Estudio clinico micologico de onimicosis en ancianos

Se realizó examen físico de las uñas a 210 ancianos y a aquellos que presentaron lesiones sugestivas de onicomicosis se les realizó toma de muestra con el objetivo de conocer los principales agentes causales, las características e incidencia de las lesiones. Se confirmó el diagnóstico mediante el aislamiento del agente causal en 74 de los casos procedentes principalmente de las uñas de los pies, para una incidencia de 35,2. La tinea pedis se presentó en el 25,7% de los casos, mientras que la enfermedad asociada más frecuente fue la Diabetes mellitus; entre las características clínicas de las uñas predominaron el engrosamiento, la pérdida del brillo y la aparición de estrías longitudinales. Existió una correspondencia significativa entre el examen microscópico directo y el cultivo. La especie de dermatofito predominate fue Trichophyton rubrum, mientras que Candida parapsilosis fue la más aislada entre las especies de Candida.

ACUTE TOXOPLASMOSIS IN A BREASTFED INFANT WITH POSSIBLE TRANSMISSION BY WATER

Toxoplasma gondii transmission via breastfeeding has been discussed; however, no cases have been confirmed to date. This article describes a case of acute toxoplasmosis diagnosed in a mother and her six-month-old breastfed infant. The study accounts for the possibility of breast milk transmission and directs both clinicians and pediatricians to the hypothesis that both patients acquired toxoplasmosis via water ingestion.

Prevalência da co-infecção HIV-sífilis em um hospital universitário da cidade do Rio de Janeiro no ano de 2005

Estudo de prevalência da co-infecção HIV-sífilis realizado com 830 pacientes em acompanhamento ambulatorial para HIV/aids entre janeiro e maio de 2005 no Hospital na cidade do Rio de Janeiro. Os participantes realizaram exames de VDRL (veneral disease research laboratory), contagens de células CD4+/CD8+ e de carga viral e responderam perguntas sobre características sócio-demográficas e história prévia de sífilis. A prevalência da sífilis foi de 2,7% (22), a relação entre homens e mulheres co-infectados foi de 4:1, aproximadamente. Homossexuais masculinos foram os mais acometidos e não encontramos associação entre co-infecção e idade, escolaridade e parâmetros laboratoriais testados. Do total de casos com sífilis, 73% (16) relataram tratamento prévio; destes, 14 (88%) pacientes foram re-infectados, enquanto 2 (12%) pacientes realizaram tratamento inapropriado. A presença de co-infecção HIV-sífilis em pacientes em acompanhamento rotineiro alerta-nos para necessidade de aconselhá-los a adotar práticas sexuais seguras durante os seus atendimentos ambulatoriais.

Hypertonic/hyperoncotic solution in hypovolemic patients: experience in the emergency room

Hypertonic solutions have been studied extensively in the treatment of hypovolemic shock, both in experimental and clinical models. Safety, efficacy, and long-term effects on animals and patients have been evaluated. The present article reviews indications, safety, mortality rates, and outcome in patients with hemorrhagic hypovolemic shock who were treated after admission with a hypertonic/hyperoncotic solution under strict observation in the emergency room.

Bile duct-duodenal fistula caused by AIDS/HIV-associated tuberculosis

Allthough infrequent, digestive fistulae in HIV/AIDS patients have been reported throughout the digestive tract from the esophagus to the anus, with predominance of esophageal fistulae. AIDS/HIV-associated opportunistic infections may invade the digestive system and lead to fistula formation. Tuberculosis is the most common infection associated with these esophageal fistulae. We report here one case of bile duct-duodenal fistula in a female AIDS patient with associated abdominal Mycobacterium tuberculosis infection compromising lymphnodes of the hepatic pedicle where the fistula was found. According to the reviewed literature, this is the third case of bile duct-duodenal fistula associated with abdominal tuberculosis in AIDS patient, and the first where both the fistula and the tuberculosis infection were diagnosed at laparotomy for acute abdomen. Whether the AIDS patient with abdominal pain needs or not a laparotomy to treat an infectious disease is often a difficult matter for the surgeon to decide, as most of the times appropriate medical treatment will bring more benefit.

Towards human-like bimanual movements in anthropomorphic robots: a nonlinear optimization approach

Previously we have presented a model for generating human-like arm and hand movements on an unimanual anthropomorphic robot involved in human-robot collaboration tasks. The present paper aims to extend our model in order to address the generation of human-like bimanual movement sequences which are challenged by scenarios cluttered with obstacles. Movement planning involves large scale nonlinear constrained optimization problems which are solved using the IPOPT solver. Simulation studies show that the model generates feasible and realistic hand trajectories for action sequences involving the two hands. The computational costs involved in the planning allow for real-time human robot-interaction. A qualitative analysis reveals that the movements of the robot exhibit basic characteristics of human movements.

Variación florística de especies arbóreas a escala local en un bosque de tierra firme en la Amazonia colombiana

El presente estudio se llevó a cabo en cinco hectáreas de una parcela permanente establecida en el Parque Nacional Amacayacu, Amazonia colombiana. En éste, se evaluó el efecto de la variación ambiental y la configuración espacial sobre los patrones florísticos de las especies arbóreas (DAP>10 cm) a escala local en un bosque de tierra firme. Se estudió la variación florística y ambiental en cuadrantes de 20x20 m. Adicionalmente, se consideraron diferentes categorías de abundancia (total, alta, media y baja). Se utilizó el Análisis de Correspondencia Linealizado y el Análisis de Correspondencia Canónica, seguido de una partición de la variación, para cuantificar la magnitud a la cual el ambiente y la limitación en dispersión determinan la variación florística. La fracción espacial, representando procesos de autocorrelación como la limitación en dispersión, se analizó mediante dos métodos: Asumiendo un polinomio de tercer grado y por el método de Coordenadas Principales de Matrices Vecinas (PCNM). La diversidad beta de la parcela fue baja. El PCNM aparece como el método de análisis más apropiado para estudios a esta escala. Las diferencias florísticas explicadas a lo largo de la parcela de 5-ha fueron principalmente asociadas con procesos biológicos como la limitación en dispersión. La mayor parte de la variación florística, no obstante, no fue explicada por las variables ambientales o espaciales consideradas. En conclusión, estos resultados sugieren que procesos aleatorios son determinantes esenciales de la variación espacial de las especies arbóreas a escala local en tierra firme en los bosques en el Parque Nacional Amacayacu.

Flood pulse and spatial dynamics of mercury in sediments in Puruzinho lake, Brazilian Amazon

The study was conducted in Puruzinho lake (Humaitá, AM) considering seasonal periods of rainy and dry in way to elucidate the flood pulse importance in the deposition, remobilization and distributions of mercury and organic matter in bottom sediments in the Madeira River Basin (Brazilian Amazon). Bottom sediments and soils samples were analyzed for total mercury and organic matter. Mercury concentrations obtained in bottom sediment were 32.20-146.40 ng g-1 and organic matter values were 3.5 - 18.0%. The main region for accumulation of mercury and organic matter was in the central and deepest lake area In the rainy season there was a greater distribution of Hg and organic matter, mainly controlled by means of income of the Madeira river water during flooding, while the predominant process in the dry season was the remobilization of total Hg due to the resuspension of bottom sediments.

Multi-temporal analysis of radiometric changes in satellite images of forest edges to infer selective-logging areas in the Amazon forest

Radiometric changes observed in multi-temporal optical satellite images have an important role in efforts to characterize selective-logging areas. The aim of this study was to analyze the multi-temporal behavior of spectral-mixture responses in satellite images in simulated selective-logging areas in the Amazon forest, considering red/near-infrared spectral relationships. Forest edges were used to infer the selective-logging infrastructure using differently oriented edges in the transition between forest and deforested areas in satellite images. TM/Landsat-5 images acquired at three dates with different solar-illumination geometries were used in this analysis. The method assumed that the radiometric responses between forest with selective-logging effects and forest edges in contact with recent clear-cuts are related. The spatial frequency attributes of red/near infrared bands for edge areas were analyzed. Analysis of dispersion diagrams showed two groups of pixels that represent selective-logging areas. The attributes for size and radiometric distance representing these two groups were related to solar-elevation angle. The results suggest that detection of timber exploitation areas is limited because of the complexity of the selective-logging radiometric response. Thus, the accuracy of detecting selective logging can be influenced by the solar-elevation angle at the time of image acquisition. We conclude that images with lower solar-elevation angles are less reliable for delineation of selecting logging.

ADSNARK: Nearly practical and privacy-preserving proofs on authenticated data

We study the problem of privacy-preserving proofs on authenticated data, where a party receives data from a trusted source and is requested to prove computations over the data to third parties in a correct and private way, i.e., the third party learns no information on the data but is still assured that the claimed proof is valid. Our work particularly focuses on the challenging requirement that the third party should be able to verify the validity with respect to the specific data authenticated by the source — even without having access to that source. This problem is motivated by various scenarios emerging from several application areas such as wearable computing, smart metering, or general business-to-business interactions. Furthermore, these applications also demand any meaningful solution to satisfy additional properties related to usability and scalability. In this paper, we formalize the above three-party model, discuss concrete application scenarios, and then we design, build, and evaluate ADSNARK, a nearly practical system for proving arbitrary computations over authenticated data in a privacy-preserving manner. ADSNARK improves significantly over state-of-the-art solutions for this model. For instance, compared to corresponding solutions based on Pinocchio (Oakland’13), ADSNARK achieves up to 25× improvement in proof-computation time and a 20× reduction in prover storage space.

Holt-Oram syndrome revisited. Two patients in the same family

Holt-Oram syndrome was first described in 1960 as an association of familial heart disease and musculoskeletal abnormalities. The most important findings include atrial septal defects, atrioventricular conduction abnormalities, vascular hypoplasia, and upper limb musculoskeletal deformities. We report two patients with this syndrome in the same family and discuss the variability of the musculoskeletal abnormalities and their association with the cardiac morphologic defects. Both patients in this study had associated eosinophilia, which has not been reported in the literature.

Postoperative necrotizing fasciitis of the thorax in cardiac surgery

Necrotizing fasciitis is a rare soft tissue infection and a life-threatening emergency, often fatal. Its incidence and management are described plentifully in the medical literature regarding the most common anatomical sites involved like the abdomen, lower and upper limbs, and perineum. However, available data and case reports of chest wall necrotizing fasciitis after thoracic procedures are scarce, mainly after major cardiac operations. We report and discuss a case of necrotizing fasciitis of the chest wall occurring in the immediate postoperative period of a cardiac procedure, and include a brief review of the concepts, pathophysiology, and treatment reported in the medical literature. We emphasize the need for early diagnosis and urgent and effective surgical debridement. Of importance is the fact that we have not found any references in the literature to cases similar or equal to the one we describe here, which occurred in the postoperative period of a cardiac procedure.

Primary Cardiac Angiosarcoma: A Therapeutical Dilemma

Cardiac angiosarcomas are malignant tumors that almost invariably have a short and fatal evolution. The therapeutic approach includes surgery, chemotherapy, and radiation therapy, alone or in combination. Heart transplantation is an attractive option in nonresectable tumors, even though the current experience is still limited. However, in most patients, the diagnosis is still established late, and survival is only slightly altered by the proposed treatments, mainly due to previously existing and undetected metastases. We report a case that illustrates the therapeutic dilemma faced with this neoplasia, and we discuss the case based on a literature review.