Meningococcal disease in a kidney transplant recipient with mannose-binding lectin (MBL) deficiency

Background: There is an increasing amount of data associating MBL deficiency with a higher susceptibility to meningococca[ disease. In addition, meningococca[ disease has been reported in patients with various immunosuppressive conditions. However, to our knowledge, only three cases of meningococca[ disease have been reported in solid organ recipients (SOT). Methods & Results: A 32 year-old male patient underwent cadaveric kidney transplantation for endstage renal disease of unknown origin. On day 71 post-transplantation he developed fever (39.6°C), shaking chilis, and tachycardia without hypotension. At this time, immunosuppression consisted of tacro[imus, prednisone 10mg daily and mycopheno[ ate mofeti[ 2 g daily. Physical examination on admission was normal, except for two small petechia[ lesions on the forearm. No meningeal signs were present. Three sets of blood cultures grew Neisseria meningitidis group C susceptible to ceftriaxone (MIC=0.003mg/[). Antibiotic therapy consisted in intravenous ceftriaxone 2 g per day for a total duration of 7 days. Serum immunog[obu[in levels, C3, C4 and CHS0 were normal However, using a method to screen for the functional activity of a[[ three pathways of complement (Wies[ab, Lund, Sweden), no activation via the MBL pathway could be detected (0%). A subsequent quantification of MBL pathway components revealed normal levels of MASP 2 but undetectab[e amounts of MBL (below 10 ng/m[, normal range: >500 ng/m[). Conclusion: Since the exact incidence and the possible relationship between meningococca[ disease and organ transplantation is not we[[ understood, we strongly encourage transplantation centers to report additional cases. The potential clinical usefu[ ness of screening SOT candidates for MBL deficiency in relation to infectious complications after transplantation remains to be determined.

Integração de Sistemas de Bombas de Calor Geotérmicas em Edifícios

A simulação de edifícios e sistemas de aquecimento está na base deste trabalho. O edifício em estudo é a Residência Universitária Polo-II-1, com o objectivo de adaptar utilização de “Ground Source Heat Pumps” (GSHP) para satisfazer a necessidade de aquecimento do edifício. Para determinar a carga térmica, o edifício terá que ser modelado no software de simulação dinâmica multizona TRNSYS (TRaNsient SYstems Simulation). Da mesma forma que o edifício, o sistema também é modelado no TRNSYS a fim de obter o desempenho da GSHP a ser utilizado no edifício. Para melhor avaliar os benefícios do sistema, vai ser preciso uma análise comparativa da GSHP com outros sistemas normalmente utilizados para o aquecimento doméstico.

Treatment of cytomegalovirus infection or disease in solid organ transplant recipients with valganciclovir.

Valganciclovir (VGC) has proved efficacious and safe for the prophylaxis against cytomegalovirus (CMV) in high-risk transplant recipients and for the treatment of CMV retinitis in AIDS patients. We used VGC for the treatment of CMV infection (viremia without symptoms) or disease (CMV syndrome or tissue-invasive disease) in kidney, heart, and lung transplant recipients. Fourteen transplant recipients were treated: five for asymptomatic CMV infection and nine for CMV disease. VGC was administered in doses adjusted to renal function for 4 to 12 weeks (induction and maintenance therapy). Clinically, all nine patients with CMV disease responded to treatment. Microbiologically, treatment with VGC turned blood culture negative for CMV within 2 weeks in all patients and was associated with a > or =2 log decrease in blood CMV DNA within 3 weeks in 8 of 8 tested patients. With a follow-up of 6 months (n = 12 patients), asymptomatic recurrent CMV viremia was noted in five cases, and CMV syndrome noted in one case (all cases in the first 2 months after the end of treatment). VGC was clinically well tolerated in all patients; however, laboratory abnormalities occurred in three cases (mild increase in transaminases, thrombocytopenia, and pancytopenia). This preliminary experience strongly suggests that therapy with VGC is effective against CMV in organ transplant recipients; however, the exact duration of therapy remains to be determined: a longer course may be necessary to prevent early recurrence.

Avaliação do projeto Final - Recursos Hídrico do Tarrafal – Cabo Verde

A avaliacão do projecto do recursos hidricos do Tarrafal (Cabo Verde ) tem por base dois objectivos: 1) Cumprir as obrigag8es do contrato, o qual roquor uwa avaliação.o final, a 2) Sujeitar-se aon requisitos da CID pars a avaliação final. Desta formal a extenslo deta avaliaqlo 6 male quo ura simples rovialo, reopondendo a obrigaqos do contracto. Esta avaliagKot tern por fim estimar a forma coo o projecto atinglu ou doixou do atingir os objectivos propostos. An recomendaga4s quo safram desta avalia qio dovem sorvir para melhorar os projectos om andamento quo integram no sistema da CID. Ambos o fundos da CID o do contracto foram utilizados nesta avaliaqlo Os pontos apresentados nests documento slo da equipe do avaliaqlo o n~o representan necessariamente 0s da Administraqlo o/ou do Executivo da CID. B. A.VLICrUi)Z DA Ai1ALIAj!O Todo o projecto do Recurnos Hfdricos do Tarrafal eat inserido dontro do pris1m desta avalia.lo. Zbora outrou relatdrios tenham servido do fontes do infor=qlo, a proeantj oxamina o projecto dead. o porfodo da preparaqEo at o trmino C. EQU!!' DE AYALIACKO A equioe roi Joloeada polo Dean ( tipo do reitor do faculdads )# Director da Cemara don Adminintradoras da CID Dr. drnont Briskoyp o polo Director do Executivo, Dr. John L. Fiecher. A avaliaqgo foi orientada pole repartiglo do Executivo da CID. 0 Dr. Barry Re. Baintonp agents director do projectop coordenou o processo do avaliaqEo. 0 Dr. Gerald 3stlockq director do programus Internacionais do agricultura na Universidade do Arizonap foi selocionado coo lider da equips . 0 Dr. Howard Peterson, professor do agriculture • ongenharia do irrgaqIo da Universidade do Utah, foi selecionado coma segundo mumbro da equips. 0 Dr. Peterson ji tinha cumprido dues misses no projecto em Cabo Verde. 0 Dr. Jean Ruley Kearns, conselheiro director da CID no poriodo do 1982-83p fot selecionado comc sondo o tarceiro membro da equipe. D. ATODO DE AVALIAQXO Os pianos proliminares para conduzir a avaliaqo foram feitos numa rounibo inicial em Tucson ( Arizona ) a 5 do novembro do 1982. Nessa rounilo foi deci dido quo o Dr. Matlock visitaria o projecto durante o afs do novembro do 1982. A visita fot planojada do forma a coincidir com a presenga do Kern Stutlor, director coordenador do projectop quo devoria astar am Cabo lirde nessa data co.mpletando os trabalho a preparando o relat6rio final. Uma c6pia do Procasio do Avaliaglo pola AID assim como cdpias do relatdrios anteriores a outros docunontos rolevantea foram diatribufdos aos membros da equips duranto a reunigo inicial. Oa docu ientos examinados polos membros da equip. encontram-se listados na secção /III, Referiencias

Humoral Response to the Influenza A H1N1/09 Monovalent AS03-Adjuvanted Vaccine in Immunocompromised Patients.

Background. Few data are available regarding the immunogenicity and safety of the pandemic influenza vaccine in immunocompromised patients. We evaluated the humoral response to the influenza A H1N1/09 vaccine in solid-organ transplant (SOT) recipients, in patients with human immunodeficiency virus (HIV) infection, and in healthy individuals. Methods. Patients scheduled to receive the pandemic influenza vaccine were invited to participate. All participants received the influenza A H1N1/09 AS03-adjuvanted vaccine containing 3.75 μg of hemagglutinin. SOT recipients and HIV-infected patients received 2 doses at 3-week intervals, whereas control subjects received 1 dose. Blood samples were taken at day 0, day 21, and day 49 after vaccination. Antibody responses were measured with the hemagglutination inhibition assay (HIA) and a microneutralization assay. Results. Twenty-nine SOT recipients, 30 HIV-infected patients, and 30 healthy individuals were included in the study. Seroconversion measured by HIA was observed in 15 (52%) of 29 SOT recipients both at day 21 and day 49; in 23 (77%) of 30 at day 21 and 26 (87%) of 30 at day 49 in HIV-infected patients, and in 20 (67%) of 30 at day 21 and in 23 (77%) of 30 at day 49 in control subjects (P = .12 at day 21 and P = .009 at day 49, between groups). Geometric means of antibody titers were not significantly different between groups at day 21 or at day 49. Conclusions. Influenza A H1N1/09 vaccine elicited a similar antibody response in HIV-infected individuals and in control subjects, whereas SOT recipients had an overall lower response. A second dose of the vaccine only moderately improved vaccine immunogenicity in HIV-infected patients.

Gestió de l'aigua i de les conques fluvials

Els dies 14 i 15 de juliol de 2005 es va celebrar a la Facultat deLletres de la Universitat de Girona la sisena edició de l'EscolaInternacional de Medi Ambient, enguany dedicada a la gestió del'aigua i les conques fluvials i organitzada per l'Institut de MediAmbient de la Universitat de Girona i el Consorci Alba-Ter

Les Unitats de paisatge de les terres de Girona

El paisatge de les comarques gironines destaca per la seva varietat. Aquest fet és el resultat de la combinació d'un medi biofísic molt divers amb una activitat humana secular. Cal tenir present que a les terres gironines hi estan representades totes les grans unitats de relleu de Catalunya, des dels Pirineus fins a les planes i serralades costaneres

Canvis i permanències a les closes de l'Alt Empordà

Una de les causes principals que van motivar la creació del Parc Natural dels Aiguamolls de l'Empordà va ser, indiscutiblement, la potencialitat de les zones marjalenques empordaneses d'acollir un gran nombre i varietat d'aus. El marc legislatiu que va fer efectiva la protecció, però, no limitava la seva acció a aquest grup, sinó que l'estenia al conjunt de flora i fauna present a la zona, i a tots els sistemes propers que n'havien de garantir la permanència. Així, a més de definir-se unes àrees de màxima protecció sota la denominació de Reserves Naturals Integrals, els límits del PNAE engloben àrees potser menys emblemàtiques, però que són clau per al manteniment del conjunt de sistemes d'aiguamolls a l'Alt Empordà. El present article se centra en un d'aquests sistemes, que tradicionalment ha realitzat un paper d'actor secundari, però que té unes qualitats que, almenys des d'una aproximació geogràfica, el converteixen en protagonista. Es tracta de les closes

Conceptos y métodos fundamentales en ecología del paisaje (landscape ecology). Una interpretación desde la geografía

L'ecologia del paisatge neix en una vinculació ben estreta amb la geografia i viu un espectacular desenvolupament a partir de la segona meitat del segle XX. En l’actualitat, és una perspectiva científica transdisciplinària, consolidada i reconeguda, que intenta comprendre i ajudar a resoldre els principals reptes ambientals contemporanis pel que fa a la conservació del patrimoni natural i cultural. En aquestes pàgines, es repassa de forma sintètica els conceptes clau i els mètodes, eminentment quantitatius, emprats per l’ecologia del paisatge per analitzar la situació i l’evolució dels paisatges

L'evolució del paisatge de les closes: 1957-2001

Comunicació on es pretenen presentar alguns dels resultats més significatius de la investigació amb referència a l’evolució de les cobertes del sòl a l’Alt Empordà entre 1957-2001, i parant especial atenció a les transformacions identificades en el paratge de closes

Composición y estructura de las comunidades de algas bentónicas de ambientes portuarios: El puerto de Blanes

The species composition and the structure of the harbour communities of Enteromorpha copmpressa, Corallina elongata and the internal communities in Blanes harbour (Girona, Spain), have been studied by means of descriptive and analytical data. All the quantitative parameters studied show a decrease of diversity in the more superficial stations of the mouth of the harbour, and also an increasing diversity and a drastic decreasing of the reproduction indices at the more polluted stations

Business Plan: Proyecto de creación de un nuevo canal publicitario a nivel nacional: Desarrollo del mercado y creación de empresa de venta de publicidad

El present Treball Final de Carrera pretén desenvolupar la viabilitat d’una empresa de serveis, que ofereix un nou suport publicitari basat en una red pròpia de tours turístics en patinets elèctrics distribuïts per les principals ciutats a nivell nacional.