter aortic valve implantation.

    Retrospective study in 149 consecutive patients that underwent transcatheter aortic valve implantation at Santa Marta Hospital. The data was collected from the periprocedural records and stratified by the occurrence of acute kidney injury according to the AKIN classification.

    A total of 149 patients, 43.0% male with median age 82.00 [77.50 – 85.00] years were included in the study. Bisperoxovanadium (HOpic) Incidence of acute kidney injury was 14.8% (n = 22). Female patients (OR 0.138, CI 95%; 0.022 – 0.854; p = 0.033) had a higher risk of that complication. Patients with acute kidney injury had longer hospitalizations (OR 1.043, CI 95%; 1.001 – 1.085; p = 0.043); acute kidney injury was associated with increased 30 day mortality (OR 13.889, 95% CI; 2.371 – 81.363; p = 0.004).

    Acute kidney injury is associated with preprocedural variables and is a determinant of morbimortality. However, the retrospective character and the reduced sample size didn’t allow the determination of the precise weight of each factor.

    Acute kidney injury is a complication after transcatheter aortic valve implantation which played a significant role in morbimortality justifying its prevention.

    Acute kidney injury is a complication after transcatheter aortic valve implantation which played a significant role in morbimortality justifying its prevention.

    Scientific evidence regarding children’s understanding of the concept of death is scarce. This has recently been pointed out by the International Children’s Palliative Care Network as a priority area of research. In particular, the avoidance of emotion in this area of research is an important shortcoming. This study aims to develop an in-depth view of the emotional dimension of the child’s understanding of death, also seeking to relate it to the cognitive dimension.

    We interviewed children (three to six years old) using a book illustrating a hypothetical scenario in which a child faced the death of a relative. We asked questions to assess the cognitive subconcepts of death and the emotional dimension (what the child would feel and what parents should say).

    Of the 54 participants, the majority said that the child would feel sad (n = 46, 85%) and that parents should inform her/him (n = 47, 87%); these responses did not vary significantly with age. The cognitive understanding of the concept of death in children who reported sadness was significantly higher.

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