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Synopsis The skin is the largest organ of the human body and its functions include protection, thermoregulation sensation and secretion. Significant advances in our understanding of how the morphology and physiology of the skin contribute to the skin’s barrier role have been achieved in recent years. The aim of this review is to summarize the principal approaches which have been used to assess variation in skin barrier function with anatomic site, age, gender, and ethnicity. The methods discussed include trans‐epidermal water loss (TEWL) measurement, assessment of corneocyte size, response to vasoactive compounds and attenuated total reflectance Fourier transform infrared (ATR‐FTIR) interrogation of skin. The utility of the various methods is considered and the most important findings in the literature to date are highlighted.

The incidence of multiple gestations is increasing worldwide and many studies have shown higher perinatal morbidity and mortality rates in monochorionic twins compared to dichorionic. The aim of this study was to assess the twin population born at a tertiary center and to evaluate the impact of chorionicity on perinatal outcomes of twin pregnancies. Material and Methods:Retrospective study of all twins born in a tertiary center from January 2004 to December 2013. Results: In this period, 1051 twins were born, related to 540 gestations (26.7% monochorionic; 73.3% dichorionic). There was no statistical significant difference between the groups concerning obstetric complications. The monochorionic group had a higher incidence of intrauterine growth restriction (20.5 vs 11.3%, p < 0.001), lower mean maternal age (29.9 vs 31.9 years, p < 0.001), lower mean gestational age (33.4 vs 34.3 weeks, p < 0.05) and lower mean birth weight (1943 vs 2147 g, p < 0.001). Monochorionic twins had a higher incidence of hyaline membrane disease (7 vs 4%, p < 0.05), sepsis (10.3 vs 5.8%, p < 0.05) and anemia (9.5 vs 5.4%, p < 0.05). There were no statistical significant differences concerning necrotizing enterocolitis, intraperiventricular hemorrhage or retinopathy of prematurity. Perinatal mortality was higher in the monochorionic group (5.2 vs 2.9%, p < 0.05). Discussion: Monochorionic twins represent considerable challenges to both obstetricians and neonatologists and should be monitored and delivered at tertiary centers. Conclusion: Currently gemelarity has a major impact on total births. It would be interesting to develop protocols to standardize clinical approach to twins.

ResumoEm pediatria oncológica, a taxa de sobrevivência tem sofrido um aumento acentuado, sendo considerável a probabilidade de cura. Não obstante, o processo de confronto com a doença pode sofrer alguns contratempos, nomeadamente uma recidiva. Esta última é responsável por elevado sofrimento, o qual poderá ser ainda maior que o confronto com o diagnóstico. Procurando conhecer as perceções dos profissionais de oncologia, relativamente às principais dificuldades experienciadas pelas crianças e adolescentes cuja doença recidivou, as autoras desenvolveram um estudo investigando o olhar desses profissionais. Entrevistaram-se 17 profissionais, de dois hospitais portugueses, exercendo funções hospitalares na área da saúde, serviço social, psicologia e educação. Suas reflexões apontaram como principais dificuldades a aceitação de ter que passar novamente por um processo fisica e psicologicamente penoso sendo que, entre os adolescentes -mais conscientes da gravidade da doença e suas implicações -acrescem as dificuldades em ter esperança na cura. Para os mais pequenos, os profissionais apontaram como mais comum a dificuldade em compreender os motivos de nova submissão a tratamentos dolorosos e do afastamento dos seus contextos de vida. Dando a conhecer uma etapa particularmente desafiante da doença oncológica, o presente estudo traz um olhar multifocal de um grupo de profissionais que acompanham de perto essas crianças/adolescentes (e respectivas famílas). A sua longa e diversa experiência -em termos de tipologias de câncer, evolução do quadro clínico, idade ou temperamento dos pacientes (e dos próprios pais) -fazem desses profissionais informantes-chave no mapeamento das dificuldades associadas ao processo de recidiva oncológica em pediatria, bem como no desenho e implementação de respostas mais ajustadas à fenomenologia destes processos. Palavras-chave: psico-oncologia pediátrica, recidiva, fenomenologia, profissionais de cuidados Cancer recurrence: perspectives of hospital staff on the difficulties of pediatric patients Abstract In pediatric oncology, the survival rate has risen considerably, and nowadays the probability of cure is very high. However, the process of fighting the disease can suffer some setbacks, namely a relapse. This event is responsible for high suffering, which may be even greater than dealing with the diagnosis of cancer. Aiming to understand the perceptions of oncology professionals regarding the main difficulties experienced by children/adolescents whose cancer relapsed, the authors developed a study in which the professionals' perspective was explored. A group of 17 professionals (from the areas of health, social work, psychology and education), working in two Portuguese hospitals, was interviewed. Their reflections indicated that the main difficulties during relapse were the acceptance of having to undergo such a -physically and psychologically -painful process all over again, and among adolescents, who are more aware of the severity of the disease and its implications, also difficulties in kee...

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