Posterior Reversible Encephalopathy Syndrome and Azathioprine

Posterior reversible encephalopathy syndrome (PRES) is a rare syndrome that presents with neurological manifestations, often associated with arterial hypertension. Magnetic resonance imaging (MRI) shows bilateral white matter oedema in the posterior vascular territories. Immunosuppression, (pre) eclampsia and autoimmune diseases can be implicated. A 27-year-old woman, with mixed connective tissue disease under azathioprine, was admitted in the emergency room in status epilepticus and with severe hypertension. The MRI showed bilateral oedema in a pattern compatible with PRES. There was clinical improvement after azathioprine suspension. PRES is typically reversible with prompt recognition of the syndrome and its trigger. The association with azathioprine is rare. LEARNING POINTS: Posterior reversible encephalopathy syndrome should be considered in patients with sudden onset of headache, altered consciousness and seizures.Recognition of this entity and identification of the trigger are essential for reversal of the clinical picture.Autoimmune diseases and some immunosuppressive drugs have been identified as causative, but reports of an association with azathioprine are very rare.info:eu-repo/semantics/publishedVersio

Chronic hyponatremia in a patient with renal salt wasting and without cerebral disease: relationship between RSW, risk of fractures and cognitive impairment

Renal salt wasting syndrome (RSW) is defined as a renal loss of sodium leading to hyponatremia and a decrease in extracellular fluid volume (ECV). Differentiation of this disorder from the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a common cause of hyponatremia, can be difficult because both can present with hyponatremia and concentrated urine with natriuresis. Our clinical case about a 78-year-old woman with a recent fracture of the right femur not only confirms that this syndrome can occur in patients without intracranial pathologies (CT documented), but depicts how the hyponatremia caused by RSW can show a chronic, oscillating course. This is an interesting point of view because it suggests to us to consider RSW in the differential diagnosis of patients with chronic hyponatremia

Policy issues and data communications for NASA earth observation missions until 1985

The series of LANDSAT sensors with the highest potential data rates of the missions were examined. An examination of LANDSAT imagery uses shows that relatively few require transmission of the full resolution data on a repetitive quasi real time basis. Accuracy of global crop size forecasting can possibly be improved through information derived from LANDSAT imagery. A current forecasting experiment uses the imagery for crop area estimation only, yield being derived from other data sources

The use of ultrasound in clinical setting for children affected by NAFLD. is it safe and accurate?

Non-alcoholic fatty liver disease (NAFLD) has become over the last decade the most common form of chronic liver disease in children and adults. Thus, establishing the diagnosis of NAFLD is of utmost importance and represents a major challenge as the disease is generally silent and the current gold standard for diagnosis is an invasive liver biopsy, a procedure that is not suitable for screening purposes. Many non-invasive diagnostic tools have been evaluated so far. Recently the utility of ultrasonography for non-invasive diagnosis and estimation of hepatic steatosis has been demonstrated in a large prospective pediatric study

La expedición británica - sueca - noruega : (1949-1952)

Fil: Corte, A. E.. Universidad Nacional de Cuyo. Facultad de Filosofía y Letra

Glaciología y ramas conexas : métodos y elementos de trabajo

Fil: Corte, A. E.. Universidad Nacional de Cuy

La adquisición y el desarrollo lingüístico de los hablantes de herencia de español: un estudio de caso basado en la investigación-acción en el aula

The so-called heritage speakers of Spanish are a type of bilinguals who have been exposed to their mother tongue for a long time, but sometimes lack the necessary linguistic skills and communicative competence when compared to native speakers since they have been raised in a social environment where English is the dominant language. This article offers an overview of the acquisition of Spanish by heritage speakers and will carry out an error analysis of a text written by a speaker of Spanish as a heritage language at the morphosyntactic level. This analysis intends to show teachers of Spanish as a Foreign Language in Europe the particular characteristics of these speakers' language development as well as to suggest areas of possible pedagogical intervention.published_or_final_versio

Postgraduate Medical Teaching

Os autores afirmam a urgência em reestruturar o ensino medico pós-graduado em Portugal. De uma forma critica, analisam esquematicamente a situação actual do ensino médico pós-graduado em geral e da Urologia em particular, no nosso país. Depois de enunciar as etapas para atingir o internato da especialidade, resumem o Plano de preparação para a especialidade de Urologia do Conselho Directivo do Colégio de Urologistas da Ordem dos Médicos, de 1979. 0 Plano refere-se a tempos de estágio, programas teórico e prático, e formas de avaliação dos internos e aponta ainda as características para que um serviço seja considerado idóneo. Referindo que a realidade actual não corresponde às exigências preconizadas, os autores indicam aquilo que de facto acontece. Respondendo negativamente a uma série de questões sobre pontos fulcrais para uma prática correcta do ensino pós-graduado, os autores terminam a primeira parte da sua exposição perguntando se, nas condições actuais, o resultado final da preparação dos médicos será mesmo um Especialista. Na segunda parte fazem propostas para a reestruturação do ensino pós-graduado em Portugal. Referem-se sucessivamente as seguintes alíneas: criação de institutos ou escolas médicas hospitalares de pós graduação, universitários; elaboração de um programa padrão nacional do ensino médico pós-graduado; criação de comissões para o ensino médico pós-graduado; definição exigente do perfil de serviço idóneo para o ensino médico pós-graduado; elaboração de programas individuais pelos serviços dos institutos de pós-graduação; caderneta; fiscalização da actividade dos docentes e discentes; avaliação, contínua e por provas intercalar e final; mestrado. Dado o carácter auto-explicativo dos quadros, os autores, para além de alguns comentários, apenas desenvolvem as alíneas referentes aos Institutos ou Escolas Médicas de Pós-graduação, Universitários e ao Mestrado, expondo, duma maneira sucinta, a forma como pensam que deviam ser organizados