Browsing by Issue Date, starting with "2023-08"
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- Heterotopic Caval Valve-in-Valve Procedure for Prosthetic Migration: Two Case ReportsPublication . Grazina, A; Ferreira, A; Ramos, R; Cacela, DBackground: Heterotopic bicaval stenting or caval valve implantation (CAVI) either with non-dedicated balloon-expandable Sapien™ valves (Edwards Lifesciences) or with dedicated TricValve™ (Products + Features) has emerged as a safe and effective percutaneous treatment for high-risk patients with severe tricuspid regurgitation (TR). One technical difficulty of CAVI is the lack of native calcified structures to anchor the device, which may lead to paravalvular leak or migration. Cases summary: We describe two patients with severe TR and high surgical risk who underwent CAVI procedures, both of them complicated with device migration to the right atrium (one inferior vena cava device and one superior vena cava device). Both cases were treated with a caval valve-in-valve procedure, with good technical and clinical results. Discussion: With the recent development of several percutaneous interventions for high-risk patients with severe TR, the rate of some possible complications is not well established, and neither are the better managing strategies. Device embolization is a rare complication of transcatheter heart interventions but with potential catastrophic consequences. Less invasive strategies such as the valve-in-valve procedure may be preferable in order to avoid the exposure of these patients to complex heart surgeries with extracorporeal circulation.
- Hypnobirthing: Confiança e Empoderamento no Trabalho de PartoPublication . Gaspar, TEste artigo tem como objetivo dar a conhecer o Hypnobirthing (HB) não só como método de preparação para o parto que harmoniza mente, corpo e feto, promovendo a confiança da mulher e o empoderamento das suas capacidades instintivas para o nascimento, mas também enquanto filosofia de cuidados do enfermeiro especialista em saúde materna e obstetrícia (ESMO), ao entender o nascimento como um evento fisiológico e natural. Propõe-se, portanto, compreender o impacto do ciclo medo-tensão-dor na evolução do trabalho de parto e na experiência de parto de cada mulher, as ferramentas utilizadas por este método e a forma como poderão ser implementadas na prática de cuidados do enfermeiro ESMO.
- What Do Portuguese Cardiologists Think and Feel About Their Work?Publication . Santarém Semedo, C; Moreira Diniz, A; Aguiar, JE; Sousa Almeida, S; Timóteo, AT; Gil, VIntroduction and objectives: This study reports the results of an online survey carried out by the Portuguese Society of Cardiology about its medical members' work characteristics before and during the COVID-19 pandemic, their job satisfaction, work motivation, and burnout. Methods: A sample of 157 participants answered a questionnaire with demographic, professional, and health-related information, followed by questionnaires on job satisfaction and motivation designed and validated for this study and a Portuguese version of the Maslach Burnout Inventory. Data were analyzed through descriptive statistics, ANOVA, and MANOVA, considering gender, professional level, and sector of activity, respectively. Multiple regression was used to assess the impact of job satisfaction and motivation on burnout. Results: The only variable that distinguished participants was sector of activity. Cardiologists working in the private sector worked fewer weekly hours during COVID-19, while those in the public sector worked more. The latter expressed more desire to reduce their working hours than those who worked in private medicine and in both sectors. There were no differences between sectors in work motivation, while job satisfaction was higher in the private sector. Moreover, job satisfaction negatively predicted burnout. Conclusions: Our findings point to a deterioration in working conditions during the COVID-19 pandemic, with its consequences being felt especially in the public sector, which may have contributed to the lower levels of satisfaction among cardiologists who worked exclusively in this sector, but also for those working in both public and private sectors.