Portuguese Air Force Academy

A 20-year-old southern ground hornbill (Bucorvus leadbeateri) developed hyperpigmented macules on its gular pouch, resembling the lesions typically seen in humans with pityriasis versicolor. Cytologic examination revealed over 100 budding yeasts per oil immersion field. Fungal culture showed rare growth of smooth, cream-colored yeast colonies, identified by PCR as Malassezia slooffiae. Histopathological analysis showed lymphocytic perivascular dermatitis. Periodic acid-Schiff staining revealed rare forms of yeasts between the layers of the stratum corneum. This clinical report provides further insights into the role of Malassezia spp. in the avian skin microbiome. To the authors' knowledge, this is the first report of Malassezia sp. as an agent of pityriasis versicolor in birds.

Abstract Background Crohn’s disease (CD) has a variable clinical course and a heterogeneous therapeutic response. Clinical decision support tools (CDSTs) for vedolizumab (VDZ) and ustekinumab (UST) have been developed to guide personalized treatment, but comparative evidence—particularly regarding the UST-CDST—remains limited. We aimed to compare the predictive performance of both CDSTs in CD. Methods We conducted a retrospective, multicenter study (9 centers), including CD patients treated with UST or VDZ. For each patient, the UST-CDST and VDZ-CDST were applied and categorized into low, intermediate, or high probability of response. The primary outcome was steroid-free clinical remission (SFCR) at week 52. Secondary outcomes included need for surgery, hospitalization and phenotypic progression. Model discrimination was evaluated with ROC/AUC, and predictors assessed via multivariable Cox regression. Results Of 711 screened patients, CDSTs were applicable in 440 [UST: 74.5% (n = 328); VDZ: 25.5% (n = 112)]. In multivariable Cox models, VDZ-CDST independently predicted SFCR only in VDZ-patients (HR 2.00; 95% CI 1.19–3.35), while UST-CDST predicted SFCR only in UST-patients (HR 1.54; 95% CI 1.23–1.94). VDZ-CDST identified SFCR with an AUC of 0.70 in VDZ-patients and 0.59 in UST-patients, whereas UST-CDST achieved an AUC of 0.63 and 0.68, respectively. Both scores significantly discriminated the risk of surgery, hospitalization and phenotypic progression in both biologics. Agreement between the two CDSTs was 75%. Conclusion Both UST-CDST and VDZ-CDST demonstrated significant predictive performance for clinical response and disease progression in CD, with superior performance for their target biologic. These findings support the integration of CDSTs into clinical practice promoting a personalized treatment in Crohn’s disease.

Introduction: Sexuality is an essential element for the health and quality of life. Rehabilitation Nursing allows training and maximization of the functionality of disabled persons. The purpose of this study is, in the scope of rehabilitation, to map the evidence of nursing interventions in terms of the function of sexuality in disabled persons.Method: Rapid Literature Review using PubMed and the EBSCOhost platform. Accepting only primary studies, published between January 1, 2014 and November 16, 2024. Cochrane guidelines were followed.Results: A total of seven articles were included. In the data analyzed, health education emerged as the main line of intervention in Rehabilitation Nursing. Nursing professionals must evaluate and teach disabled persons, and their family members and caregivers about the role of sexuality, the factors that affect it and the techniques used to optimize it. The application of intervention models and therapeutic communication facilitate the elaboration of individualized care plans. The use of techniques like videos or simulations strategies facilitate the discussion of sexuality and help to teach specific instructions.Conclusion: Rehabilitation Nursing Specialists must perform health education using validated intervention models. It is suggested that a Systematic Review of Literature and Case Reports be carried out to increase knowledge on this topic.

RESUMO Em Portugal, a transição da criança com Perturbação do Espetro do Autismo (PEA) para o primeiro ciclo do ensino básico constitui uma fase de desafios relacionados com a mudança e a adaptação a um novo sistema de ensino. Este estudo procurou analisar as perceções das famílias e dos profissionais relativamente à transição de crianças com PEA da educação pré-escolar para o primeiro ciclo do ensino básico. Desenvolveu-se uma investigação de natureza qualitativa, com 16 participantes, tendo por base a metodologia de estudo de caso e a entrevista semiestruturada como instrumento de recolha de dados. Como resultados desta investigação, destacam-se a importância da participação das famílias e do trabalho colaborativo. Os processos de transição foram maioritariamente descritos de forma positiva pelos participantes. As barreiras que dificultam o processo de transição relacionam-se com a diferença dos modelos e contextos de intervenção nos dois ciclos de estudo, a descontinuidade do apoio da Intervenção Precoce na Infância, a falta de formação dos profissionais e a ausência de avaliação do processo de transição. Os resultados deste estudo poderão influenciar as práticas e as políticas, de modo a salvaguardar a qualidade do processo de transição e o sucesso da criança com PEA.

The military serves as a vital bridge between strategic goals and societal values. This study aims to comprehensively analyze the potential and limitations of Empowering Leadership (EL) in the armed forces. Considering the current post-pandemic context and the geopolitical shifts in a volatile, uncertain, fragile, and complex world, we look at how EL can boost adaptability. We started by addressing military organization structure and evolution, followed by the EL concept and its impact on organizational performance. We discussed its benefits, progress, and role in modern military environments. The analysis points out EL benefits, despite the challenges posed by the military’s strict hierarchy, which can limit EL’s effectiveness, but concluded that this style can be effective when aligned with Mission Command. We analyze EL’s nuances in military settings, presenting three propositions and stating their potential, challenges, and limitations. This study offers insights into leadership dynamics in the military, highlighting the delicate balance between empowerment and traditional structures.

Ketamine has been widely used in refractory pain as an opioid adjuvant. Evidence suggests that ketamine can also have an essential role in easing depressive symptoms. Its rapid onset of action makes it a valuable choice in palliative care. We present a case of a 70-year-old man with stage IV renal carcinoma and bone metastasis. The main symptoms included neuropathic pain, depression, and a persistent and severe desire for death. We started continuous subcutaneous infusion with morphine 30 mg and ketamine 100 mg/day. The dose of ketamine was incremented to the maximum of 250 mg/day. During the 28-day treatment, we observed an overall improvement in neuropathic pain, depressive symptoms, and other end-of-life psychological aspects of distress. Only minor psychological side effects were identified, which were controlled by using midazolam in the continuous subcutaneous infusion. Some studies have already demonstrated the benefits of ketamine use in alleviating depression, using parental infusion or oral formulas, which are administered in hospice care. Our report enhances the benefit of the subcutaneous route for palliative patients cared for at home.

In this paper, we seek to define the Portuguese Electronic Jurisdictional Administrative Procedure and characterize the scope and success of its implementation in terms of access to justice and court efficiency. It encompasses different perspectives on the judicial system and the electronic administrative procedure, reflecting the diversity of its authors, and combines a theoretical approach and discussion with statistics produced with official judicial data. Therefore, it introduces the issue and its background and discusses the models and principles of electronic judicial procedure and its representation in the Portuguese judicial procedure and law. It also presents the Portuguese exceptional and temporary regime for conducting judicial hearings in the context of the COVID-19 pandemic, discussing its merits and presenting the corresponding judicial statistics. The paper concludes that the advent of electronic judicial procedure, driven by technological advancements and aiming to achieve procedural effectiveness and efficiency, represents a paradigm shift and a change in the nature of the legal process, i.e., an ontological transformation in the theory of the process that requires a robust conceptual framework, to ensure consistent interpretation and application of procedural law and to guarantee respect for equality and legal certainty.