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

Modern estates and the production of Lisbon’s suburbs: From the planned to the lived neighbourhood

Alto da Barra and Portela are two modern estates designed by the same architect and located on two sides of the periphery of Lisbon: the west side, Costa do Sol, where the river meets the Atlantic and the east, with no label, which is upstream. The estates were planned and built in the same period (1960s to 1970s), the height of Lisbon’s urban development. This article presents a comparative analysis of these estates: their plans, implementation, social appropriation and resilience, by exploring the sociological profile and place-attachment perceptions of their inhabitants. The analysis also contextualises the development of the estates within the consolidation of these two quite different Lisbon peripheries: the west side traditionally highly valued in relation to the east. An intensive methodology was developed—case studies of the two estates—combining quantitative (survey, inter-census analysis) and qualitative (interviews and documentary analysis) methods. In addition to the differences between the two estates, which were largely due to their specificities in terms of geographic location and status, both reveal significant feelings of place-attachment and a rejection of the suburbia label.info:eu-repo/semantics/publishedVersio

Salvage Flexor Hallucis Longus Transfer for a Failed Achilles Repair: Endoscopic Technique

Flexor hallucis longus (FHL) transfer is a well-established treatment option in failed Achilles tendon (AT) repair and has been routinely performed as an open procedure. We detail the surgical steps needed to perform an arthroscopic transfer of the FHL for a chronic AT rupture. The FHL tendon is harvested as it enters in its tunnel beneath the sustentaculum tali; a tunnel is then drilled in the calcaneus as near to the AT footprint as possible. By use of a suture-passing device, the free end of the FHL is advanced to the plantar aspect of the foot. After adequate tension is applied to the construct, the tendon is fixed in place with an interference screw in an inside-out fashion. This minimally invasive approach is a safe and valid alternative to classic open procedures with the obvious advantages of preserving the soft-tissue envelope and using a biologically intact tendon

Low-level laser therapy in neurosensory recovery : case series in dental and maxillofacial rehabilitation

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Bitemarks analysis of orthodontically treated suspects – an identification approach

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

The Empirical Forcing Function as a tool for the diagnosis of large-scale atmospheric anomalies

The time-mean quasi-geostrophic potential vorticity equation of the atmospheric flow on isobaric surfaces can explicitly include an atmospheric (internal) forcing term of the stationary-eddy flow. In fact, neglecting some non-linear terms in this equation, this forcing can be mathematically expressed as a single function, called Empirical Forcing Function (EFF), which is equal to the material derivative of the time-mean potential vorticity. Furthermore, the EFF can be decomposed as a sum of seven components, each one representing a forcing mechanism of different nature. These mechanisms include diabatic components associated with the radiative forcing, latent heat release and frictional dissipation, and components related to transient eddy transports of heat and momentum. All these factors quantify the role of the transient eddies in forcing the atmospheric circulation. In order to assess the relevance of the EFF in diagnosing large-scale anomalies in the atmospheric circulation, the relationship between the EFF and the occurrence of strong North Atlantic ridges over the Eastern North Atlantic is analyzed, which are often precursors of severe droughts over Western Iberia. For such events, the EFF pattern depicts a clear dipolar structure over the North Atlantic; cyclonic (anticyclonic) forcing of potential vorticity is found upstream (downstream) of the anomalously strong ridges. Results also show that the most significant components are related to the diabatic processes. Lastly, these results highlight the relevance of the EFF in diagnosing large-scale anomalies, also providing some insight into their interaction with different physical mechanisms

Object-based spatial segmentation of video guided by depth and motion information

Automatic spatial video segmentation is a problem withouta general solution at the current state-of-the-art. Mostof the difficulties arise from the process of capturing images,which remain a very limited sample of the scene they represent.The capture of additional information, in the form ofdepth data, is a step forward to address this problem. Westart by investigating the use of depth data for better imagesegmentation; a novel segmentation framework is proposed,with depth being mainly used to guide a segmentationalgorithm on the colour information. Then, we extendthe method to also incorporate motion information in thesegmentation process. The effectiveness and simplicity ofthe proposed method is documented with results on a selectedset of images sequences. The achieved quality raisesthe expectation for a significant improvement on operationsrelying on spatial video segmentation as a pre-process

Legionella: Novas Abordagens, Novas Necessidades

1º Prémio na Jornada Técnica: Prevenção e Controlo da LegionellaINTRODUÇÃO: O CHLC desenvolve, desde há vários anos, procedimentos contra o crescimento e proliferação da Legionella, monitorizando e auditando as estruturas e as práticas. De acordo com as recentes orientações e normas emanadas pela DGS, surge a necessidade de criar novos instrumentos para a avaliação do risco e dar resposta às necessidades do Centro Hospitalar. OBJETIVO Identificar os fatores de risco que determinam os pontos críticos para a monitorização da Legionella. MATERIAIS E MÉTODOS: Foram construídas listas e grelhas de observação, com os fatores de risco que determinam os pontos críticos, a partir das quais se observaram as estruturas e práticas do CHLC. Os instrumentos utilizados tiveram como base os documentos publicados pela DGS, IPQ, ECDC, o procedimento multissectorial do CHLC - AMB.102 e os relatórios das auditorias. RESULTADOS: Para a avaliação das condições microbiológicas, os pontos críticos deverão ser aqueles, mais suscetíveis da ocorrência da proliferação da Legionella. Destes, a literatura salienta: Pontos distais das redes prediais Zonas de estagnação de água Idade e complexidade das redes e sistemas Sistemas e equipamentos geradores de aerossóis Após a análise dos pontos críticos foram determinados os fatores de risco que estão associados, nomeadamente: Presença de nutrientes e de biofilmes Zonas suscetíveis a fenómenos de corrosão e incrustação Origem do abastecimento de água Zonas de estagnação de água da rede predial e da água dos sistemas e equipamentos geradores de aerossóis Ausência de biocida na rede predial Tipos de materiais utilizados nas redes de canalização CONCLUSÕES A avaliação do risco permitiu reorganizar os pontos críticos definidos anteriormente e atualizar o conhecimento das condições favoráveis ao crescimento da Legionella na nossa instituição, promovendo a melhoria e atualização do programa do CHLC. Assim, torna-se evidente de que a existência de um cadastro completo e atualizado das infraestruturas, redes, sistemas e equipamentos, incluindo peças desenhadas e memórias descritivas das redes de água fria e quente, das redes dos circuitos de água de aquecimento e arrefecimento e uso terapêutico, é essencial para que a avaliação do risco seja mais proficiente.info:eu-repo/semantics/publishedVersio

Impacts of climate and land use changes on the hydrological and erosion processes of two contrasting Mediterranean catchments

The impacts of climate and land use changes on streamflow and sediment export were evaluated for a humid (São Lourenço) and a dry (Guadalupe) Mediterranean catchment, using the SWAT model. SWAT was able to produce viable streamflow and sediment export simulations for both catchments, which provided a baseline for investigating climate and land use changes under the A1B and B1 emission scenarios for 2071–2100. Compared to the baseline scenario (1971–2000), climate change scenarios showed a decrease in annual rainfall for both catchments (humid: − 12%; dry: − 8%), together with strong increases in rainfall during winter. Land use changes were derived from a socio-economic storyline in which traditional agriculture is replaced by more profitable land uses (i.e. corn and commercial forestry at the humid site; sunflower at the dry site). Climate change projections showed a decrease in streamflow for both catchments, whereas sediment export decreased only for the São Lourenço catchment. Land use changes resulted in an increase in streamflow, but the erosive response differed between catchments. The combination of climate and land use change scenarios led to a reduction in streamflow for both catchments, suggesting a domain of the climatic response. As for sediments, contrasting results were observed for the humid (A1B: − 29%; B1: − 22%) and dry catchment (A1B: + 222%; B1: + 5%), which is mainly due to differences in the present-day and forecasted vegetation types. The results highlight the importance of climate-induced land-use change impacts, which could be similar to or more severe than the direct impacts of climate change alone