MAL DE POTT EM PACIENTE IMUNOSSUPRIMIDO, UM RELATO DE CASO.

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. The pulmonary form is more frequent, but other body structures may be affected. Pott's Disease is a rare entity and accounts for about 0.5% - 1% of extrapulmonary manifestation, especially in immunosuppressed patients. It occurs through reactivation of sites for the spine and sometimes lower limbs. The symptomatology presents itself through the triad: abscess, paraplegia and gibbosity, associated with the classic clinical picture of pulmonary TB: fever, night sweats and chills. The aim of this study is to demonstrate a case of Pott's disease in a 56-year-old female patient with a history of chemotherapy due to non-Hodgkin's lymphoma. After treatment, the patient evolved with symptomatic improvement and good clinical outcome.A tuberculose (TB) é uma doença infectocontagiosa, de transmissão aérea causada pelo Mycobacterium tuberculosis. A forma pulmonar é mais frequente, mas outras estruturas corporais podem ser acometidas. O Mal de Pott (MP) é uma entidade rara e corresponde a cerca de 0,5% - 1% da manifestação extrapulmonar, principalmente em pacientes imunossuprimidos. Ocorre através da reativação de sítios para a coluna e as vezes membros inferiores. A sintomatologia se apresenta através da tríade: abscesso, paraplegia e gibosidade, associado ao quadro clínico clássico da TB pulmonar: febre, sudorese noturna e calafrios. O objetivo deste estudo é demonstrar um caso de Mal de Pott em uma paciente do sexo feminino de 56 anos, com história prévia de quimioterapia devido Linfoma não Hodgkin. Após instituído tratamento paciente evoluiu com melhora sintomática e bom desfecho clínico

DOENÇA HEMANGIOMATOSA MÚLTIPLA ENVOLVENDO TRATO GASTROINTESTINAL: DESCRIÇÃO DE UM CASO CLÍNICO

Hemangiomas are a type of benign vascular tumor, originated from angiogenesis disorders and prevalent in approximately 4% to 5% of the population. Among the most common complications are: ulcerations and bleeding, in cases of those located in the gastrointestinal tract; impairment of airways and vision; visceral complications; obstruction of the ear canal causing deficit in hearing; or problems in eating or in the emission of sounds due to its presence in the oral cavity. Colon and rectum hemangiomas are a rare cause of lower digestive hemorrhage. The aim of this study is to demonstrate the case of multiple hemangiomatose disease in an inpatient undergoing treatment at the Palmas General Public Hospital (HGPP).Hemangioma é um tipo de tumor vascular benigno, originado a partir de distúrbios na angiogênese e está presente em cerca de 4% a 5% da população. Dentre as complicações mais comuns destacam-se: ulcerações e sangramentos, nos casos de hemangiomas localizados no trato gastrointestinal, comprometimento da via aérea e da visão, complicações viscerais, obstrução do canal auditivo e até déficit na alimentação ou na emissão de sons devido a sua presença na região da cavidade oral. O hemangioma de cólon e reto é uma causa rara de hemorragia digestiva baixa. O objetivo deste estudo é demonstrar um caso de doença hemangiomatosa múltipla em uma paciente internada e submetida a tratamento no Hospital Geral Público de Palmas (HGPP)

Using genomics to understand the origin and dispersion of multidrug and extensively drug resistant tuberculosis in Portugal.

Portugal is a low incidence country for tuberculosis (TB) disease. Now figuring among TB low incidence countries, it has since the 1990s reported multidrug resistant and extensively drug resistant (XDR) TB cases, driven predominantly by two strain-types: Lisboa3 and Q1. This study describes the largest characterization of the evolutionary trajectory of M/XDR-TB strains in Portugal, spanning a time-period of two decades. By combining whole-genome sequencing and phenotypic susceptibility data for 207 isolates, we report the geospatial patterns of drug resistant TB, particularly the dispersion of Lisboa3 and Q1 clades, which underly 64.2% and 94.0% of all MDR-TB and XDR-TB isolates, respectively. Genomic-based similarity and a phylogenetic analysis revealed multiple clusters (n = 16) reflecting ongoing and uncontrolled recent transmission of M/XDR-TB, predominantly associated with the Lisboa3 and Q1 clades. These clades are now thought to be evolving in a polycentric mode across multiple geographical districts. The inferred evolutionary history is compatible with MDR- and XDR-TB originating in Portugal in the 70's and 80's, respectively, but with subsequent multiple emergence events of MDR and XDR-TB particularly involving the Lisboa3 clade. A SNP barcode was defined for Lisboa3 and Q1 and comparison with a phylogeny of global strain-types (n = 28 385) revealed the presence of Lisboa3 and Q1 strains in Europe, South America and Africa. In summary, Portugal displays an unusual and unique epidemiological setting shaped by >40 years of uncontrolled circulation of two main phylogenetic clades, leading to a sympatric evolutionary trajectory towards XDR-TB with the potential for global reach

Implementación en la UCM del Grado en Estudios Europeos / Bachelor in European Studies en el marco de la alianza europea de universidades UNA EUROPA

El presente proyecto de innovación ha tenido por objetivo la implementación en la Universidad Complutense de Madrid del Nuevo Grado en Estudios Europeos / Bachelor of European Studies (BAES) creado en el marco de la nueva alianza europea de universidades UNA EUROPA integrada por la Universidad Complutense de Madrid, la Universidad de la Sorbona (París – I), Universidad Libre de Berlín, Universidad de Bolonia, Universidad Jaguelónica de Cracovia, Universidad de Helsinki, Universidad Católica de Lovaina, y Universidad de Edimburgo

Puesta en marcha del Doble Grado Internacional en Derecho UCM - Sorbona en el marco de la alianza europea de universidades UNA EUROPA

Implementación de mejoras que potencien el Doble Grado Internacional en Derecho impartido conjuntamente entre la UCM y la Universidad de la Sorbona y que esta doble titulación internacional refuerce el papel de la UCM en la alianza europea UNA EUROP

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Edible ectomycorrhizal fungi and Cistaceae. A study on compatibility and fungal ecological strategies.

Wild edible mycorrhizal mushrooms are among the most appreciated and prized mushrooms in the world. Despite the cultivation of ectomycorrhizal (ECM) mushrooms has been a growing subject of study worldwide, it has been hampered by the mutualistic lifestyle of the fungi. Although not being obligate symbionts, most of the species of ECM mushrooms only produce fruit bodies in association with trees or shrubs. In the present study, we aimed at understanding certain aspects of the ecology of four different edible ECM fungi: Lactarius deliciosus, Tricholoma equestre, T. portentosum and Boletus fragrans. Despite having a broad distribution worldwide, these fungi inhabit also Mediterranean habitats with understories typically dominated by rockroses (Cistaceae). Studying the ecology of these mutualistic fungi as well as the interaction with these species of shrubs is not only scientifically relevant but also pivotal for the discovery of profitable cultivation protocols. We evaluated the compatibility of these ECM species with five species within Cistaceae family - Cistus ladanifer, C. psilosepalus, C. salviifolius, Halimium halimifolium and Tuberaria lignosa. Each species of fungi proved to be able to establish mycorrhizas with at least 2 different plants species but varied in their host range of the tested Cistaceae. The dissimilarity in terms of host specificity between some fungal species seemed to be connected with the phylogenetic distances of the fungi. A correlation between the colonization percentage of the root systems and the mycelial growth rates in pure culture was found. The connection of these traits might be an important key to understanding the ecological competitor-colonizer tradeoffs of these ECM fungal species. Altogether, our study reports unknown plant-fungi combinations with economical relevance and also adds new insights about the ecology of these species of ECM fungi

ABSCESSO ILIOPSSOAS: UM RELATO DE CASO

Iliopsoas Abscess (IA) is a rare condition that predominantly affects young adults. It is a purulent collection that forms inside the iliopsoas muscle for several reasons. The primary form is due to hematogenous or lymphatic dissemination and the secondary form is the direct expansion of an infectious focus near the iliopsoas muscle. It is an insidious disease with a dragged clinical course, presenting with fever, thigh pain associated with abdominal and/or lower back pain, and there may be limitation of movements in the hip joint. The aim of this study is to demonstrate a case of IA in a 32-year-old female patient, admitted to the Palmas General Public Hospital (HGPP). After treatment, the patient evolved with symptomatic improvement and good clinical outcome.      PORTUGUÊS INGLÊS ESPANHOL               771/5000     Abscesso iliopsoas (IA) é uma condição rara que afeta predominantemente adultos jovens. É uma coleção purulenta que se forma dentro do músculo iliopsoas por várias razões. A forma primária é devida à disseminação hematogênica ou linfática e a forma secundária é a expansão direta de um foco infeccioso próximo ao músculo iliopsoas. É uma doença insidiosa com curso clínico arrastado, apresentando febre, dor na coxa associada a dor abdominal e / ou lombar, podendo haver limitação de movimentos na articulação do quadril. O objetivo deste estudo é demonstrar um caso de IA em uma paciente de 32 anos, internada no Hospital Público Geral de Palmas (HGPP). Após o tratamento, o paciente evoluiu com melhora sintomática e boa evolução clínica

ACRETISMO PLACENTÁRIO: PLACENTA PERCRETA.

INTRODUÇÃO: O acretismo placentário é uma complicação gestacional, definida pela implantação anômala da placenta, que se caracteriza conforme o grau de profundidade da implantação em: placenta acreta quando as vilosidades coriônicas aderem ao miométrio até um terço de sua parede, com ausência de decídua basal, increta quando penetram profundamente o miométrio e percreta quando chegam à serosa uterina podendo invadir órgãos adjacentes.  A placenta percreta é pouco comum, mas uma causa importante de morbimortalidade materna, devido ao alto risco de complicações. DESCRIÇÃO: O seguinte relato apresenta o caso de uma gestante de 36 anos, proveniente de Porto Nacional-TO, GV PCIII NII A0 com 39 semanas, realizou 08 consultas de pré-natal e obteve diagnóstico de placenta percreta no momento do parto. DISCUSSÃO: Tem-se como objetivo, alertar os profissionais de saúde sobre a gravidade da placenta percreta e a importância do diagnóstico precoce do acretismo placentário.  Por meio de, uma anamnese detalhada afim da identificação de fatores de risco como: cesáreas anteriores, placenta prévia e multiparidade, associada a exames de imagem (ultra INTRODUÇÃO: O acretismo placentário é uma complicação gestacional, definida pela implantação anômala da placenta, que se caracteriza conforme o grau de profundidade da implantação em: placenta acreta quando as vilosidades coriônicas aderem ao miométrio até um terço de sua parede, com ausência de decídua basal, increta quando penetram profundamente o miométrio e percreta quando chegam à serosa uterina podendo invadir órgãos adjacentes.  A placenta percreta é pouco comum, mas uma causa importante de morbimortalidade materna, devido ao alto risco de complicações. DESCRIÇÃO: O seguinte relato apresenta o caso de uma gestante de 36 anos, proveniente de Porto Nacional-TO, GV PCIII NII A0 com 39 semanas, realizou 08 consultas de pré-natal e obteve diagnóstico de placenta percreta no momento do parto. DISCUSSÃO: Tem-se como objetivo, alertar os profissionais de saúde sobre a gravidade da placenta percreta e a importância do diagnóstico precoce do acretismo placentário.  Por meio de, uma anamnese detalhada afim da identificação de fatores de risco como: cesáreas anteriores, placenta prévia e multiparidade, associada a exames de imagem (ultrassom, ressonância magnética e ultrassom com doppler) que podem facilitar o diagnóstico. Descritores: Acretismo placentário, placenta percreta, complicações na gestação. ssom, ressonância magnética e ultrassom com doppler) que podem facilitar o diagnóstico. Descritores: Acretismo placentário, placenta percreta, complicações na gestação