Bleomycin-induced flagellate hyperpigmentation

Bleomycin is a chemotherapeutic agent used in the treatment of different tumours. It has several side effects, including flagellate hyperpigmentation, which is a unique and a well-documented side effect of bleomycin therapy. We report a case of a 23-year-old woman with a personal history of ovarian dysgerminoma, who developed flagellate hyperpigmentation on trunk after bleomycin therapy

Left-sided infective endocarditis: analysis of in-hospital and medium-term outcome and predictors of mortality

Abstract Introduction: Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a challenging and potentially lethal disease. The prognosis of IE remains poor; in the last 30 years, its incidence and mortality have only been marginally reduced. Early identification of high-risk patients can change the course of the disease and improve outcomes. Objectives and methods: To describe and investigate predictors of mortality during hospital stay and in the six months after discharge in a cohort of left-sided IE patients in two tertiary centers. All patients diagnosed with IE (ICD9 code 133) were registered in a uniform database. Results: One hundred and forty-seven consecutive case patients with left-sided IE were included in this study. Thirty-five patients (23.8%) died during hospital stay. The variables significantly associated with increased mortality in univariate analysis were Charlson index ≥5, use of immunosuppressants, sepsis (severe sepsis and/or septic shock), cardiogenic shock and inappropriate use of antibiotic therapy. Conversely, surgical therapy and hospital length of stay ≥30 days were significantly associated with lower mortality. In multivariate analysis the most important predictors of in-hospital mortality were sepsis (severe and/or shock), use of immunosuppressants and inappropriate use of antibiotic therapy. There was a significant relation between the use of immunosuppressants and the occurrence of sepsis. The presence of significant valve disease after IE significantly increased the risk of heart failure. Conclusions: Our results may help to identify IE patients at increased risk for in-hospital mortality and medium-term disability. These findings can help to identify candidates for earlier and more aggressive management

Pneumotórax espontâneo num pulmão vicariante

AbstractSpontaneous contralateral pneumothorax after pneumonectomy is a rare condition. A high index of suspicion is required for a correct diagnosis. Management can be challenging, as surgical intervention, if necessary, is a very high risk procedure. Chemical pleurodesis can be a simple and effective measure in cases with no major air leak. We describe the case of a 21-year-old female with spontaneous pneumothorax in a single lung, which posed several diagnostic and therapeutic problems. The presence of a “buffalo chest” made the initial chest x-ray interpretation difficult. The patient had an important air leak without complete pulmonary expansion and thoracic surgery was considered of risk. Accordingly, instillation of talc slurry through one of the thoracic drains was undertaken with eventual resolution. We are convinced that bron-co-pleural fistula resolution was facilitated by slurry talc, despite complete lung expansion never having been achieved.Rev Port Pneumol 2007; XIII (4): 613-61

On finite monoids of cellular automata.

For any group G and set A, a cellular automaton over G and A is a transformation τ:AG→AGτ:AG→AG defined via a finite neighbourhood S⊆GS⊆G (called a memory set of ττ) and a local function μ:AS→Aμ:AS→A. In this paper, we assume that G and A are both finite and study various algebraic properties of the finite monoid CA(G,A)CA(G,A) consisting of all cellular automata over G and A. Let ICA(G;A)ICA(G;A) be the group of invertible cellular automata over G and A. In the first part, using information on the conjugacy classes of subgroups of G, we give a detailed description of the structure of ICA(G;A)ICA(G;A) in terms of direct and wreath products. In the second part, we study generating sets of CA(G;A)CA(G;A). In particular, we prove that CA(G,A)CA(G,A) cannot be generated by cellular automata with small memory set, and, when G is finite abelian, we determine the minimal size of a set V⊆CA(G;A)V⊆CA(G;A) such that CA(G;A)=⟨ICA(G;A)∪V⟩CA(G;A)=⟨ICA(G;A)∪V⟩

Stress induced magnetic anisotropy on BaTiO3-CoFe2O4 nanogranular composite thin films

The influence of stress on the magnetic properties of BaTiO3-CoFe2O4 nanocomposites deposited by laser ablation on platinum covered Si(001) substrates, was characterized. The cobalt ferrite phase was under compressive strain in the growth direction that progressively relaxed as its concentration increased. A stress induced perpendicular magnetic anisotropy was observed, that decreased with increasing CoFe2O4 content, due to the relaxation of stress in the films.This work has been financially supported by the Portuguese Foundation for Science and Technology (FCT) and FEDER, through the projects POCI/CTM/60181/2004, FEDER/POCTI/0155/94, and through the Associated Laboratory-IN

Project management practices for collaborative university-industry R&D: a hybrid approach

This paper aims to help stakeholders involved in collaborative university-industry R&D initiatives by presenting a hybrid project management (PM) approach, with a set of key distinct PM practices for this particular context. Collaborative university-industry R&D initiatives are usually organized as programs with a set of related projects associated. Therefore, a hybrid PM approach was developed based on a case study research strategy. During the large case study analysis two research methods were applied: participant observation and document analysis. The hybrid management approach was developed based on the contingency theory, which identifies a set of 24 Must Have PM practices, and that are transversal to all projects in the program as the program governance must have to be assured. Additionally, it identifies three different sets of Nice to Have PM practices, which are optional and are dependent on the particular project context and PM approach adopted by each project team: waterfall or agile. Overall 32 Nice to Have PM practices were identified, being 15 of them agile, 3 waterfall and the 14 remaining transversal to both agile and waterfall approaches.This research is sponsored by the Portugal Incentive System for Research and Technological Development. Project in co-promotion nº 002814/2015 (iFACTORY 2015-2018) and by the FCT (SFRH/BPD/111033/2015)

A Paraneoplastic Syndrome to Remember: A Case of Disseminated Intravascular Coagulation in Lung Cancer

Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by the widespread activation of coagulation. It can present as an acute life-threatening emergency or as a chronic process. Mortality is highly dependent on the reversibility of the aetiology and degree of coagulation impairment, so treatment of the underlying cause is vital. The authors present the case of a 57-year-old man whose inaugural presentation of lung cancer was chronic DIC, characterized by three thrombotic events, followed by acute DIC, culminating in death. Metastatic lung cancer was diagnosed only after death