Introdução: A gestão e monitorização hemodinâmica nas unidades de cuidados intensivos (UCI) em Portugal ainda não foi avaliada recentemente. Projetámos um questionário eletrónico para entender melhor a prática clínica e o alinhamento com as diretrizes internacionais mais recentes. Métodos: Um questionário de 24 questões, abordando a monitorização e gestão hemodinâmica na UCI, foi partilhado nas redes sociais e via email (e-blast®) pelos autores e pela Sociedade Portuguesa de Cuidados Intensivos de 11 de maio a 11 de setembro de 2023. Resultados: Dos 174 questionários válidos, 54% eram especialistas em medicina intensiva e os restantes eram médicos em formação em medicina intensiva. Ao abordar o paciente em choque séptico, o volume de bólus de fluído variou entre 500 mL (42%), 250 mL (30,5%) e 1.000 mL (19%), e o tipo de fluído mais utilizado foram soluções balanceadas (85,5% vs 14,4% de soro fisiológico). A norepinefrina foi universalmente a primeira escolha como vasopressor no choque séptico e a maioria dos respondedores considerou adicionar complementarmente corticóides (em 96%) e vasopressina (em 66,1%). A ferramenta mais utilizada para avaliar a responsividade a fluídos e para monitorização hemodinâmica foi a ecocardiografia (97,1%), mas 31% dos respondedores consideraram que menos da metade da equipa médica tinha capacidade técnica para avaliação ecocardiográfica. Conclusão: A ecocardiografia é a ferramenta preferencial para avaliação hemodinâmica, mas parte dos respondedores considerou que a equipa não tinha proficiência na técnica, destacando assim a importância do treino e da padronização da mesma na UCI.

Introduction: A promising technique to treat persistent olfactory impairment has recently been explored: platelet rich plasma (PRP) injection into the olfactory mucosa. Objectives: This study aimed to determine efficacy, safety, and feasibility of a new PRP injection protocol in treating persistent COVID-19 induced olfactory dysfunction (pCIOD). Material and Methods: Patients with pCIOD lasting for ≥ 12 months were enrolled. All patients had previously performed olfactory training and adjuvant therapy without achieving substantial improvement. Olfactory perception threshold (OPT) and visual analog scale (VAS) were measured at baseline, one month and three months after injection. Results: Twenty patients were enrolled. There was a significant change in OPT after injection (mean baseline OPT: 4.36 ± 1.6 versus 1-month after injection: 6.9 ± 2.6, p = 0.012 versus 3-months after injection: 7.2 ± 2.8, p =0.009). No severe complications were reported. Conclusions: Single-site PRP injection into the olfactory mucosa is a novel, safe and effective approach that may enhance olfactory recovery in pCIOD patients.

Abstract Introduction: A promising technique to treat persistent olfactory impairment has recently been explored: platelet rich plasma (PRP) injection into the olfactory mucosa. Objectives: This study aimed to determine efficacy, safety, and feasibility of a new PRP injection protocol in treating persistent COVID-19 induced olfactory dysfunction (pCIOD). Material and Methods: Patients with pCIOD lasting for ≥ 12 months were enrolled. All patients had previously performed olfactory training and adjuvant therapy without achieving substantial improvement. Olfactory perception threshold (OPT) and visual analog scale (VAS) were measured at baseline, one month and three months after injection. Results: Twenty patients were enrolled. There was a significant change in OPT after injection (mean baseline OPT: 4.36 ± 1.6 versus 1-month after injection: 6.9 ± 2.6, p = 0.012 versus 3-months after injection: 7.2 ± 2.8, p =0.009). No severe complications were reported. Conclusions: Single-site PRP injection into the olfactory mucosa is a novel, safe and effective approach that may enhance olfactory recovery in pCIOD patients.

The global burden of population ageing imposes the need of innovative care models and good practices to ensure the sustainability of health and social care support, as well as optimal quality of life of the citizens. Science and technology-based innovation is required to be cross-fertilized with co-creation strategies, involving different stakeholders and the citizens. Health literacy is a crucial component of this challenge, including instruments focused on better training of formal and informal caregivers and citizen’s empowerment towards healthy lifestyles. In the present paper, we highlight the implementation of two EIT Health projects, Healiqs4cities and CARE Campus, and one event, Praça Vida+, as good examples of the interdisciplinary approach to develop innovative good practices, science outreach and innovative ICT-based training schemes for care providers. Moreover, we identify the European Innovation Partnership on Active and Healthy Ageing Reference Sites and the Reference Site Collaborative Network as quadruple helix-based ecosystems ideally positioned to inspire other European regions and their decision makers for large adoption of innovative practices and change management across Europe.

Among the transmissible spongiform encephalopathies (TSEs), chronic wasting disease (CWD) in cervids is now the rising concern within Europe. CWD will be outlined in this chapter gathering its epidemiology, transmission, diagnosis, genetics, and control. Prion diseases are fatal neurodegenerative diseases characterized by the accumulation of an abnormal isoform of the prion protein (PrPc), usually designated by PrPsc or prion. CWD is a prion disease of natural transmission affecting cervids detected mainly in North America. The first European case was detected in Norway, in 2016, in a wild reindeer; until April 2018, a total of 23 cases were described. The definite diagnosis is postmortem, performed in target areas of the brain and lymph nodes. Samples are first screened using a rapid test and, if positive, confirmed by immunohistochemistry and Western immunoblotting. It is not possible to establish a culling plan based on the genotype, once affected animals appear with all genotypes. However, some polymorphisms seem to result in longer incubation periods or confer a reduced risk. The control is not easy in captive cervids and even more in the wildlife; some recommendations have been proposed in order to understand the danger and impact of CWD on animal and public health.

<p>Prosseguindo a nova periodicidade adotada no presente ano, a revista População e Sociedade apresenta agora o seu segundo número semestral de 2015, mantendo a estrutura já consagrada.</p> <p>Assim, o dossier temático da presente edição, coordenado pela professora Paula Pinto, surge sob o título Homens de oração e homens de ação: a dimensão política dos mestres e freires das Ordens Militares, com três estudos em torno de outras tantas personagens: D. Jorge, mestre das Ordens Militares de Avis e de Santiago, Vasco da Gama e as implicações políticas e estratégicas da sua viagem à Índia e, por último, frei Pedro Álvares Seco, autor do Livro das Comendas da Ordem de Cristo.</p> <p>Já a secção Varia é composta de cinco artigos sobre tópicos diversos: os retábulos do Alto Minho nos séculos XVII e XVIII; a emigração portuguesa para o Pará nos ¬finais de Oitocentos; António Ferro e a promoção do turismo; diplomacia e plataformas continentais de Portugal e Espanha e ainda um estudo sobre a intenção empreendedora dos estudantes universitários.</p> <p>A direção da revista População e Sociedade aproveita para agradecer a cooperação de todos quantos participaram no presente número, designadamente autores mas também avaliadores cientí¬cos, reconhecendo a sua imprescindível colaboração.</p>

Among the transmissible spongiform encephalopathies (TSEs), chronic wasting disease (CWD) in cervids is now a rising concern in wildlife within Europe, after the detection of the first case in Norway in 2016, in a wild reindeer and until June 2022 a total of 34 cases were described in Norway, Sweden and Finland. The definite diagnosis is post-mortem, performed in target areas of the brain and lymph nodes. Samples are first screened using a rapid test and, if positive, confirmed by immunohistochemistry and Western immunoblotting. The study of the genetics of the prion protein gene, PRNP, has been proved to be a valuable tool for determining the relative susceptibility to TSEs. In the present study, the exon 3 of PRNP gene of 143 samples from red deer (Cervus elaphus) and fallow deer (Dama dama) of Portugal was analysed. Three single nucleotide polymorphisms (SNPs) were found in red deer – codon A136A, codon T98A, codon Q226E – and no sequence variation was detected in fallow deer. The low genetic diversity found in our samples is compatible with previous studies in Europe. The comparison with results from North America suggests that the free-ranging deer from our study may present susceptibility to CWD, although lack of experimental data and the necessity of continuous survey are necessary to evaluate these populations.