Jejunal Stricture: single manifestation of Crohn’s Disease

A 60 year-old male patient was admitted to our institution referring repeated episodes of abdominal cramps and distention, weight loss, fatigue and anorexia. Abdominal radiogram showed dilatation of small bowel loops with few gas-fluid level

Endogenous endophthalmitis secondary to erysipelas

A 64-year-old woman with chronic right arm lymphoedema presented with progressive and painful vision loss in the right eye following diagnosis of erysipelas in the ipsilateral arm. Visual acuity was light perception. Biomicroscopy revealed marked conjunctival injection, decreased corneal transparency and an inflammatory mass in the anterior chamber, which precluded fundoscopy. The ocular ultrasonography features were consistent with acute endophthalmitis, and the patient was admitted to the hospital. A systemic evaluation, including complete physical examination, echocardiography and blood tests, ruled out other sources of infection besides the cutaneous site. Blood cultures were positive for group A Streptococcus. A diagnosis of unilateral acute endophthalmitis due to group A Streptococcus bacteraemia secondary to erysipelas was made and successfully treated with optimal medical care, including prompt intravitreal and systemic antibiotic administration. Despite resolution of the infectious process, visual acuity did not improve.info:eu-repo/semantics/publishedVersio

Sequential Morphological Changes in the CNV Net after Intravitreal Anti-VEGF Evaluated with OCT Angiography

PURPOSE: To assess and describe sequential morphological changes in the choroidal neovascularization (CNV) net using optical coherence tomography angiography (OCTA) in patients undergoing treatment with intravitreal antivascular endothelial growth factor (VEGF). METHODS: Prospective cohort study. OCTA was performed sequentially: before (t0), 1 h (t1), 1 week (t2) and 1 month after the injection (t3), using Avanti RTVue XR equipped with the AngioVue® software (Optovue, Calif., USA). All images were classified by two independent graders. RESULTS: Ten eyes of 10 patients, with a mean age of 72.4 ± 10.5 years, were included. CNV morphology was described as tree-like in 5 eyes, glomerular in 1 and fragmented in 4. A fibrovascular capsule surrounding the CNV net was found in 4 eyes and a feeder trunk was noticed in 6. No changes were observed at t1. Loss of peripheral capillaries, vessel fragmentation and decreased vessel density were evident in 8 eyes at t2. The CNV capillary density and the peripheral anastomosis increased in all of these at t3. Two eyes remained unchanged through the whole length of follow-up. CONCLUSIONS: Significant changes in the CNV net can be observable in OCTA at least 1 week after intravitreal anti-VEGF. The safety of frequent examinations may provide a method of gauging treatment effects

A 65 k.y. time series from sediment-hosted glasses reveals rapid transitions in ocean ridge magmas

Studies of ocean ridge magmatism have been hampered by the difficulty in constructing time-series data over more than a few thousand years. Sediment rapidly covers newly formed ocean crust, and older rocks, even when recovered from fault scarps, cannot be dated accurately. Ridge eruptions, however, disperse pyroclastic glass over distances as far as 5 km, and these glasses have been shown to persist for thousands of years in on-ridge sediment push cores. Here we present data on such glasses from a piston core that impacted basement in much older (600 ka) sediment. The age of deposition was determined using established stratigraphic methods to date the host sediment, yielding an average sample resolution of a few thousand years and a continuous 65 k.y. time series. The new time-series data show systematic temporal variations in magma compositions related to a change to the dynamics of crustal storage, which led to greater extents of pre-eruptive differentiation. Shortly thereafter was a small but discernable shift toward more enriched primary melt compositions. These events coincide with the onset of enhanced crustal production, previously identified using seismic data and interpreted to reflect the capture of a hotspot by the ridge. These results show the long-term preservation of pyroclastic glasses and suggest that the construction of high-resolution volcanic stratigraphy over a million years or more may be possible at ocean ridges, using multiple piston cores that impact basement. Sediment-hosted glasses have the potential to transform ocean ridges from the volcanic setting with the worst time-series data to that with the best

Invasive Meningococcal Disease Unraveling a Novel Mutation in the C5 Gene in a Portuguese Family

Although bacterial meningitis is a rare presentation of a congenital immunodeficiency, invasive meningococcal disease is classically associated with complement deficiencies. We report a patient from a consanguineous kindred presenting with an invasive meningococcal disease caused by serogroup B meningococcus that revealed an underlying C5 deficiency caused by a novel mutation in the C5 gene.info:eu-repo/semantics/publishedVersio

Placebo prescription and empathy of the physician: a cross-sectional study

Background: Empathy in the patient-physician relationship is a major component in an effective placebo treatment, as in every medical treatment. Understanding the role of empathy of the physician in the placebo effect may help dissect some of the context variables responsible for the effectiveness of the placebo. Objectives: To determine the frequency of placebo prescription, doctors' beliefs, motivation, and attitudes to placebos in general practice in northern Portugal and to test the association between placebo prescription and physician empathy. Methods: A cross-sectional study was conducted between November 2014 and January 2015 among general practice specialists and interns from 14 health centres in a northern Portuguese health region. The self-report questionnaire included the Portuguese version of the Jefferson scale of physician empathy (JSPE) and a questionnaire about placebo prescription. Associations between demographic variables, JSPE score, prescription of placebo, and the attitudes to placebo score were tested with the chi-squared statistic, student t-tests for independent samples, and Pearson correlation. Results: The study included 93 general practitioners (GP) (response rate: 74%). Placebos were prescribed by 73% (n = 68) of the respondents. GPs who prescribe placebo are significantly younger (mean age = 38.4 years; SD = 11.1; t (90) = 2.98, P<.05, d = 0.67) than non-prescribers (mean age = 46.5 years; SD = 13.3). Favourable attitudes towards placebo prescription are associated with higher empathy scores (R = 0.310, P<.01). Conclusion: Placebo prescription is frequent and associated with empathy from the prescriber, especially among younger GPs.info:eu-repo/semantics/publishedVersio

Climate Dynamics: A Network-Based Approach for the Analysis of Global Precipitation

Precipitation is one of the most important meteorological variables for defining the climate dynamics, but the spatial patterns of precipitation have not been fully investigated yet. The complex network theory, which provides a robust tool to investigate the statistical interdependence of many interacting elements, is used here to analyze the spatial dynamics of annual precipitation over seventy years (1941-2010). The precipitation network is built associating a node to a geographical region, which has a temporal distribution of precipitation, and identifying possible links among nodes through the correlation function. The precipitation network reveals significant spatial variability with barely connected regions, as Eastern China and Japan, and highly connected regions, such as the African Sahel, Eastern Australia and, to a lesser extent, Northern Europe. Sahel and Eastern Australia are remarkably dry regions, where low amounts of rainfall are uniformly distributed on continental scales and small-scale extreme events are rare. As a consequence, the precipitation gradient is low, making these regions well connected on a large spatial scale. On the contrary, the Asiatic South-East is often reached by extreme events such as monsoons, tropical cyclones and heat waves, which can all contribute to reduce the correlation to the short-range scale only. Some patterns emerging between mid-latitude and tropical regions suggest a possible impact of the propagation of planetary waves on precipitation at a global scale. Other links can be qualitatively associated to the atmospheric and oceanic circulation. To analyze the sensitivity of the network to the physical closeness of the nodes, short-term connections are broken. The African Sahel, Eastern Australia and Northern Europe regions again appear as the supernodes of the network, confirming furthermore their long-range connection structure. Almost all North-American and Asian nodes vanish, revealing that extreme events can enhance high precipitation gradients, leading to a systematic absence of long-range patterns

Portugal and Angola: the politics of a troubled media relationship

In his last text of 2016, published on Christmas day, the editor of Angola’s official newspaper, Jornal de Angola, wrote a ‘message of harmony’ where he chose to focus on diplomatic relations with the former colonial power. José Ribeiro’s reading was clear: “Forty one years after independence the Portuguese elites still treat us impolitely as if we were their slaves” (Ribeiro, 2016). This posture would be reinforced precisely a week later in the first editorial of 2017: “Angola will not cease to be an independent country (…) no longer willing to accept mouldy neo-colonial impositions from abroad” (Ribeiro, 2017).(undefined)info:eu-repo/semantics/publishedVersio