VIH e Doença Coronária - Quando a Prevenção Secundária É Insuficiente

Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented. We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal). Two drug-eluting stents were successfully implanted. The patient was discharged under dual antiplatelet therapy (aspirin 100 mg/day and clopidogrel 75 mg/day) and standard coronary artery disease medication. He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed. Coronary angiography was performed within one hour and documented thrombosis of both stents. Optical coherence tomography revealed good apposition of the stent in the RCA, with intrastent thrombus. Angioplasty was performed, with a good outcome. The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes. There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes. A multidisciplinary approach is essential for optimal management of these patients.info:eu-repo/semantics/publishedVersio

A Rash Decision. The Hazards of the Wrongful Use of Adrenaline

Anaphylaxis is life-threatening and should be addressed urgently. Its treatment is not without side effects and an accurate diagnosis must be made to prevent potential harm by the wrongful use of medication. A 46-year-old woman with hypertension treated with angiotensin converting enzyme inhibitor (ACEI) presented to the emergency department with non-pitting oedema of the face and limbs. A hasty diagnosis of anaphylaxis was made and intravenous adrenaline administered. The patient developed a myocardial infarction caused by coronary artery spasm that required invasive intervention. The initial clinical picture was resolved when the ACEI was discontinued unmasking a case of ACEI-induced angioedema. The correct differentiation of these two apparently similar clinical entities is of utmost importance in the management of emergency department patients.info:eu-repo/semantics/publishedVersio

Integrating Phylogenetic and Network Approaches to Study Gene Family Evolution: The Case of the \u3ci\u3eAGAMOUS\u3c/i\u3e Family of Floral Genes

The study of gene family evolution has benefited from the use of phylogenetic tools, which can greatly inform studies of both relationships within gene families and functional divergence. Here, we propose the use of a network-based approach that in combination with phylogenetic methods can provide additional support for models of gene family evolution. We dissect the contributions of each method to the improved understanding of relationships and functions within the well-characterized family of AGAMOUS floral development genes. The results obtained with the two methods largely agreed with one another. In particular, we show how network approaches can provide improved interpretations of branches with low support in a conventional gene tree. The network approach used here may also better reflect known and suspected patterns of functional divergence relative to phylogenetic methods. Overall, we believe that the combined use of phylogenetic and network tools provide a more robust assessment of gene family evolution

Integrating Phylogenetic and Network Approaches to Study Gene Family Evolution: The Case of the \u3ci\u3eAGAMOUS\u3c/i\u3e Family of Floral Genes

The study of gene family evolution has benefited from the use of phylogenetic tools, which can greatly inform studies of both relationships within gene families and functional divergence. Here, we propose the use of a network-based approach that in combination with phylogenetic methods can provide additional support for models of gene family evolution. We dissect the contributions of each method to the improved understanding of relationships and functions within the well-characterized family of AGAMOUS floral development genes. The results obtained with the two methods largely agreed with one another. In particular, we show how network approaches can provide improved interpretations of branches with low support in a conventional gene tree. The network approach used here may also better reflect known and suspected patterns of functional divergence relative to phylogenetic methods. Overall, we believe that the combined use of phylogenetic and network tools provide a more robust assessment of gene family evolution

Forecasting temporal dynamics of cutaneous leishmaniasis in Northeast Brazil.

IntroductionCutaneous leishmaniasis (CL) is a vector-borne disease of increasing importance in northeastern Brazil. It is known that sandflies, which spread the causative parasites, have weather-dependent population dynamics. Routinely-gathered weather data may be useful for anticipating disease risk and planning interventions.Methodology/principal findingsWe fit time series models using meteorological covariates to predict CL cases in a rural region of Bahía, Brazil from 1994 to 2004. We used the models to forecast CL cases for the period 2005 to 2008. Models accounting for meteorological predictors reduced mean squared error in one, two, and three month-ahead forecasts by up to 16% relative to forecasts from a null model accounting only for temporal autocorrelation.SignificanceThese outcomes suggest CL risk in northeastern Brazil might be partially dependent on weather. Responses to forecasted CL epidemics may include bolstering clinical capacity and disease surveillance in at-risk areas. Ecological mechanisms by which weather influences CL risk merit future research attention as public health intervention targets

Radio Properties of z>4 Optically-Selected Quasars

We report on two programs to address differential evolution between the radio-loud and radio-quiet quasar populations at high (z>4) redshift. Both programs entail studying the radio properties of optically-selected quasars. First, we have observed 32 optically-selected, high-redshift (z>4) quasars with the VLA at 6 cm (5 GHz). These sources comprise a statistically complete and well-understood sample. We detect four quasars above our 3-sigma limit of ~0.15 mJy, which is sufficiently sensitive to detect all radio-loud quasars at the probed redshift range. Second, we have correlated 134 z>4 quasars, comprising all such sources that we are aware of as of mid-1999, with FIRST and NVSS. These two recent 1.4 GHz VLA sky surveys reach 3-sigma limits of approximately 0.6 mJy and 1.4 mJy respectively. We identify a total of 15 z>4 quasars, of which six were not previously known to be radio-loud. The depth of these surveys does not reach the radio-loud/radio-quiet demarcation luminosity density (L(1.4 GHz) = 10^32.5 h(50)^(-2) ergs/s/Hz) at the redshift range considered; this correlation therefore only provides a lower limit to the radio-loud fraction of quasars at high-redshift. The two programs together identify eight new radio-loud quasars at z>4, a significant increase over the seven currently in the published literature. We find no evidence for radio-loud fraction depending on optical luminosity for -25 > M_B > -28 at z~2, or for -26>M_B>-28 at z>4. Our results also show no evolution in the radio-loud fraction between z~2 and z>4 (-26>M_B>-28).Comment: 19 pages, 7 figures; to appear in The Astronomical Journal (April 2000

Use Dosimetry Virtual Tool for Security Studies Physics and Nuclear

AbstractThe objective of this work is to develop a virtual detection tool of radioactive sources, such as to facilitate and assist the training and nuclear security planning. To accomplish this tool was created a virtual model of the Nuclear Engineering Institute (IEN) with virtual characters (avatars), able to move and interact with the environment, radiation detectors (fixed and portable) and sources radioactive. A tool developed enabled the simulation where individuals who were carrying radioactive sources were identified through the detectors installed at strategic points in the virtual environment. Furthermore, it was possible to detect and locate sources for handling portable detectors, operated by the characters within the virtual environment. The results showed a radiation detection system before the continuous profile radioactive sources, making it possible to evaluate the dose rate at any position of the virtual environment. So this work could help in both the security agents training and in the evaluation of the radiological safety of a nuclear site