McCune Albright Syndrome: A Diagnosis to be Kept in Mind

Precocious puberty, defined as the development of secondary sexual characteristics before the age of 8, often leads to anxiety in patients and their families but also in clinicians searching for the final diagnosis. After adequate investigation, the majority of the cases in girls turn out to be idiopathic. The authors present a case of McCune Albright syndrome in order to call attention to a rare cause of sexual precocity and the value of ultrasound in the evaluation of these situations. 10 years old infant girl admitted in our department due to irregular menstrual bleeding. She experienced a vaginal bleeding by the age of 3 which led to the diagnosis of McCune Albright Syndrome after a complete evaluation. Pubertal assessment revealed a reversed sequence in the remaining events with adrenarche at 5 and thelarche at 8. Hormonal evaluation demonstrated low FSH and LH levels (11,2 and 6,72 respectively) with high estrogen (204). Pelvic ultrasound showed a normal sized uterus (73x 29x32 mm), endometrial thickness of 5 mm and ovaries with several microfollicles and a copus luteum measuring 23 mm in the right ovary. McCune Albright syndrome is a very uncommon cause of sexual precocity that should, however, be suspected in all infant girls who present with vaginal bleeding. It is characterized by a triad: polyostotic fibrous dysplasia, gonadotropin-independent precocious puberty and café-au-lait skin spots. Due to autonomous production of estrogen by the ovaries, ultrasound image of the female reproductive tract is inconsistent with chronologic age. Pelvic ultrasound demonstrates a normal sized uterus with a well defined cervix and clearly identified ovaries with several follicles, similar to adult women of reproductive age. Ultrasonography of the pelvis has also an important role excluding other causes of GnRH-independent precocious puberty conditions like ovarian cysts or tumors

Sistemas de Información en Enfermería: explotación de la información compartida con los médicos

Enquadramento: Ao longo dos anos foram-se verificando alterações substanciais ao nível da documentação em enfermagem resultantes da utilização de tecnologias da informação na atividade diária dos profissionais de saúde. Os médicos são os maiores consumidores da informação recolhida, processada e documentada pelos enfermeiros, dada a relevância dessa informação no seu processo de tomada de decisão clínica. Objetivos: Identificar e descrever a informação recolhida, processada e documentada pelos enfermeiros que é mais relevante para atividade profissional dos médicos. Metodologia: Estudo qualitativo e exploratório com recurso à observação participante (98 horas) e entrevistas semi-estruturadas (3) com informantes-chave, realizado em contexto hospitalar. Foi realizada a análise indutiva de conteúdo das notas de campo e entrevistas. Resultados: A informação mais relevante para os médicos depende do contexto dos sujeitos, da ação e das profissões, e foi agregada em três categorias: «parâmetros de vigilância»; «medicação e atitudes terapêuticas»; e «dados intercorrentes». Conclusão: As estratégias de recolha de dados mostraram-se capazes de gerar dados válidos para a identificação das categorias de informação mais relevantes para os médicos («parâmetros de vigilância», «medicação e atitudes terapêuticas» e «dados intercorrentes»). A informação relevante para os médicos não é influenciada por quem toma a decisão de prescrição da colheita dos dados

Knowledge of official ethical standards and tolerance towards corruption: An exploratory study

Corruption is often defined as a deviant conduct from established legal and formal norms and expected ways of behaving in the exercise of official duties and the discharge of official responsibilities. Readiness to tolerate corruption will hinge primarily upon the evaluator’s understanding of what those ethical standards are. This means that citizens’ willingness to accept corruption as something “normal” to the functioning of democracy or “beneficial” to economic development is likely to be affected by how knowledgeable they are about the ethical standards of governing public office. Such knowledge can be instilled by academic and experiential learning. So, we question to what extent citizens’ knowledge of official ethical standards affect their tolerance towards corruption? Based on new individual level data collected from six focus groups conducted in Portugal, we show a possible negative association between the appropriate knowledge of official ethical standards and tolerance towards corruption. The results are exploratory, but sufficiently interesting to test our hypothesis with a larger sample.info:eu-repo/semantics/publishedVersio

THE INFLUENCE OF PRECEDING MOVEMENTS IN THE PERFORMANCE OF BALLET JUMPS

The purpose of this study was to gain more insights about the individual technique used in the performance of ballet jumps and determine the influence of preceding movements in the efficiency of its performance. Seven female ballet students participate voluntarily in the study. Ground reaction forces were measured using a Bertec force plate. A triaxial accelerometer was placed at the low back of the subject on the skin surface, approximately at the height of the centre of mass. Results suggest that generally, a positive influence from preceding movements was observed in the performance of the selected jumps. Jumps preceded by only one movement, show a tendency to an increase in the reached height. Due to an immature technique of performance, our ballet students did not use appropriately preceding movements to potentiate the subsequent jumps

Exchange stiffness in ultrathin perpendicularly-magnetized CoFeB layers determined using spin wave spectroscopy

We measure the frequencies of spin waves in nm-thick perpendicularly magnetized FeCoB systems, and model the frequencies to deduce the exchange stiffness of this material in the ultrathin limit. For this, we embody the layers in magnetic tunnel junctions patterned into circular nanopillars of diameters ranging from 100 to 300 nm and we use magneto-resistance to determine which rf-current frequencies are efficient in populating the spin wave modes. Micromagnetic calculations indicate that the ultrathin nature of the layer and the large wave vectors used ensure that the spin wave frequencies are predominantly determined by the exchange stiffness, such that the number of modes in a given frequency window can be used to estimate the exchange. For 1 nm layers the experimental data are consistent with an exchange stiffness A= 20 pJ/m, which is slightly lower that its bulk counterpart. The thickness dependence of the exchange stiffness has strong implications for the numerous situations that involve ultrathin films hosting strong magnetization gradients, and the micromagnetic description thereof.Comment: 5 pages, 4 figures, submitted to PR

Irrigação e fertirrigação na cultura do maracujá.

Métodos e sistemas de irrigação; Necessidades hídricas da cultura; Exigências nutricionais; Necessidades de nutrientes para fertirrigação; Marcha de absorção de nutrientes; Cálculo da necessidade de fertilizante; Cálculo da solução fertilizante