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

Postgraduate Medical Teaching

Os autores afirmam a urgência em reestruturar o ensino medico pós-graduado em Portugal. De uma forma critica, analisam esquematicamente a situação actual do ensino médico pós-graduado em geral e da Urologia em particular, no nosso país. Depois de enunciar as etapas para atingir o internato da especialidade, resumem o Plano de preparação para a especialidade de Urologia do Conselho Directivo do Colégio de Urologistas da Ordem dos Médicos, de 1979. 0 Plano refere-se a tempos de estágio, programas teórico e prático, e formas de avaliação dos internos e aponta ainda as características para que um serviço seja considerado idóneo. Referindo que a realidade actual não corresponde às exigências preconizadas, os autores indicam aquilo que de facto acontece. Respondendo negativamente a uma série de questões sobre pontos fulcrais para uma prática correcta do ensino pós-graduado, os autores terminam a primeira parte da sua exposição perguntando se, nas condições actuais, o resultado final da preparação dos médicos será mesmo um Especialista. Na segunda parte fazem propostas para a reestruturação do ensino pós-graduado em Portugal. Referem-se sucessivamente as seguintes alíneas: criação de institutos ou escolas médicas hospitalares de pós graduação, universitários; elaboração de um programa padrão nacional do ensino médico pós-graduado; criação de comissões para o ensino médico pós-graduado; definição exigente do perfil de serviço idóneo para o ensino médico pós-graduado; elaboração de programas individuais pelos serviços dos institutos de pós-graduação; caderneta; fiscalização da actividade dos docentes e discentes; avaliação, contínua e por provas intercalar e final; mestrado. Dado o carácter auto-explicativo dos quadros, os autores, para além de alguns comentários, apenas desenvolvem as alíneas referentes aos Institutos ou Escolas Médicas de Pós-graduação, Universitários e ao Mestrado, expondo, duma maneira sucinta, a forma como pensam que deviam ser organizados

Schwann cells as putative safe host cells for Leishmania amazonensis

Submitted by Sandra Infurna ([email protected]) on 2018-12-20T14:18:35Z No. of bitstreams: 1 suzane_cortereal_etal_IOC_2009.pdf: 131775 bytes, checksum: 082ac468bc8211d57b52efeded0ebd5f (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2018-12-20T14:25:00Z (GMT) No. of bitstreams: 1 suzane_cortereal_etal_IOC_2009.pdf: 131775 bytes, checksum: 082ac468bc8211d57b52efeded0ebd5f (MD5)Made available in DSpace on 2018-12-20T14:25:00Z (GMT). No. of bitstreams: 1 suzane_cortereal_etal_IOC_2009.pdf: 131775 bytes, checksum: 082ac468bc8211d57b52efeded0ebd5f (MD5) Previous issue date: 2009Universidade Federal do Rio de Janeiro. Instituto de Biofísica Carlos Chagas Filho. Laboratório de Neurobiologia do Desenvolvimento. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia Estrutural. Rio de Janeiro, RJ. Brasil.Universidade Federal do Rio de Janeiro. Instituto de Biofísica Carlos Chagas Filho. Laboratório de Neurobiologia do Desenvolvimento. Rio de Janeiro, RJ, Brasil

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

Avaliações cognitivas, emoções e coping : um estudo com futebolistas portugueses

O presente trabalho teve como objectivo analisar os padrões e associações das estratégias de coping, da avaliação cognitiva, da ansiedade e de outras emoções em atletas de futebol. Os sujeitos deste estudo foram 14 atletas, com idades entre 17 e 19 anos (M=18.35±0.71). Foram utilizados os instrumentos: Escala de Avaliação Cognitiva da Competição – Percepção Ameaça e Desafio; Inventário de Emoções no Desporto V-2; Escala de Ansiedade no Desporto – 2; Escala de Avaliação da Ansiedade; e Brief COPE. Os resultados mostraram a estratégia de coping mais frequente, o coping activo, e a menos frequente, o uso de substâncias. A competição desportiva foi percepcionada mais em termos de desafio do que ameaça, a esperança foi a emoção mais experienciada e a vergonha foi a emoção menos experienciadaThis study aimed to analyze the patterns and associations of coping strategies, cognitive appraisals, anxiety and other emotions of soccer players. The subjects were 14 athletes, aged between 17 and 19 years (M=18.35±0.71). We used the instruments: Cognitive Assessment Scale Competition - Threat and Challenge; Inventory Emotions in Sport V-2, Sport Anxiety Scale, Revised Anxiety Rating Scale – 2, and Brief COPE. Results showed the most common coping strategy, active coping, and the less frequent, substance use. The sports competition was appraised more in terms of challenge than threat, hope was the emotion more experienced and shame the emotion less experienced.Este estudio tuvo como objetivo analizar los patrones y las asociaciones de las estrategias de coping, evaluación cognitiva, ansiedad y otras emociones de jugadores de fútbol. Los sujetos fueron 14 atletas, con edades comprendidas entre 17 y 19 años (M=18.35±0.71). Se utilizaron los instrumentos: Escala de Evaluación Cognitiva de Competición-Percepción de Amenaza y Desafio; Inventario de Emociones en el deporte V-2; Escala de Ansiedad de Deporte; Escala de Evaluación de Ansiedad – 2 y Brief COPE. Los resultados mostraron la estrategia de coping más común, coping activo, y uso de sustancias menos frecuente. La competición deportiva se percibía más en términos de desafio que amenaza, esperanza era la emoción que se experimentado más y vergüenza la emoción que se experimentado menos

Implementação de um Estudo de Efetividade da Vacina Contra a Gripe no Contexto Hospitalar em Portugal: Projeto EVA Hospital

Introduction: The project ‘Integrated Monitoring of Vaccines in Europe’ aimed to measure seasonal influenza vaccine effectiveness against hospitalised adults, aged 65 years and over, with influenza. We describe the protocol implementation in Portugal. Material and Methods: We implemented a test-negative design, targeting community-dwelling patients aged 65 years old and over hospitalised with severe acute respiratory illness. Patients were reverse transverse-polymerase chain reaction tested for influenza. Cases were those positive for influenza while others were controls. Most variables were collected using hospital medical records. Selection bias was evaluated by comparison with the laboratory influenza test requests database according to demographic characteristics. Crude, season-adjusted influenza vaccine effectiveness was estimated as = 1 – odds ratio, and 95% confidence intervals were obtained by conditional logistical regression, matched with the disease onset month. Results: The recruitment rate was 37.8%. Most participants (n = 368) were female (55.8%) and aged 80 years old and over (55.8%). This was similar to values for potentially eligible severe acute respiratory illness patients (80 years old and over: 56.8%, female: 56.2%). The proportion of missing values was below 2.5% for 20 variables and above 5% (maximum 11.6%) for six variables. Influenza vaccine effectiveness estimates were 62.1% against AH1pdm09 (95% confidence intervals: -28.1 to 88.8), 14.9% against A(H3N2) (95% confidence intervals: -69.6 to 57.3), 43.6% against B/Yam (95% confidence intervals: -66.2 to 80.8). Discussion: Given the non-existence of a coded admission database in either participating hospital the selection of severe acute respiratory illness due to clinical features was the feasible one. These results are only valid for the older adult population residing in the catchment area of the two participating hospitals who were admitted to a public hospital with severe influenza or SARI symptoms. Conclusion: Despite the low participation rate, we observed comparable characteristics of participants and eligible severe acute respiratory illness patients. Data quality was high, and influenza vaccine effectiveness results were in accordance with the results of meta-analyses and European season-specific estimates. The final sample size was low, which inhibited obtaining estimates with good precision.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

Large-scale atmospheric dynamics of the wet winter 2009–2010 and its impact on hydrology in Portugal

The anomalously wet winter of 2010 had a very important impact on the Portuguese hydrological system. Owing to the detrimental effects of reduced precipitation in Portugal on the environmental and socio-economic systems, the 2010 winter was predominantly beneficial by reversing the accumulated precipitation deficits during the previous hydrological years. The recorded anomalously high precipitation amounts have contributed to an overall increase in river runoffs and dam recharges in the 4 major river basins. In synoptic terms, the winter 2010 was characterised by an anomalously strong westerly flow component over the North Atlantic that triggered high precipitation amounts. A dynamically coherent enhancement in the frequencies of mid-latitude cyclones close to Portugal, also accompanied by significant increases in the occurrence of cyclonic, south and south-westerly circulation weather types, are noteworthy. Furthermore, the prevalence of the strong negative phase of the North Atlantic Oscillation (NAO) also emphasises the main dynamical features of the 2010 winter. A comparison of the hydrological and atmospheric conditions between the 2010 winter and the previous 2 anomalously wet winters (1996 and 2001) was also carried out to isolate not only their similarities, but also their contrasting conditions, highlighting the limitations of estimating winter precipitation amounts in Portugal using solely the NAO phase as a predictor