The esthetic and functional rehabilitation of patients with multiple missing teeth can be performed with several techniques and materials. Ceramic restorations provide reliable masticatory function and good esthetics. However, fracture can occur in some cases due to their brittle behavior. In some cases, the replacement of an extensive prosthesis is a problem due to the high treatment cost. In this paper, two cases are presented, in which fractures occurred in extensive metal-ceramic fixed partial dentures, and their replacement was not possible. Ceramic repair was chosen and the sequences of treatment with and without presence of the ceramic fragment are also discussed. The cases illustrate that, in some situations, fractured metal-ceramic partial dentures can be successfully repaired when prosthetic replacement is not a choice. Prosthodontists must use alternatives that allow a reliable repair to extensive metal-ceramic fixed partial dentures. Surface preparation of the ceramic with hydrofluoric acid in conjunction with a silane coupling agent is essential for a predictable bonding of composite resin. The repair performed with composite resin is an esthetic and functional alternative when extensive fixed partial dentures cannot be replaced.

INTRODUCTION: Pancreatic cancer is the fourth major cause of cancer-related deaths. About 50% of the patients are diagnosed with advanced disease. Metastatic disease to the colon is a very rare entity with only 5 cases described in english literature. CASE PRESENTATION: Male, 60 years-old, presents to a surgical consult with the diagnosis of an adenocarcinoma of the sigmoid colon. The physical exam revealed a periumbilical nodule with suspicious features. The staging CT-scan showed a mass in the tail of the pancreas involving the spleen and left kidney, thickening of the sigmoid colon, multiple mesenteric masses and trabecular changes in the ischium, suggesting metastatic disease. The case was discussed by a multidisciplinary team and it was decided to do a biopsy of the umbilical nodule and review the specimen obtained in colonoscopy. Pathological analysis revealed a metastasis from pancreatic adenocarcinoma. The patient was proposed to start palliative chemotherapy for metastatic pancreatic cancer. After 2 cycles of FOLFOX the patient was admitted in the OR with a perforation of the sigmoid mass. He was submitted to a sigmoidectomy with end colostomy, with discharge at the 5th postoperative day. Pathological analysis of the specimen confirmed the pancreatic origin of the tumor. Patient proceeded with palliative treatment, with death 9 months after the diagnosis. DISCUSSION: Pancreatic metastasis to the colon is a very rare entity. Care should be taken when addressing these patients. CONCLUSION: Although rare, a sigmoid tumor in a patient with known pancreatic adenocarcinoma must raise the suspicion of metastasis.

Background/Objectives: Disasters have a substantial impact on health systems and populations worldwide, with increasing frequency, mortality, and economic losses associated with natural hazards. The United Nations emphasises that disasters result from the interaction between hazards, exposure, and vulnerability, requiring integrated, people-centred health responses aligned with the 2030 Agenda. However, empirical evidence describing specific nursing interventions, particularly during response and recovery phases, is limited. This study aims to analyse the fundamental nursing care interventions provided to disaster victims in the Autonomous Region of Azores, Portugal. Methods: A qualitative multiple case study was conducted using documentary analysis of the nursing records from two disaster survivors with different clinical trajectories. Data were collected between August 2023 and May 2024 through complete transcription of nursing documentation contained in the clinical files. Data analysis followed Yin’s case study methodology and was theoretically supported by the Fundamentals of Care Framework. Results: The findings indicated a predominance of interventions addressing physiological needs during the acute phase, which progressively evolved to maintenance, psychosocial support, and adaptation needs during prolonged hospitalizations. Nursing care integrates advanced technical skills with relational and person-centred interventions, including emotional support, therapeutic communication, and promotion of patient autonomy. Conclusions: Nursing practice in disaster situations should be conceptualised as integrative, person-centred care grounded in international nursing frameworks. Strengthening disaster-specific nursing education, developing phase-adapted care protocols, and promoting multicentre longitudinal research appear to play a critical role for advancing nursing care models and informing health policies in disaster-prone regions.

O presente relatório pretende descrever as atividades desenvolvidas ao longo da unidade curricular Estágio Final, na obtenção do grau de Mestre em enfermagem na área de Especialização em Enfermagem de Reabilitação, com o objetivo de desenvolver competências comuns do enfermeiro especialista e especificas do enfermeiro especialista em enfermagem de reabilitação [EEER] preconizadas pela Ordem dos Enfermeiros. Na prestação de cuidados ao utente pediátrico, em contexto de unidade de cuidados intensivos, são abordadas duas dimensões: a intervenção do EEER na mobilização precoce do bebé prematuro e na criança com necessidade de reabilitação respiratória. Foi utilizada a metodologia de estudo de caso descritivo, através do planeamento e implementação de um plano de intervenção de Enfermagem de Reabilitação numa criança com bronquiolite aguda. Como referencial teórico foi considerada a teoria de médio alcance de Afaf Meleis, uma vez que todos os processos de saúde/doença são experimentados pela criança e família apresentando-se todos eles como processos de transição. Considera-se, portanto, que as competências adquiridas e desenvolvidas durante todo o percurso académico contribuíram para o desenvolvimento da prática baseada na evidência, multidisciplinariedade e valorização do papel do EEER no cuidar do utente pediátrico.

Solid-organ transplant patients have a high risk of severe infection related to COVID-19 disease. In heart transplanted patients the impact of this infection remains unknown, as well as importance of rehabilitation, on recovery process. Objective: To describe intervention of rehabilitation nurse in a case of a heart transplanted person infected with COVID-19 in UCI. Methods: Case report follow CARE guidelines. This case represents a 60-year-old man, a heart transplant recipient, who presented with a 5-day history of cough, fever, and activity intolerance, who required hospitalization in intensive care. Rehabilitation nursing intervention in respiratory and functional functions was due 2 times a day, during 30-45minutes, adapted to the evolution of the person. Results: This case supports the possibility and impact of rehabilitation nursing intervention, in the multidisciplinary team, on the improvement of the person, either through the improvement/resolution of the rehabilitation nursing diagnosis status or on the clinical improvement of the person. Demonstrates the possibility of prescribing early mobilization interventions, breathing exercises in the context of the transplanted person with severe covid disease, admitted to the ICU, using different techniques. Conclusion: Rehabilitation Nursing interventions, in this case, translated into an improvement in the respiratory and functional function of a heart transplant patient infected with COVID-19during UCI care.

Upper limb impairment after stroke is a major contributor to functional dependence and reduced quality of life. Although sensorimotor rehabilitation strategies are recommended to promote motor recovery, evidence regarding the therapeutic use of viscoelastic materials remains limited. This case report describes the outcomes of a rehabilitation nursing intervention using a viscoelastic product in a 56-year-old man with multifocal ischemic stroke and left upper limb impairment. The patient completed a 21-day rehabilitation nursing program comprising eight sessions that combined conventional upper limb rehabilitation exercises with sensorimotor stimulation using a viscoelastic product. Functional outcomes were assessed using the Medical Research Council Scale, the Barthel Index, and the Functional Independence Measure. Muscle strength improved from grades 1–3 to grades 4–5 on the Medical Research Council Scale. Functional recovery included improvements in dynamic balance, gait performance, and independence in activities of daily living, with the Barthel Index increasing from 75 (moderate dependence) to 95 (mild dependence). No follow-up data beyond hospital discharge were available to evaluate the long-term maintenance of these functional gains. This case suggests that incorporating a viscoelastic product into a rehabilitation nursing program is feasible and may contribute to improvements in upper limb motor performance and functional independence following stroke. Further prospective studies with larger samples and longer follow-up are warranted.

Objective: To describe the effects of an early mobilization program in a critically ill patient with acquired muscle weakness in the intensive care unit (AMWICU). Methods: Case report of a 65-year-old male diagnosed with pneumoperitoneum, septic shock, and multiple organ dysfunction. The patient underwent an early mobilization program between 13th and 30th of June 2022, based on expert consensus on safety criteria for mobilization in critically ill patients. The intervention was delivered by a rehabilitation nursing team. Results: The early mobilization program contributed to improvements in muscle strength, body mobility, and functional independence in the critically ill patient. Conclusions: Although there is no consensus on the ideal type, timing, or intensity of early mobilization in critically ill patients, this case study suggests that individualized early mobilization may promote functional recovery and should be considered in intensive care settings.

The esthetic and functional rehabilitation of patients with multiple missing teeth can be performed with several techniques and materials. Ceramic restorations provide reliable masticatory function and good esthetics. However, fracture can occur in some cases due to their brittle behavior. In some cases, the replacement of an extensive prosthesis is a problem due to the high treatment cost. In this paper, two cases are presented, in which fractures occurred in extensive metal-ceramic fixed partial dentures, and their replacement was not possible. Ceramic repair was chosen and the sequences of treatment with and without presence of the ceramic fragment are also discussed. The cases illustrate that, in some situations, fractured metal-ceramic partial dentures can be successfully repaired when prosthetic replacement is not a choice. Prosthodontists must use alternatives that allow a reliable repair to extensive metal-ceramic fixed partial dentures. Surface preparation of the ceramic with hydrofluoric acid in conjunction with a silane coupling agent is essential for a predictable bonding of composite resin. The repair performed with composite resin is an esthetic and functional alternative when extensive fixed partial dentures cannot be replaced.

ABSTRACT Objectives Several cases of bilateral diffuse pigmented villonodular synovitis (PVNS) or tenosynovial giant cell tumor have been described in the literature. Nevertheless, some presentations are rare and differential diagnoses are necessary. Methods The purpose of this study was to perform a systematic review of the literature related to PVNS and to report a rare supra-patellar bilateral and focal presentation. We performed a systematic data review in the Pubmed Clinical Queries database using MeSH and keywords related to PVNS and tenosynovial giant cell tumor. Results Two cases of bilateral and local PVNS had been previously described, but neither was localized in the supra-patellar compartment. To our knowledge, this case report is the first to describe supra-patellar bilateral and localized PVNS of the knee. This case involves a 28 -year-old woman with bilateral localized PVNS of the supra-patellar recess of the knee. MRI showed a low-signal intensity nodule in T1- and T2-weighted images. These were associated with hemosiderin pigmentation. Conclusion The most important finding of the case reported is related to rarity and location. Histopathology analysis confirmed a rare case of hemosiderin pigmentation in the capsular nodule with internal non-pigmented villous content. Lipoma arborescens in the supra-patellar form must be ruled out as a differential diagnosis since it occurs in the same site. Level of Evidence IV; Case series.