Uma Forma Rara de Balanite

Syphilis is an old disease and a major public health concern, which is re-emerging in the western world. Atypical syphi- litic presentations can be challenging to diagnose. We present a 23-year-old, HIV-positive man who has sex with men who presented with a 2-week history of an asymptomatic lesion on the glans. Previous topical and systemic treatments proved unsuccessful. Physical examination demonstrated a slightly indurated, ill-defined erythematous plaque over most of the glans. Enlarged, non-tender, bilateral inguinal lymph nodes were palpable. Serological tests revealed a fourfold increase in the VDRL titre (1:8, previously 1:2). A diagnosis of syphilitic balanitis of Follmann was made and complete resolution was achieved with an intramuscular single dose of benzathine penicillin 2.4 MU. Syphilitic balanitis of Follmann represents an uncommon manifestation of primary syphilis, with less than 100 cases reported. Untrea- ted, it will resolve spontaneously, but the patient will remain highly infectious and at-risk for long-term morbidity. In an era in which the number of syphilis cases is increasing sharply both in Western Europe and the United States, all physicians should be aware for the typical and atypical early syphilitic manifestations as they represent opportunities of paramount importance for treatment and epide- mic control.Apesar de ser uma doença antiga, a Sífilis continua uma preocupação muito atual em Saúde Pública e o seu número de casos continua a aumentar. As apresentações atípicas desta infeção podem ser verdadeiros desafios diagnósticos.Relatamos o caso de um homem VIH-positivo de 23 anos de idade, HSH, observadio por uma lesão assintomática na glande com duas semanas de evolução. Vários tratamentos tópicos e sistémicos foram tentados previamente, sem benefício. O exame objetivo demonstrou uma placa eritematosa, mal delimitada, endurecida, de superfície lisa que ocupava a maior parte da glande. Adenome- gálias indolores bilaterais eram palpáveis. Os testes serológicos demonstraram uma subida de 4x o título do VDRL (1:8, previamente 1:2). Foi realizado o diagnóstico de balanite sifilítica de Follmann. A resolução completa da lesão foi conseguida com uma dose única intramuscular de penicilina benzatínica de 2,4 M.U. A balanite sifilítica de Follmann é uma manifestação pouco comum de sífilis primária, havendo menos de 100 casos relatados. Ape- sar das lesões clínicas evoluírem para a resolução espontânea mesmo sem tratamento adequado, o doente permanecerá altamente infecioso e em risco de morbilidade futura. Numa era em que o número de casos de sífilis têm aumentado rapidamente na Europa Ocidental e Estados Unidos, recomenda-se que se conheçam as manifestações clássicas e atípicas de sífilis precoce, já que estas representam oportunidades únicas para tratamento e prevenção de transmissão futura de doença pelo individuo infetado

Machado de Castro nos jardins de Belém

in Varia, Revista do IHA, N.4 (2007), pp.370-37

Exemplos de decorum: De rerum natura nos jardins barrocos portugueses

Revista do IHA, N.3 (2007), pp.152-181Este artigo toma como ponto de partida a abordagem de Gombrich ao princípio de decorum. O que os tratados sobre a arte dos jardins disseram sobre o assunto e como ele foi aplicado nos jardins portugueses barrocos foram os principais objectivos desta investigação. Analisando fontes literárias e gráficas das representações divinas relacionadas com a natureza, como Vénus, Diana, Ceres, Flora, Pomona, Pan e Neptuno, ou personificações, como Rios e Estações localizados em jardins de palácios e quintas dos séculos XVII e XVIII em Portugal, concluímos pela liberdade dos artistas ao trabalharem sobre as fontes da Antiguidade e as mitografias

Extractability and mobility of mercury from agricultural soils surrounding industrial and mining contaminated areas

This study focussed on a comparison of the extractability of mercury in soils with two different contamination sources (a chlor-alkali plant and mining activities) and on the evaluation of the influence of specific soil properties on the behaviour of the contaminant. The method applied here did not target the identification of individual species, but instead provided information concerning the mobility of mercury species in soil. Mercury fractions were classified as mobile, semi-mobile and non-mobile. The fractionation study revealed that in all samples mercury was mainly present in the semi-mobile phase (between 63 and 97%). The highest mercury mobility (2.7 mg kg-1) was found in soils from the industrial area. Mining soils exhibited higher percentage of non-mobile mercury, up to 35%, due to their elevated sulfur content. Results of factor analysis indicate that the presence of mercury in the mobile phase could be related to manganese and aluminum soil contents. A positive relation between mercury in the semi-mobile fraction and the aluminium content was also observed. By contrary, organic matter and sulfur contents contributed to mercury retention in the soil matrix reducing the mobility of the metal. Despite known limitations of sequential extraction procedures, the methodology applied in this study for the fractionation of mercury in contaminated soil samples provided relevant information on mercury's relative mobility

Definition of MV Load Diagrams via Weighted Evidence Accumulation Clustering using Subsampling

A definition of medium voltage (MV) load diagrams was made, based on the data base knowledge discovery process. Clustering techniques were used as support for the agents of the electric power retail markets to obtain specific knowledge of their customers’ consumption habits. Each customer class resulting from the clustering operation is represented by its load diagram. The Two-step clustering algorithm and the WEACS approach based on evidence accumulation (EAC) were applied to an electricity consumption data from a utility client’s database in order to form the customer’s classes and to find a set of representative consumption patterns. The WEACS approach is a clustering ensemble combination approach that uses subsampling and that weights differently the partitions in the co-association matrix. As a complementary step to the WEACS approach, all the final data partitions produced by the different variations of the method are combined and the Ward Link algorithm is used to obtain the final data partition. Experiment results showed that WEACS approach led to better accuracy than many other clustering approaches. In this paper the WEACS approach separates better the customer’s population than Two-step clustering algorithm

Determination of electricity consumers’ load profiles via weighted evidence accumulation clustering using subsampling

With the electricity market liberalization, the distribution and retail companies are looking for better market strategies based on adequate information upon the consumption patterns of its electricity consumers. A fair insight on the consumers’ behavior will permit the definition of specific contract aspects based on the different consumption patterns. In order to form the different consumers’ classes, and find a set of representative consumption patterns we use electricity consumption data from a utility client’s database and two approaches: Two-step clustering algorithm and the WEACS approach based on evidence accumulation (EAC) for combining partitions in a clustering ensemble. While EAC uses a voting mechanism to produce a co-association matrix based on the pairwise associations obtained from N partitions and where each partition has equal weight in the combination process, the WEACS approach uses subsampling and weights differently the partitions. As a complementary step to the WEACS approach, we combine the partitions obtained in the WEACS approach with the ALL clustering ensemble construction method and we use the Ward Link algorithm to obtain the final data partition. The characterization of the obtained consumers’ clusters was performed using the C5.0 classification algorithm. Experiment results showed that the WEACS approach leads to better results than many other clustering approaches

Aspectos clínicos da hemorragia digestiva baixa em pacientes idosos internados no Hospital Universitário.

Trabalho de Conclusão de Curso - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Clínica Médica, Curso de Medicina, Florianópolis, 200

Mediation of Self-Compassion on Pathways from Stress and Anxiety to Depression among Portuguese Higher Education Students

Higher education is a context that requires students to develop academic, social and institutional tasks. As a result of this complex and multidimensional process, students tend to experience greater stress, anxiety and depression, making it crucial for students to mobilize a set of essential personal, social and instrumental resources, for a more positive adaptation to the academic context. Self-compassion is an adaptative emotion-regulation strategy and may help students to better adjust to academic issues. The purpose of this study was to investigate the role of self-compassion as a mediator in the relationship between anxiety and depression, as well as stress and depression. Methods: A cross-sectional study was conducted using an online questionnaire distributed through social media. Stress and anxiety were found to be positively related to depression scores and negatively related to self-compassion. A bootstrapped mediation model confirmed the existence of a significant positive partial mediation effect exerted by self-compassion on the relationship between stress and depression (b = 0.12, 95% CI [0.05, 0.18]). The analysis also showed a significant positive partial mediation effect exerted by self-compassion in the relationship between anxiety and depression (b = 0.13, 95% CI [0.08, 0.18]). Conclusions: Self-compassion might partially mediate the relationship between stress and depression and between anxiety and depression. Findings underscore self-compassion as a potentially protective factor against negative psychological symptoms.info:eu-repo/semantics/publishedVersio