Angina bullosa hemorrhagica an enigmatic oral disease

Angina bullosa hemorrhagica (ABH) is an enigmatic oral disorder described for the first time by Badham in 1967 to define blisters with a hematic content in the oral cavity and oropharynx unrelated to any hematological, dermatological or systemic disease. The ABH is an uncommon disease of the oral cavity distinctively affecting adults, with the highest incidence over the 5th decade of life. This process is considered nowadays to have a multifactorial etiopathogenesis, where mild oral traumatisms can trigger the blisters in susceptible individuals. Certain association on the onset of the lesion with the chronic use of inhaled steroids and, more controversially, with triggering systemic disorders, such as, diabetes or hypertension has been described. Characteristically, the ABH blisters are acute and are located on the lining mucosa, more frequently on the soft palate. Usually, the lesions are solitary and rupture easily, resulting in a superficial ulceration that heals quickly without scarring. The histopathological analysis shows a subepithelial blister containing blood and direct immunofluorescence on the epithelium is negative. The differential diagnosis should consider all oral vesiculobullous disorders with hematic content, including mucocutaneos, hematological or cystic pathology. The diagnosis of ABH is clearly clinical, although the biopsy might be helpful on atypical or abnormally recurrent cases. The general prognosis of ABH is good and the treatment is symptomatic. Although it is an uncommon disease, the angina bullosa hemorrhagica should be considered in the differential diagnosis of oral vesiculo-bullous processes. Acknowledging this entity will help in differentiating it from important mucocutaneous and hematological diseases such as pemphigus vulgaris, mucous membrane pemphigoid or coagulation disorders. In this review we analyze the main etiopathogenic, clinicopathological, diagnostic and therapeutic aspects of this enigmatic oral condition.peer-reviewe

A influência da utilização do resíduo de marmoraria na durabilidade do concreto autoadensável

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Civil e Ambiental, 2019.O Concreto Autoadensável (CAA) tem como foco principal a trabalhabilidade da mistura, visto que é capaz de espalhar-se pelo espaço da fôrma sem necessidade de adensamento externo, mas ainda com boa compactação. Para ser autoadensável, o concreto precisa garantir fluidez, habilidade de passar por obstáculos e resistência à segregação. Para isso, a dosagem do concreto autoadensável inclui, além dos componentes do Concreto Convencional (CCV), aditivos superplastificantes e, principalmente, maior proporção de materiais finos, que asseguram o preenchimento dos vazios e o bom empacotamento das partículas. O Resíduo de Marmoraria (RM) é uma adição mineral do tipo fíler, fina e inerte, que desempenha bem essas funções; esse material é produzido em larga escala em todo o Brasil e frequentemente é descartado sem tratamento prévio, provocando graves problemas ambientais; em contrapartida, tem sido estudado em misturas de concreto para aplicação estrutural. A presente pesquisa teve como intuito avaliar a influência do resíduo de marmoraria pela substituição do cimento por esse resíduo, nas proporções de 5%, 15% e 25%, especialmente no que diz respeito à durabilidade do concreto, mas sem deixar de contemplar também suas propriedades mecânicas e suas propriedades no estado fresco. Para isso, foram realizados, em cada traço de concreto produzido, ensaios de caracterização dos materiais componentes do concreto; ensaios para o CAA em seu estado fresco; ensaios quanto às propriedades mecânicas; e ensaios de avaliação da durabilidade. Os resultados foram comparados entre si e com um CAA de referência sem adição de RM. Mantidas as características de autoadensabilidade, os valores assumidos tanto pelas propriedades mecânicas quanto pelas de durabilidade demonstraram a possibilidade do RM ser aplicado de maneira vantajosa por diminuir o consumo de cimento, sobretudo no teor de 5% de substituição

Hemorrhagic Shock Secondary To Button Battery Ingestion.

Button battery ingestion is a frequent pediatric complaint. The serious complications resulting from accidental ingestion have increased significantly over the last two decades due to easy access to gadgets and electronic toys. Over recent years, the increasing use of lithium batteries of diameter 20 mm has brought new challenges, because these are more detrimental to the mucosa, compared with other types, with high morbidity and mortality. The clinical complaints, which are often nonspecific, may lead to delayed diagnosis, thereby increasing the risk of severe complications. A five-year-old boy who had been complaining of abdominal pain for ten days, was brought to the emergency service with a clinical condition of hematemesis that started two hours earlier. On admission, he presented pallor, tachycardia and hypotension. A plain abdominal x-ray produced an image suggestive of a button battery. Digestive endoscopy showed a deep ulcerated lesion in the esophagus without active bleeding. After this procedure, the patient presented profuse hematemesis and severe hypotension, followed by cardiorespiratory arrest, which was reversed. He then underwent emergency exploratory laparotomy and presented a new episode of cardiorespiratory arrest, which he did not survive. The battery was removed through rectal exploration. This case describes a fatal evolution of button battery ingestion with late diagnosis and severe associated injury of the digestive mucosa. A high level of clinical suspicion is essential for preventing this evolution. Preventive strategies are required, as well as health education, with warnings to parents, caregivers and healthcare professionals.132184-

Choque hemorrágico secundário à ingestão de bateria em disco

CONTEXT: Button battery ingestion is a frequent pediatric complaint. The serious complications resulting from accidental ingestion have increased significantly over the last two decades due to easy access to gadgets and electronic toys. Over recent years, the increasing use of lithium batteries of diameter 20 mm has brought new challenges, because these are more detrimental to the mucosa, compared with other types, with high morbidity and mortality. The clinical complaints, which are often nonspecific, may lead to delayed diagnosis, thereby increasing the risk of severe complications. CASE REPORT: A five-year-old boy who had been complaining of abdominal pain for ten days, was brought to the emergency service with a clinical condition of hematemesis that started two hours earlier. On admission, he presented pallor, tachycardia and hypotension. A plain abdominal x-ray produced an image suggestive of a button battery. Digestive endoscopy showed a deep ulcerated lesion in the esophagus without active bleeding. After this procedure, the patient presented profuse hematemesis and severe hypotension, followed by cardiorespiratory arrest, which was reversed. He then underwent emergency exploratory laparotomy and presented a new episode of cardiorespiratory arrest, which he did not survive. The battery was removed through rectal exploration. CONCLUSION: This case describes a fatal evolution of button battery ingestion with late diagnosis and severe associated injury of the digestive mucosa. A high level of clinical suspicion is essential for preventing this evolution. Preventive strategies are required, as well as health education, with warnings to parents, caregivers and healthcare professionals1323184188CONTEXTO: A ingestão de bateria em disco é queixa frequente em pediatria. As complicações graves decorrentes de ingestão acidental têm aumentado significativamente nas últimas duas décadas, devido ao fácil acesso aos aparelhos e brinquedos eletrônicos. Nos últimos anos, o aumento do uso de baterias de lítio com diâmetro de 20 mm trouxe novos desafios, por serem mais prejudiciais para a mucosa em comparação com outros tipos, com elevada morbidade e mortalidade. As queixas clínicas, muitas vezes inespecíficas, podem levar ao atraso no diagnóstico, aumentando o risco de complicação grave. RELATO DE CASO: Menino de cinco anos, com queixa de dor abdominal há 10 dias, é trazido ao serviço de emergência com quadro clínico de hematêmese há duas horas. Na admissão, apresentava palidez, taquicardia e hipotensão. Imagem sugestiva de bateria em disco foi visualizada na radiografia simples de abdome. A endoscopia digestiva demonstrou lesão ulcerada profunda no esôfago sem sangramento ativo. Após o procedimento, o paciente apresentou hematêmese profusa e hipotensão grave, seguidos de parada cardiorrespiratória (PCR), revertida. Submetido a laparotomia exploradora de urgência, apresentou novo episódio de PCR, sem reversão. A bateria foi removida por exploração retal. CONCLUSÃO: Este caso descreve a evolução fatal de ingestão da bateria em disco com diagnóstico tardio e associação com lesão grave de mucosa digestiva. Alto nível de suspeita clínica é obrigatório para evitar tal evolução. As estratégias de prevenção são necessárias, bem como a educação em saúde, com alerta aos pais, cuidadores e profissionais de saúdesem informaçã

La producción y colaboración científica por área temática de las Universidades públicas españolas

Due to the growing interest in the evaluation systems of scientific activity, especially in university rankings, by the scientific community and government organs responsible for science policy, it is necessary to have tools to show what the different dimensions involved in these evaluation processes, especially in the case of universities, which have different profiles. For this reason, compared to synthetic indicators, it is considered more appropriate to have a battery of indicators grouped by areas of knowledge, in order to avoid comparative grievances and get as fairly as possible among evaluation objects. We present some preliminary results, by subject area, in relation to scientific production and the degree of international collaboration of Spanish public universities. The data were collected from those contained in the observatory IUNE, showing the scientific activity of the Spanish Universities grouped into 6 major areas: Arts and Humanities (ART) Life Sciences (BIO) Experimental Science (EXP ), Architecture, Engineering and Computer Science (ENG); Medicine and Pharmacology (MED) and Social Sciences (SOC). The time period studied covered the years 2002-2011. These results show that the area of Experimental Sciences (EXP) has the highest scientific activity, representing approximately 40% of total public university system, ahead of ING and MED, with percentages representing about 25% each one. These documents are published in international collaboration in different proportions, with the area of EXP with 43% of this type of document, which stands over others, such as ING and MED whose average rates of international collaborative papers is about 30 %

Marketing mix y satisfacción del cliente en una estación de servicios de Surquillo, Lima 2022

El estudio tuvo como objetivo determinar la relación entre el marketing mix y satisfacción del cliente en una estación de servicios de Surquillo. El método fue de tipo aplicado, diseño no experimental, nivel correlacional y enfoque cuantitativo. La población estuvo conformada por 1405 y una muestra de 91 clientes. Para el procedimiento de recolección se usó el análisis exploratorio, evaluando las variables marketing mix y satisfacción del cliente con el instrumento del cuestionario, de acuerdo a la escala de Likert, que constó de 20 preguntas para la primera variable y 18 para la segunda. Los resultados obtenidos según el estadígrafo de Rho de Spearman indica que existe correlación bilateral entre las variables de Rho=0.799 y un nivel de significancia bilateral de 0.000. Para el procesamiento de datos se usó el programa SPSS Vers-26. Concluyendo la existencia de una correlación positiva muy fuerte, entre las variables marketing mix y satisfacción del cliente. Se recomienda implementar estrategias en cuanto a: producto, precio, plaza y promoción, las cuales tienen una relación directa con la satisfacción del cliente, a través de acciones estratégicas

Perfil del mercado y la cadena del cacao en Wampusirpi, Honduras

Este informe hace parte de los productos del proyecto EU DeSIRA: “Cinco Grandes Bosques de Mesoamérica: Una iniciativa regional para el clima, la biodiversidad y las personas”, liderado por Wildlife Conservation Society (WCS), y que busca construir un modelo replicable para transformar la agricultura y los sistemas alimentarios y proteger ecosistemas boscosos intactos en los Cinco Grandes Bosques de Mesoamérica. En Honduras, WCS ha venido trabajando en el fortalecimiento de los medios de vida de las comunidades del área de la Mosquitia, como un instrumento para reducir la presión en los bosques y fomentar su conservación. Dentro de las actividades económicas priorizadas por las comunidades y actores regionales para alcanzar estos objetivos, se destaca la producción de cacao, la cual hace parte de las apuestas del gobierno y cooperación internacional para mejorar las economías del territorio. La Alianza Bioversity International y el CIAT (ABC) como co-implementador del proyecto, busca contribuir en los esfuerzos a través del análisis de alternativas productivas y cadenas de valor con mayor potencial para la región, describiendo su funcionamiento e identificando las principales oportunidades, retos y amenazas, haciendo énfasis en los componentes relacionados a los mercados. En consecuencia, este reporte presenta un perfil de la cadena de valor regional del cacao, junto con información estratégica de sus mercados actuales y potenciales

Global and local envelope protein dynamics of hepatitis C virus determine broad antibody sensitivity

Broad antibody sensitivity differences of hepatitis C virus (HCV) isolates and their ability to persist in the presence of neutralizing antibodies (NAbs) remain poorly understood. Here, we show that polymorphisms within glycoprotein E2, including hypervariable region 1 (HVR1) and antigenic site 412 (AS412), broadly affect NAb sensitivity by shifting global envelope protein conformation dynamics between theoretical “closed,” neutralizationresistant and “open,” neutralization-sensitive states. The conformational space of AS412 was skewed toward -hairpin–like conformations in closed states, which also depended on HVR1, assigning function to these enigmatic E2 regions. Scavenger receptor class B, type I entry dependency of HCV was associated with NAb resistance and correlated perfectly with decreased virus propensity to interact with HCV co-receptor CD81, indicating that decreased NAb sensitivity resulted in a more complex entry pathway. This link between global E1/E2 states and functionally distinct AS412 conformations has important implications for targeting AS412 in rational HCV vaccine design

Remote Loading of ⁶⁴Cu²⁺ into Liposomes without the Use of Ion Transport Enhancers

Due to low ion permeability of lipid bilayers, it has been and still is common practice to use transporter molecules such as ionophores or lipophilic chelators to increase transmembrane diffusion rates and loading efficiencies of radionuclides into liposomes. Here, we report a novel and very simple method for loading the positron emitter ⁶⁴Cu²⁺ into liposomes, which is important for <i>in vivo</i> positron emission tomography (PET) imaging. By this approach, copper is added to liposomes entrapping a chelator, which causes spontaneous diffusion of copper across the lipid bilayer where it is trapped. Using this method, we achieve highly efficient ⁶⁴Cu²⁺ loading (>95%), high radionuclide retention (>95%), and favorable loading kinetics, excluding the use of transporter molecule additives. Therefore, clinically relevant activities of 200–400 MBq/patient can be loaded fast (60–75 min) and efficiently into preformed stealth liposomes avoiding subsequent purification steps. We investigate the molecular coordination of entrapped copper using X-ray absorption spectroscopy and demonstrate high adaptability of the loading method to pegylated, nonpegylated, gel- or fluid-like, cholesterol rich or cholesterol depleted, cationic, anionic, and zwitterionic lipid compositions. We demonstrate high <i>in vivo</i> stability of ⁶⁴Cu-liposomes in a large canine model observing a blood circulation half-life of 24 h and show a tumor accumulation of 6% ID/g in FaDu xenograft mice using PET imaging. With this work, it is demonstrated that copper ions are capable of crossing a lipid membrane unassisted. This method is highly valuable for characterizing the <i>in vivo</i> performance of liposome-based nanomedicine with great potential in diagnostic imaging applications