Suicidal intoxication by copper sulphate

Poster apresentado no 60th Annual Meeting of the American Academy of Forensic Sciences, 18-23 Fevereiro, 2008, Washington, DC, EUAPortugal is traditionally an agricultural country, consequently intoxications by pesticides are very common. An 81 year old male, diabetic, with chronic renal failure, was admitted at the hospital with a suspicion of voluntary ingestion of copper sulfate. Four days later he died. At the autopsy it was possible to see a green colouration of the nails, (...)N/

Chorangioma and John Clarke

Perinatal mortality is a relevant indicator of a country health status. Through the centuries, measures have been promoted to reduce modifiable risk factors or to treat installed diseases. That was the example of the English medical doctor John Clarke (1758/1760?-1851), who dedicated his life to mother-child health care [1]. Among his contributions is the report of a placental tumour in 1798, named Chorangioma placenta (CP) [2]. It may occur in primiparas or multiparas, apparently increasing with the mother’s age, with association to the mother’s hypertension or diabetes mellitus [3]. Chorangioma may appear in single or multiple pregnancies and may lead to foetal heart failure, hydrops, or sudden intra-uterine death [3]. The authors report the case of a 2 cm diameter chorangioma (Fig. 1A), which ended in premature death of the male foetus in utero at 35 weeks and 5 days, in a multiparous mother. Histopathological examination confirmed the macroscopic suspicion by disclosing a benign vascular capillary proliferation (Fig. 1B) positive for endothelial markers CD34/CD31 (Fig. 1C). Its current incidence ranges from 0.5% to 1% of analysed placentas [4] and may represent a primitive angioblastic tissue malformation, aggravated with hypoxia and/or haemodynamic changes during pregnancy. To conclude, we highlight the relevance of chorangioma as a cause of perinatal death, which is around 30% [4]info:eu-repo/semantics/publishedVersio

Maternidad en parejas constituidas por dos mujeres. Análisis de vivencias desde una perspectiva de género para el Trabajo Social.

La maternidad lésbica ha sido una cuestión silenciada y de la que se cuentan con escasas investigaciones y referentes. Investigar sobre la misma supone analizarla desde una perspectiva interseccional, en la que se tenga en cuenta la multicausalidad de las discriminaciones que sufren estas mujeres. Es por ello por lo que el presente trabajo, une la revisión bibliográfica sobre el tema, junto a experiencias personales de mujeres que han sido madres junto a otra mujer en el seno de una sociedad patriarcal.<br /

Prognostic biomarkers of chronic diabetic macular edema treated with a fluocinolone acetonide intravitreal implant

Background: This study aimed to investigate retinal imaging biomarkers, such as disorganization of the retinal inner layers (DRIL) and/or ellipsoid zone (EZ) disruption by spectral domain optical coherence tomography (SD-OCT), and functional outcomes in eyes treated with 0.2 µg/day of a fluocinolone acetonide intravitreal implant (FAc) after an insufficient response to previous treatments. Methods: This was a retrospective comparative study of 18 eyes (15 patients) with persistent and/or recurrent diabetic macular edema (DME) treated with FAc. Eyes were divided according to the number of prior intravitreal treatments: group 1 (n = 8) with less than or equal to 6 injections (early switch) and group 2 (n = 10) with &gt; 6 injections (late switch). Outcomes included percentage of eyes with DRIL and/or EZ disruption at baseline and analysis of the best corrected visual acuity (BCVA) using ETDRS letters, central macular thickness (CMT), DRIL, and EZ disruption at the last observation. Results: Group 2 revealed a significantly higher percentage of DRIL and/or EZ disruption than group 1 (P &lt; 0.05). At the last observation, group 1 revealed a higher percentage of eyes achieving vision stability/improvement, gaining greater than or equal to15 letters, and achieving greater than or equal to 70 letters (P &gt; 0.05 for all comparisons). The mean BCVA gain was 8.8 and 0.7 letters for groups 1 and 2 (P = 0.397). Both groups revealed a significant mean CMT reduction (&gt;20% reduction from the baseline value), without a significant statistical difference between them (P = 0.749). After treatment, most eyes from both groups showed resolution of DRIL and EZ disruption. Conclusions: Patients with DME presenting with a lower percentage of DRIL and/or EZ disruption at baseline had better functional outcomes, supporting the possible benefit of an early switch to FAc after insufficient response to previous treatments. Future randomized studies with a larger patient cohort are warranted to confirm our conclusions

Maternidad en parejas constituidas por dos mujeres. Análisis de vivencias desde una perspectiva de género para el Trabajo Social.

La maternidad lésbica ha sido una cuestión silenciada y de la que se cuentan con escasas investigaciones y referentes. Investigar sobre la misma supone analizarla desde una perspectiva interseccional, en la que se tenga en cuenta la multicausalidad de las discriminaciones que sufren estas mujeres. Es por ello por lo que el presente trabajo, une la revisión bibliográfica sobre el tema, junto a experiencias personales de mujeres que han sido madres junto a otra mujer en el seno de una sociedad patriarcal.<br /

Dental abscess and “unexpected death”...

Even though we are living in an era of major technical-scientific advances and effective antimicrobial and antiviral therapy,dental infections are still the most important predisposing factors for head and neck infections. Odontogenic infections can cause severe complications, e.g. compromised airways, tissue necrosis, deep neck infections, mediastinitis, endocarditis and sepsis. These severe odontogenic infections can be potentially life-threatening. Usually odontogenic infections respond well to a combination of surgical treatment (incision, rainage) and antibiotic therapy. However, especially when the medico-surgical therapy is installed late, cases may evolve unfavourably and be fatal. The authors report a case of a 30-year-old man who was observed on three consecutive occasions by the General Practitioner in a District Hospital, for a decayed tooth with abscess and was, then, referred to a Central Hospital. There, he was examined for the fourth time, this one by a Stomatologist at the Emergency Department, where he died. The post mortem examination revealed bacterial (Gram +) acute neutrophilic (purulent) infection of soft tissues of the mandibular region and neck with para-tracheal extension, as well as thrombosis ofthe left jugular vein. Circumstantial clinical information, post mortem findings, pathophysiology (including complications andprogression of the disease to death) are discussed, highlighting the relevance of accurate and timely diagnosis and treatmentto avoid malpractice and mortality.info:eu-repo/semantics/publishedVersio

Climate mitigation models need to become circular : let's start with the construction sector

ABSTRACT: Circular Economy (CE) is presented today as the way forward to achieving a sustainable and carbon-neutral society. Yet, circularity assessment tools such as Life Cycle Assessment (LCA), Material Flow Analysis (MFA), and Supply and value-chain analysis are currently disconnected from the models used to advise bodies that steer sustainability-driven policies like the Intergovernmental Panel on Climate Change (IPCC). Climate mitigation models (henceforth climate models) are used in policy discussions and international negotiations to track GHG emissions and identify pathways towards a low-carbon economy. One example is the JRC-EU-TIMES model developed by the International Energy Agency or the PRIMES model, which is the backbone of the energy and climate policy of the European Union (EU). These climate models are inherently suitable for representing only linear patterns of economic activity, where GHG emissions are modelled per economic sector (primary energy resource extraction, final energy generation, energy, and materials used in industry, buildings, etc.).info:eu-repo/semantics/publishedVersio

Mycobacterium tuberculosis whole genome sequencing provides insights into the Manila strain and drug-resistance mutations in the Philippines.

The Philippines has a high incidence of tuberculosis disease (TB), with an increasing prevalence of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) strains making its control difficult. Although the M. tuberculosis "Manila" ancient lineage 1 strain-type is thought to be prevalent in the country, with evidence of export to others, little is known about the genetic diversity of circulating strains. By whole genome sequencing (WGS) 178 isolates from the Philippines National Drug Resistance Survey, we found the majority (143/178; 80.3%) belonged to the lineage 1 Manila clade, with the minority belonging to lineages 4 (European-American; n = 33) and 2 (East Asian; n = 2). A high proportion were found to be multidrug-resistant (34/178; 19.1%), established through highly concordant laboratory drug susceptibility testing and in silico prediction methods. Some MDR-TB isolates had near identical genomic variation, providing potential evidence of transmission. By placing the Philippine isolates within a phylogeny of global M. tuberculosis (n > 17,000), we established that they are genetically similar to those observed outside the country, including a clade of Manila-like strain-types in Thailand. An analysis of the phylogeny revealed a set of ~200 SNPs that are specific for the Manila strain-type, and a subset can be used within a molecular barcode. Sixty-eight mutations known to be associated with 10 anti-TB drug resistance were identified in the Philippine strains, and all have been observed in other populations. Whilst nine putative streptomycin resistance conferring markers in gid (8) and rrs (1) genes appear to be novel and with functional consequences. Overall, this study provides an important baseline characterisation of M. tuberculosis genetic diversity for the Philippines, and will fill a gap in global datasets and aid the development of a nation-wide database for epidemiological studies and clinical decision making. Further, by establishing a molecular barcode for detecting Manila strains it will assist with the design of diagnostic tools for disease control activities

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217