999 resultados para Moot Case


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Hepatobiliary alterations found in an autopsy case of massive Biliary Ascariasis, are reported on histological grounds. Severe cholangitis was the main finding, but other changes were also detected, such as pyloric and intestinal metaplasia, hyperplasia of the epithelial lining, with intraductal papillomas and adenomatous proliferation. Remnants of the worm were observed tightly adhered to the epithelium, forming microscopic intrahepatic calculi. Mucopolysaccharides, especially acid, showed to be strongly positive on the luminal border, and in proliferated glands around the ducts. The authors discuss the similarity between such findings and Oriental Cholangiohepatitis, and suggest that inflammation and the presence of the parasitic remnants are responsible for the hyperplastic and metaplastic changes, similarly with what occurs in chlonorchiasis, fascioliasis and schistosomiasis.

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A case of phaeohyphomycosis caused by Bipolaris hawaiiensis is reported. The patient, an immunocompetent host, presented a verrucous lesion on the first finger of the left foot. Dematiaceous septate hyphae and yeast-like elements were seen in direct and histological examination. The isolated strain was identified on the basis of micro and macromorphological aspects. Treated with electrocoagulation, the lesions healed and presented no relapse after two years follow-up.

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Serum sample obtained from a male, 12 year old patient suffering from Guillain-Barré syndrome (GBS) was positive for human T-lymphotropic virus (HTLV-I) antibody by the enzyme-linked immunosorbent assay (ELISA) and the Western Blot analysis (WB). Attempts to isolate enteroviruses (including poliovirus) from faecal material in both tissue culture and suckling mice were unsuccessful; in addition, acute and convalescent paired serum samples did not show any evidence of recent poliovirus infection when tested against the three serotypes. Specific tests for detection of Epstein-Barr virus infection were not performed; however, the Paul-Bunnel test yielded negative results. ELISA for detection of anti-cytomegalovirus IgM was also negative. The concomitant occurrence of either adult T cell leukemia (ATL) or lymphoma was not recorded in this case.

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The Tagus estuary is bordered by the largest metropolitan area in Portugal, the Lisbon capital city council. It has suffered the impact of several major tsunamis in the past, as shown by a recent revision of the catalogue of tsunamis that struck the Portuguese coast over the past two millennia. Hence, the exposure of populations and infrastructure established along the riverfront comprises a critical concern for the civil protection services. The main objectives of this work are to determine critical inundation areas in Lisbon and to quantify the associated severity through a simple index derived from the local maximum of momentum flux per unit mass and width. The employed methodology is based on the mathematical modelling of a tsunami propagating along the estuary, resembling the one occurred on the 1 November of 1755 that followed the 8.5 M-w Great Lisbon Earthquake. The employed simulation tool was STAV-2D, a shallow-flow solver coupled with conservation equations for fine solid phases, and now featuring the novelty of discrete Lagrangian tracking of large debris. Different sets of initial conditions were studied, combining distinct tidal, atmospheric and fluvial scenarios, so that the civil protection services were provided with comprehensive information to devise public warning and alert systems and post-event mitigation intervention. For the most severe scenario, the obtained results have shown a maximum inundation extent of 1.29 km at the AlcA cent ntara valley and water depths reaching nearly 10 m across Lisbon's riverfront.

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TICEduca. III Congresso Internacional TIC e Educação. 14 a 16 Novembro, Lisboa

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Given the significant impact that cultural events may have in local communities and the inherent organization complexity, it is important to understand their specificities. Most of the times cultural events disregard marketing and often marketing is distant from art. Thus an analysis of an inside perspective might bring significant returns to the organization of such an event. This paper considers the three editions (2011, 2012 and 2013) of a cultural event – Noc Noc – organized by a local association in the city of Guimarães, Portugal. Its format is based in analogous events, as Noc Noc intends to convert everyday spaces (homes, commercial outlets and a number of other buildings) into cultural spaces, processed and transformed by artists, hosts and audiences. By interviewing a sample of people (20) who have hosted this cultural event, sometimes doubling as artists, and by experiencing the three editions of the event, this paper illustrates how the internal public understands this particular cultural event, analyzing specifically their motivations, ways of acting and participating, as well as their relationship with the public, with the organization of the event and with art in general. Results support that artists and hosts motivations must be identified in a timely and appropriate moment, as well as their views of this particular cultural event, in order to keep them participating, since low budget cultural events such as this one may have a key role in small scale cities.

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The new recast of Directive 2010/31/EU in order to implement the new concept NZEB in new buildings, is to be fully respected by all Member States, and is revealed as important measure to promote the reduction of energy consumption of buildings and encouraging the use of renewable energy. In this study, it was tested the applicability of the nearly zero energy building concept to a big size office building and its impact after a 50-years life cycle span.

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This is a report of a 25 years old black woman from the city of São Paulo, Brazil, who developed acute obstructive cholangitis of Ascaris lumbricoides with septicemia and multiple hepatic abscesses. The patient had sickle cell trait and normal delivery 3 months ago. Massive infestation of the biliary tract by Ascaris lumbricoides was diagnosed by abdominal ultrasonography and endoscopic retrograde cholangiography. Sixty worms were removed from the common bile duct and hepatic abscesses were drained by surgery. The infectious process was polymicrobial. The patient's recovery was complete after a long evolution with a wide spectrum antibiotic therapy. New surgeries were needed to remove residual worms in the biliary tract. The diagnostic methods, clinical-biochemical features and also the clinical and surgical management are presented. The biliary ascariasis pathophysiology is commented.

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Within a large set of renewable energies being explored to tackle energy sourcing problems, bioenergy can represent an attractive solution if effectively managed. The supply chain design supported by mathematical programming can be used as a decision support tool to the successful bioenergy production systems establishment. This strategic decision problem is addressed in this paper where we intent to study the design of the residual forestry biomass to bioelectricity production in the Portuguese context. In order to contribute to attain better solutions a mixed integer linear programming (MILP) model is developed and applied in order to optimize the design and planning of the bioenergy supply chain. While minimizing the total supply chain cost the production energy facilities capacity and location are defined. The model also includes the optimal selection of biomass amounts and sources, the transportation modes selection, and links that must be established for biomass transportation and products delivers to markets. Results illustrate the positive contribution of the mathematical programming approach to achieve viable economic solutions. Sensitivity analysis on the most uncertain parameters was performed: biomass availability, transportation costs, fixed operating costs and investment costs. (C) 2015 Elsevier Ltd. All rights reserved.

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Glass fibre-reinforced plastics (GFRP) have been considered inherently difficult to recycle due to both: crosslinked nature of thermoset resins, which cannot be remoulded, and complex composition of the composite itself. Presently, most of the GFRP waste is landfilled leading to negative environmental impacts and supplementary added costs. With an increasing awareness of environmental matters and the subsequent desire to save resources, recycling would convert an expensive waste disposal into a profitable reusable material. In this study, efforts were made in order to recycle grinded GFRP waste, proceeding from pultrusion production scrap, into new and sustainable composite materials. For this purpose, GFRP waste recyclates, were incorporated into polyester based mortars as fine aggregate and filler replacements at different load contents and particle size distributions. Potential recycling solution was assessed by mechanical behaviour of resultant GFRP waste modified polymer mortars. Results revealed that GFRP waste filled polymer mortars present improved flexural and compressive behaviour over unmodified polyester based mortars, thus indicating the feasibility of the GFRP industrial waste reuse into concrete-polymer composite materials.

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Listeriosis is a not uncommon infection in humans, usually associated with immunodeficient states and with newborns. However, relatively few cases have been reported in HIV-infected patients. This scarcity of reported cases has aroused interest in the association of listerosis and AIDS. In this paper we present a case of meningitis and septicemia caused by Listeria monocytogenes in a female patient with AIDS. A review of recent medical literature indicates that association of listeriosis and AIDS may be more common than it seems. Recent research in host-parasite interaction in listerial infection suggests an important role for tumor necrosis factor (TNF) and for integralin, a bacterial protein, in modulating listerial disease in AIDS patients. Inadequate diagnosis may be in part responsible for the scarcity of reports.

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Dissertação apresentada para a obtenção do grau de Mestre em Engenharia do Ambiente, Perfil Engenharia Sanitária

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Purpose – Our paper aims at analyzing how different European countries cope with the European Energy Policy, which proposes a set of measures (free energy market, smart meters, energy certificates) to improve energy utilization and management in Europe. Design/methodology/approach – The paper first reports the general vision, regulations and goals set up by Europe to implement the European Energy Policy. Later on, it performs an analysis of how some European countries are coping with the goals, with financial, legal, economical and regulatory measures. Finally, the paper draws a comparison between the countries to present a view on how Europe is responding to the emerging energy emergency of the modern world. Findings – Our analysis on different use cases (countries) showed that European countries are converging to a common energy policy, even though some countries appear to be later than others In particular, Southern European countries were slowed down by the world financial and economical crisis. Still, it appears that contingency plans were put into action, and Europe as a whole is proceeding steadily towards the common vision. Research limitations/implications – European countries are applying yet more cuts to financing green technologies, and it is not possible to predict clearly how each country will evolve its support to the European energy policy. Practical implications – Different countries applied the concepts and measures in different ways. The implementation of the European energy policy has to cope with the resulting plethora of regulations, and a company proposing enhancement regarding energy management still has to possess robust knowledge of the single country, before being able to export experience and know-how between European countries. Originality/Value – Even though a few surveys on energy measures in Europe are already part of the state-of-the-art, organic analysis diagonal to the different topics of the European Energy Policy is missing. Moreover, this paper highlights how European countries are converging on a common view, and provides some details on the differences between the countries, thus facilitating parties interesting into cross-country export of experience and technology for energy management.

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Social responsibility arises as a measure of the corporate policy that goes beyond the production activity, thus covering also the social and environmental activities. This issue has been gaining importance over time. The number of companies that are implementing socially responsible actions has been growing steadily even though it is still centered on large and medium sized companies. Social responsibility is an accessible theme to any company of any size, once the social and environmental issues are resolved through concrete actions, but in the small and micro-sized companies there are factors that inhibit such actions. Some of these factors are: reduced investment capacity; minimal expectations of medium to long term returns; or even the short-term management focus that is aimed at survival. Such facts can be verified in the case of Portuguese companies, where out of the 41 companies certified by SA 8000 only 5 are micro-sized or small and even these are linked to large organizations.

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We report the first case of African histoplasmosis diagnosed in Brazil. The patient was an immigrant from Angola who had come to Brazil six months after the appearance of the skin lesion. The skin of the right retroauricular area was the only site of involvement. The diagnosis was established by direct mycologic examination, culture and by histopathologic examination of the lesion. The patient was successfully treated with Itraconazole 100mg a day for 52 days. No recurrent skin lesions were observed during the ten month follow-up period.