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

Perfil da fluência: comparação entre falantes do Português Brasileiro e do Português Europeu

The purpose of the study was to compare the speech fluency of Brazilian Portuguese speakers with that of European Portuguese speakers. The study participants were 76 individuals of any ethnicity or skin color aged 18–29 years. Of the participants, 38 lived in Brazil and 38 in Portugal. Speech samples from all participants were obtained and analyzed according to the variables of typology and frequency of speech disruptions and speech rate. Descriptive and inferential statistical analyses were performed to assess the association between the fluency profile and linguistic variant variables. We found that the speech rate of European Portuguese speakers was higher than the speech rate of Brazilian Portuguese speakers in words per minute (p=0.004). The qualitative distribution of the typology of common dysfluencies (p<0.001) also discriminated between the linguistic variants. While a speech fluency profile of European Portuguese speakers is not available, speech therapists in Portugal can use the same speech fluency assessment as has been used in Brazil to establish a diagnosis of stuttering, especially in regard to typical and stuttering dysfluencies, with care taken when evaluating the speech rate.O objetivo do estudo foi comparar a fluência de fala de falantes do Português Brasileiro com a de falantes do Português Europeu. Participaram deste estudo 76 indivíduos, sem distinção de raça e cor, com idades entre 18 e 29 anos, sendo 38 residentes no Brasil e 38 em Portugal. Foram obtidas amostras de fala de todos os participantes e analisadas segundo as variáveis de tipologia e frequência das disfluências e velocidade de fala. Foi realizada análise estatística descritiva e inferencial para verificar a associação entre as variáveis do perfil da fluência e da variante linguística. Foi observado que a velocidade de fala dos falantes do Português Europeu em palavras por minuto (p=0,004) é maior que a dos falantes do Português Brasileiro. A distribuição qualitativa das tipologias das disfluências comuns (p<0,001) também diferencia as variantes linguísticas. Enquanto não há um perfil de fluência de fala dos falantes do Português Europeu, para se estabelecer um diagnóstico de gagueira, os fonoaudiólogos podem utilizar em Portugal a mesma avaliação de fluência de fala utilizada no Brasil, principalmente no que se refere às disfluências comuns e gagas, tendo cuidado apenas no que se refere à velocidade de falaFundação de Amparo à Pesquisa do Estado de Minas Gerais (CDS – APQ – 02141-11)info:eu-repo/semantics/publishedVersio

YEAST SUCCESSION IN THE AMAZON FRUIT PARAHANCORNIA-AMAPA AS RESOURCE PARTITIONING AMONG DROSOPHILA SPP

The succession of yeasts colonizing the fallen ripe amapa fruit, from Parahancornia. amapa, aas examined. The occupation of the substrate depended on both the competitive interactions of yeast species, such as the production of killer toxins, and the selective dispersion by the drosophilid guild of the amapa fruit. The yeast community associated with this Amazon fruit differed from those isolated from other fruits in the same forest. The physiological profile of these yeasts was mostly restricted to the assimilation of a few simple carbon sources, mainly L-sorbose, D-glycerol, DL-lactate, cellobiose, and salicin. Common fruit-associated yeasts of the genera Kloeckera and Hanseniaspora, Candida guilliermondii, and Candida krusei colonized fruits during the first three days after the fruit fell. These yeasts were dispersed and served as food for the invader Drosophila malerkotliana. The resident flies of the Drosophila willistoni group fed selectively on patches of yeasts colonizing fruits 3 to 10 days after the fruit fell. The killer toxin-producing yeasts Pichia kluyveri var. kluyveri and Candida fructus were probably involved in the exclusion of some species during the intermediate stages of fruit deterioration. An increase in pH, inhibiting toxin activity and the depletion of simple sugars, may have promoted an increase in yeast diversity in the later stages of decomposition. The yeast succession provided a patchy environment for the drosophilids sharing this ephemeral substrate.61124251425

Male Uro-Rectal Iatrogenic Fistula Treatment in Pelvic Tumours: A National Multi-Institutional Study

Introdução: As fístulas uro-rectais (FUR) constituem uma complicação devastadora do tratamento de tumores pélvicos e um desafio cirúrgico para o cirurgião reconstrutivo. Contudo, apesar da sua crescente incidência associada a uma utilização cada vez mais frequente das diferentes modalidades não-cirúrgicas, especialmente de radioterapia, com ou sem cirurgia, para o tratamento de tumores pélvicos, a fístula urorectal permanece relativamente rara. Dada a elevada improbabilidade do encerramento espontâneo da fístula uro-rectal, a correcção cirúrgica torna-se necessária na quase totalidade dos casos. Apesar da existência de várias técnicas cirúrgicas, as taxas de falência/recorrência são habitualmente elevadas, particularmente em fístulas rádicas. Descrevemos neste estudo a nossa experiência limitada no tratamento de fístulas urorectais resultantes de tratamentos de tumores pélvicos (aparelho urinário inferior e recto). Métodos: Entre Outubro de 2008 e Fevereiro de 2015, foram identificados 12 pacientes do sexo masculino com fístula urorectal e tratados nas nossas instituições. Foi efectuada revisão dos processos clínicos dos pacientes, incluindo a idade, sintomas, presença de comorbilidades, marcha diagnóstica, tipo e etiologia da fístula, tipo de reconstrução cirúrgica, follow-up e resultados. Foram excluídos do estudo todos os pacientes com fístula não-neoplásica/inflamatória. Resultados: Foram identificados e tratados 12 pacientes nas nossas instituições. Um dos pacientes, após ressecção anterior do recto, desenvolveu metástases ganglionares e hepáticas 4 meses após o diagnóstico da fístula urorectal, durante tratamento médico/antibiótico de abcesso pélvico e sua resolução após drenagem e, consequentemente, foi excluído do tratamento cirúrgico e do estudo. A idade média dos doentes era de 68 anos (53 – 78). Nove pacientes desenvolveram fístula uro-rectal após terapêutica de carcinoma da próstata): Dois após braquiterapia de baixa dosagem combinada com radioterapia externa; cinco após prostatectomia radical retropúbica (PRR), com radioterapia externa adjuvante em um; um após braquiterapia de baixa dosagem seguida de ressecção transuretral por obstrução prostática; e um após ultra-som focalizado de alta intensidade e radioterapia externa. Em dois pacientes, a fístula resultou de tratamento cirúrgico de carcinoma rectal, associado a radioterapia externa em um deles. Foi efectuada em todos os pacientes derivação fecal com colostomia e derivação urinária, ou com cateterização suprapúbica, ou com cateterização uretral durante o período de espera para a reconstrução cirúrgica. Não houve encerramento espontâneo de fístula urorectal em nenhum paciente. Onze pacientes foram submetidos a reconstrução cirúrgica. Foi utilizada abordagem exclusivamente perineal em sete doentes e abdominoperineal em quatro. Obteve-se encerramento eficaz da fístula em seis pacientes à primeira tentativa cirúrgica, dois doentes necessitaram uma segunda tentativa, enquanto que em um doente foram necessárias três tentativas cirúrgicas (duas delas em outras instituições) de forma a atingir um resultado com sucesso. Ocorreu falência cirúrgica em dois doentes, os quais, actualmente, não desejam qualquer tentativa reconstrutiva adicional. Estes dois doentes e um doente, em quem a reconstrução foi eficaz, permanecem ainda com colostomia. O tempo médio de follow- -up foi de 25,5 meses (3-75). Conclusão: As fístulas uro-rectais são uma complicação pouco frequente, mas devastadora, do tratamento dos tumores pélvicos, habitualmente associada com morbilidade debilitante e degradação da qualidade de vida. Embora a sua reconstrução cirúrgica possa ser extremamente difícil, ela é possível com sucesso na maioria dos casos através de uma abordagem perineal ou abdominoperineal agressiva e interposição de tecidos, quando indicada.info:eu-repo/semantics/publishedVersio

Addressing drinking water salinity due to sea water intrusion in Praia de Leste, Parana, by a brackish water desalination pilot plant

Seawater intrusion into the Pombas River, source of freshwater to Praia de Leste on the coast of Parana in Brazil presents a problem to the water utility as most water treatment plants in Brazil are conventional. To find a solution to this problem, a pilot plant (1 m3 /h) consisting of ultrafiltration (UF) followed by reverse osmosis (RO) was developed and evaluated. For testing, brackish water was produced with a concentration of 1,500 ± 100 mg/L of total dissolved solids (TDS), mixing seawater and fresh water. To evaluate the water quality, TDS, electrical conductivity, pH, temperature, apparent color, turbidity, alkalinity, total hardness, calcium, chloride and sulfate were monitored. For operational performance, flowrates, osmotic pressure, filtration rate, recovery rate and mass balance were analyzed. On average, the UF system removed 96.4% of turbidity and 98.6% of apparent color; whereas the RO system removed 99.4% of TDS. The overall average recovery (UF and RO) was 45.81% with average osmotic pressure of 8.21 bar, filtration rate of 30.7 L/h/m2 in the UF system and 21.7 L/h/m2 in the RO system. From a water quality point of view, the system was effective in processing brackish into fresh water of high quality

Deficits in emotion recognition as markers of frontal behavioral dysfunction in Amyotrophic Lateral Sclerosis

Objective: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with prominent motor symptoms. Patients with ALS may also manifest frontal behavior symptoms and cognitive decline, including impairment in facial emotion recognition. The authors aimed to investigate whether deficits in emotion recognition were associated with frontal behavior symptoms in ALS. Methods: Participants were patients with probable or definite sporadic ALS (N521; male:female ratio, 11:10; median age, 62 years; median disease duration, 3 years) and agematched and education-matched healthy control subjects (N525; male:female ratio, 14:11; median age, 61 years). The Facial Emotion Recognition Test (FERT) was administered to all participants. Patients with ALS were assessed using the Cambridge Behavior Inventory-Revised and were classified into two groups according to the presence of frontal behavioral symptoms: ALS with no behavioral symptom (ALSns; N59) and ALS with at least one behavioral symptom (ALSbs; N512). Results: Apathy and mood symptoms were the most frequent neuropsychiatric symptoms in the patient group. Patients with ALS performed worse than control subjects in the recognition of sadness (p,0.004). There were no differences between control subjects and patients in the ALSns group in all FERT scores, but the ALSbs group had lower performance than control subjects in sadness (p,0.003). Conclusions: Emotion recognition deficit may be a marker of frontal behavior in ALS

Evaluation of matrix metalloproteinases-2 and-9 in cats under bone demineralization secondary to induced thyrotoxicosis

Significant increase of activity of active forms of matrix metalloproteinases -2 and -9 in cats under induced thyrotoxicosis and bone demineralization was observed. Pro and intermediated forms of matrix metalloproteinases -2 and -9 increased at 14 days of hormonal treatment, followed by decrease tendency. A negative correlation between active forms of matrix metalloproteinases -2 and -9 and bone mineral density of radius distal extremity was also observed. The results suggest an increase of collagen matrix degradation secondary to high levels of thyroid hormones.6051053106