Massive lower gastrointestinal bleeding from idiopathic ileocolonic varix: report of a case

Dis Colon Rectum. 2006 Apr;49(4):524-6. Massive lower gastrointestinal bleeding from idiopathic ileocolonic varix: report of a case. Lopes LM, Ramada JM, Certo MG, Pereira PR, Soares JM, Ribeiro M, Areias J, Pinho C. SourceGastroenterology Department, Hospital Geral Santo António, Porto, Portugal. [email protected] Abstract Idiopathic varices of the entire colon are very rare. We report on a 64-year-old patient with massive lower gastrointestinal hemorrhage from an extensive ileocolonic varix. Diagnosis was established by colonoscopy. The patient underwent an emergency ileocolectomy with satisfactory results. This rare case shows the importance of colonoscopy in the evaluation of patients with lower gastrointestinal hemorrhage and reminds us that sometimes the diagnosis is not what we expect. Recognition of this abnormality is important because varices may be the cause of massive lower gastrointestinal hemorrhage. PMID: 16395635 [PubMed - indexed for MEDLINE

Quinze anos de monitorização das comunidades biológicas do estuário do Tejo no âmbito da construção e funcionamento das ETARs do Portinho da Costa e da Mutela (Concelho de Almada): Experiência adquirida e ensinamentos para futuros casos semelhantes.

Desde 2001 que a Câmara Municipal de Almada tem vindo a promover, em colaboração com o MARE, a monitorização ambiental das regiões estuarinas sob influência das ETARs do Portinho da Costa e da Mutela, que vieram substituir efluentes não tratados emitidos sensivelmente nas mesmas regiões. O objetivo deste programa de monitorização consiste em avaliar as principais alterações ocorridas (na maioria dos casos positivas) nos ecossistemas estuarinos dos vários locais, após a entrada em funcionamento de ambas as infraestruturas. Estes 15 anos de estudos das comunidades bentónicas e de peixes locais têm permitido identificar variações nos padrões espácio-temporais destes compartimentos biológicos e identificar quais dessas evoluções podem ser presumivelmente relacionáveis com o funcionamento das infraestruturas e quais derivam provavelmente de flutuações naturais. Nesta comunicação são enunciados os pressupostos do estudo, descritos os delineamentos experimentais e metodologias de tratamento dos dados adotados, apresentados os principais resultados obtidos e discutidas as grandes dificuldades sentidas para cumprir os objetivos estabelecidos. Este conjunto de elementos será analisado numa perspetiva de como a experiência adquirida pode ser útil, no futuro, para casos semelhantes, sobretudo numa ótica da correta identificação dos verdadeiros efeitos infraestruturais e de despiste da influência de outros fatores concorrentes

Productive traits and nutritional value of Urochloa ruziziensis submitted to different planting densities and defoliation intensities

ABSTRACT The aim of this study was to evaluate the forage mass and accumulation and nutritional value of cultivars Kennedy and BRS Integra (Urochloa ruziziensis), subjected to two planting densities (15 and 30 plants/m2) and three stubble height (15, 30 and 40 cm). The experimental design was a randomized block, in a 2x2x3 factorial, with three replications. The experimental period comprised two agrostological years. Plants managed under lower stubble height (15cm), showed lower leaf:stem ratio and higher canopy heights at harvest, based on the light interception of 95%. The highest forage mass was observed to cultivar BRS Integra under lower planting density (15 plants/m2). The two cultivars showed high nutritive value, without influence of studied factors. In general, the cultivars were similar for most variables studied. Planting with 15 plants/m2 and moderate defoliation (30cm residue) resulted in higher forage accumulation, especially in the second year after planting. These targets are suggested for the management of U. ruziziensis cultivars

Automated final lesion segmentation in posterior circulation acute ischemic stroke using deep learning

Final lesion volume (FLV) is a surrogate outcome measure in anterior circulation stroke (ACS). In posterior circulation stroke (PCS), this relation is plausibly understudied due to a lack of methods that automatically quantify FLV. The applicability of deep learning approaches to PCS is limited due to its lower incidence compared to ACS. We evaluated strategies to develop a convolutional neural network (CNN) for PCS lesion segmentation by using image data from both ACS and PCS patients. We included follow-up non-contrast computed tomography scans of 1018 patients with ACS and 107 patients with PCS. To assess whether an ACS lesion segmentation generalizes to PCS, a CNN was trained on ACS data (ACS-CNN). Second, to evaluate the performance of only including PCS patients, a CNN was trained on PCS data. Third, to evaluate the performance when combining the datasets, a CNN was trained on both datasets. Finally, to evaluate the performance of transfer learning, the ACS-CNN was fine-tuned using PCS patients. The transfer learning strategy outperformed the other strategies in volume agreement with an intra-class correlation of 0.88 (95% CI: 0.83–0.92) vs. 0.55 to 0.83 and a lesion detection rate of 87% vs. 41–77 for the other strategies. Hence, transfer learning improved the FLV quantification and detection rate of PCS lesions compared to the other strategies

Phosphate fertilization and phosphorus forms in an Oxisol under no-till

Under no-till phosphorus (P) accumulates in a few centimeters of the topsoil layer. Plant residues left on the soil surface release P and organic acids, which may improve P availability and fertilizer efficiency, including both soluble (such as triple super phosphate) and less soluble sources (such as reactive natural phosphates). In this study, soybean response to P fertilizer and P forms in the top 40 cm of an Oxisol were evaluated after surface application of different phosphates in a 5-year-old no-till system. Treatments consisted of 0 or 80 kg ha-1 of total P2O5 applied on the soil surface, both as natural reactive phosphate (NRP) or triple super phosphate (TSP). In addition, 80 kg ha-1 of P2O5 were applied to subplots, in furrows below and beside the soybean (Glycine max L.) seeds, in different combinations of NRP and TSP. Soil samples were taken before and after the soybean growth, down to 0.40 m and soil phosphorus was chemically fractionated. The responses to NRP were similar to TSP, with an increase in P reserves at greater depths, even in non-available forms, such as P-occluded. After the soybean harvest, P-occluded levels were lower at the surface layer, but an increase was observed in the soluble, organic and total P down to 40 cm. An improved P distribution in soil depth, especially regarding the soluble and organic forms, resulted in higher soybean yields, even when the phosphates were applied to the soil surface.Em semeadura direta o fósforo (P) acumula-se na camada mais superficial do solo, mas os resíduos deixados na superfície liberam P e ácidos orgânicos, que podem melhorar a disponibilidade e a eficiência de fertilizantes como o superfosfato triplo e fosfatos naturais reativos. Neste estudo, a resposta da soja à adubação com P e as formas de P até 40 cm de profundidade do solo foram avaliadas após a aplicação de fosfatos em um sistema conduzido em semeadura direta há cinco anos. Os tratamentos consistiram de 0 ou 80 kg ha-1 P2O5 total, aplicados na superfície do solo como fosfato natural reativo (FNR) ou superfosfato triplo (SFT). Nas subparcelas foram aplicados, no sulco de semeadura, 80 kg ha-1 de P2O5, em diferentes combinações de FNR e SFT. Amostras de solo foram coletadas até 0.4 m, antes e depois do cultivo da soja (Glycine max L.), para fracionamento do P. As respostas ao FNR foram semelhantes às do SFT, com aumento das reservas de P em profundidade, mesmo em formas não-disponíveis como P-ocluso. Após a colheita da soja, os teores de P-ocluso diminuíram na camada mais superficial, mas foi observado um aumento nas formas solúvel, orgânica e P - total em toda a espessura de solo estudada. A melhor distribuição do P no solo, principalmente em formas solúvel e orgânica, resultou em maior produtividade da soja, mesmo quando o fertilizante foi aplicado na superfície do solo