Agreement between premortem and postmortem diagnoses in patients with acquired immunodeficiency syndrome observed at a brazilian teaching hospital

Acquired immunodeficiency syndrome (AIDS) is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical) diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7%) autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition

Evolution of IgG antibody response against Toxoplasma gondii tissue cyst in acute and chronic human infections

The recognition profile of the tissue cysts antigens by IgG antibodies was studied during acute and chronic human toxoplasmic infection. Thus the IgG response against Toxoplasma gondii was investigated by immunoblotting in two patients accidentally infected with the RH strain as well as in group of naturally infected patients at acute and chronic phase. There was an overall coincidence of molecular mass among antigens of tachyzoites and tissue cysts recognized by these sera, however, they appear not to be the same molecules. The response against tissue cysts starts early during acute infection, and the reactivity of antibodies is strong against a wide range of antigens. Six bands (between 82 and 151 kDa) were exclusively recognized by chronic phase sera but only the 132 kDa band was positive in more than 50% of the sera analysed. A mixture of these antigens could be used to discriminate between the two infection phases. The most important antigens recognized by the acute and the chronic phase sera were 4 clusters in the ranges 20-24 kDa, 34-39 kDa, 58-80 kDa and 105-130 kDa as well as two additional antigens of 18 and 29 kDa. Both accidentally infected patients and some of the naturally infected patients showed a weak specific response against tissue cyst antigens.

Rapid Evolution of the Sequences and Gene Repertoires

Proteins secreted to the extracellular environment or to the periphery of the cell envelope, the secretome, play essential roles in foraging, antagonistic and mutualistic interactions. We hypothesize that arms races, genetic conflicts and varying selective pressures should lead to the rapid change of sequences and gene repertoires of the secretome. The analysis of 42 bacterial pan-genomes shows that secreted, and especially extracellular proteins, are predominantly encoded in the accessory genome, i.e. among genes not ubiquitous within the clade. Genes encoding outer membrane proteins might engage more frequently in intra-chromosomal gene conversion because they are more often in multi-genic families. The gene sequences encoding the secretome evolve faster than the rest of the genome and in particular at non-synonymous positions. Cell wall proteins in Firmicutes evolve particularly fast when compared with outer membrane proteins of Proteobacteria. Virulence factors are over-represented in the secretome, notably in outer membrane proteins, but cell localization explains more of the variance in substitution rates and gene repertoires than sequence homology to known virulence factors. Accordingly, the repertoires and sequences of the genes encoding the secretome change fast in the clades of obligatory and facultative pathogens and also in the clades of mutualists and free-living bacteria. Our study shows that cell localization shapes genome evolution. In agreement with our hypothesis, the repertoires and the sequences of genes encoding secreted proteins evolve fast. The particularly rapid change of extracellular proteins suggests that these public goods are key players in bacterial adaptation.

Evolution of Drug Resistance: Insight on TEM β-Lactamases Structure and Activity and β-Lactam Antibiotics

Since the discovery of the first penicillin bacterial resistance to β-lactam antibiotics has spread and evolved promoting new resistances to pathogens. The most common mechanism of resistance is the production of β-lactamases that have spread thorough nature and evolve to complex phenotypes like CMT type enzymes. New antibiotics have been introduced in clinical practice, and therefore it becomes necessary a concise summary about their molecular targets, specific use and other properties. β-lactamases are still a major medical concern and they have been extensively studied and described in the scientific literature. Several authors agree that Glu166 should be the general base and Ser70 should perform the nucleophilic attack to the carbon of the carbonyl group of the β-lactam ring. Nevertheless there still is controversy on their catalytic mechanism. TEMs evolve at incredible pace presenting more complex phenotypes due to their tolerance to mutations. These mutations lead to an increasing need of novel, stronger and more specific and stable antibiotics. The present review summarizes key structural, molecular and functional aspects of ESBL, IRT and CMT TEM β-lactamases properties and up to date diagrams of the TEM variants with defined phenotype. The activity and structural characteristics of several available TEMs in the NCBI-PDB are presented, as well as the relation of the various mutated residues and their specific properties and some previously proposed catalytic mechanisms.

Digital storytelling: student ID in higher education

Identity achievement is related to personality, as well as cognitive and interpersonal development. In tandem with the deep structural changes that have taken place in society, education must also shift towards a teaching approach focused on learning and the overall development of the student. The integration of technology may be the drive to foster the needed changes. We draw on the literature of multiple subject areas as basis for our work, namely: identity construction and self-representation, within a psychological and social standpoint; Higher Education (HE) in Portugal after Bologna, college student development and other intrinsic relationships, namely the role of emotions and interpersonal relationships in the learning process; the technological evolution of storytelling towards Digital Storytelling (DS) – the Californian model – and its connections to identity and education. Ultimately we propose DS as the aggregator capable of humanizing HE while developing essential skills and competences. Grounded on an interpretative/constructivist paradigm, we implemented a qualitative case study to explore DS in HE. In three attempts to collect student data, we gathered detailed observation notes from two Story Circles; twelve student written reflections; fourteen Digital Stories and detailed observation notes from one Story Show. We carried out three focus groups with teachers where we discussed their perceptions of each student prior to and after watching the Digital Stories, in addition to their opinion on DS in HE as a teaching and learning method and its influence on interpersonal relationships. We sought understandings of the integration of DS to analyze student selfperception and self-representation in HE contexts and intersected our findings with teachers’ perceptions of their students. We compared teachers’ and students’ perspectives, through the analysis of data collected throughout the DS process – Story Circle, Story Creation and Story Show – and triangulated that information with the students’ personal reflections and teacher perceptions. Finally we questioned if and how DS may influence teachers’ perceptions of students. We found participants to be the ultimate gatekeepers in our study. Very few students and teachers voluntarily came forth to take part in the study, confirming the challenge remains in getting participants to see the value and understand the academic rigor of DS. Despite this reluctance, DS proved to be an asset for teachers and students directly and indirectly involved in the study. DS challenges HE contexts, namely teacher established perception of students; student’s own expectations regarding learning in HE; the emotional realm, the private vs. public dichotomy and the shift in educational roles.

The genetic basis of morphological change in convergent evolution of natural populations: identifying candidate genes behind convergent evolution in blind cavefish astyanax mexicanus

Dissertation presented to obtain the Ph.D. degree in Biology at the Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa.

As representações dos professores acerca da participação de alunos com necessidades educativas especiais em diversas atividades escolares

Os paradigmas concernentes à educação e ao atendimento de crianças com necessidades educativas especiais têm evoluído ao longo do tempo. De facto, se no paradigma da segregação o foco de incapacidade se situava no indivíduo, com o paradigma da inclusão o foco desloca-se para o ambiente, na medida em que este se deve organizar e preparar para dar resposta aos indivíduos com incapacidade. Por conseguinte, o meio deve assumir-se como facilitador à participação de todas as crianças. Tal fundamento comporta desafios para os professores e educadores, aos quais compete identificar as pressões de exclusão que inibem a participação plena de todos os alunos em todas as atividades inerentes ao meio escolar e acionar os suportes necessários para que tal não suceda. Com a realização deste estudo pretendemos conhecer de modo mais aprofundado as representações dos professores acerca da participação de alunos com diferentes tipos de incapacidade em variadas atividades e contextos escolares, identificando barreiras e facilitadores à sua participação e analisando os possíveis contributos pessoais dos professores para incrementar o nível de participação dos alunos com incapacidade em atividades inerentes ao meio escolar. O estudo operacionalizou-se através da aplicação de um inquérito por questionário, destinado a professores de todos os níveis de ensino e grupos de recrutamento. Através da aplicação deste instrumento, procurámos obter informações sobre os inquiridos, as representações dos professores acerca da participação de alunos com diferentes tipos de incapacidade em diversas atividades escolares, e, por fim, possíveis contributos para incrementar o nível de participação desses mesmos alunos. Os resultados sugerem que o tipo de incapacidade apresentado pelo aluno influencia as expetativas de participação de educadores e professores do ensino regular e da educação especial. Contudo, não confirmámos a existência de diferenças estatisticamente significativas entre os dois grupos de professores. No que concerne a possíveis contributos para incrementar a participação de alunos com incapacidade em diversas atividades escolares, identificámos a necessidade de se fomentar e desenvolver uma cultura de inclusão na escola.

Evolution of genotypes of Group A streptococci from colonization and infection

Dissertação para obtenção do Grau de Doutor em Biologia

Clinical characteristics and evolution of syphilis in 24 HIV+ individuals in Rio de Janeiro, Brazil

A total of 24 patients with syphilis and HIV infection were treated from January 1997 to March 2003 at the Infectious Dermatology Outpatient Clinic of the Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. The caseload consisted of 20 males (83.3%) and four females (16.7%), with a mean age of 38.04 years and mean T CD4+ count of 389.5 cells/mL. Syphilis was diagnosed as secondary in 16 (62.5%) patients, late latent in eight (33.3%), and tertiary in one (4.2%). Manifestations of secondary syphilis were palmar and plantar erythematopapulous cutaneous lesions in nine (37.5%), papulous exanthema in four (16.7%), patchy alopecia in 3 (12.5%) and osteochondritis in one patient (4.2%). Tertiary syphilis was characterized by verrucous lesions. Neurosyphilis was diagnosed in four patients (16.7%), with headache as the only manifestation in two patients. Drugs used in treatment included benzathine penicillin, ceftriaxone, erythromycin, and crystalline penicillin. Cure was achieved in 18 patients (75%). Five patients (20.8%) were retreated, three of whom presented a history of re-exposure. This study confirms the importance of establishing the diagnosis of neurosyphilis in patients with HIV infection, in addition to performing follow-up on treatment for syphilis.

Standard commercial education robotic platform: intermediate solution to teaching robotics

Teaching robotics to students at the beginning of their studies has become a huge challenge. Simulation environments can be an effective solution to that challenge where students can interact with simulated robots and have the first contact with robotic constraints. From our previous experience with simulation environments it was possible to observe that students with lower background knowledge in robotics where able to deal with a limited number of constraints, implement a simulated robotic platform and study several sensors. The question is: after this first phase what should be the best approach? Should the student start developing their own hardware? Hardware development is a very important part of an engineer's education but it can also be a difficult phase that could lead to discouragement and loss of motivation in some students. Considering the previous constraints and first year engineering students’ high abandonment rate it is important to develop teaching strategies to deal with this problem in a feasible way. The solution that we propose is the integration of a low-cost standard robotic platform WowWee Rovio as an intermediate solution between the simulation phase and the stage where the students can develop their own robots. This approach will allow the students to keep working in robotic areas such as: cooperative behaviour, perception, navigation and data fusion. The propose approach proved to be a motivation step not only for the students but also for the teachers. Students and teachers were able to reach an agreement between the level of demand imposed by the teachers and satisfaction/motivation of the students.

Abdominal angiostrongyliasis: a case with severe evolution

A case of acute abdomen disease caused by abdominal angiostrongyliasis is reported. A 42-year-old otherwise healthy patient presented with a complaint of nine days of abdominal pain, constipation, disury, fever and right iliac fossa palpable mass. Exploratory laparotomy was performed. After surgical treatment the patient presented serious complications.

Teaching accounting and management through business simulation

Everyday accounting and management teachers face the challenge of creating learning environments that motivate students. This chapter describes the Business Simulation (BS) experience that has taken place at the Polytechnic Institute of Porto, Institute of Accounting and Administration (IPP/ISCAP). The chapter presents students’ perceptions about the course and the teaching/learning approach. The results show that pedagogical methods used (competency-oriented), generic competencies (cooperation and group work), and interpersonal skills (organisational and communication skills) are relevant for future accounting professionals. In addition, positive remarks and possible constraints based on observation, staff meetings, and past research are reported. The chapter concludes with some recommendations from the project implementation

Developing writing skills in English language teaching through the use of blogs and e-mail at primary school level

Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teaching English as a Second / Foreign Language

Training and discovering corpus-based data driven exercices in english teaching (L2/FL) to native speakers of portuguese (L1)

Project submitted as part requirement for the degree of Masters in English teaching,