12 research outputs found

    Retardo en la erupción dental en adolescentes con hipotiroidismo

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    OBJECTIVE: To report the case of an adolescent with undiagnosed hypothyroidism who sought dental clinic care due to delayed tooth eruption. Multiprofessionalwork enabled the diagnosis. CASE DESCRIPTION: This is a 16 years and 4 month-old patient whose initial complaint was delayed tooth eruption. Dental evaluation drew attention to the significant delay in tooth eruption as it could be related to organic diseases. This has prompted the intervention of medical professionals who diagnosed hypothyroidism in the follow-up. COMMENTS: Teenagers typically value acceptance by their peers and may have aesthetic concerns that lead them to seek health services for seemingly trivial complaints. A high degree of surveillance in these cases can detect more serious underlying organic problems. We highlight the importance of the multidisciplinary team in this approach.OBJETIVO: Relatar caso de adolescente que buscó servicio odontológico de un ambulatorio de medicina del adolescente, por presentar retardo en la erupción dental y cuya actuación multiprofesional permitió llegar al diagnóstico de hipotiroidismo. DESCRIPCIÓN DEL CASO: Se describe la historia de una paciente de 16 años y 4 meses de edad cuya queja fue retardo en la erupción dental. En la evaluación odontológica, llamaba la atención el importante retardo en la erupción dental, lo que podría estar relacionado a alguna enfermedad orgánica. De este modo, se solicitó la intervención del equipo médico que, en el seguimiento, constató tratarse de hipotiroidismo. COMENTARIOS: Se llama la atención para el hecho de que adolescentes estiman mucho la aceptación por sus pares y las cuestiones estéticas y, muchas veces, la búsqueda por un servicio de salud implica quejas que pueden parecer comunes, pero una mirada atenta no dejará que problemas orgánicos más graves pasen desapercibidos. Se subraya además la importancia de la actuación del equipo multiprofesional.OBJETIVO: Relatar o caso de adolescente que procurou serviço odontológico de um ambulatório de medicina do adolescente por apresentar atraso de erupção dentária. A atuação multiprofissional permitiu chegar ao diagnóstico de hipotireoidismo. DESCRIÇÃO DO CASO: Paciente de 16 anos e 4 meses cuja queixa inicial foi atraso na erupção dentária. Na avaliação odontológica, chamava atenção o importante atraso na erupção dentária, o que poderia estar relacionado a alguma moléstia orgânica. Desta forma, solicitou-se a intervenção da equipe médica, que, no acompanhamento, constatou se tratar de hipotireoidismo. COMENTÁRIOS: Chama-se a atenção o fato de que adolescentes prezam a aceitação pelos seus pares e as questões estéticas e, muitas vezes, a procura por um serviço de saúde envolve queixas que podem parecer triviais. Porém, o olhar atento não deixará que problemas orgânicos mais graves passem despercebidos. Salienta-se ainda a importância da atuação da equipe multiprofissional.UNIFESP Centro de Atendimento e Apoio ao Adolescente Departamento de PediatriaUNIFESP Departamento de PediatriaUNIFESP CAAAUNIFESP Departamento de Pediatria Setor de Hematologia InfantilUNIFESP, Centro de Atendimento e Apoio ao Adolescente Depto. de PediatriaUNIFESP, Depto. de PediatriaUNIFESP, CAAAUNIFESP, Depto. de Pediatria Setor de Hematologia InfantilSciEL

    The James Webb Space Telescope Mission

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    Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least 4m4m. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the 6.5m6.5m James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

    Estimativa do risco de infecção tuberculosa em populações vacinadas pelo BCG Determining the risk of tuberculosis infection in BCG-vaccinated populations

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    A revacinação de escolares com BCG, capaz de restaurar a alergia remanescente de vacinação realizada nos primeiros meses de vida, porém incapaz de modificar a alergia devida à infecção pelo M. tuberculosis, possibilitaria a quantificação da parcela dessa população infectada pelo bacilo de Koch. Foi desenvolvida pesquisa com o objetivo de avaliar a aplicabilidade desses pressupostos na estimativa do risco de infecção tuberculosa em áreas sob elevada cobertura com BCG. A população de estudo foi constituída por escolares com 6 a 9 anos de idade freqüentando escolas municipais da zona leste da cidade de São Paulo, durante o primeiro semestre letivo de 1988. De 11.455 vacinados, apenas 7.470 foram submetidos ao teste tuberculínico, revacinados em seguida e retestados dez semanas depois. Destes, 3.314 tinham sido vacinados no primeiro trimestre de vida com meia dose e os demais 4.156 receberam dose plena acima dessa idade (75% no primeiro ano de vida, 20% no segundo e 5% no terceiro). A contagem dos infectados, pelo confronto dos resultados pré e pós vacinais em tabelas de correlação, foi realizada segundo os critérios do método original e modificação introduzida pelos autores, separadamente para os vacinados no primeiro trimestre de vida e após essa idade. O risco de infecção foi, respectivamente, 0,35% e 0,37% com o critério original e 0,45% e 0,49% com o modificado. O referencial médio disponível para a área estudada, estimado por outros métodos, foi 0,55%. As diferenças entre critérios e idades e destes com o referencial não foram significantes (P > 0,05). Os resultados sugerem que o método é aplicável para a estimativa do risco de infecção tuberculosa na idade escolar, em vacinados com BCG no primeiro ano de vida, com dose plena de vacina.<br>The revaccination of schoolchildren can restore the residual allergy induced by vaccination in the first years of life but can not modify the allergy resulting from a natural infection. So revaccination in this population should indicate the group infected by the Koch bacilli. To assess the applicability of these assumptions in estimating the risk of tuberculosis infection in regions with high BCG coverage a study was undertaken on schoolchildren between 6 and 9 years of age who were attending the municipal schools in the east zone of S. Paulo City, in the course of the first semester of 1988. Of 11,455 who were vaccinated only 7,470 were tested with PPD, revaccinated and retested ten weeks later; 3,314 of these were vaccinated in the first trimester of life with a half dose and 4,156 received a full dose at later ages (75% during the first year, 20% during the second and 5% during the third). In comparing the results pre and post vaccination by correlation table, the calculation of infection was made according to the criteria of the original method and to the modifications made by the authors under separate cover for those vaccinated in the first trimester and those vaccinated later. The risk of infection was 0.35% and 0.37%, respectively, for the original model and 0.45% and 0.49% for the modified model. The referencial was 0.55%. The difference between model and age or with the referencial was not significant (p > 0.005). Data suggest that the method is applicable to estimate the risk of tuberculosis infection in schoolchildren vaccinated with a full dose of BCG during the first year of life

    A proteomic survival predictor for COVID-19 patients in intensive care.

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    Global healthcare systems are challenged by the COVID-19 pandemic. There is a need to optimize allocation of treatment and resources in intensive care, as clinically established risk assessments such as SOFA and APACHE II scores show only limited performance for predicting the survival of severely ill COVID-19 patients. Additional tools are also needed to monitor treatment, including experimental therapies in clinical trials. Comprehensively capturing human physiology, we speculated that proteomics in combination with new data-driven analysis strategies could produce a new generation of prognostic discriminators. We studied two independent cohorts of patients with severe COVID-19 who required intensive care and invasive mechanical ventilation. SOFA score, Charlson comorbidity index, and APACHE II score showed limited performance in predicting the COVID-19 outcome. Instead, the quantification of 321 plasma protein groups at 349 timepoints in 50 critically ill patients receiving invasive mechanical ventilation revealed 14 proteins that showed trajectories different between survivors and non-survivors. A predictor trained on proteomic measurements obtained at the first time point at maximum treatment level (i.e. WHO grade 7), which was weeks before the outcome, achieved accurate classification of survivors (AUROC 0.81). We tested the established predictor on an independent validation cohort (AUROC 1.0). The majority of proteins with high relevance in the prediction model belong to the coagulation system and complement cascade. Our study demonstrates that plasma proteomics can give rise to prognostic predictors substantially outperforming current prognostic markers in intensive care

    A proteomic survival predictor for COVID-19 patients in intensive care.

    No full text
    Global healthcare systems are challenged by the COVID-19 pandemic. There is a need to optimize allocation of treatment and resources in intensive care, as clinically established risk assessments such as SOFA and APACHE II scores show only limited performance for predicting the survival of severely ill COVID-19 patients. Additional tools are also needed to monitor treatment, including experimental therapies in clinical trials. Comprehensively capturing human physiology, we speculated that proteomics in combination with new data-driven analysis strategies could produce a new generation of prognostic discriminators. We studied two independent cohorts of patients with severe COVID-19 who required intensive care and invasive mechanical ventilation. SOFA score, Charlson comorbidity index, and APACHE II score showed limited performance in predicting the COVID-19 outcome. Instead, the quantification of 321 plasma protein groups at 349 timepoints in 50 critically ill patients receiving invasive mechanical ventilation revealed 14 proteins that showed trajectories different between survivors and non-survivors. A predictor trained on proteomic measurements obtained at the first time point at maximum treatment level (i.e. WHO grade 7), which was weeks before the outcome, achieved accurate classification of survivors (AUROC 0.81). We tested the established predictor on an independent validation cohort (AUROC 1.0). The majority of proteins with high relevance in the prediction model belong to the coagulation system and complement cascade. Our study demonstrates that plasma proteomics can give rise to prognostic predictors substantially outperforming current prognostic markers in intensive care

    The James Webb Space Telescope Mission

    No full text
    Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least 4 m. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the 6.5 m James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 yr, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit
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