Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study

Background: Emergency department (ED) management relies on real-time information. Patient flow, lengthof-stay (LOS), complaint related readmissions, and patients that leave without being seen (LWBS), are monitoring parameters. The objective of this study was to evaluate activity time trends regarding ED at Centro Hospitalar do Porto from 2007 to 2016. Methods: Analysis of ED data warehouse (Alert® Emergency Room) was carried out. Manchester Triage System (MTS) is used, and the mentioned priorities (P1, P2, P3, P4 and P5) correspond to its terminology. Spearman correlation between variables was applied. Results: Patient records from 1.256.900 ED visits were evaluated. ED demand increased 16%. Priority 2 increased by 50% (p<0.001). A decrease of priority 4 (p<0.001) was observed. Patients that visit ED for unrelated reasons (labeled white) decreased (p<0.001). Difference between patients’ medians at different day hours (p<0.001) was found. A steady peak influx between 10 h-11 h and 14 h-16 h was found and significant increase was observed during night/dawn hours (3-8 h). No differences were observed between weekdays affluence. A priority difference was observed in weekdays, with a Monday peak for P3 and P4 priorities (p<0.001). A decrease in all patients’ ages was observed till sixty years old (p<0.001); A raise was noticed after eighty years old (p<0.001). Nevertheless, the LWBS was kept under 2.5% LOS under 5 h 30 m, with a sustained time-to-first-medical-observation (TFMO) under 70 minutes. Complaint indexed to readmissions (CIR) remained constant. Discussion: A constant LOS, TFMO, CIR, and small LWBS indicate a positive trend of ED clinical management. Population’s characteristics should be taken in to consideration to maintain these results. Conclusions: ED affluence increased during the studied period, especially by the older and the sicker. Primary care increased availability did not influence ED demand. Real time data storage helped to maintain clinical management by evidence based decisionsinfo:eu-repo/semantics/publishedVersio

Selection Rules for One- and Two-Photon Absorption by Excitons in Carbon Nanotubes

Recent optical absorption/emission experiments showed that the lower energy optical transitions in carbon nanotubes are excitonic in nature, as predicted by theory. These experiments were based on the symmetry aspects of free electron-hole states and bound excitonic states. The present work shows, however, that group theory does not predict the selection rules needed to explain the two photon experiments. We obtain the symmetries and selection rules for the optical transitions of excitons in single-wall carbon nanotubes within the approach of the group of the wavevector, thus providing important information for the interpretation of theoretical and experimental optical spectra of these materials.Comment: 4 pages, 1 figure, 1 tabl

Cerebellar Cortical Degeneration in Cattle Poisoned with <i>Solanum</i> spp. in South America: An Epidemiological, Clinicopathological, Pathological, and Toxicological Review

Cattle that consume Solanum bonariense L (= Solanum fastigiatum Willd.) or Solanum paniculatum L. develop a typical cerebellar cortical degeneration characterized by periodic episodes of ataxia, hypermetria, hyperesthesia, head and thoracic limb extension, opisthotonus, nystagmus, and falling to the side or backward. Histological lesions include vacuolation, degeneration, and loss of Purkinje cells. Axonal spheroids, microcavitations, and other changes of Wallerian degeneration in cerebellar granular layer and white matter are also observed. Neurotoxic compounds in Solanum spp. causing neurologic dysfunction in ruminants were not definitively elucidated. The same Solanaceae species are extensively used with culinary purposes or for the treatment of liver and gastrointestinal disorders as hangovers in humans. In the present paper, we review the epidemiology, clinical signs, and pathological hallmarks of poisoning by Solanum —S. bonariense L. (=S. fastigiatum Willd.) and S. paniculatum—with emphasis in histopathology, ultrastructural, and lectin- and immuno-histochemical changes in spontaneous and experimentally poisoned cattle in South America. The current knowledge of the pathogenesis of these bovine cerebellar cortical degenerations is discussed, and some advances in botanical and toxicological aspects of these Solanaceae species are presented, taking into account the potential risk of human poisoning.Facultad de Ciencias Veterinaria

Cerebellar Cortical Degeneration in Cattle Poisoned with <i>Solanum</i> spp. in South America: An Epidemiological, Clinicopathological, Pathological, and Toxicological Review

Cattle that consume Solanum bonariense L (= Solanum fastigiatum Willd.) or Solanum paniculatum L. develop a typical cerebellar cortical degeneration characterized by periodic episodes of ataxia, hypermetria, hyperesthesia, head and thoracic limb extension, opisthotonus, nystagmus, and falling to the side or backward. Histological lesions include vacuolation, degeneration, and loss of Purkinje cells. Axonal spheroids, microcavitations, and other changes of Wallerian degeneration in cerebellar granular layer and white matter are also observed. Neurotoxic compounds in Solanum spp. causing neurologic dysfunction in ruminants were not definitively elucidated. The same Solanaceae species are extensively used with culinary purposes or for the treatment of liver and gastrointestinal disorders as hangovers in humans. In the present paper, we review the epidemiology, clinical signs, and pathological hallmarks of poisoning by Solanum —S. bonariense L. (=S. fastigiatum Willd.) and S. paniculatum—with emphasis in histopathology, ultrastructural, and lectin- and immuno-histochemical changes in spontaneous and experimentally poisoned cattle in South America. The current knowledge of the pathogenesis of these bovine cerebellar cortical degenerations is discussed, and some advances in botanical and toxicological aspects of these Solanaceae species are presented, taking into account the potential risk of human poisoning.Facultad de Ciencias Veterinaria

Cerebellar Cortical Degeneration in Cattle Poisoned With Solanum spp. in South America: An Epidemiological, Clinicopathological, Pathological, and Toxicological Review

Cattle that consume Solanum bonariense L (= Solanum fastigiatum Willd.) or Solanum paniculatum L. develop a typical cerebellar cortical degeneration characterized by periodic episodes of ataxia, hypermetria, hyperesthesia, head and thoracic limb extension, opisthotonus, nystagmus, and falling to the side or backward. Histological lesions include vacuolation, degeneration, and loss of Purkinje cells. Axonal spheroids, microcavitations, and other changes of Wallerian degeneration in cerebellar granular layer and white matter are also observed. Neurotoxic compounds in Solanum spp. causing neurologic dysfunction in ruminants were not definitively elucidated. The same Solanaceae species are extensively used with culinary purposes or for the treatment of liver and gastrointestinal disorders as hangovers in humans. In the present paper, we review the epidemiology, clinical signs, and pathological hallmarks of poisoning by Solanum —S. bonariense L. (=S. fastigiatum Willd.) and S. paniculatum—with emphasis in histopathology, ultrastructural, and lectin- and immuno-histochemical changes in spontaneous and experimentally poisoned cattle in South America. The current knowledge of the pathogenesis of these bovine cerebellar cortical degenerations is discussed, and some advances in botanical and toxicological aspects of these Solanaceae species are presented, taking into account the potential risk of human poisoning.Fil: Verdes, Jose M.. Universidad de la República; UruguayFil: Riet Correa, Franklin. Federal University of Campina Grande; BrasilFil: Medeiros, Rosane M.T.. Federal University of Campina Grande; BrasilFil: Moraña, Antonio. Universidad de la República; UruguayFil: Battes, Daniel. Universidad de la República; UruguayFil: Dehl, Virginia. Universidad de la República; UruguayFil: Borteiro, Claudio. Universidad de la República; UruguayFil: Gimeno, Eduardo Juan. Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sant’Ana, Fabiano J.F.. Universidade Federal de Goiás; BrasilFil: Barros, Claudio S.L.. Federal University of Santa Maria; BrasilFil: Barros, Servero S.. Federal University of Santa Maria; Brasi

Serological Monitoring Of A Toxoplasma Infection After Hematopoietic Stem Cell Transplantation.

We report a primary response to Toxoplasma gondii following a hematopoietic stem cell transplantation in a patient with multiple myeloma. The primary response to T. gondii was supported by IgM, IgG and IgA seroconversion. The patient was promptly treated and there were no complications related to toxoplasmosis in the subsequent months.52225-

Monitoramento sorológico de uma infecção toxoplásmica após transplante de células progenitoras hematopoiéticas

We report a primary response to Toxoplasma gondii following a hematopoietic stem cell transplantation in a patient with multiple myeloma. The primary response to T. gondii was supported by IgM, IgG and IgA seroconversion. The patient was promptly treated and there were no complications related to toxoplasmosis in the subsequent months.Esse relato de caso descreve uma resposta primária ao Toxoplasma gondii após transplante de células progenitoras hematopoiéticas em paciente com mieloma múltiplo. A resposta primária para o T. gondii foi evidenciada pela soroconversão observada na resposta de anticorpos IgM, IgG e IgA. O paciente foi prontamente tratado e complicações relacionadas à toxoplasmose não foram observadas nos meses subseqüentes

Seguimento clínico de dois pacientes brasileiros com MODY-glicoquinase (MODY2) e descrição de uma nova mutação

Mutations in the glucokinase gene (GCK) account for many cases of monogenic diabetes featuring maturity-onset diabetes of the young type 2 (MODY2). The clinical pattern of this form of hyperglycemia is rather stable, with a slight elevation in blood glucose, which is usually not progressive. Patients rarely require pharmacological interventions and microvascular complications related to diabetes are unusual. We describe the clinical follow-up of two cases of MODY2 with two different mutations in GCK gene, one in exon 7, p.Glu265Lys (c.793 G> A), which has been previously described, and a novel one, in exon 2, p.Ser69Stop (c. 206C> G). The clinical course of both cases shows similarity in metabolic control of this form of diabetes over the years. Arq Bras Endocrinol Metab. 2012;56(8):490-5Mutações no gene da glicoquinase (GCK) são determinantes de uma forma de diabetes monogênico denominada de MODY2 (maturity-onset diabetes of the young, tipo 2). O padrão clínico dessa forma de distúrbio glicêmico é bastante estável, com hiperglicemia leve, geralmente não progressiva. Intervenções farmacológicas raramente são necessárias e complicações crônicas secundárias ao diabetes são infrequentes. Descrevemos o acompanhamento clínico de dois casos de MODY2 com duas mutações diferentes, uma no éxon 7, p.Glu265Lys (c.793 G>A) já descrita anteriormente, e outra inédita no éxon 2 p.Ser69Stop (c. 206C>G). A evolução clínica de ambos os casos demonstra uma semelhança no padrão metabólico dessa forma de diabetes ao longo dos anos. Arq Bras Endocrinol Metab. 2012;56(8):490-5Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas Instituto da CriançaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Laboratório de Endocrinologia Molecular e TranslacionalUNIFESP-EPM Centro de DiabetesUNIFESP, EPM, Laboratório de Endocrinologia Molecular e TranslacionalUNIFESP, EPM Centro de DiabetesSciEL

Evaluation of SHOX defects in the era of next‐generation sequencing

Short stature homeobox (SHOX) haploinsufficiency is a frequent cause of short stature. Despite advances in sequencing technologies, the identification of SHOX mutations continues to be performed using standard methods, including multiplex ligation‐dependent probe amplification (MLPA) followed by Sanger sequencing. We designed a targeted panel of genes associated with growth impairment, including SHOX genomic and enhancer regions, to improve the resolution of next‐generation sequencing for SHOX analysis. We used two software packages, CONTRA and Nexus Copy Number, in addition to visual analysis to investigate the presence of copy number variants (CNVs). We evaluated 15 patients with previously known SHOX defects, including point mutations, deletions and a duplication, and 77 patients with idiopathic short stature (ISS). The panel was able to confirm all known defects in the validation analysis. During the prospective evaluation, we identified two new partial SHOX deletions (one detected only by visual analysis), including an intragenic deletion not detected by MLPA. Additionally, we were able to determine the breakpoints in four cases. Our results show that the designed panel can be used for the molecular investigation of patients with ISS, and it may even detect CNVs in SHOX and its enhancers, which may be present in a significant fraction of patients.Copy number variants analyses and Sanger sequencing of breakpoint regions in Case 11, which has a heterozygous deletions involving exons 4, 5, and 6a of short stature homeobox (SHOX).Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151254/1/cge13587.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151254/2/CGE_13587-sup-0001-Supinfo.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151254/3/cge13587_am.pd