Majocchi’s Granuloma by Trichophytum rubrum in a kidney transplant patient - A case report

Introduction: Trichophytum rubrum is a filamentous fungus, with worldwide distribution, that usually causes superficial infections of skin and nails, namely tinea pedis, tinea corporis, tinea cruris and onychomycosis. Rarely, severe dermatophytosis can occur, presenting as deep dermatophytosis, Majocchi’s Granuloma or extensive dermatophytosis. Objectives and Methods: Case report of Majocchi’s Granuloma in a kidney transplant patient. Results: A case of a 55-year-old woman who underwent a kidney transplant 7 months before, under immunosuppressive therapy with tacrolimus and mycophenolate mofetil. She attended a Dermatology consultation to clarify skin lesions that appeared 6 months earlier. The skin exam revealed hard and painful plaque lesions on both legs, with an ulcer on the left leg lesion, violaceous papular lesions on the dorsum of the left foot and toes and a hard consistency nodule on the left leg. Some of the toe nails presented dystrophy or onycholysis. The patient denied any previous trauma or contact with plants or soil. Biopsies of lesions of the left leg and foot dorsum where sent for histology and mycological culture and toe nails for mycological culture. The histological examinations showed, in the reticular dermis and reaching the hypodermis, suppurative granulomas with multinucleated giant cells and areas of necrosis. PAS (Periodic Acid- Schiff) and GMS (Grocott’s Methenamine Silver) staining revealed multiple spores and septate hypha within the granulomas but not in the stratum corneum. No remnants of hair follicles where found. Culture of skin biopsies were positive for Tricophytum rubrum but nails´ culture was negative. Identification was further confirmed by sequencing of ITS region of ribosomal DNA (GenBank accession number MK967277). Oral Itraconazole 100mg bid and topic Sertoconazole where initiated. The patient was observed one month after and reported general malaise, tiredness, exertional dyspnea, whitish stools and increased abdominal volume. The physician chose to discontinue itraconazole and initiate oral terbinafine 250mg id. After two months on oral terbinafine, there was regression of the legs´ and left foot lesions with ulcer healing and disappearance of the left leg nodule. Conclusion: Diagnosis of deeper dermatophytosis is difficult, in part because there is no specific clinical presentation and, in many cases, it is even polymorphic. However, especially in patients with immunodeficiency, this hypothesis should be weighed. Confirmation is achieved by finding hyphae compatible with dermatophytes in the dermis and a positive culture for a dermatophyte. Treatment should include systemic antifungal agents, to which topical medication may be associated. Multiple therapeutic regimens have been proposed, but randomized trials or large case series are lacking. Antifungal therapy should be continued until the lesions are completely resolved. Surgical treatment has been reported as an option for highly localized lesions.info:eu-repo/semantics/publishedVersio

Effect of inhomogeneities on the expansion rate of the Universe

While the expansion rate of a homogeneous isotropic Universe is simply proportional to the square-root of the energy density, the expansion rate of an inhomogeneous Universe also depends on the nature of the density inhomogeneities. In this paper we calculate to second order in perturbation variables the expansion rate of an inhomogeneous Universe and demonstrate corrections to the evolution of the expansion rate. While we find that the mean correction is small, the variance of the correction on the scale of the Hubble radius is sensitive to the physical significance of the unknown spectrum of density perturbations beyond the Hubble radius.Comment: 19 pages, 2 figures Version 2 includes some changes in numerical factors and corrected typos. It is the version accepted for publication in Physical review

On the spatial distribution of dark matter halos

We study the spatial distribution of dark matter halos in the Universe in terms of their number density contrast, related to the underlying dark matter fluctuation via a non-local and non-linear bias random field. The description of the matter dynamics is simplified by adopting the `truncated' Zel'dovich approximation to obtain both analytical results and simulated maps. The halo number density field in our maps and its probability distribution reproduce with excellent accuracy those of halos in a high-resolution N-body simulation with the same initial conditions. Our non-linear and non-local bias prescription matches the N-body halo distribution better than any Eulerian linear and local bias.Comment: 4 pages, LaTeX (uses emulateapj; included psfig.tex), 3 figures, 1 table. Shortened version, matching the size requirements of ApJ Letters. Accepted for publicatio

Celiac disease and headache in children: A narrative state of the art

Celiac disease (CD) is one of the most important entity of the wide spectrum of gluten-related disorders (GRDs). It is well known that neurological manifestation can be present either at the onset of CD, or appear during the development of the pathology, and different can be the neurologic findings. Clinical features are very variable, ranging from typical manifestations of gastrointestinal involvement to neurologic symptom. The most frequent neurologic signs reported were headache, epileptic seizure, migraine, mental retardation, ataxia and attention deficit and hyperactive disorder. Headache either in form of migraine, or in non-specific form represents one of the main clinical presentation in CD. The aim of this work is to provide a narrative review of the pediatric literature focused on the cephalalgic features of children with CD evaluating the potential benefits of a gluten free diet (GFD). Papers were identified by searching for related literature in Medline (PubMed) and Embase using the words “Celiac Disease” and “Headache” or “Migraine” by specifying “children”/“paediatric age” for reports published since 1972 till 31th October 2018. According to our inclusion criteria, a total of 25 papers has been evaluated. Although it is still controversial if headache is prevalent in CD children a correct compliance to a GFD seems to improve the neurological symptoms even if the underlying pathogenic relationship between CD and neurologic system involvement is still not fully understood. (www.actabiomedica.it)

Modelo físico de sistema de produção de leite para as mesorregiões metropolitana de Belém e Nordeste paraense.

Publicado também na página 230

CMB Anisotropies at Second Order I

We present the computation of the full system of Boltzmann equations at second-order describing the evolution of the photon, baryon and cold dark matter fluids. These equations allow to follow the time evolution of the Cosmic Microwave Background (CMB) anisotropies at second-order at all angular scales from the early epoch, when the cosmological perturbations were generated, to the present through the recombination era. This paper sets the stage for the computation of the full second-order radiation transfer function at all scales and for a a generic set of initial conditions specifying the level of primordial non-Gaussianity. In a companion paper, we will present the computation of the three-point correlation function at recombination which is so relevant for the issue of non-Gaussianity in the CMB anisotropies.Comment: 26 pages, LaTeX file, typos correcte

General Relativistic Dynamics of Irrotational Dust: Cosmological Implications

The non--linear dynamics of cosmological perturbations of an irrotational collisionless fluid is analyzed within General Relativity. Relativistic and Newtonian solutions are compared, stressing the different role of boundary conditions in the two theories. Cosmological implications of relativistic effects, already present at second order in perturbation theory, are studied and the dynamical role of the magnetic part of the Weyl tensor is elucidated.Comment: 12 pages , DFPD 93/A/6

Weak antilocalization in quasi-two-dimensional electronic states of epitaxial LuSb thin films

Observation of large non-saturating magnetoresistance in rare-earth monopnictides has raised enormous interest in understanding the role of its electronic structure. Here, by a combination of molecular-beam epitaxy, low-temperature transport, angle-resolved photoemssion spectroscopy, and hybrid density functional theory we have unveiled the bandstructure of LuSb, where electron-hole compensation is identified as a mechanism responsible for large magnetoresistance in this topologically trivial compound. In contrast to bulk single crystal analogues, quasi-two-dimensional behavior is observed in our thin films for both electron and holelike carriers, indicative of dimensional confinement of the electronic states. Introduction of defects through growth parameter tuning results in the appearance of quantum interference effects at low temperatures, which has allowed us to identify the dominant inelastic scattering processes and elucidate the role of spin-orbit coupling. Our findings open up new possibilities of band structure engineering and control of transport properties in rare-earth monopnictides via epitaxial synthesis.Comment: 20 pages, 12 figures; includes supplementary informatio

Dba-free" Palladium Intermediates Of The Heck-matsuda Reaction."

The dba-free Heck-Matsuda reaction was investigated via direct ESI-MS(/MS) monitoring. Palladium species involved in the reduction of Pd(II) during a Wacker type reaction and several dba-free arylpalladium transient complexes were detected and characterized. Based on these findings, a more comprehensible catalytic cycle for this pivotal reaction is suggested.113277-8

Accessible technologies for kinetic and kinematic analysis of people with disabilities: a literature review/ Tecnologias acessíveis para análise cinética e cinemática da pessoa com deficiência: uma revisão da literatura

Locomotion is the process by which a being moves from one place to another, including stopping, changing speed, changes in direction and adaptation to changes in terrain. Human walking follows a pattern, and it is one of the forms of locomotion that most calls the attention of researchers. Its variation among a group may indicate pathological conditions that influence the treatment and rehabilitation of patients with low mobility. The objective of this article is to carry out a review for the development of a low-cost instrumented treadmill that can assist in the rehabilitation, treatment and follow-up of patients with stroke, and for that, a search of articles related to the topic was carried out in databases such as ScienceDirect, PubMed and others. The results obtained were satisfactory and enabled the creation of a good database. It was possible to conclude that there is a diversity of existing resources and that it is up to the professionals to direct their choice to the one that suits them best