Bone Marrow Langerhans Cell Histiocytosis in Association with Kasabach-Merritt Syndrome: The Difficulty of a Differential Diagnosis

Langerhans cell histiocytosis is a rare haematological disorder with variable clinical findings and a high mortality rate. On the other hand, Kasabach-Merritt syndrome is of rare onset at adult age, requiring the simultaneous presentation of vascular lesion, thrombocytopenia, and consumptive coagulopathy. We present the first reported case of both diseases in a single patient and highlight the difficulties of diagnostic. A 69-year-old woman with immune thrombocytopenic purpura underwent surgery for the removal of giant skin haemangiomas. During post-operative care, intravascular disseminated coagulopathy developed. After weeks of corticosteroids and immunosuppressive therapy with no clinical improvement, pulmonary tuberculosis was diagnosed and appropriate treatment initiated. Despite all the efforts, the patient's clinical condition kept worsening and she eventually died. An autopsy revealed bone marrow Langerhans cell histiocytosis. In this case, the patient's autoimmune background together with tuberculosis and intravascular disseminated coagulopathy masked the presentation and made the diagnosis of a rapidly progressive fatal disease very difficult.info:eu-repo/semantics/publishedVersio

Are perceived benefits of heated tobacco products consumption aiding smoking cessation?

Background: The tobacco industry has been facing several transformations, considering that technology has evolved and health concerns have increased. One way for this industry to meet the growing social and health concerns is to provide alternative solutions. Heated tobacco products (HTPs) were the solution found, but they nevertheless pose several challenges to regulators, companies, and consumers, since HTPs are advertised as a less harmful alternative to conventional cigarettes. Focus of the Article: This study aims to analyze smokers' perception of HTPs to provide insights for social marketing campaigns targeting behavioral change. Research questions: The main objectives of this research are: (1) to assess whether smokers and ex-smokers view HTPs as less harmful to health than traditional cigarettes; and (2) to determine to what extent HTPs can help increase the intention to quit smoking. Methods: This study explores smokers’ perception of HTPs consumption using a modified version of the Health Belief Model (HBM). A survey study involving 250 smokers and ex-smokers was conducted to test the conceptual model using PLS-Path modeling to validate the research hypotheses. The data were analyzed using the SPSS 27 and SmartPLS 3.3 programs. Results: The results suggest that the perceived benefits of heated tobacco consumption negatively influence the likelihood of quitting smoking. Therefore, HTPs do not work as auxiliary products with regard to the intention to quit smoking. In some cases, the effect is quite the opposite, as HTPs use increases tobacco consumption and dependence. Perceived susceptibility and perceived severity are not significant predictors of the decision to quit smoking. Research limitations: Future research could use a sample that includes only HTPs smokers and ex-smokers, analyze HTPs benefits and understand the primary motivation behind replacing conventional cigarettes with HTPs. Practical implications: Entities attempting to promote the reduction of tobacco consumption should equate HTPs to conventional tobacco and focus on campaigns targeting only HTPs smokers. Whenever studying perceptions on HTPs, it is important to consider smokers’ dependence on nicotine and the particularities of the devices used to consume HTPs. Importance to the Social Marketing Field: Considering the social relevance and growth of heated tobacco consumption, as well as the increase of the tobacco industry’s economic power, this research offers relevant insights into consumers’ perceptions toward HTPs.info:eu-repo/semantics/publishedVersio

Population expansion in the North African Late Pleistocene signalled by mitochondrial DNA haplogroup U6

Background <br/> The archaeology of North Africa remains enigmatic, with questions of population continuity versus discontinuity taking centre-stage. Debates have focused on population transitions between the bearers of the Middle Palaeolithic Aterian industry and the later Upper Palaeolithic populations of the Maghreb, as well as between the late Pleistocene and Holocene. <br/> Results Improved resolution of the mitochondrial DNA (mtDNA) haplogroup U6 phylogeny, by the screening of 39 new complete sequences, has enabled us to infer a signal of moderate population expansion using Bayesian coalescent methods. To ascertain the time for this expansion, we applied both a mutation rate accounting for purifying selection and one with an internal calibration based on four approximate archaeological dates: the settlement of the Canary Islands, the settlement of Sardinia and its internal population re-expansion, and the split between haplogroups U5 and U6 around the time of the first modern human settlement of the Near East. <br/> Conclusions <br/> A Bayesian skyline plot placed the main expansion in the time frame of the Late Pleistocene, around 20 ka, and spatial smoothing techniques suggested that the most probable geographic region for this demographic event was to the west of North Africa. A comparison with U6's European sister clade, U5, revealed a stronger population expansion at around this time in Europe. Also in contrast with U5, a weak signal of a recent population expansion in the last 5,000 years was observed in North Africa, pointing to a moderate impact of the late Neolithic on the local population size of the southern Mediterranean coast

Life Design Counseling outcome and process: a case study with an adolescent

This article aims to explore the relationship between clients' narrative transformation and the promotion of vocational decidedness and career maturity in a mid-adolescent case of Life Design Counseling (LDC). To assess LDC outcomes the Vocational Certainty Scale and the Career Maturity Inventory — Form C were used before and after the intervention. To intensively analyze the process of LDC change two measures of narrative change were used: the Innovative Moments Coding System (IMCS), as a measure of innovation emergence, and the Return to the Problem Coding System (RPCS), as a measure of ambivalence towards change. The results show that the three LDC sessions produced a significant change in vocational certainty but not in career maturity. Findings confirm that the process of change, according to the IMCS, is similar to the one observed in previous studies with adults. Implications for future research and practice are discussed.Portuguese Foundation for Science and Technology and the Portuguese Ministry of Education and Science through national funds and when applicable co-financed by FEDER under the PT2020 Partnership Agreement (UID/PSI/01662/2013)University of Lisbon. CICPS