Caso para diagnóstico

Human scabies is an intensely pruritic skin infestation caused by Sarcoptes scabiei var. hominis. Crusted scabies (previously known as Norwegian scabies) is a rare form, very contagious and transmitted by direct contact with the skin. Despite being readily treatable, a delayed diagnosis often leads to widespread infestation of contacts, and therefore difficult to restrain. This case concerns a patient where dermoscopy (with scabetic burrows and a visible hand-glider structure), together with direct microscopic examination, allowed a prompt diagnosis, thereby reinforcing the increasing importance of this technique in daily practice

Autoimmune alternating hyper- and hypo-thyroidism: a rare condition in pediatrics

Alternating between hyper- and hypo-thyroidism may be explained by the simultaneous presence of both types of TSH receptor autoantibodies (TRAbs) - thyroid stimulating autoantibodies (TSAbs) and TSH blocking autoantibodies (TBAbs). It is a very rare condition, particulary in the pediatric age. The clinical state of these patients is determined by the balance between TSAbs and TBAbs and can change over time. Many mechanisms may be involved in fluctuating thyroid function: hormonal supplementation, antithyroid drugs and levels of TSAbs and TBAbs. Frequent dose adjustments are needed in order to achieve euthyroidism. A definitive therapy may be necessary to avoid switches in thyroid function and frequent need of therapeutic changes. We describe an immune-mediated case of oscillating thyroid function in a 13-year-old adolescent. After a short period of levothyroxine treatment, the patient switched to a hyperthyroid state that was only controlled by adding an antithyroid drug. LEARNING POINTS: Autoimmune alternating hypo- and hyper-thyroidism is a highly uncommon condition in the pediatric age.It may be due to the simultaneous presence of both TSAbs and TBAbs, whose activity may be estimated in vitro through bioassays.The clinical state of these patients is determined by the balance between TSAbs and TBAbs and can change over time.The management of this condition is challenging, and three therapeutic options could be considered: I-131 ablation, thyroidectomy or pharmacological treatment (single or double therapy).Therapeutic decisions should be taken according to clinical manifestations and thyroid function tests, independent of the bioassays results.A definitive treatment might be considered due to the frequent switches in thyroid function and the need for close monitoring of pharmacological treatment. A definitive treatment might be considered due to the frequent switches in thyroid function and the need for close monitoring of pharmacological treatment.info:eu-repo/semantics/publishedVersio

Upturn in secondary forest clearing buffers primary forest loss in the Brazilian Amazon

Brazil contains two-thirds of remaining Amazonian rainforests and is responsible for the most Amazon forest loss. Primary forest loss in the Brazilian Amazon has declined considerably since 2004 but secondary forest loss has never been quantified. We use a recently developed high-resolution land use/land cover dataset to track secondary forests in the Brazilian Amazon over 14 yr, providing the first estimates of secondary forest loss for the region. We find that secondary forest loss increased by (187 ± 48)% from 2008 to 2014. Moreover, the proportion of total forest loss accounted for by secondary forests rose from (37 ± 3)% in 2000 to (72 ± 5)% in 2014. The recent acceleration in secondary forests loss occurred across the entire region and was not driven simply by increasing secondary forest area but probably a conscious preferential shift towards clearance of a little-protected forest ecosystem (secondary forests). Our results suggest that secondary forests loss has eased deforestation pressure on primary forests. However, this has been at the expense of a lost carbon sequestration opportunity of 2.59–2.66 Pg C over our study period

A simple method for estimating relative risk using logistic regression

<p>Abstract</p> <p>Background</p> <p>Odds ratios (OR) significantly overestimate associations between risk factors and common outcomes. The estimation of relative risks (RR) or prevalence ratios (PR) has represented a statistical challenge in multivariate analysis and, furthermore, some researchers do not have access to the available methods. Objective: To propose and evaluate a new method for estimating RR and PR by logistic regression.</p> <p>Methods</p> <p>A provisional database was designed in which events were duplicated but identified as non-events. After, a logistic regression was performed and effect measures were calculated, which were considered RR estimations. This method was compared with binomial regression, Cox regression with robust variance and ordinary logistic regression in analyses with three outcomes of different frequencies.</p> <p>Results</p> <p>ORs estimated by ordinary logistic regression progressively overestimated RRs as the outcome frequency increased. RRs estimated by Cox regression and the method proposed in this article were similar to those estimated by binomial regression for every outcome. However, confidence intervals were wider with the proposed method.</p> <p>Conclusion</p> <p>This simple tool could be useful for calculating the effect of risk factors and the impact of health interventions in developing countries when other statistical strategies are not available.</p

Colony Defense Behavior of the Primitively Eusocial Wasp, Mischocyttarus cerberus is Related to Age

The colony defense behavior of the wasp Mischocyttarus cerberus Richards (Hymenoptera, Vespidae) was studied to verify whether there were different reactions of wasps of different ages and hierarchical positions during attacks of ants. Detailed nest mapping was first performed, then the wasps were marked and were divided in four distinct categories: queens, older workers, younger workers and males. Tests were made simulating attacks of ants in the nests. The main results showed that the M. cerberus behaviors against ant attacks is more related to the age of the wasps than to their hierarchical position. The oldest wasps (queens and older workers) defend the nest more than the younger workers and males, representing a form of temporal polyethism

Broadening INPP5E phenotypic spectrum: detection of rare variants in syndromic and non-syndromic IRD

Pathogenic variants in INPP5E cause Joubert syndrome (JBTS), a ciliopathy with retinal involvement. However, despite sporadic cases in large cohort sequencing studies, a clear association with non-syndromic inherited retinal degenerations (IRDs) has not been made. We validate this association by reporting 16 non-syndromic IRD patients from ten families with bi-allelic mutations in INPP5E. Additional two patients showed early onset IRD with limited JBTS features. Detailed phenotypic description for all probands is presented. We report 14 rare INPP5E variants, 12 of which have not been reported in previous studies. We present tertiary protein modeling and analyze all INPP5E variants for deleteriousness and phenotypic correlation. We observe that the combined impact of INPP5E variants in JBTS and non-syndromic IRD patients does not reveal a clear genotype–phenotype correlation, suggesting the involvement of genetic modifiers. Our study cements the wide phenotypic spectrum of INPP5E disease, adding proof that sequence defects in this gene can lead to early-onset non-syndromic IRD

Parentage test in broad-snouted caimans (Caiman latirostris, Crocodylidae) using microsatellite DNA

In this study, microsatellite markers, developed for Alligator mississipiensis and Caiman latirostris, were used to assess parentage among individuals from the captive colony of Caiman latirostris at the University of São Paulo, in Piracicaba, São Paulo, Brazil. Many of the females in the colony were full siblings, which made maternal identification difficult due to genotypic similarity. Even so, the most likely mother could be identified unambiguously among offspring in most of the clutches studied. Two non-parental females displayed maternal behavior which would have misled managers in assigning maternity based on behavior alone. This set of variable loci demonstrates the utility of parentage testing in captive propagation programs