Fever with spontaneous gingival bleeding: A diagnostic challenge

A previously healthy 4-year-old girl was admitted to our institution with fever and painless spontaneous gingival bleeding, persisting over a week, without evident lesions or trauma. She was born in Italy and had always lived in Palermo. She had never travelled internationally. Lab oratory testing showed a negative swab test for Sars-CoV2 and a tri linear pancytopenia with neutropenia (0.6 × 103/mm3), lymphopenia (1.17 × 103/mm3), thrombocytopenia (115 × 103/mm3) and anemia (Hb 7.1 g/dL, RBC 3.48 × 103/mm3, Hct 21.2%, RDW-CV 23.4%, RDW SD 51,6 fL). Other laboratory findings showed hyponatremia (130 mmol/dL), hypocalcemia (8.7 mmol/dL), hypoalbuminemia (3.5 g/dL), increase of LDH (267 IU/L), C-reactive protein (1.64 mg/dL) and alka line phosphatase levels (190 IU/L). On physical examination she appeared in pain, pale, with hyperemic pharynx without plaque or pu rulent secretion and hypertrophic bleeding gingiva (see Fig. 1). There was notable cervical lymphadenopathy, hepatomegaly (1 cm below the costal margin), and splenomegaly (3 cm below the costal margin). An abdominal ultrasound showed an enlarged spleen (15.6 × 6.6 cm) and ascites. Additional history revealed the diagnosis of visceral leishmaniasis, treated with six doses of Amphotericin B liposomal (administered for first 5 days plus one dose on the 10th day) seven months earlier. A subsequent leishmania polymerase chain reaction (PCR) assay on blood and gingival brush confirmed the diagnosis of a leishmaniasis relapse. A comprehensive immunological evaluation including an HIV test excluded any primary or acquired immunodeficiency disease. Treatment with amphotericin B was administered over 10 days, leading to a full recovery. Visceral leishmaniasis caused by Leishmania infantum is endemic in the Mediterranean region. Mucocutaneus lesions are extremely rare with this species and usually affect immunosuppressed patients. In children leishmaniasis relapse with atypical mucosal involvement represent a rarity. Clinical follow up and periodic PCR tests (performed at 3-6-9-12 months after treatment) should be considered for early recognition of a relapse

Memorial da música

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Faculdade de Arquitetura e Urbanismo, Projeto de Diplomação 2, 2013.O Memorial da Música de Brasília (MMB) é um espaço destinado à preservação e à divulgação da música na cidade. Conduziu o projeto a convicção de se planejar um espaço de convívio cultural no centro urbano da Capital Federal. A intenção foi a de aliar espaços privados e espaços públicos, permitindo apresentações musicais e encontros culturais diversos. Foi premissa do projeto a busca da consciência do convívio coletivo e cultural

Entre a cidade de Concreto e a cidade narrada : o imaginário de Brasília na poesia de Nicolas Behr

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Arquitetura e Urbanismo, Programa de Pós-Graduação em Arquitetura e Urbanismo, 2018.Este trabalho discute e analisa as representações de Brasília presentes nas poesias do cuiabano-brasiliense Nicolas Behr. O objetivo é apreender, nos poemas dedicados à Capital Federal, parte do imaginário social da cidade, temporalmente situado entre a década de setenta e o começo dos anos dois mil. Behr chegou adolescente na Brasília dos anos de 1970 e o espanto foi o primeiro sentimento experimentado diante da inusitada cidade modernista. O estranhamento do poeta, partilhado com outros, como o de Clarice Lispector, nos fala de uma cidade sem saturação histórica, frequentemente associada ao deserto e à solidão no seu quase grau zero. As representações da primeira fase da obra de Behr são como uma imagem invertida das intenções de Lucio Costa. Posteriormente, sua poesia parece entregar-se à cidade-utopia do urbanista. Coteja- -se a cidade da memória do poeta, cujos escritos circularam pelos bares e espaços culturais de Brasília, aquela do urbanista, em folhas mimeografadas. Há, em seus poemas, metáforas e imagens sobre o cotidiano de uma cidade para a qual era necessário o conhecimento de um vocabulário específico a demandar esforço para sua decifração. Os sentimentos nos registros poéticos de Behr possibilitam mais uma camada na espessura da história de Brasília.This paper discusses and analyzes the representations of Brasilia present in the marginal poetry of Nicolas Behr. The objective is to understand part of the social imaginary of the city in his poems, between the seventies and the beginning of the two thousands. Behr was a teenager in Brasilia in the 1970s, where astonishment was the first feeling he experienced before the unusual modernist city. The estrangement felt by the poet, shared with others such as Clarice Lispector, reveals a city without historical saturation, often associated with deserts and solitude at its almost zero degree. The representations of the first phase of Behr’s work are like an inverted image of Lucio Costa’s intentions. Later, his poetry seems to surrender to the city of the urbanist. His poems are filled with metaphors and images about the daily life of the city, which demand a certain knowledge of a specific vocabulary for its deciphering. The sentiments in Behr’s poetic records provide yet another layer in the thickness of Brasília’s history

Hidden Consequences of Living in a Wormy World: Nematode‐Induced Immune Suppression Facilitates Tuberculosis Invasion in African Buffalo

Most hosts are infected with multiple parasites, and responses of the immune system to co-occurring parasites may influence disease spread. Helminth infection can bias the host immune response toward a T-helper type 2 (Th2) over a type 1 (Th1) response, impairing the host’s ability to control concurrent intracellular microparasite infections and potentially modifying disease dynamics. In humans, immune-mediated interactions between helminths and microparasites can alter host susceptibility to diseases such as HIV, tuberculosis (TB), and malaria. However, the extent to which similar processes operate in natural animal populations and influence disease spread remains unknown.We used cross-sectional, experimental, and genetic studies to show that gastrointestinal nematode infection alters immunity to intracellular microparasites in free-ranging African buffalo (Syncerus caffer). Buffalo that were more resistant to nematode infection had weaker Th1 responses, there was significant genotypic variation in nematode resistance, and anthelminthic treatment enhanced Th1 immunity. Using a disease dynamic model parameterized with empirical data, we found that nematode-induced immune suppression can facilitate the invasion of bovine TB in buffalo. In the absence of nematodes, TB failed to invade the system, illustrating the critical role nematodes may play in disease establishment. Our results suggest that helminths, by influencing the likelihood of microparasite invasion, may influence patterns of disease emergence in the wild

Digital Storytelling and Mathematical Thinking: An Educational Psychology Embrace

This article proposes Digital Storytelling as an education model that combines science, narrative thinking and art. This model has been implemented in Italian school settings over recent years. After a short introduction of the theoretical foundations of narrative thinking in the history of Educational Psychology, the paper focuses on Digital Storytelling as a co-constructive educational method that uses digital technologies for promoting an active, situated, meaningful and reflexive learning process. The proposed intervention in the Italian settings adds the artistic digital component (the use of avatar, comics and science fiction) to the Digital Storytelling systems. The set of implemented activities, as well as the individual and group actions taken, promote both the cognitive and emotional aspects of the learning process. The findings show that Digital Storytelling, spiced with artistic features, prompts the engagement of students in learning activities and offers a platform to enhance behavioural, emotional and cognitive commitment in mathematics education

Representações de Brasília em poemas de Nicolas Behr (1977-1980): uma perspectiva metodológica a partir de Hans Robert Jauss | Representations of the city of Brasília in the poetry of Nicolas Behr (1977-1980): a methodological perspective by Hans Robert Jauss

Este artigo discute as representações de Brasília presentes nos poemas de Nicolas Behr, escritos entre 1977 e 1980. O objetivo é apreender, nos poemas dedicados à Capital Federal, parte do ima­ginário social da cidade quase em seu grau zero de saturação histórica. Apresenta-se, para isso, a leitura e a análise orientadas por Hans Robert Jauss que, sob bases da hermenêutica, propõe que se opere sobre os textos literários em três etapas: percepção estética (intelligere), interpretação retros­pectiva (interpretare) e histórica (applicare). Assim, ele também é um experimento metodológico posto a favor da literatura como fonte singular para pensar e representar a cidade

Successful endovascular treatment of a 13 cm abdominal aortic aneurysm. Case report

There is increasing evidence in the literature that endovascular aneurysm repair is the first-line approach for most of abdominal aortic aneurysms (AAAs). Furthermore aortouniiliac stent graft placement is, in high risk patients or during emergency setting, a safe procedure over the mid- and long-term period and compares well with the results of bifurcated stent grafts. We present a case of a 66 -year-old gentleman, with pneumothorax after therapeutic thoracentesis and a giant AAA, successfully treated with an aortomonoiliac stent grafting and femoro-femoral crossover bypass

A Methodology for the Design of Safety-Compliant and Secure Communication of Autonomous Vehicles

International audience; The automotive industry is increasing its effort towards scientific and technological innovations regarding autonomous vehicles. The expectation is a reduction of road accidents, which are too often caused by human errors. Moreover, technological solutions, such as connected autonomous vehicle platoons, are expected to help humans in emergency situations. In this context, safety and security issues do not yet have a satisfactory answer. In this paper, we address the domain of secure communication among vehicles - especially the issues related to authentication and authorization of inter-vehicular signals and services carrying safety commands. We propose a novel design methodology, where we take a contract-based approach for specifying safety, and combine it in the design flow with the use of the Arrowhead Framework to support security. Furthermore, we present the results through a demo, which employs model-based design for software implementation and the physical realization on autonomous model cars

Outcome of Allogeneic Peripheral Blood Stem Cell Transplantation by Donor Graft CD3+/Tregs Ratio: A Single-Center Experience

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Meta-Analysis of Mitochondrial DNA Reveals Several Population Bottlenecks during Worldwide Migrations of Cattle

Several studies have investigated the differentiation of mitochondrial DNA in Eurasian, African and American cattle as well as archaeological bovine material. A global survey of these studies shows that haplogroup distributions are more stable in time than in space. All major migrations of cattle have shifted the haplogroup distributions considerably with a reduction of the number of haplogroups and/or an expansion of haplotypes that are rare or absent in the ancestral populations. The most extreme case is the almost exclusive colonization of Africa by the T1 haplogroup, which is rare in Southwest Asian cattle. In contrast, ancient samples invariably show continuity with present-day cattle from the same location. These findings indicate strong maternal founder effects followed by limited maternal gene flow when new territories are colonized. However, effects of adaptation to new environments may also play a rol