Case Report: Patient with Deficiency of ADA2 Presenting Leukocytoclastic Vasculitis and Pericarditis during Infliximab Treatment

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Past and future blurring at fundamental length scale

We obtain the $\kappa$-deformed versions of the retarded and advanced Green functions and show that their causality properties are blurred in a time interval of the order of a length parameter $q=1/(2\kappa)$. The functions also indicate a smearing of the light cone. These results favor the interpretation of $q$ as a fundamental length scale below which the concept of a point in spacetime should be substituted by the concept of a fuzzy region of radius $q$, as proposed long ago by Heisenberg.Comment: Essentially, this is the version published in the Phys. Rev. Lett. 105, 211601 (2010). It has 4 pages and contains 2 figure

ATRÉSIA ESOFÁGICA: 10 ANOS DE EXPERIÊNCIA DE UM SERVIÇO DE CUIDADOS INTENSIVOS PEDIÁTRICOS

Background/Purpose: Oesophageal atresia (OA) is a congenital malformation with a variable prognosis. The aims were to establish OA’s incidence in the central region, to characterize infants with OA admitted and to compare its clinical outcome after surgical repair, according to OA classification. Methods: A retrospective review of infants with OA admitted to a PICU, after surgical repair, between 2002 and 2011. Patient characteristics, OA’s classification, surgery, morbidity and mortality were analyzed. Two groups were compared according to OA classification. Results: Thirty-four infants were admitted, out of which 65% were male, with a median gestational age of 36 weeks and birth weight of 2310g. Nineteen of them presented other malformations, mainly cardiac. Nine cases were classified as long-gap OA. Fistula ligation and primary oesophageal anastomosis was the most common surgical option (n=27). Early complications occurred in 13 infants (38%), mostly anastomotic leak, and were similar according to gap length (p=0.704). PICU stay and mechanical ventilation were longer in long-gap OA patients (p=0.009 and p<0.001 respectively) and in infants with other malformations (p=0.027 and p=0.003 respectively). There was no mortality. Conclusions: The frequency of OA associated malformations implies a systematic screening of these patients. Gap length and presence of associated malformations were the major determinants of length of intensive care stay and ventilation days in OA patients

Impacto do Diâmetro do Nervo Óptico na Amplitude de Pulso Ocular no Glaucoma Primário de Ângulo Aberto

Introdução: A pressão intra-craniana (PIC) tem sido descrita como estando envolvida no glaucoma primário de ângulo aberto (GPAA). A sua avaliação está contudo limitada pela necessidade de métodos invasivos, como a punção lombar. A ecografia ocular permite uma avaliação indirecta da PIC através da medição do diâmetro da bainha do nervo óptico (NO). Desconhece-se se esta nova variável tem capacidade de modular factores de risco normalmente investigados em doentes com GPAA. Objectivo: Avaliar o impacto do diâmetro da bainha do NO na pressão intra-ocular (PIO) e na amplitude de pulso ocular (OPA) de doentes com GPAA. Métodos: Quinze doentes com GPAA foram submetidos a medição da PIO por tonometria de contorno dinâmico, avaliação topográfica do disco óptico e ecografia ocular modo B com sonda doppler. Apenas o olho com maior dano glaucomatoso foi seleccionado por doente. Resultados: A média do diâmetro da bainha do NO foi de 5,6±0,67mm, a PIO média de 17,8±2,2mmHg e a OPA de 3,1±1,7mmHg. O diâmetro da bainha do NO correlacionou-se negativamente a OPA (r=-0.54, p=0.05), não tendo influenciado a PIO (r=-0,25, p=0,41). Da avaliação hemodinâmica, apenas o índice de resistência da artéria central da retina (CRA) foi influenciado pelo diâmetro da bainha do NO (r=-0.52, p=0.04). Conclusão: O diâmetro da bainha do NO correlaciona-se negativamente com a OPA. Este efeito poderá ser explicado pela alteração da resistência vascular da artéria que atravessa este espaço subaracnoideu, a CRA. O estudo da região retrobulbar e do balanço entre as pressões aí exercidas é assim um campo cuja importância será crescente na avaliação do doente com GPAA

Ocular Pulse Amplitude and Doppler Waveform Analysis in Glaucoma Patients

PURPOSE: To determine the correlation between ocular blood flow velocities and ocular pulse amplitude (OPA) in glaucoma patients using colour Doppler imaging (CDI) waveform analysis. METHOD: A prospective, observer-masked, case-control study was performed. OPA and blood flow variables from central retinal artery and vein (CRA, CRV), nasal and temporal short posterior ciliary arteries (NPCA, TPCA) and ophthalmic artery (OA) were obtained through dynamic contour tonometry and CDI, respectively. Univariate and multiple regression analyses were performed to explore the correlations between OPA and retrobulbar CDI waveform and systemic cardiovascular parameters (blood pressure, blood pressure amplitude, mean ocular perfusion pressure and peripheral pulse). RESULTS: One hundred and ninety-two patients were included [healthy controls: 55; primary open-angle glaucoma (POAG): 74; normal-tension glaucoma (NTG): 63]. OPA was statistically different between groups (Healthy: 3.17 ± 1.2 mmHg; NTG: 2.58 ± 1.2 mmHg; POAG: 2.60 ± 1.1 mmHg; p < 0.01), but not between the glaucoma groups (p = 0.60). Multiple regression models to explain OPA variance were made for each cohort (healthy: p < 0.001, r = 0.605; NTG: p = 0.003, r = 0.372; POAG: p < 0.001, r = 0.412). OPA was independently associated with retrobulbar CDI parameters in the healthy subjects and POAG patients (healthy CRV resistance index: β = 3.37, CI: 0.16-6.59; healthy NPCA mean systolic/diastolic velocity ratio: β = 1.34, CI: 0.52-2.15; POAG TPCA mean systolic velocity: β = 0.14, CI 0.05-0.23). OPA in the NTG group was associated with diastolic blood pressure and pulse rate (β = -0.04, CI: -0.06 to -0.01; β = -0.04, CI: -0.06 to -0.001, respectively). CONCLUSIONS: Vascular-related models provide a better explanation to OPA variance in healthy individuals than in glaucoma patients. The variables that influence OPA seem to be different in healthy, POAG and NTG patients

A model of the reflection distribution in the vacuum ultra violet region

A reflection model with three components, a specular spike, a specular lobe and a diffuse lobe is discussed. This model was successfully applied to describe reflection of xenon scintillation light (175 nm) by PTFE and other fluoropolymers and can be used for Monte Carlo simulation and analysis of scintillation detectors. The measured data favors a Trowbridge-Reitz distribution function of ellipsoidal micro-surfaces. The intensity of the coherent reflection increases with increasing angle of incidence, as expected, since the surface appears smoother at grazing angles. The total reflectance obtained for PTFE is about 70% for VUV light at normal incidence in vacuum and estimated to be up to 100% in contact with liquid xenon

Lack of Spontaneous Venous Pulsation: Possible Risk Indicator in Normal Tension Glaucoma?

PURPOSE: Recently, the absence of spontaneous venous pulsation (SVP) has been suggested as a vascular risk factor for primary open-angle glaucoma (POAG). As the mechanism behind this phenomenon is still unknown, the authors have studied this vascular component using colour Doppler imaging (CDI). METHODS: A total of 236 patients were divided into three diagnostic groups: healthy controls (81), POAG (86) and normal tension glaucoma (NTG; 69). All subjects were submitted to CDI studies of the retrobulbar circulation, intraocular pressure measurements and assessment of SVP existence. Mann-Whitney, chi-square contingency tables and Spearman correlations were used to explore differences and correlations between variables in the diagnostic groups. RESULTS: Eighty-two percent of healthy controls had SVP (66/81), while a smaller numbers were registered in both glaucoma groups: POAG - 50% (43/86); NTG - 51% (35/69). In NTG patients, but not in POAG patients, the prevalence of the SVP phenomenon decreases with increased glaucoma damage (p = 0.04; p = 0.55, respectively). Overall glaucoma patients from both groups had lower central retinal vein (CRV) velocities than the healthy controls (p < 0.05). NTG patients with SVP had less severe visual field defects (mean defect -6.92 versus -11.1, p < 0.05), higher [correction added after online publication 21 September 2012; the word 'higher' has been inserted to replace the word 'lower'] peak systolic and mean flow velocities in the central retinal artery (p < 0.01; p < 0.05, respectively) as well as higher [correction added after online publication 21 September 2012; the word higher has been inserted to replace the word lower] maximal velocities and RI of the CRV (p < 0.02; p < 0.05, respectively). CONCLUSIONS: Glaucoma patients have a decrease in CRV velocities. SVP is less prevalent in glaucoma patients than in healthy individuals. This phenomenon apparently reflects different hemodynamic patterns in the central retinal vessels. This variable may be of particular importance in NTG patients, where it may be associated with more advanced functional damage

Testes de conforto térmico aplicados a uma malha multifuncional desenvolvida com novos materiais

Os produtores europeus, os engenheiros têxteis e os designers devem, no desenvolvimento de novas peças de vestuário, terem em consideração as novas exigências dos consumidores em relação ao conforto. Uma grande variedade de áreas de investigação foram, nos últimos tempos, criadas e desenvolvidas permitindo atingir as exigências relacionadas com o conforto, nomeadamente, considerando os aspectos funcionais e estéticos, entre outros. O conforto térmico humano é, de certa forma, um dos componentes mais importantes a considerar, podendo ser definido como a principal troca de calor e massa e calor do corpo humano com o meio ambiente, através da roupa. Um dos objectivos deste trabalho foi, através do trabalho de uma equipa multidisciplinar, desenvolver uma malha funcional de forma a permitir o conforto termo-fisiológico a quem a utilizar. O presente trabalho permite assim investigar as várias etapas relacionadas com o estudo do conforto no desenvolvimento de novas peças de vestuário: o desenvolvimento de novas malhas, a execução de testes num manequim térmico; a simulação numérica do corpo humano com e sem roupa e o desenvolvimento de testes subjectivos de conforto térmico. A nova malha produzida foi caracterizada e testada em laboratório, em termos de quantidade de vapor de água e da permeabilidade ao ar e outros parâmetros físicos. A malha produzida foi aplicada como forro de botas de caminhada e para o fabrico de t-shirts. Os protótipos das botas de caminhada foram avaliados de forma subjectiva através de questionários. Um manequim térmico foi utilizado para medir o isolamento térmico das t-shirts e a distribuição de temperatura na pele. Juntamente com este trabalho experimental, um modelo de termo regulação do corpo humano foi desenvolvido para validar os dados experimentais obtidos. Alguns dos resultados são apresentados e discutidos

Ophthalmic Artery Doppler Waveform Changes Associated with Increased Damage in Glaucoma Patients

PURPOSE: To characterize Doppler waveform variables (early systolic acceleration [ESA] and systolic/diastolic mean velocity ratios [Sm/Dm]) of the Ophthalmic Artery (OA) by color Doppler imaging (CDI) in eyes with primary open-angle glaucoma (POAG). METHODS: Analysis of CDI examinations of the retrobulbar circulation of patients with POAG (n = 102), normal tension glaucoma (NTG, n = 89), and healthy controls (n = 59) by a condition-masked investigator. One-way ANOVA, chi-square, and Spearman's rank correlation tests were used to determine differences, establish comparisons, and to explore associations between variables, respectively. RESULTS: The overall Doppler waveform presented a shift to the right in the glaucoma groups, with significantly lower Sm/Dm ratios when compared to the control group (healthy: 2.94 ± 0.86, POAG: 2.60 ± 0.67, NTG: 2.63 ± 0.84; P = 0.01). ESA was significantly lower in the glaucoma groups (healthy: 688.8 ± 484 cm·s(-2), POAG: 548.1 ± 419 cm·s(-2), NTG: 548.5 ± 337 cm·s(-2); P = 0.03). No statistical differences were, however, detected in the OA velocities or resistance index (P ranged between 0.08 and 0.96). In the glaucoma groups, waveform parameters such as ESA, acceleration time, and systolic mean velocities correlated with systemic blood pressure variables (P < 0.05). In these groups, negative correlations were detected between Sm/Dm ratios and the degree of visual field defects (POAG: P = 0.01; r = -0.25) and retinal nerve fiber layer thickness (NTG: P = 0.02; r = -0.25). CONCLUSIONS: The pattern of blood flow velocities in the OA throughout the cardiac cycle seems to be altered in glaucoma patients. Further studies on how systemic blood pressure affects waveform variables in glaucoma patients may provide a better understanding of an underlying vascular dysfunction