The impact of Behçet's disease on intimate relationships in women: A qualitative study.

OBJECTIVE: Behçet's disease is a rare and incurable condition where the body's immune system attacks healthy tissue. Behçet's can cause blood clots and ulcerations to form in every organ and system in the body, including deep and painful genital ulceration. The psychological impact of the disease on intimacy and relationships is unexplored. This study aimed to explore how the disease impacts on female patients' intimate partner relationships. METHODS: Participants were seven female, UK patients with Behçet's disease who were in committed relationships. In depth, semi-structured interviews lasting approximately 80 minutes were conducted via video conferencing about participants' sexual functioning and intimate relationships. Data was analysed using Interpretative Phenomenological Analysis. RESULTS: Patients' sexual relationships and intimacy were impacted by issues due to lack of knowledge of symptoms (misdiagnosis of herpes), issues due to symptoms (genital manifestations, painful sex, exhaustion), difficulties communicating with medical professionals, medication, partner support, and support from fellow Behçet's patients. DISCUSSION: Female Behçet's patients are at risk of developing psychological problems with intimacy due to symptoms, lack of knowledge of symptoms, and negative impacts of medication. Intimacy needs to be discussed in medical consultations so these issues can be addressed before a lack of intimacy negatively impacts relationships

Neonatal sepsis – a retrospective analysis 2004 to 2006 of Bissaya Barreto Maternity

Introdução: As doenças infecciosas são uma causa frequente de morbi- -mortalidade no período neonatal. O conhecimento da epidemiologia de cada unidade é um factor decisivo para o sucesso da antibioterapia empírica. Objectivos: Caracterizar os episódios de sépsis neonatal (SNN) ocorridos de Janeiro de 2004 a Dezembro de 2006 na Unidade de Cuidados Intensivos Neonatais (UCIN) da Maternidade Bissaya Barreto. Material e métodos: Estudo descritivo retrospectivo dos processos clínicos dos recém-nascidos com o diagnóstico de SNN. Definiu-se sépsis com confirmação laboratorial se dois ou mais critérios clínicos compatíveis, associados a um dos seguintes critérios laboratoriais: a) identificação de qualquer agente patogénico bacteriano na hemocultura ou no líquor cefalo-raquídeo; b) identificação de Staphylococcus coagulase negativo na presença de proteína C reactiva >2,0 mg/dl ou plaquetas <100.000/μl ou relação neutrófilos imaturos / neutrófilos totais >0,2. Definiu-se sépsis clínica quando se verificou: instituição de terapêutica antibiótica durante 5 dias, hemocultura negativa ou não pedida, ausência de infecção noutro local e dois ou mais critérios clínicos compatíveis. No caso de sépsis clínica deveria haver pelo menos também um dos seguintes: proteína C reactiva >2,0 mg/dl; leucócitos >30.000 ou <5.000/μl; relação neutrófilos imaturos / neutrófilos totais >0,2; plaquetas <100 000/μl. Considerou-se SNN precoce ou tardia, respectivamente se início até ou após as 72 horas de vida. Resultados: Cumpriram critérios de inclusão 61 episódios infecciosos (16 precoces e 45 tardios), correspondendo a 58 recém-nascidos. Destes, 50% apresentavam peso de nascimento inferior a 1500 gramas. A idade gestacional variou entre as 25 e as 41 semanas, com mediana de 30 semanas. Da amostra considerada, 45 (73,8%) foram sépsis com confirmação laboratorial e 16 (26,2%) foram sépsis clínicas. Os gérmens isolados foram 26 (57,8%) Staphylococcus coagulase negativos – 17 (37,8%) Staphylococcus epidermidis, 9 (20,0%) outros Staphylococcus coagulase negativos; 9 (20,0%) Escherichia coli; 6 (13,3%) Staphylococcus aureus; 2 (4,4%) Streptococcus do grupo B; 1 (2,2%) Proteus mirabilis; 1 (2,2%) Cândica albicans.A percentagem de resistências da Escherichia coli à ampicilina foi de 77,8%. Houve dois Staphylococcus aureus meticilino-resistentes, ambos sensíveis à vancomicina. Faleceram 6 recém-nascidos com SNN. Comentários: Os nossos resultados estão de acordo com os estudos nacionais e internacionais sobre SNN, salientando-se contudo o diminuto número de Streptococcus do grupo B isolados e o maior número de Escherichia coli, com uma elevada percentagem de estirpes ampicilino- resistentes. A mortalidade relacionada com a SNN encontra-se dentro dos dados referidos na literatura

Evidence for a spectroscopic direct detection of reflected light from 51 Peg b

The detection of reflected light from an exoplanet is a difficult technical challenge at optical wavelengths. Even though this signal is expected to replicate the stellar signal, not only is it several orders of magnitude fainter, but it is also hidden among the stellar noise. We apply a variant of the cross-correlation technique to HARPS observations of 51 Peg to detect the reflected signal from planet 51 Peg b. Our method makes use of the cross-correlation function of a binary mask with high-resolution spectra to amplify the minute planetary signal that is present in the spectra by a factor proportional to the number of spectral lines when performing the cross correlation. The resulting cross-correlation functions are then normalized by a stellar template to remove the stellar signal. Carefully selected sections of the resulting normalized CCFs are stacked to increase the planetary signal further. The recovered signal allows probing several of the planetary properties, including its real mass and albedo. We detect evidence for the reflected signal from planet 51 Peg b at a significance of 3\sigma_noise. The detection of the signal permits us to infer a real mass of 0.46^+0.06_-0.01 M_Jup (assuming a stellar mass of 1.04\;M_Sun) for the planet and an orbital inclination of 80^+10_-19 degrees. The analysis of the data also allows us to infer a tentative value for the (radius-dependent) geometric albedo of the planet. The results suggest that 51Peg b may be an inflated hot Jupiter with a high albedo (e.g., an albedo of 0.5 yields a radius of 1.9 \pm 0.3 R_Jup for a signal amplitude of 6.0\pm0.4 x 10^-5). We confirm that the method we perfected can be used to retrieve an exoplanet's reflected signal, even with current observing facilities. The advent of next generation of observing facilities will yield new opportunities for this type of technique to probe deeper into exoplanets.Comment: 9 pages, 6 figure

Outbreak of Clostridium difficile PCR ribotype 027-the recent experience of a regional hospital

Background: Clostridium difficile infection (CDI) is the leading cause of healthcare-associated diarrhea, and several outbreaks with increased severity and mortality have been reported. In this study we report a C. difficile PCR ribotype 027 outbreak in Portugal, aiming to contribute to a better knowledge of the epidemiology of this agent in Europe. Methods: Outbreak report with retrospective study of medical records and active surveillance data of all inpatients with the diagnosis of CDI, from 1st January to 31th December 2012, in a Portuguese hospital. C. difficile isolates were characterized regarding ribotype, toxin genes and moxifloxin resistance. Outbreak control measures were taken, concerning communication, education, reinforcement of infection control measures, optimization of diagnosis and treatment of CDI, and antibiotic stewardship. Results: Fifty-three inpatients met the case definition of C. difficile-associated infection: 55% males, median age was 78.0 years (interquartile range: 71.0-86.0), 75% had co-morbidities, only 15% had a nonfatal condition, 68% had at least one criteria of severe disease at diagnosis, 89% received prior antibiotherapy, 79% of episodes were nosocomial. CDI rate peak was 13.89/10,000 bed days. Crude mortality rate at 6 months was 64.2% while CDI attributable cause was 11.3%. Worse outcome was related to older age (P = 0.022), severity criteria at diagnosis (leukocytosis (P = 0.008) and renal failure), and presence of fatal underlying condition (P = 0.025). PCR ribotype 027 was identified in 16 of 22 studied samples. Conclusions: This is the first report of a 027-CDI outbreak in Portugal. We emphasize the relevance of the measures taken to control the outbreak and highlight the importance of implementing a close and active surveillance of CDI

Ichnological evidence of Megalosaurid Dinosaurs crossing Middle Jurassic tidal flats

A new dinosaur tracksite in the Vale de Meios quarry (Serra de Aire Formation, Bathonian, Portugal) preserves more than 700 theropod tracks. They are organized in at least 80 unidirectional trackways arranged in a bimodal orientation pattern (W/NW and E/SE). Quantitative and qualitative comparisons reveal that the large tridactyl, elongated and asymmetric tracks resemble the typical Late JurassicEarly Cretaceous Megalosauripus ichnogenus in all morphometric parameters. Few of the numerous tracks are preserved as elite tracks while the rest are preserved as different gradients of modified true tracks according to water content, erosive factors, radial fractures and internal overtrack formations. Taphonomical determinations are consistent with paleoenvironmental observations that indicate an inter-tidal flat located at the margin of a coastal barrier. The Megalosauripus tracks represent the oldest occurrence of this ichnotaxon and are attributed to large megalosaurid dinosaurs. Their occurrence in Vale de Meios tidal flat represents the unique paleoethological evidence of megalosaurids moving towards the lagoon, most likley during the low tide periods with feeding purposes

Enfarte agudo do miocárdio no YouTube – Is it all fake news?

Introduction and objectives: The Internet is a fundamental aspect of health information. However, the absence of quality control encourages misinformation. We aim to assess the relevance and quality of acute myocardial infarction videos shared on YouTube (www.youtube.com) in Portuguese. Methods: We analyzed 1,000 videos corresponding to the first 100 search results on YouTube using the following terms (in Portuguese): "cardiac + arrest"; "heart + attack"; "heart + thrombosis"; "coronary + thrombosis"; "infarction - brain", "myocardial + infarction" and "acute + myocardial + infarction". Irrelevant (n=316), duplicated (n=345), without audio (n=24) or non-Portuguese (n=106) videos were excluded. Included videos were assessed according to source, topic, target audience and scientific inaccuracies. Quality of information was assessed using The Health on the Net Code (HONCode from 0 to 8) and DISCERN (from 0 to 5) scores - the higher the score, the better the quality. Results: 242 videos were included. The majority were from independent instructors (n=95, 39.0%) and were addressed to the general population (n=202, 83.5%). One third of the videos (n=79) contained inaccuracies while scientific society and governmental/health institution videos had no inaccuracies. The mean video quality was poor or moderate; only one video was good quality without any inaccuracies. Governmental/health institutions were the source with the best quality videos (HONCode 4±1, DISCERN 2±1). Conclusions: One third of the videos had irrelevant information and one third of the relevant ones contained inaccuracies. The average video quality was poor; therefore it is important to define strategies to improve the quality of online health information.info:eu-repo/semantics/publishedVersio