Subpial Hemorrhage : A Distinctive Neonatal Stroke Pattern

Background and purpose: Subpial hemorrhage is a rare form of neonatal stroke, still poorly understood. The aim of this study was to characterize a cohort of term and preterm neonates with subpial hemorrhages and contribute to a better knowledge of this condition. Material and methods: Clinical records and magnetic resonance (MR) imaging data of all neonates with subpial hemorrhage followed at a pediatric hospital between 2010 and 2020 were retrospectively reviewed. Results: A total of 10 patients were included in the analysis, 40% of whom were term neonates. Operative vaginal delivery was registered in 30%. Temporal was the most common location of subpial hemorrhage (70%), and all patients displayed underlying brain infarction. A characteristic yin-yang pattern was present in 90% of the study cohort, and ingurgitation of medullary veins on susceptibility weighted imaging in 80%. Cerebellar microbleeds were observed in 60% of neonates, both term and preterm. When available, MR angiography and venography were unremarkable. Patients' clinical outcome was variable, with early prematurity not associated to worse outcomes. Conclusion: Subpial hemorrhage has a distinctive MR pattern, with underlying parenchymal venous infarction, and can occur in term and preterm neonates. This study results suggest an association between subpial hemorrhage and cerebellar microbleeds but further studies are required to confirm it and better understand the pathophysiology of subpial hemorrhage.info:eu-repo/semantics/publishedVersio

Autoimmune Hemolytic Anemia and Hodgkin's Disease: An Unusual Pediatric Association

Autoimmune hemolytic anemia (AIHA) is a recognized complication of lymphoproliferative disorders. AIHA associated with Hodgkin's disease (HD) is uncommon especially in the pediatric population. The diagnosis of AIHA is usually associated with HD at the time of initial presentation or during the course of disease, but it could precede it by years to months. In adults the association of AIHA and HD is more frequent in advanced stages and in the nodular sclerosis and mixed cellularity type HD. Warm immune hemolytic anemia is mainly controlled with steroids and chemotherapy. We report a case of a pediatric patient with direct antiglobulin positive test at the diagnosis of a late relapse of stage III B mixed cellularity type HD

Representation of hypersonic glide vehicles as fluctuating radar targets

The monostatic RCS of a generic Hypersonic Glide Vehicle (HGV) is presented at S-band and is derived using a Physical Optics (PO) based simulation approach. Target RCS histograms are then produced and used to generate a custom statistical distribution which is subsequently compared against the conventional Swerling models associated with representation of target fluctuation when using the Radar Range Equation (RRE). The accuracy of the Swerling models for this particular target type and frequency band is subsequently discussed

Psoriasis

Pretende-se nestas Recomendações Terapêuticas dar uma visão global dos conhecimentos actuais sobre a patogenia, clínica e tratamento da psoríase. A educação dos doentes deve incidir na evicção dos factores desencadeantes (medicamentos, trauma, álcool, infecções, stress) e enfa tizar a acção benéfica da exposição solar controlada na psoríase. A terapêutica tópica emolientes, queratolíticos, derivados do alcatrão, antralina, corticosteróides tópicos, calcipotriol — é essencial no controlo da psoríase vulgar em placas e é importante como adjuvante nos casos mais graves; chama-se a atenção para os graus de potência e para os potenciais efeitos indesejáveis da corticoterapia tópica. A radiação UV isolada (fototerapia) ou em associação a fotos sensibilizantes (fotoquimioterapia) está indicada nalgumas formas de psoríase (gutata, em placas, palmo-plantar) refractárias aos tópicos. A terapêutica sistémica — retinóides, metotrexato, ciclosporina está reservada para as formas mais graves, extensas e refractárias de psoríase, sendo indispensável na psoríase eritrodérmica, pustulosa ou artropática. A estratégia actual visa obter o melhor índice terapêutico e dá particular importância às terapêuticas combinadas e/ou rotativas. Para finalizar, incluem-se alguns fluxogramas, com o objectivo de ordenar os passos a dar na abordagem do doente com psorfase e salientar a validade científica das diferentes terapêuticas disponíveis

The Regulation of Axon Diameter: From Axonal Circumferential Contractility to Activity-Dependent Axon Swelling

In the adult nervous system axon caliber varies widely amongst different tracts. When considering a given axon, its diameter can further fluctuate in space and time, according to processes including the distribution of organelles and activity-dependent mechanisms. In addition, evidence is emerging supporting that in axons circumferential tension/contractility is present. Axonal diameter is generically regarded as being regulated by neurofilaments. When neurofilaments are absent or low, microtubule-dependent mechanisms can also contribute to the regulation of axon caliber. Despite this knowledge, the fine-tune mechanisms controlling diameter and circumferential tension throughout the lifetime of an axon, remain largely elusive. Recent data supports the role of the actin-spectrin-based membrane periodic skeleton and of non-muscle myosin II in the control of axon diameter. However, the cytoskeletal arrangement that underlies circumferential axonal contraction and expansion is still to be discovered. Here, we discuss in a critical viewpoint the existing knowledge on the regulation of axon diameter, with a specific focus on the possible role played by the axonal actin cytoskeleton.This work from the authors’ group was supported by Prémio Melo e Castro—Santa Casa da Misericórdia de Lisboa; by the Infrastructure for NMR, EM and X-rays for Translational Research (iNEXT); and by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the Norte Portugal Regional Operational Programme (NORTE 2020), Portugal 2020, and by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior in the framework of the project NORTE-01-0145-FEDER-028623. AC and RP-C are funded by Fundação para a Ciência e Tecnologia—FCT (fellowships SFRH/BPD/114912/2016 and SFRH/BD/112112/2015, respectively)

Twin parenting experience – reshaping the family web

Being a parent of twin siblings is a major challenge for parents and requires a family restructuring to adapt to a new family environment. OBJECTIVE. To understand the experiences of parents of twins and meanings attributed to them. METHODS: a qualitative study was conducted, having the symbolic interactionism as a theoretical referential and the interpretative interactionism as the methodological referential. Twenty-nine parents with children under 4 years participated in this study. A semi-structured interview was conducted for data collection. RESULTS. The twins family responses to parenting challenges are conditioned by the management and articulation of their di*culties, their strengths and personal resources. There is a clear choice in being a family with children that privileges negotiation and involvement of the couple in caring for the family, or, at least, part of the family, meaning the children and playing the parenting role. CONCLUSIONS. The family grows as a complex web, including its elements and interactions. The symbolic construction evidences the way the family adjusts to this environment of twin parenting. The health professionals should be able to anticipate the needs of families going through this process.info:eu-repo/semantics/publishedVersio

CISTO TRAUMÁTICO DA MANDÍBULA- RELATO DE CASO CLÍNICO

O  cisto  ósseo  traumático  é  uma  lesão  não  neoplásica  que representa aproximadamente 1% de todos os cistos maxilares, acometendo as regiões de corpo e sínfise de mandíbula com maior freqüência. Sua etiologia é desconhecida,  mas  acredita-se  que  o  trauma  local  seja  fator  relacionado  ao seu  desenvolvimento. Não  há  predileção  por  sexo  e  afeta mais  jovens  abaixo de 25 anos. O diagnóstico pode ser por radiografias de rotina que apresentam lesão radiolúcida, uniradicular, de crescimento lento, tamanho variável e limites definidos.  O  tratamento  é  cirúrgico  com  curetagem  e  punção

Effect of denture-related stomatitis fluconazole treatment on oral Candida albicans susceptibility profile and genotypic variability

Denture-related stomatitis (DRS) is the most common condition affecting removable-denture wearers, and Candida albicans the most frequent pathogenic agent. Systemic antifungal treatment is indicated but recurrences are frequent. The aim of this study was to characterize the oral load, fluconazole susceptibility profile and genotypic variability of oral C. albicans isolates from patients with DRS before (T0), immediately after fluconazole treatment (Tat) and after 6-months follow-up (T6m). Eighteen patients presenting DRS and treated with fluconazole were followed at the Faculty of Dentistry of Oporto University. Seventy C. albicans isolates were obtained and identified using standard cultural and biochemical multi-testing. Fluconazole susceptibility was tested by E-test®. Microsatellite-primed PCR was performed to assess the genotypic variability of C. albicans isolates. The patientsâ mean age was 58.0±3.2 years, and 55.6%/44.4% had total/partial dentures. Before treatment, 22.2%, 44.4% and 33.3% of the patients presented DRS type I, II or III, respectively. Fluconazole treatment healed or improved DRS in 77.8% of the patients, accompanied by an 83.5% reduction in oral C. albicans load. However, after 6-months, oral C. albicans load increased significantly and DRS severity was similar to the one observed before treatment. Moreover, the prevalence of patients presenting fluconazole resistant isolates of C. albicans increased significantly throughout the study: T0-5.6%, Tat-10.0% and T6m-42.9%. A change in the genotypic variability of C. albicans isolates was also verified, being mostly associated to fluconazole susceptibility profile change. In conclusion, fluconazole presents a good short-term DRS treatment efficiency, but may be associated to a long-term emergence of C. albicans fluconazole resistance. © Figueiral et al.; Licensee Bentham Open

Exploring geographical influences on physicochemical characteristics of honey: the Montesinho Natural Park scenario

Objectives In recent years, there has been a substantial increase in the global consumption of honey, driven by the high demand for natural products that offer health benefits. Consequently, consumers show a preference for honey, recognised for its superior quality, namely honey with a Protected Designation of Origin (PDO) or honey produced in protected areas, as it is associated with superior attributes and characteristics. Portugal is one of the leading countries in the production of PDO honey, with Montesinho Natural Park (MNP) being an excellent example of high-quality Portuguese honey, known for its distinctive attributes. However, environmental threats pose a double challenge, leading to a decline in honey production and compromising its overall quality. This study aimed to assess the specific physicochemical parameters and nutritional characteristics of MNP honey and investigate their correlation with the different locations of apiaries.Materials and Methods MNP honey samples (n=13) were obtained from local producers or purchased at supermarkets. Standard physicochemical parameters, such as 5-hydroxymethylfurfural, diastase activity, moisture and ash content, free acidity, electrical conductivity and pH, were determined according to honey legislation. Additionally, colour parameters, protein, low-molecular-weight carbohydrates (mono- and disaccharides), and mineral content were determined.Results The results obtained were consistent with the requirements outlined in the legislation and those described in the literature. The results suggest that geographical factors within the park and boundaries do not contribute to variations in the analysed parameters.Conclusions A significant level of homogeneity was evident in all parameters evaluated among the MNP honey samples. This is the first comprehensive study of the physicochemical properties of honey from various apiaries within the MNP

A Post Hoc Analysis on Rhythm and High Intensity Interval Training in Cardiac Resynchronization Therapy

Objectives. Evaluate the effects of a 6-month High Intensity Interval Training (HIIT) program on (1) functional capacity and health-related quality of life, (2) multiple blood biomarkers, (3) echocardiographic parameters, and (4) exercise performance, in patients in cardiac resynchronization therapy (CRT) stratified by the presence of atrial fibrillation (AF), targeting the following questions: (1) Does CRT provide similar benefits in patients in AF and sinus rhythm (SR)?; and (2) Does HIIT provides similar benefits in patients in AF and SR? Design. Estimates were available at baseline and 6 months after CRT implantation in 37 patients with heart failure. Patients were randomized after CRT to a 24-week HIIT group or to a usual care group (CON). In this sub-analysis, HIIT (AF = 7; SR = 11) and CON (AF = 9; SR = 10) were stratified by the presence of AF. Results. Patients in AF benefitted to a lesser degree from CRT in functional status than patients in SR (23.8-46.0%). However, HIIT induced superior improvements in patients in AF compared to CON (23.9-61.0%). Decreases in TNF-α (8.5-42.9%), BNP (15.3-34.6%) and left ventricular mass (9.6-26.2%) were only observed in patients in SR, whereas increases in peak oxygen uptake were only observed in patients in AF (19.5-23.2%). HIIT improved exercise capacity (8.8-59.4%) in patients in SR. Conclusions. Patients in AF or SR undergoing CRT demonstrated distinct benefits from device implantation and from HIIT as an adjunctive therapeutic strategy. This suggests that both mainstay and adjunctive therapeutics may need to be managed differently in patients in AF and SR.info:eu-repo/semantics/publishedVersio