Imperforate hymen: the importance of early diagnosis

The imperforate hymen is one of the most common obstructive lesions of the female genital system, with a prevalence from 1: 1000 to 1: 10000. Anomalies of the hymen are due to incomplete degeneration of the hymen central portion. It can be diagnosed at physical examination from birth and treated surgically. The most common clinical presentation is cyclic pelvic abdominal pain, urinary retention and hematocolpos. 12-year-old girl, premenarche who appealed to the Emergency department with abdominal pain and bilateral lumbar irradiation, over 2 weeks of evolution. Physical examination showed abdominal tumefaction in the hypogastric region, painful to palpation and under tension. Gynecological examination revealed an imperforate hymen, protruding from the introitus. Rectal ultrasonography performed at the emergency room showed vaginal distension with a hypoechoic content of 16 cm, larger diameter. Surgical hymenectomy was performed as treatment. On the 58th postoperative day, the patient was asymptomatic.The authors present a clinical case of imperforate hymen diagnosed at menarche, an anomaly diagnosed increasingly early due to the earlier physical examination that involves observation of the external genitalia of the new-born and the pre-pubertal child

Contribuição para o conhecimento hidrogeológico da freguesia de Creixomil no concelho de Barcelos

A água subterrânea é o mais importante recurso natural que existe no planeta Terra, porque dela depende o ser humano desde o consumo mais básico, na satisfação das suas necessidades físicas, ao fornecimento de sectores como o agrícola ou o industrial, que sustentam os pilares sócio-económicos dos dias de hoje. Esta realidade implica então uma necessidade de gerir adequadamente os recursos hídricos subterrâneos, que, apesar de existirem em quantidade suficiente para alimentar as necessidades actuais e futuras, encontram-se muitas vezes em meios de difícil exploração ou de captação intermitente e insuficiente face à resposta necessária para a problemática da água. Surge assim a hidrogeologia, que com um conjunto vasto de ferramentas ao seu dispor, permite caracterizar de forma bastante acurada, as etapas e processos associados à circulação das águas subterrâneas, ao armazenamento e à qualidade da mesma. O estudo hidrogeológico realizado na freguesia de Creixomil assume então uma importância vital não só na caracterização dos meios hídricos subterrâneos disponíveis mas também no upgrade do conhecimento por parte da população quanto às potenciais aplicações destas, e na consciencialização da problemática da qualidade das águas subterrâneas. Esta tese surge neste contexto como instrumento a ser utilizado no futuro quanto a novas captações, quanto a possíveis investimentos em fins e utilizações distintas às actuais e acima de tudo como fonte de informação da actualidade dos recursos hídricos existentes, do seu estado e da necessidade de gerir e proteger as águas subterrâneas. Assim, no Capítulo 1, Introdução, apresentam-se o enquadramento do tema, o objectivo e a metodologia da dissertação. No capítulo 2, Aspectos Básicos sobres Águas Subterrâneas, apresentam-se alguns conceitos fundamentais e outros elementos importantes para servirem de base ao desenvolvimento do presente trabalho. No capítulo 3, Águas Subterrâneas em Portugal, apresenta-se uma breve resenha dos principais sistemas aquíferos do País. De seguida, no Capítulo 4, O Estudo de Caso da Freguesia de Creixomil no Concelho de Barcelos, dedica-se com algum detalhe à caracterização da região, nomeadamente nos aspectos físicos, geomorfológicos, geológicos, e em especial hidrogeológicos. Por fim, no último capítulo, Conclusões, sintetizam-se aqueles aspectos considerandos mais relevantes em termos conclusivos, propondo-se alguns caminhos a seguir em trabalhos futuros.Groundwater is the most important natural resource on planet Earth, as human beings depend on it for their most basic necessities. It is also vital for sectors such as the agriculture and industry, which are the social-economical foundations of today. As such, there is a need to manage groundwater resources properly. Although they exist in sufficient quantity to meet current and future needs, they are often located in places where extraction is difficult or collection is intermittent and insufficient to meet the demand for water. The solution to this problem is hydrogeology, which possesses a vast array of tools and enables us to characterize rather accurately the stages and processes associated with the circulation, storing and quality of groundwater. The hydrogeology review conducted in the parish council of Creixomil is extremely important for characterizing available groundwater resources and for helping the population to know how to use them, as well as for raising awareness in relation to the problem of groundwater quality. This thesis seeks to be an instrument to be used in the future regarding new extractions, possible investments in different purposes and uses than the ones that already exist today, and most of all as a source of information on available groundwater resources, including their condition and the need to manage and protect groundwater. Chapter 1, Introduction, presents the framework, purpose and methodology for the dissertation. Chapter 2, Basic Features on Groundwater, presents some fundamental concepts and other important elements on which this work is based. Chapter 3, Groundwater in Portugal, presents a short summary of the main aquifer systems in the Country. Chapter 4, Case-study of the Parish Council of Creixomil, Council of Barcelos, details the characterization of the region, namely in physical, geomorphologic, geological and particularly hydrogeological terms. The final chapter, Conclusions, summarizes the features considered to be the most important and proposes some paths to be followed in future works

Utilização de uma dieta microalgal, de um efluente piscícola e de dois subprodutos da indústria alimentar na cultura de juvenis de Tapes decussatus (L.)

Dissertação de Mestrado em Ecologia Aplicada apresentada à Faculdade de Ciências da Universidade do Port

RECURRENT INTESTINAL OCCLUSION / SUB-OCCLUSION IN THE NEONATAL PERIOD: INTESTINAL DYSPLASIA OR IMATURITY?

Introdução: As alterações da motilidade intestinal podem ser devidas a causas primárias ou secundárias, sendo a manifestação clínica mais grave a pseudo-obstrução intestinal. No entanto, no período neonatal estas podem dever-se a anomalias da inervação intestinal, e/ou graus variáveis de imaturidade das células ganglionares. Caso Clínico: Uma bebé prematura de 26 semanas de gestação apresentou, ao 43º dia de vida, quadro clínico compatível com enterocolite necrosante tipo IIA, que não foi confirmado. Nos meses seguintes apresenta quadros intestinais sub-oclusivos e oclusivos sucessivos culminando em ileostomia. O exame anatomo-patológico revelou alguns plexos submucosos (com aumento do número de células ganglionares) e mioentéricos, e alguns gânglios maiores do que o habitual. A evolução clínica posterior foi favorável, com boa progressão estaturo-ponderal necessitando contudo, transitoriamente, de suporte nutricional artificial; a reconstituição do trânsito intestinal ocorreu aos 21 meses. Discussão/Conclusões: Os autores apresentam este caso pelo prognóstico favorável desta entidade clínica, displasia neuronal intestinal, que está associada ao crescimento e maturação intestinal com a idade. Palavras-chave: displasia neuronal intestinal; oclusão intestinal; prematuridad

Effect of short chain fructooligosaccharides (scFOS) on immunological status and gut microbiota of gilthead sea bream (Sparus aurata) reared at two temperatures

The effects of dietary short chain fructooligosaccharides (scFOS) incorporation on hematology, fish immune status, gut microbiota composition, digestive enzymes activities, and gut morphology, was evaluated in gilthead sea bream (Sparus aurata) juveniles reared at 18 °C and 25 °C. For that purpose, fish with 32 g were fed diets including 0, 0.1, 0.25 and 0.5% scFOS during 8 weeks. Overall, scFOS had only minor effects on gilthead sea bream immune status. Lymphocytes decreased in fish fed the 0.1% scFOS diet. Fish fed the 0.5% scFOS diet presented increased nitric oxide (NO) production, while total immunoglobulins (Ig) dropped in those fish, but only in the ones reared at 25 °C. Red blood cells, hemoglobin, bactericidal activity and NO were higher at 25 °C, whereas total white blood cells, circulating thrombocytes, monocytes and neutrophils were higher at 18 °C. In fish fed scFOS, lymphocytes were higher at 18 °C. Total Ig were also higher at 18 °C but only in fish fed 0.1% and 0.5% scFOS diets. No differences in gut bacterial profiles were detected by PCR-DGGE (polymerase chain reaction denaturing gradient gel electrophoresis) between dietary treatments. However, group's similarity was higher at 25 °C. Digestive enzymes activities were higher at 25 °C but were unaffected by prebiotics incorporation. Gut morphology was also unaffected by dietary prebiotic incorporation. Overall, gut microbiota composition, digestive enzymes activities and immunity parameters were affected by rearing temperature whereas dietary scFOS incorporation had only minor effects on these parameters. In conclusion, at the tested levels scFOS does not seem worthy of including it in gilthead sea bream juveniles diets.This research was partially supported by the European Regional Development Fund (ERDF) through the COMPETE - Operational Competitiveness Programme and national funds through FCT Foundation for Science and Technology, under the projects "PEst-C/MAR/LA0015/2013 and UID/Multi/04423/2013". I. Guerreiro, P. Enes, A. Couto and B. Costas were supported by grants (SFRH/BD/76139/2011; BPD/39688/2007, BD/47495/2008 and BPD/77210/2011, respectively) from FCT, Portugal. C. Serra and A. Salvador were recipient of grants within the Project AQUAIMPROV (reference NORTE-07-0124-FEDER-000038) and Project BioEnv (REF. NORTE-07-0124-FEDER-000048), co-financed by the North Portugal Regional Operational Programme (ON.2 - O Novo Norte). We would like to express our thanks to Pedro Correia for the assistance during the growth trial. Authors would also thank to Jefo Species-specific additives France, for providing the prebiotic

Isolation of Chitinolytic Bacteria from European Sea Bass Gut Microbiota Fed Diets with Distinct Insect Meals

SIMPLE SUMMARY: The ever-growing human population is increasingly demanding more fish. As a response, aquaculture has become the fastest growing industry in its sector. Alternatives to fish meal, an unsustainable commodity used as the main protein source for carnivorous species, are urgently needed in aquafeeds. Recently, in Europe, seven insect species have been approved as potential ingredients for animal feeds, including fish feed. However, chitin, one of the components of an insect’s exoskeleton, is indigestible for several economically valuable fish species, decreasing fish performance upon inclusion. This work aimed to isolate, from the European sea bass gastrointestinal tract, probiotic bacteria capable of producing chitinases to improve the use of diets containing high levels of insect meal. Based on the enhanced adaptability of gut microbial communities and the selective pressure of chitin-enriched diets on fish gut microbiota, bacteria were first isolated from the gastrointestinal tract of European sea bass fed chitin-enriched diets. Isolates were then comprehensively screened in vitro for important traits such as their ability to utilize chitin, gut-survival aptitude, and biosafety-related issues required to be considered eligible as probiotics by the European Food Safety Authority (EFSA). ABSTRACT: Insect meal (IM), recently authorized for use in aquafeeds, positions itself as a promising commodity for aquafeed inclusion. However, insects are also rich in chitin, a structural polysaccharide present in the exoskeleton, which is not digested by fish, resulting in lower fish performance. Through the application of a dietary pressure, this study aimed to modulate European sea bass gut microbiota towards the enrichment of chitinolytic bacteria to allow the isolation of novel probiotics capable of improving the use of IM-containing diets, overcoming chitin drawbacks. Five isoproteic (44%) and isolipidic (18%) diets were used: a fish meal (FM)-based diet (diet CTR), a chitin-supplemented diet (diet CHIT5), and three diets with either 25% of Hermetia illucens and Tenebrio molitor larvae meals (HM25 and TM25, respectively) or H. illucens exuviae meal (diet HEM25) as partial FM substitutes. After an 8-week feeding trial, the results showed a clear modulatory effect towards spore-forming bacteria by HM25 and HEM25 diets, with the latter being responsible for the majority of the chitinolytic fish isolates (FIs) obtained. Sequential evaluation of the FI hemolytic activity, antibiotic resistance, total chitinolytic activity, sporulation, and survival in gastrointestinal-like conditions identified FI645 and FI658 as the most promising chitinolytic probiotics for in vivo application

Fluoroless catheter ablation of atrial fibrillation: integration of intracardiac echocardiography and cartosound module

Objective: To evaluate the feasibility, safety, and clinical efficacy of non-fluoroscopic radiofrequency catheter ablation of atrial fibrillation (AF) in comparison to traditional fluoroscopy-guided ablation in a local Canadian community cohort. Methods: We retrospectively studied consecutive patients with paroxysmal and persistent AF undergoing pulmonary vein isolation (PVI) guided by intracardiac echocardiography (ICE) and Carto system (CartoSound module). ICE-guided PVI without fluoroscopy (Zero-fluoro group) was performed in 116 patients, and conventional fluoroscopy-guided PVI (Traditional group) was performed in 131 patients. Results: Two hundred and forty-seven patients with AF (60.7% male; mean age: 62.2 ± 10.6 years; paroxysmal AF =63.1%) who underwent PVI were studied. Mean procedure times were similar between both groups (136.8±33.4 minutes in the zero-fluoro group vs. 144.3±44.9 minutes in the traditional group; p=0.2). Acute PVI was achieved in all patients. Survival from early AF recurrence was 85% and 81% in the zero-fluoro and traditional groups, respectively (p = 0.06). Survival from late AF recurrence (12-months) between the zero-fluoro and traditional groups was also similar (p=0.1). Moreover, there were no significant differences between complication rates, including hematoma (p = 0.2) and tamponade (p = 1),between both groups. Conclusions: Zero-fluoroscopy ICE and CartoSound-guided AF ablation may be safe and feasible in patients undergoing PVI compared to conventional fluoroscopy-guided ablation

Digestive enzyme activity and nutrient digestibility in meagre (Argyrosomus regius) fed increasing levels of black soldier fly meal (Hermetia illucens)

The effect of partially replacing fishmeal (FM) by black soldier fly larvae meal (Hermetia meal--HM) in meagre (Argyrosomus regius) diet was evaluated for nutrient digestibility and digestive enzyme activity. For that purpose, triplicate groups of fish (18.0 ± 0.02 g) were fed during 48 days either a control diet (CTR), without HM, or one of three diets including 100, 200 and 300 g/kg of HM, replacing 17, 35 and 52% of FM, respectively. Apparent digestibility coefficients (ADCs) of dry matter, energy, protein, lysine, isoleucine, leucine, phenylalanine, alanine, glutamate, glycine and serine presented a decreasing response with increased HM inclusion. Chitin ADC was null, independent of dietary HM inclusion. Total alkaline protease activity increased while trypsin activity decreased with dietary HM inclusion. No intestinal chitinolytic activity was detected. Intestinal alkaline protease zymogram revealed nine bands with proteolytic activity against casein, with molecular weights ranging between 15 and 75 kDa. Anti-protease activity in the intestine was not affected by dietary inclusion of HM compared to the CTR diet. Overall, it is concluded that replacement of up to 17% FM with HM (100 g/kg HM inclusion level) in meagre diets has no major adverse effects in diet digestibility and digestive enzyme activity