Primary vulvar Paget disease - the importance of clinical suspicion

Extramammary Paget disease of the vulva is a rare condition that accounts for only 1-2% of vulvar malignancies and represents a frequent cause of misdiagnosis. It is most commonly seen in postmenopausal women. Clinically it is similar to Paget disease of the breast, appearing as red, well-demarcated eczematoid lesions, with slightly raised edges. A high degree of clinical suspicion is very important when evaluating these lesions in order to avoid misdiagnosis and delay of effective treatment. We present a case of vulvar Paget disease treated with vulvectomy.info:eu-repo/semantics/publishedVersio

Accuracy of Siri and Brozek equations in the percent body fat estimation in older adults

To identify which equation, Siri or Brozek, based on the two compartment model, provides a more accurate conversion of body density (BD) in percent body fat (%BF) in a group of older adults. Cross-sectional study. Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto. 60 older adults, aged 60-92 years. Skinfold thickness was used to estimate BD through Visser et al. prediction equation. The conversion of BD to %BF was done with Siri (%BF-Siri) and Brozek (%BF-Brozek) formulas and these determined values were both compared to Dual-Energy X-ray Absorptiometry (%BF-DXA) evaluations. A strong correlation between the %BF-DXA value and %BF-Siri (r=0.91, p < 0.001) and %BF-Brozek (r=0.91, p < 0.001) was found, although %BF-Siri and %BF-Brozek overestimated %BF-DXA (p < 0.001). The comparison of the %BF-Siri and %BF-Brozek mean values also revealed significant differences (p < 0.001). The %BF-Brozek reflects a better agreement than the %BF-Siri with %BF-DXA with respectively a mean difference of -4.0%BF (limits of agreement = -10.9 to 2.9%) and -5.7%BF (-12.6 to 1.2). The Bland and Altman plots confirmed that %BF-Brozek reflects a better agreement with %BF-DXA. The results of the present study show that the use of Brozek equation may correspond to a more accurate alternative than Siri equation for the conversion of BD in %BF in older adults

Induction of xylanolytic activity by Aureobasidium pullulans using xerographic paper

PRAXIS/BIO/1133/95

Preliminary studies on enzymatic applications in the paper industry

Disponível apenas o abstract

Diagnosticar síndrome de Schmidt na adolescência

A poli-endocrinopatia auto-imune tipo II divide-se em 2 síndromes: o síndrome de Schmidt, que se caracteriza pela associação entre a doença de Addison (DA) e tiroidite auto-imune, e o síndrome de Carpenter, em que há associação entre estas e diabetes tipo 1. É uma patologia rara, particularmente em idade pediátrica. Apresenta-se o caso de uma adolescente de 14 anos, do sexo feminino, orientada para a consulta do Grupo Endocrinológico Pediátrico por hipotiroidismo primário, no contexto de tiroidite de Hashimoto, estando medicada há cerca de 1 mês com levotiroxina. Negava sintomatologia característica ou infecções recentes. Na observação apresentava cabelo fino e ralo, hiper-pigmentação difusa e brilho cutâneo. Perante este quadro clínico foi colocada a hipótese de DA, que foi confirmada analiticamente. Iniciou tratamento com hidrocortisona e fludrocortisona, com melhoria clínica. (Comentários) Nesta doente só a presença de hiper-pigmentação cutânea e mucosa levantou a suspeita de DA, permitindo chegar ao diagnóstico de síndrome de Schmidt. É uma patologia muito rara em idade pediátrica. São dados favoráveis a este diagnóstico: o doseamento de cortisol matinal normal ou baixo, e um valor de ACTH muito alto. A determinação isolada de cortisol não tem valor diagnóstico, uma vez que pode ser normal e não ocorrer a elevação esperada em situações de 'stress' metabólico, como p. ex. doença aguda. O diagnóstico pode ser confirmado com uma prova de estimulação com ACTH, em que se verifica ausência da normal elevação dos níveis de cortisol. Nesta doente o valor elevado de ACTH perante doseamentos de cortisol diminuídos, inclusive na prova de estimulação com tetracosatido, possibilitou a confirmação diagnóstica definitiva. A hiponatrémia é um dado diagnóstico importante, permitindo inferir insuficiência mineralo-corticóide. A utilização de fludrocortisona no tratamento desta adolescente possibilitou não só a compensação do referido défice mineralo-corticóide, mas também a utilização de menor dose de glicocorticóide, reduzindo os efeitos secundários desta terapêutica. O doseamento da actividade plasmática de renina não foi efectuado, por dificuldades na sua determinação no nosso hospital. Investigou-se causa auto-imune, visto que é esta a mais frequente em idade pediátrica. A ausência de causas infecciosas, alterações imagiológicas ou exposição a fármacos tornaram menos prováveis outras etiologias. Como patologia auto-imune este síndrome caracteriza-se pela presença de auto-anticorpos (Ac), sendo os Ac anti-córtex supra-renal positivos em 85% dos casos, contra 70% nos casos de doença de Addison isolada. A sua negatividade não exclui no entanto o diagnóstico desta patologia, como ocorreu neste caso. Os doentes com síndrome poli-glandular necessitam de seguimento cuidado, no sentido de identificar precocemente outras doenças auto-imunes que poderão surgir concomitantemente, e evitar a sua progressão. Estas doenças podem surgir em qualquer idade, e como tal a negatividade inicial dos auto-anticorpos não permite excluí-las. O tratamento da insuficiência supra-renal é um tratamento de substituição para toda a vida, com necessidade de ajustes terapêuticos durante o crescimento e em situações de 'stress' metabólico. Foi efectuado, como é recomendado, plano terapêutico de emergência para situações de 'stress' metabólico, de forma a prevenir a descompensação aguda. Neste caso o início da terapêutica com levotiroxina terá agravado os sinais clínicos de insuficiência supra-renal. Dada a precocidade do diagnóstico, evitou-se a forma de apresentação mais grave de crise adrenal aguda, e a adolescente não chegou a apresentar sintomatologia significativa. Destaca-se a importância da suspeição diagnóstica de DA perante um quadro clínico de hiper-pigmentação cutânea progressiva, particularmente com hipotiroidismo ou outra doença auto-imune simultânea

Genetic evaluation using multi-trait and random regression models in Simmental beef cattle.

The Brazilian Association of Simmental and Simbrasil Cattle Farmers provided 29,510 records from 10,659 Simmental beef cattle; these were used to estimate (co)variance components and genetic parameters for weights in the growth trajectory, based on multi-trait (MTM) and random regression models (RRM). The (co)variance components and genetic parameters were estimated by restricted maximum likelihood. In the MTM analysis, the likelihood ratio test was used to determine the significance of random effects included in the model and to define the most appropriate model. All random effects were significant and included in the final model. In the RRM analysis, different adjustments of polynomial orders were compared for 5 different criteria to choose the best fit model. An RRM of third order for the direct additive genetic, direct permanent environmental, maternal additive genetic, and maternal permanent environment effects was sufficient to model variance structures in the growth trajectory of the animals. The (co)variance components were generally similar in MTM and RRM. Direct heritabilities of MTM were slightly lower than RRM and varied from 0.04 to 0.42 and 0.16 to 0.45, respectively. Additive direct correlations were mostly positive and of high magnitude, being highest at closest ages. Considering the results and that pre-adjustment of the weights to standard ages is not required, RRM is recommended for genetic evaluation of Simmental beef cattle in Brazil

The influence of animals from embryo transfer on the genetic evaluation of growth in Simmental beef cattle by using multi-trait models.

The weight records from Simmental beef cattle were used in a genetic evaluation of growth with or without the inclusion of animals obtained by embryo transfer. A multi-trait model in which embryo transfer individuals were excluded (MTM1) contained 29,510 records from 10,659 animals, while another model without exclusion of these animals (MTM2) contained 62,895 weight records from 23,160 animals. The weight records were adjusted for ages of 100, 205, 365, 450, 550 and 730 days. The (co)variance components and genetic parameters were estimated by the restricted maximum likelihood method. The (co)variance components were similar in both models, except for maternal permanent environment variance. Direct heritabilities (h2 d) in MTM1 were 0.04, 0.11, 0.20, 0.27, 0.31 and 0.42, while in MTM2 they were 0.11, 0.11, 0.17, 0.21, 0.22 and 0.26 for 100, 205, 365, 450, 550 and 730 days of age, respectively. Estimates of h2 d in MTM1 were higher than in MTM2 for the weight at 365 days of age. Genetic correlations between weights in both models ranged from moderate to high, suggesting that these traits may be determined mainly by the same genes. Animals from embryo transfer may be included in the genetic evaluation of Simmental beef cattle in Brazil; this inclusion may provide potential gains in accuracy and genetic gains by reducing the interval between generations

Estruturação de dados para avaliação genética de bubalinos em rebanhos-núcleo do Pará: resultados preliminares.

bitstream/item/42049/1/DOC-370.pdfVersão eletrônica disponível em papel

Influence of animals obtained using embryo transfer on the genetic evaluation of growth in Simmental beef cattle with random regression models.

Weight records of Simmental beef cattle were used in a genetic evaluation of growth with and without embryo transfer (ET). A random regression model in which ET individuals were excluded (RRM1) contained 29,510 records from 10,659 animals, while another model that did not exclude these animals (RRM2) contained 62,895 records from 23,160 animals. The fixed and random regressions were represented by continuous functions, and a model with an order of three for the fixed curve and random effects was used to consider the homogeneity of residual variance. In general, the (co)variance components were similar in both models, except the maternal permanent environment and residual components. The direct heritability in RRM1 and RRM2 showed the same behavior with oscillations along the growth curve and were slightly higher in RRM1. Generally, the estimated correlations were the same and smaller as the ages distanced themselves. The inclusion of animals from ET in genetic evaluations can be done using random regression models; the inclusion of these animals would provide potential accuracy gains and greater genetic gains per unit time because of the reduction in the generation interval from the use of this reproductive technique