Whipple's Disease as the First Manifestation of Chronic Lymphocytic Leukaemia

Whipple's disease is a rare multisystemic infectious disease that can mimic lymphoproliferative disorders and must be considered in the differential diagnosis of febrile syndromes. The authors describe the case of a 55-year-old man who presented to the Emergency Department with dyspnoea and abdominal pain. He had a 2-month history of fever, night sweats, asthenia and unintentional weight loss. Upon clinical examination he had bilateral inguinal lymphadenopathy. Blood tests showed iron-deficit anaemia and high C-reactive protein. Abdominal ultrasound showed mesenteric and iliac adenopathies and hepatosplenomegaly. The patient was admitted to the Internal Medicine department for additional testing. Flow cytometry analysis of peripheral blood showed CD5-positive monoclonal B-cell expansion. Excisional biopsy of a retroperitoneal adenopathy guided by computed tomography showed periodic acid–Schiff-positive bacilli inside the macrophages, further identified as Tropheryma whipplei through polymerase chain reaction. Bone marrow biopsy showed a scarce positive CD5 lymphoid population and haematopoietic alterations related to infection. The patient started treatment for T. whipplei with complete symptom resolution. This is the first case describing the simultaneous diagnosis of Whipple's disease and chronic lymphocytic leukaemia in a patient with constitutional symptoms, fever and lymphadenopathies

O profissional de Educação Física no Centro de Atenção Psicossocial: percepção dos limites e potencialidades no processo de trabalho

This study aimed at analyzing the perception by physical education professionals of their working process in the psychosocial care centers in the city of Recife. It is a qualitative descriptive field research. Twelve Physical Education professionals participated in a focus group, which was used as an instrument of data collection. For the treatment of the data, the Thematic Analysis was used. Organizational and political constraints were identified, such as the absence of proper physical spaces for the practices and the difficulties in the articulation with the social network. However, it was observed that there are potentialities in the professional-user relationship, constituting a Technical Composition gathered at Live Work, which favors the completeness and the resolution of the users’ needs.Este estudo teve como objetivo analisar a percepção dos profissionais de Educação Física sobre seu processo de trabalho nos serviços de atenção psicossocial de Recife. Trata-se de uma pesquisa qualitativa descritiva, de campo. Doze profissionais de Educação Física participaram de um grupo focal, o qual foi utilizado como instrumento de coleta de dados. Para tratamento dos dados, foi utilizada a Análise Temática. Limitações organizacionais e políticas foram identificadas como a ausência de espaços físicos adequados para as práticas e dificuldades de articulação com a rede social. Contudo, observou-se que existem potencialidades na relação profissional-usuário, constituindo uma Composição Técnica centrada no Trabalho Vivo, o que favorece a integralidade e a resolução das necessidades dos usuários

O INSIGHT NO TRANSTORNO BIPOLAR

The research addressed the topic of insight in bipolar disorder through an exploratory literature review. The objective was to analyze the concept of insight and its relationship with bipolar disorder, as well as to identify factors that influence its development and possible therapeutic approaches. The problem explored was the difficulty in acquiring and maintaining insight into this disorder, a factor that can impact the treatment and prognosis of patients. The results pointed to the importance of the role of the family and the medical team in the development of insight, as well as the use of specific therapeutic interventions, such as Cognitive-Behavioral Therapy, to assist in the construction and maintenance of this process. The methodology used was the analysis of scientific articles and specialized books, allowing a broad understanding of the subject. The contribution of the work to the academic area was to provide theoretical and practical subsidies for professionals who work with patients with bipolar disorder, in addition to stimulating discussions about the importance of insight in this context. It is concluded that insight is a crucial element in the management of bipolar disorder and should be addressed comprehensively in the treatment of these patients.A pesquisa abordou o tema do insight no transtorno bipolar por meio de uma revisão bibliográfica exploratória. O objetivo foi analisar o conceito de insight e sua relação com o transtorno bipolar, além de identificar fatores que influenciam seu desenvolvimento e possíveis abordagens terapêuticas. A problemática explorada foi a dificuldade em adquirir e manter o insight nesse transtorno, fator que pode impactar no tratamento e prognóstico dos pacientes. Os resultados apontaram para a importância do papel da família e da equipe médica no desenvolvimento do insight, assim como a utilização de intervenções terapêuticas específicas, como a Terapia Cognitivo-Comportamental, para auxiliar na construção e manutenção desse processo. A metodologia utilizada foi a análise de artigos científicos e livros especializados, permitindo uma ampla compreensão do tema. A contribuição do trabalho para a área acadêmica foi fornecer subsídios teóricos e práticos para profissionais que atuam com pacientes com transtorno bipolar, além de estimular discussões sobre a importância do insight nesse contexto. Conclui-se que o insight é um elemento crucial no manejo do transtorno bipolar e deve ser abordado de forma integral no tratamento desses pacientes

Individual common variants exert weak effects on the risk for autism spectrum disorders.

While it is apparent that rare variation can play an important role in the genetic architecture of autism spectrum disorders (ASDs), the contribution of common variation to the risk of developing ASD is less clear. To produce a more comprehensive picture, we report Stage 2 of the Autism Genome Project genome-wide association study, adding 1301 ASD families and bringing the total to 2705 families analysed (Stages 1 and 2). In addition to evaluating the association of individual single nucleotide polymorphisms (SNPs), we also sought evidence that common variants, en masse, might affect the risk. Despite genotyping over a million SNPs covering the genome, no single SNP shows significant association with ASD or selected phenotypes at a genome-wide level. The SNP that achieves the smallest P-value from secondary analyses is rs1718101. It falls in CNTNAP2, a gene previously implicated in susceptibility for ASD. This SNP also shows modest association with age of word/phrase acquisition in ASD subjects, of interest because features of language development are also associated with other variation in CNTNAP2. In contrast, allele scores derived from the transmission of common alleles to Stage 1 cases significantly predict case status in the independent Stage 2 sample. Despite being significant, the variance explained by these allele scores was small (Vm< 1%). Based on results from individual SNPs and their en masse effect on risk, as inferred from the allele score results, it is reasonable to conclude that common variants affect the risk for ASD but their individual effects are modest

COOPEDU IV — Cooperação e Educação de Qualidade

O quarto Congresso Internacional de Cooperação e Educação-IV COOPEDU, organizado pelo Centro de Estudos Internacionais (CEI) do Instituto Universitário de Lisboa e pela Escola Superior de Educação e Ciências Sociais do Instituto Politécnico de Leiria decorreu nos dias 8 e 9 de novembro de 2018, subordinado à temática Cooperação e Educação de Qualidade. Este congresso insere-se numa linha de continuidade de intervenção por parte das duas instituições organizadoras e dos elementos coordenadores e este ano beneficiou do financiamento do Instituto Camões, obtido através de um procedimento concursal, que nos permitiu contar com a participação presencial de elementos dos Países Africanos de Língua Portuguesa, fortemente implicados nas problemáticas da Educação e da Formação. Contou também com a participação do Instituto Camões e da Fundação Calouste Gulbenkian, entidades que sistematizaram a sua intervenção nos domínios da cooperação na área da educação nos últimos anos. A opção pela temática da qualidade pareceu aos organizadores pertinente e actual. Com efeito os sistemas educativos dos países que constituem a Comunidade de países de língua portuguesa têm implementado várias reformas mas em vários domínios mantem-se a insatisfação de responsáveis políticos, pedagogos, técnicos sociais face aos resultados obtidos. Aliás o caminho de procura da Qualidade é interminável porque vai a par da aposta na exigência e na promoção da cidadania e responsabilidade social. As comunicações que agora se publicam estão organizadas em dois eixos: o das Políticas da Educação e Formação e o das dimensões em que se traduzem essas políticas. Neste último eixo encontramos fios condutores para agregarmos as comunicações apresentadas

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements