Repositório RCAAP

Isolated coronary arteritis without systemic involvement in adults is exceedingly rare. A 60-year-old patient developed recurrent non–ST-segment elevation myocardial infarctions for 1 year. After an initial coronary angiogram that was normal, serial angiograms showed de novo aneurysm formation. The patient responded favorably to corticosteroids, supporting the diagnosis of isolated coronary arteritis.

An Egyptian burial assemblage in the collection of the Museum of Ancient Art and Archaeology of the University of Aarhus, Denmark, comprises an anthropoid coffin, a mummy-cover and a mummy. Several analyses have been carried out on the human remains since their arrival to the Museum in 1950 but these results have never been published nor critically accessed from an Egyptological perspective. Notwithstanding the unique opportunity provided by this burial assemblage to carry out the integrated study of the funerary equipment and the human remains, only recently has the coffin set been thoroughly analysed, described and published. This paper presents the results obtained from former anthropological studies with an Egyptological assessment of the data, comparing them with the information provided by the burial equipment. The critical integration of this data reveals important clues regarding the special social status held by an elderly woman suffering from a severe and chronic disability within the priesthood of Amun during the Twenty-first Dynasty.

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A produção científica dedicada ao estudo da emigração portuguesa, seja em Portugal, seja no estrangeiro, continua a considerar preponderantemente aqueles e aquelas que deixaram o país como “emigrantes”, e não como “migrantes”. Apesar da mudança que se tem operado desde os finais dos anos 1980 com o sociólogo Abdelmalek Sayad (1999a, 1999b), que viu a necessidade absoluta de restabelecer a integridade do emigrante/imigrante reconciliando estas duas figuras aparentemente diferentes numa só, os/as portugueses/as que partiram continuam a ser referidos/as nos dias de hoje como os/as “emigrantes”. Estes títulos posteriores ao ano 2000 são disso testemunho (não obstante, consideramo-los essenciais à compreensão do fenómeno migratório português!): Desenvolvimento em meio rural: contributos da emigração e do regresso (Gonçalves, 2007); Portugal 2010: The return of the country of emigration? (Malheiros, 2011); L’émigration au Portugal, avatar d’un pays “semipériphérique” (Santos, 2013); Regresso e circulação de emigrantes portugueses no início do século XXI (Oliveira et al., 2016); Regresso ao futuro: A nova emigração e a sociedade portuguesa (Peixoto et al., 2016); L’émigration à l’écran: la rhétorique du succès. La série documentaire Portugueses pelo mundo (Cunha, 2017); A mobilidade académica e a emigração portuguesa qualificada (Gomes, 2019); New and old routes of Portuguese emigration (Pereira & Azevedo, 2019); A emigração portuguesa no século XXI (Pires et al., 2020), etc. Uma série de ideias preconcebidas acompanham a partida destes “emigrantes” e a expectativa do seu regresso, deixando um rasto nos discursos, nas políticas desenhadas para os recuperar, na forma como são representados nos meios de comunicação social ou ainda na forma como são vistos nas comunidades de onde partiram. Assim, o binómio “emigração/regresso” pode representar uma armadilha, no sentido em que inviabiliza uma análise mais ampla e complexa das diversas experiências de movimento(s), espera(s) e imobilidade(s) – entre múltiplas combinações possíveis – que uma mesma pessoa ou família vivencia.

Em 1498, quando Vasco da Gama chegou à Índia, encontrou um mundo estruturado, com rotas marítimas específicas cobrindo todo o espaço do oceano Índico e ligando os principais portos, desde a costa africana até à longínqua China e ao Japão. A progressiva aprendizagem das relações entre os participantes de um comércio próspero permitiu aos portugueses a concepção de um projecto político e militar cujo objectivo claro era o domínio destas vias marítimas. Esse projecto está patente no “Regimento” dado a D. Francisco de Almeida, em 1505, prevendo a construção de um conjunto de fortalezas em pontos estratégicos e a manutenção de uma armada no mar, de forma a impedir os acessos a todos os que recusassem a soberania portuguesa. Afonso de Albuquerque, assumindo o governo do Estado da Índia em 1509, foi o principal obreiro deste projecto de domínio naval, obtido sobretudo com as conquistas de Goa, Malaca e Ormuz.

Pesquisa encomendada pela Comissão Nacional para as Comemorações dos Descobrimentos Portugueses para integrar a Secção Documental da Revista Mare Liberum. Consta de um estudo publicado no nº 13, dividido em três capítulos, seguido de uma colecção de súmulas de documentos ordenada cronologicamente, e de uma bibliografia referindo fontes manuscritas e impressas, guias de documentação e de estudo, para além de outros utensílios, e ainda uma relação de estudos específicos. Segue-se a esta contextualização aprofundada e ao confronto de testemunhos, a publicação, no nº 14, de uma Compilação de Documentos, catorze no total, transcritos do original, cinco dos quais publicados pela primeira vez. Em virtude de razões fundamentadas no terceiro capítulo do Estudo, propõe-se uma fixação com maior rigor da data de dois pareceres anónimos que se publicam. Inquire-se ainda sobre a sua utilização por Diogo do Couto no Diálogo do Soldado Prático que trata dos enganos e desenganos da Índia e sobre a provável troca de documentos e de informações entre aquele autor e Manuel Severim de Faria. Foi publicada pela CNPCDP a Edição conjunta de estudo e compilação de documentos, em 1998 (divulgada no RUL).

In this paper, we examine the accounts in Book 2 so as to access Herodotus effective knowledge of Egyptian temples. Although presenting an accurate portrait of the land and the people, Herodotus’ texts betray an insufficient understanding of the local priestly traditions which probably resulted from an unwelcoming reception by the Egyptian priests. Memphis, stands out as an exception in this panorama, providing Herodotus with a direct contact with the historical sources which later on would be brilliantly used by Manetho to write his History of Egypt.

This contribution focuses on the implications of an enquiry on return migration in a border region. The northeastern region of Trás-osMontes in Portugal is a paradigmatic area of out-migration, from colonial migrations to the ones to western and northern Europe during the Estado Novo, and the more recent migrations post-2008 crisis. The area went through dramatic demographic losses, accounting for a third of its population between the 1960s and 2000s. But it is also one of the areas with the highest rate of new residents - many of them coming (back) from France. The back and forth of inhabitants is only one form of mobilities in the history of the peninsula: as a border region, Trásos-Montes is recently revisiting its transcultural heritage, such as the one of the Sephardic Jewish community, the Mirandese minority and more. Enquiring at the border hence holds many meanings, both in time and space, and both for those who stay and those mobile. Based on Pratt (1991) or Cohen & Sheringham (2017)'s understanding of “contact zones”, I explore the dynamics of place production in such a cultural space of encounters, conflicts, and renewal between several communities, in a region which has historically functioned as a transitional space. The theoretical reflection is accompanied by preliminary results of an ethnographic fieldwork conducted between 2018 and 2020 in the region. The case study of a village embedded in various networks, through out-migration and return migration, shows the extent to which the regional efforts to promote the area as “open to the outside” deny the potential of Portuguese migrants and returnees as active place-makers.

Entre 2010 e 2015, o contexto migratório português alterou-se significativamente em consequência dos impactos sociais da crise financeira e económica, o que resultou num saldo migratório negativo, combinando redução do fluxo de entrada e incremento nas saídas de imigrantes (para novos destinos ou retorno ao país de origem) com o aumento da emigração portuguesa. Neste contexto, alguns casais luso-brasileiros mudaram-se para o Brasil, onde as oportunidades económicas e sociais, naquele período, pareciam mais favoráveis; contudo, entre 2016 e 2019, esse fluxo terá de novo oscilado, favorecendo agora Portugal enquanto espaço de destino. Combinando dados quantitativos sobre casamentos e nascimentos para demonstrar as ligações familiares entre brasileiras/os e portugueses/as e dados qualitativos coletados em entrevistas com famílias luso-brasileiras que vieram para Portugal, este texto procurou escrutinar duas ideias principais: (i) as razões do retorno para Portugal e a relevância dos contextos familiares, neste processo; e (ii) os projetos migratórios futuros e as suas implicações na (im)permanência neste país europeu. Teoricamente este artigo pretende desafiar e discutir categorias migratórias clássicas dos estudos migratórios como emigrantes-imigrantes e, sobretudo, partida e retorno, posicionando-as em contextos binacionais. Pretende-se assim desafiar a noção clássica de retorno a partir de uma perspetiva centrada em sujeitos migrantes mais complexos (os casais mistos) em relação aos espaços originais de referência que, por sua vez, também se vão transformando no quadro da circularidade migratória.

After fourteen decades of medical and technological evolution, infective endocarditis continues to challenge physicians in its daily diagnosis and management. Its increasing incidence, demographic shifts (affecting older patients), microbiology with higher rates of Staphylococcus infection, still frequent serious complications and substantial mortality make endocarditis a very complex disease. Despite this, innovations in the diagnosis, involving microbiology and imaging, and improvements in intensive care and cardiac surgical techniques, materials and timing can impact the prognosis of this disease. Ongoing challenges persist, including rethinking prophylaxis, improving the diagnosis criteria comprising blood culture-negative endocarditis and prosthetic valve endocarditis, timing of surgical intervention, and whether to perform surgery in the presence of ischemic stroke or in intravenous drug users. A combined strategy on infective endocarditis is crucial, involving advanced clinical decisions and protocols, a multidisciplinary approach, national healthcare organization and health policies to achieve better results for our patients.

Marie-Antoinette Hily nasceu em França, em 1946, e doutorou-se em sociologia, em 1993, com uma tese sobre os portugueses em França. Integrou o centro de investigação Migrinter em Poitiers, França, entre 1996 e 2011. Foi diretora da Revue Européenne des Migrations Internationales, entre 2000 e 2014. É autora de uma vasta obra publicada em livros e revistas científicas sobre migrações, mobilidade residencial, circulações migratórias e redes transnacionais.

Thoracic aortic aneurysms (TAA) may grow asymptomatically until they rupture, with a mortality over 90%. The true incidence and prevalence of this condition is uncertain and epidemiologic data is scarce, understudied and dispersed. Therefore, we aimed to conduct a systematic review and meta-analysis of the incidence and prevalence of TAAs in population-based studies. We searched MEDLINE, EMBASE and CENTRAL from inception to October 2020 for all population-based studies reporting on incidence and/or prevalence of TAAs. Data were pooled using a random effects model. The main outcome was the overall available worldwide incidence and prevalence of TAAs. The secondary outcomes were to evaluate the incidence of ruptured TAAs, differences in the location of these aneurysms (either ascending, arch or descending aorta) and differences in prevalence/incidence across different study designs. Twenty-two studies were included in the review and meta-analysis. The pooled incidence and prevalence of TAAs was 5.3 per 100,000 individuals/year (95% confidence interval [CI]: 3.0; 8.3) and 0.16% (95% CI: 0.12; 0.20), respectively. The pooled incidence of ruptured aneurysms was 1.6 per 100,000 individuals/year (95% CI: 1.3; 2.1). We found a significant difference of the prevalence in autopsy-only studies, which was 0.76% (95% CI: 0.47; 1.13) and the prevalence of TAAs dropped down to 0.07% (95% CI: 0.05;0.11) when these studies were excluded from the overall analysis. The current epidemiologic information provided serve as a base for future public-health decisions. The lack of well-design population-base studies and the limitations encountered serve as calling for future research in this field.

Após catorze décadas de evolução médica e tecnológica, a endocardite infeciosa continua a desafiar médicos no seu diagnóstico e manejo diário. O aumento da incidência, alterações demográficas (afetando pacientes mais idosos), microbiologia com taxas de infeção por Staphylococcus mais elevadas, com complicações graves ainda frequentes e uma mortalidade substancial tornam a endocardite uma doença muito complexa. Apesar de tudo, a inovação no seu diagnóstico, nomeadamente na área da microbiologia e imagem, e a melhoria nos cuidados intensivos e na cirurgia cardíaca (quanto às técnicas, materiais usados e momento de intervenção) podem ter um impacto no seu prognóstico. Os desafios persistem, incluindo repensar a profilaxia, melhorar os critérios de diagnóstico incluindo a endocardite com culturas negativas e endocardite de prótese valvar, o timing para a intervenção cirúrgica, e sua realização ou não na presença de acidente vascular cerebral isquêmico e em usuários de drogas intravenosas. Uma estratégia combinada na endocardite infeciosa é fundamental, incluindo decisões e protocolos clínicos avançados, um manejo multidisciplinar, organização e políticas de saúde que culminem em melhores resultados para os nossos pacientes.

Accelerated and premature cardiovascular calcification is a hallmark of chronic kidney disease (CKD) patients. Valvular calcification (VC) is a critical indicator of cardiovascular disease and all-cause mortality in this population, lacking validated biomarkers for early diagnosis. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor recently associated with vascular calcification, pulse pressure, mineral metabolism markers and kidney function. Here, we examined the association between GRP serum levels and mitral and aortic valves calcification in a cohort of 80 diabetic patients with CKD stages 2-4. Mitral and aortic valves calcification were detected in 36.2% and 34.4% of the patients and associated with lower GRP levels, even after adjustments for age and gender. In this pilot study, univariate, multivariate and Poisson regression analysis, show that low levels of GRP and magnesium (Mg), and high levels of phosphate (P) are associated with mitral and aortic valves calcification. Receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) values of GRP for mitral (0.762) and aortic (0.802) valves calcification were higher than those of Mg and P. These results suggest that low levels of GRP and Mg, and high levels of P, are independent and cumulative risk factors for VC in this population; the GRP diagnostic value might be potentially useful in cardiovascular risk assessment.

Objective: To perform a systematic review and meta-analysis of all population-based studies reporting on incidence of acute aortic dissections (AADs). Methods: We searched the MEDLINE, EMBASE, CENTRAL, and Open Grey databases from inception to August 2020 for population-based studies reporting on the incidence of AAD. A systematic review was conducted following the PRISMA guidelines using a registered protocol (CRD42020204007). Data were pooled using a random effects model of proportions using Freeman-Tukey double arcsine transformation. The main outcome was the incidence of AAD. Secondary outcomes were incidence type A aortic dissections (TAAD) and type B aortic dissections (TBAD), the incidence of aortic dissection repair and medical management, and the incidence of in-hospital mortality. In addition, we estimated the proportion of aortic dissection repair and mortality (in hospital, overall and specific mortality according to subtype) among patients with AAD. Results: Thirty-three studies were included. The pooled incidence of AADs was 4.8 per 100,000 individuals/year (95% confidence interval [CI], 3.6-6.1). The incidence of TAAD was 3.0 per 100,000/year (95% CI, 1.8-4.4) and the incidence of TBAD was 1.6 per 100,000/year (95% CI, 1.1-2.2). The incidence of AAD needing repair was 1.4 per 100,000/year (95% CI, 1.0-2.0) (or 1.4 [95% CI, 1.2-1.7] for TAAD and 0.4 [95% CI, 0.2-0.7] for TBAD). The incidence of medically managed AAD was 3.4 per 100,000/year (95% CI, 2.4-4.5). The incidence of in-hospital death owing to AAD was 1.3 per 100,000 individuals/year (95% CI, 0.9-1.9), 1.0 (95% CI, 0.6-1.4; I2 = 97%) for TAAD, and 0.3 for TBAD (95% CI, 0.2-0.4; I2 = 96%). Conclusions: A global estimate regarding the incidence rate of AADs was achieved. The incidence of AAD varied significantly between study designs and geographical regions. More accurate information on AAD epidemiology is crucial for public health decisions, clinical understanding, and healthcare management.

Pesquisa encomendada pela Comissão Nacional para as Comemorações dos Descobrimentos Portugueses para integrar a Secção Documental da Revista Mare Liberum. Consta de um estudo dividido em três capítulos, publicado no nº 13, seguido de uma colecção de súmulas de documentos ordenada cronologicamente, e de uma bibliografia referindo fontes manuscritas e impressas, guias de documentação e de estudo, para além de outros utensílios, e ainda uma relação de estudos específicos. Segue-se a esta contextualização aprofundada e ao confronto de testemunhos, a publicação, no nº 14, de uma Compilação de Documentos, catorze no total, transcritos do original, cinco dos quais publicados pela primeira vez. Em virtude de razões fundamentadas no terceiro capítulo do Estudo, propõe-se uma fixação com maior rigor da data de dois pareceres anónimos que se publicam. Inquire-se ainda sobre a sua utilização por Diogo do Couto no Diálogo do Soldado Prático que trata dos enganos e desenganos da Índia e sobre a provável troca de documentos e de informações entre aquele autor e Manuel Severim de Faria. Foi publicada pela CNPCDP a Edição conjunta de estudo e compilação de documentos, em 1998 (divulgada no RUL).

Background: Depression is the most prevalent mental disorder. In the treatment of depressive symptoms, patients' religious practices and beliefs are often not considered. We carried out a systematic review and meta-analysis of RCTs to analyse the effect of religious interventions on depression. Methods: A literature screening was performed on August 2021, using the Cochrane Collaboration, PubMed, Scopus, and Web of Science databases. Primary source articles published from 2015 to August 2021 in peer-reviewed journals were eligible for inclusion if data were presented on religious interventions' effects on depression. Results: The literature search yielded 208 potentially relevant publications. Eight articles were identified and included in the review. One of the articles was excluded from the meta-analysis because it did not report the mean data for the baseline and follow-up assessment results. From the 7 out of 8 included studies, the results consistently indicated that religious-based interventions effectively reduced depressive symptoms among vulnerable persons with chronic medical illness, pregnant women, haemodialysis patients, elderly nursing home residents, people with major depressive disorders or dysthymia, and coronary artery bypass graft surgery patients. Limitations: The definition of the religious-based intervention varied substantially among the trials. These differences can make interpretation and comparing implications on the treatment of depression difficult. Conclusion: Compared to standard/other usual therapies for treating depression, religious-based interventions provide superior effects. This review and meta-analysis strongly suggest that patients' religious beliefs should be considered when diagnosing and treating depression.

Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020). Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2. Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection. Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.

Introduction: We investigated the mediating role of leisure activity engagement as marker of cognitive reserve in the relation between neighborhood socio-economic position (SEP) and cognitive decline over 6 years. Methods: The study analyzed longitudinal data from 897 older adults who participated in the two waves (2011 and 2017) of the Vivre-Leben-Vivere (VLV) survey in Switzerland (M = 74.33 years in the first wave). Trail Making Test parts A and B were administered in both waves. Leisure activity engagement was assessed during interviews. Neighborhood SEP was derived from the Swiss Neighborhood Index of Socio-Economic Position (Swiss-SEP), provided by the Swiss National Cohort (SNC). Results: Latent change score modeling revealed that 42.5% of the relationship between higher neighborhood SEP and smaller cognitive decline was mediated via a higher frequency of leisure activities in the first wave. Conclusion: Neighborhood SEP constitutes an important contextual factor potentially influencing the pathways of cognitive reserve accumulation and, therefore, should be taken into account to better understand their effects on cognitive decline in old age.

This study aimed to assess the trends of health-related cardiorespiratory fitness (CRF) during two school years with a 3-month summer break in children and adolescents. A 2-year longitudinal study, including 440 6th to 8th graders (218 boys), mean age 12.3 years, was conducted. The Progressive Aerobic Cardiovascular Endurance Run (PACER) was used to assess CRF. Physical activity was measured using accelerometers. Repeated measures linear models were used to analyses differences and trends in VO2peak and health-related CRF. Overall differences between time-point VO2peak were significant for both boys (p<0.001) and girls (p=0.003). Pairwise comparisons showed that VO2peak improved from the beginning to the end of the same school year for boys (school-year 1: 1.53 ml/kg/min, 95%CI=0.98, 2.09; school-year 2: 1.81 ml/kg/min, 95%CI=1.28, 2.34) and girls (school-year 1: 0.85 ml/kg/min, 95%CI=0.43, 1.27; school-year 2: 1.05 ml/kg/min, 95%CI=0.73, 1.36), while, differences in CRF during summer break were not significant. However, significance was only maintained for girls when performing monthly adjusted analysis. Improvements in CRF were observed during school year and remained unchanged during summer break. These findings provide relevant information for the health education community, suggesting the need for additional efforts to counteract the summer break effects on CRF, especially for girls.