Penile Skin Involvement as the First Presentation of Henoch-Schonlein Purpura Report of Nine Cases and Review of Literature

Introduction: Involvement of penis is a rare presentation in henoch-schonlein purpura (HSP). The presentations are mainly due to the deposition of immunoglobulin A (IgA) into the vessel walls. In this report, we present the clinical history of nine HSP cases that presented with penile skin involvement. Case Presentation: All patients were referred in the acute phase of HSP. Penile skin involvement was evident as erythema, edema, ecchymosis, or induration of prepuce and/or penile shaft, that appeared simultaneously with skin rash in seven patients. Gastrointestinal involvement was positive in six patients. Patients were treated with steroids and follow up visits were normal except for one patient that developed crescentic glomerulonephritis. Conclusions: We present nine cases of HSP with penile involvement in order to indicate another rare aspect of HSP and its possible complications as well as its appropriate treatment.

Estudo sobre a migração transuterina e a razão sexual de conceptos em bovinos da raça Nelore (Bos taurus indicus)

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Agronomia e Medicina Veterinária, 2016.

The early shorebird will catch fewer invertebrates on trampled sandy beaches

Many species of birds breeding on ocean beaches and in coastal dunes are of global conservation concern. Most of these species rely on invertebrates (e.g. insects, small crustaceans) as an irreplaceable food source, foraging primarily around the strandline on the upper beach near the dunes. Sandy beaches are also prime sites for human recreation, which impacts these food resources via negative trampling effects. We quantified acute trampling impacts on assemblages of upper shore invertebrates in a controlled experiment over a range of foot traffic intensities (up to 56 steps per square metre) on a temperate beach in Victoria, Australia. Trampling significantly altered assemblage structure (species composition and density) and was correlated with significant declines in invertebrate abundance and species richness. Trampling effects were strongest for rare species. In heavily trafficked plots the abundance of sand hoppers (Amphipoda), a principal prey item of threatened Hooded Plovers breeding on this beach, was halved. In contrast to the consistently strong effects of trampling, natural habitat attributes (e.g. sediment grain size, compactness) were much less influential predictors. If acute suppression of invertebrates caused by trampling, as demonstrated here, is more widespread on beaches it may constitute a significant threat to endangered vertebrates reliant on these invertebrates. This calls for a re-thinking of conservation actions by considering active management of food resources, possibly through enhancement of wrack or direct augmentation of prey items to breeding territories.

2016 Eastern Equine Encephalitis Activity

Eastern equine encephalitis virus (EEEV) is transmitted to humans by the bite of an infected mosquito. Eastern equine encephalitis (EEE) is a rare illness in humans, and only a few cases are reported in the United States each year. Most cases occur in the Atlantic and Gulf Coast states. Most people infected with EEEV have no apparent illness. Severe cases of EEE (involving encephalitis, an inflammation of the brain) begin with the sudden onset of headache, high fever, chills, and vomiting. The illness may then progress into disorientation, seizures, or coma. EEE virus is one of the most severe mosquito transmitted diseases in the United States with approximately 33% mortality and significant brain damage in most survivors. There is no specific treatment for EEE; care is based on symptoms. You can reduce your risk of being infected with EEEV by using insect repellent, wearing protective clothing, and staying indoors while mosquitoes are most active.

Modelo de gestión para la atención integral de pacientes con enfermedades huérfanas o raras en Colombia

Las enfermedades raras o huérfanas corresponden a aquellas con baja prevalencia en la población, y en varios países tienen una definición distinta de acuerdo con el número de pacientes que afectan en la población. La Organización Mundial de la Salud (OMS), las define como un trastorno que afecta de 650 a 1.000 personas por millón de habitantes, de las que se han identificado alrededor de 7.000. En Colombia su prevalencia es menor de 1 por cada 5.000 personas y comprenden: las enfermedades raras, las ultra-huérfanas y las olvidadas. Los pacientes con este tipo de enfermedades imponen retos a los sistemas sanitarios, pues si bien afectan a un bajo porcentaje de la población, su atención implica una alta carga económica por los costos que involucra su atención, la complejidad en su diagnóstico, tratamiento, seguimiento y rehabilitación. El abordaje de las enfermedades raras requiere un manejo interdisciplinar e intersectorial, lo que implica la organización de cada actor del sistema sanitario para su manejo a través de un modelo que abraque las dinámicas posibles entre ellos y las competencias de cada uno. Por lo anterior, y teniendo en cuenta la necesidad de formular políticas sanitarias específicas para la gestión de estas enfermedades, el presente trabajo presenta una aproximación a la formulación de un modelo de gestión para la atención integral de pacientes con enfermedades raras en Colombia. Esta investigación describe los distintos elementos y características de los modelos de gestión clínica y de las enfermedades raras a través de una revisión de literatura, en la que se incluye la descripción de los distintos actores del Sistema de Salud Colombiano, relacionados con la atención integral de estos pacientes para la documentación de un modelo de gestión integral.

Caracterización sociodemográfica de las enfermedades huérfanas en Colombia

Las enfermedades huérfanas en Colombia, se definen como aquellas crónicamente debilitantes, que amenazan la vida, de baja prevalencia (menor 1/5000) y alta complejidad. Se estima que a nivel mundial existen entre 6000 a 8000 enfermedades raras diferentes(1). Varios países a nivel mundial individual o colectivamente, en los últimos años han creado políticas e incentivos para la investigación y protección de los pacientes con enfermedades raras. Sin embargo, a pesar del creciente número de publicaciones; la información sobre su etiología, fisiología, historia natural y datos epidemiológicos persiste escasa o ausente. Los registros de pacientes, son una valiosa herramienta para la caracterización de las enfermedades, su manejo y desenlaces con o sin tratamiento. Permiten mejorar políticas de salud pública y cuidado del paciente, contribuyendo a mejorar desenlaces sociales, económicos y de calidad de vida. En Colombia, bajo el decreto 1954 de 2012 y las resoluciones 3681 de 2013 y 0430 de 2013 se creó el fundamento legal para la creación de un registro nacional de enfermedades huérfanas. El presente estudio busca determinar la caracterización socio-demográfica y la prevalencia de las enfermedades huérfanas en Colombia en el periodo 2013. Métodos: Se realizó un estudio observacional de corte transversal de fuente secundaria sobre pacientes con enfermedades huérfanas en el territorio nacional; basándose en el registro nacional de enfermedades huérfanas obtenido por el Ministerio de Salud y Protección Social en el periodo 2013 bajo la normativa del decreto 1954 de 2012 y las resoluciones 3681 de 2013 y 0430 de 2013. Las bases de datos obtenidas fueron re-categorizadas en Excel versión 15.17 para la extracción de datos y su análisis estadístico posterior, fue realizado en el paquete estadístico para las ciencias sociales (SPSS v.20, Chicago, IL). Resultados: Se encontraron un total de 13173 pacientes con enfermedades huérfanas para el 2013. De estos, el 53.96% (7132) eran de género femenino y el 46.03% (6083) masculino; la mediana de la edad fue de 28 años con un rango inter-cuartil de 39 años, el 9% de los pacientes presentaron discapacidad. El registro contenía un total de 653 enfermedades huérfanas; el 34% del total de las enfermedades listadas en nuestro país (2). Las patologías más frecuentes fueron el Déficit Congénito del Factor VIII, Miastenia Grave, Enfermedad de Von Willebrand, Estatura Baja por Anomalía de Hormona de Crecimiento y Displasia Broncopulmonar. Discusión: Se estimó que aproximadamente 3.3 millones de colombianos debían tener una enfermedad huérfana para el 2013. El registro nacional logró recolectar datos de 13173 (0.4%). Este bajo número de pacientes, marca un importante sub-registro que se debe al uso de los códigos CIE-10, desconocimiento del personal de salud frente a las enfermedades huérfanas y clasificación errónea de los pacientes. Se encontraron un total de 653 enfermedades, un 34% de las enfermedades reportadas en el listado nacional de enfermedades huérfanas (2) y un 7% del total de enfermedades reportadas en ORPHANET para el periodo 2013 (3). Conclusiones: La recolección de datos y la sensibilización sobre las enfermedades huérfanas al personal de salud, es una estrategia de vital importancia para el diagnóstico temprano, medidas específicas de control e intervenciones de los pacientes. El identificar apropiadamente a los pacientes con este tipo de patologías, permite su ingreso en el registro y por ende mejora el sub-registro de datos. Sin embargo, cabe aclarar que el panorama ideal sería, el uso de un sistema de recolección diferente al CIE-10 y que abarque en mayor medida la totalidad de las enfermedades huérfanas.

Clínica de animais de companhia

O presente relatório diz respeito ao estágio curricular realizado no Hospital Veterinário de Portimão, sob a orientação da Prof. Doutora Josefina Coucelo e com a duração de cinco meses, entre um de janeiro de 2016 e trinta e um de maio de 2016. Este relatório foi realizado no âmbito da conclusão do Mestrado Integrado em Medicina Veterinária e consiste em duas partes. A primeira é referente aos casos acompanhados no decorrer do estágio curricular, e a segunda é uma revisão bibliográfica do tema “Leishmaniose Felina”, seguida de um caso clínico acompanhado pelo autor. A Leishmaniose é uma importante zoonose, endémica em várias regiões no mundo, como o sul da Europa, afetando variados mamíferos, debilitando-os e podendo ser fatal. Causada por protozoários do género Leishmania, considera-se como uma afeção rara em gatos. Existe um número crescente de casos nesta espécie, que não é, no entanto, reservatório da infeção para humanos; Small Animal Practice Abstract: The present report describes a training in Portimãos’s Veterinary Hospital, under Doctor Josefina Coucelo’s supervision with the duration of five months, between the 1st January 2016 and the 31st May 2016. This report was written in the context of the Veterinary Medicine Integrated Master degree’s conclusion and is made up of two parts. The first refers to the clinical cases followed during the training and the second is a monography about “Feline Leishmaniasis”, followed by a case report on the subject observed by the author. Leishmaniasis is an important zoonosis endemic in many world regions as well as in southern Europe, affecting many mammals debilitating them and sometimes fatal. It is caused by protozoan of the genus Leishmania. It’s considered a rare affection in cats, however, there’s an increasing number of cases in this host species which still isn’t considered a human infection reservoir.

Modelação do cancro da mama na região do Alentejo

Estudos epidemiológicos são estudos estatísticos onde se procura relacionar ocorrências de eventos de saúde com uma ou várias causas específicas. A importância que os modelos epidemiológicos assumem hoje no estudo de doenças de foro oncológico, em particular no estabelecimento das suas etiologias, é incontornável. Segundo Ogden, J. (1999) o cancro é "um crescimento incontrolável de células anormais que produzem tumores chamados neoplasias". Estes tumores podem ter origem benigna (não se espalham pelo corpo) ou maligna (apresentam metastização de outros órgãos). Sendo uma doença actual, com uma elevada taxa de incidência em Portugal quando comparada com outras doenças (Instituto Nacional de Estatística- INE, 2009), aumentando esta taxa com a idade tal como refere Marques, L. (2003), podendo ocorrer o diagnóstico desta doença em qualquer idade. De acordo com INE (2000) pode dizer-se que o cancro está entre as três principais causas de morte em Portugal, registando-se um aumento progressivo do seu peso proporcional, sendo o cancro da mama o tipo de cancro mais comum entre as mulheres e uma das doenças com maior impacto na nossa sociedade. O objectivo principal deste trabalho é a estimação e modelação do risco de contrair uma doença de natureza não contagiosa e rara (neste caso, cancro da mama), usando dados da região do Alentejo. Pretende-se fazer um apanhado das metodologias mais empregues nesta área e aplicá-las na prática, com ênfase nos estudos caso-controlo e nos modelos lineares generalizados (GLM) - mais concretamente regressão logística. Os estudos caso-controlo são usados para identificar os factores que podem contribuir para uma condição médica, comparando indivíduos que têm essa condição (casos) com pacientes que não têm a condição, mas que de resto são semelhantes (controlos). Neste trabalho utilizou-se essa metodologia para estudar a associação entre o viver em ambiente rural/urbano e o cancro da mama. Tendo em conta que o objectivo principal deste estudo se prende com o estudo da relação entre variáveis, mais propriamente, análise de influência que uma ou mais variáveis (explicativas) têm sobre uma variável de interesse (resposta), para esse efeito são estudados os modelos lineares generalizados - GLM - unificados na mesma moldura teórica pela primeira vez por Nelder & Wedderburn (1972) - e, posteriormente aplicados ao conjunto de dados sobre cancro da mama na Região do Alentejo. O presente trabalho pretende assim, ser um contributo na identificação de factores de risco do cancro da mama na região do Alentejo. ABSTRACT: Epidemiological studies are statistical studies where attempts to relate occurrences of health events with one or more specific causes. The importance of epidemiological models that are far in the study of diseases of cancer forum, particularly in establishing their etiology, is inescapable. According to Ogden, J. (1999) cancer is "an incontrollable growth of abnormal cells that produce tumors called cancer". These tumors may be benign (not spread throughout the body) or malignant (show metastasis to other organs). Being a current illness with a high incidence rate in Portugal compared with the same respect to other diseases (National Statistics 1nstitute -1NE, 2009) having an increasing rate with age as mentioned Marques, L. (2003), and can possibly be diagnosed at any age. According to 1NE (2000) the cancer is among the top three causes of death in Portugal and there is a progressive increase of its proportional weight. Breast cancer is the most common form of cancer among women and the diseases with major impact in our society. The main objective of this work is to model and estimate the risk of contracting a non-contagious and rare disease (in this case, breast cancer), using data from the Alentejo region. It is intended to summarize some of the methodologies employed in this area and apply them in practice, with emphasis on case-control studies and generalized linear models (GLM) - more specifically the logistic regression. The case-control studies are used to identify factors that may contribute to a medical condition, comparing individuals who have this condition (cases) with patients who have not the condition but that are otherwise similar (controls). ln this work we used this methodology to study the association between living in a rural/urban and breast cancer. Given that the main objective of this study rather relates to the study of the relationship between variables to analyze the influence that one or more variables (explanatory) have on a variable (response), for this purpose we study the generalized linear models - GLM - first unified in the same theoretical framework by Nelder and Wedderburn (1972) and subsequently applied to the data set on breast cancer in the Alentejo region. This work intends to be a contribution in identifying risk factors for breast cancer in the Alentejo region.

Novel fabrication process of planar waveguides in rare-earth doped fluoroindate glasses

We report the successful fabrication of planar waveguides in rare-earth doped fluoroindate glass substrates. A new procedure for waveguide fabrication using a thermally evaporated AgF nonmetallic film was developed. The refractive index changes of more than 0.03, associated to low propagation losses achieved, open new perspectives and show the potentiality of using this glass family toward further developments in fabrication and design of integrated optical devices for optical communication wavelengths.© 1995 American Institute of Physics.

Frequency upconversion in rare-earth doped fluoroindate glasses

We present recent results on frequency upconversion (UPC) obtained in fluoroindate glasses (FIG) doped with Ho3+, Tm3+ and Nd3+ ions and codoped with Pr3+/Nd3+ and Yb3+/Tb3+ ions. The results for the Ho3+-doped samples show strong evidence of energy transfer (ET) between Ho3+ ions resonantly excited at 640 nm. The origin of the blue-green upconverted fluorescence observed was identified and the dynamics of the signals revealed the pathways involved in the UPC process. In the case of Tm3+-doped FIG, the samples were resonantly excited at 650 nm and the main mechanism that contributes for the red-to-blue upconversion is excited-state absorption (ESA). The FIG samples codoped with Pr3+/Nd3+ were excited at 588 nm in resonance with transitions starting from the ground state of the Nd 3+ and the Pr3+ ions. It was observed that the presence of Nd3+ ions enhanced the Pr3+ emission at 480 nm by two orders of magnitude. Multiphonon (MP)-assisted upconversion is also discussed for Nd3+-doped FIG pumped at 866 nm. Emission at 750 nm with a peculiar linear dependence with the laser intensity was observed and explained. A rate-equation model that includes MP absorption via thermally coupled electronic excited states of Nd3+ was developed and describes well the experimental results. The role played by effective phonon modes is clearly demonstrated. MP-assisted UPC process was also studied in Yb3+/ Tb3+-codoped FIG samples excited at 1064 nm, which is off-resonance with electronic transitions starting from the ground state. It was determined that the mechanism leading to Tb3+ emission in the blue is due to ET from a pair of excited Yb3+ ions followed by ESA in the Tb 3+ ions. © 2002 Académie des sciences/Éditions scientifiques et médicales Elsevier SAS.

Temperature chaos in 3D Ising spin glasses is driven by rare events

Temperature chaos has often been reported in the literature as a rare-event–driven phenomenon. However, this fact has always been ignored in the data analysis, thus erasing the signal of the chaotic behavior (still rare in the sizes achieved) and leading to an overall picture of a weak and gradual phenomenon. On the contrary, our analysis relies on a largedeviations functional that allows to discuss the size dependences. In addition, we had at our disposal unprecedentedly large configurations equilibrated at low temperatures, thanks to the Janus computer. According to our results, when temperature chaos occurs its effects are strong and can be felt even at short distances.

Direct observation of R...R distances in rare-earth (R) phosphate glasses by magnetic difference neutron diffraction

A magnetic difference neutron diffraction study of a rare-earth (Tb) phosphate glass has revealed exclusively the Tb...Tb distances. The difference between data taken with and without an applied magnetic field of 4 T shows Tb...Tb pairwise atomic correlations at 3.9 and 6.4 A, respectively, with relative coordination numbers of 1:14. The first distance arises when two Tb3+ ions share a common oxygen neighbor, and indicates a clustering of rare-earth ions. The second distance arises when two Tb3+ ions are coordinated to different oxygens in the same PO4 group, in a near-linear arrangement.

Identification of the relative distribution of rare-earth ions in phosphate glasses

The relative distribution of rare-earth ions R3+ (Dy3+ or Ho3+) in the phosphate glass RAl0.30P3.05O9.62 was measured by employing the method of isomorphic substitution in neutron diffraction. It is found that 7.9(7) R-R nearest neighbors reside at 5.62(6) Angstrom in a network made from interlinked PO4 tetrahedra. Provided that the role of Al is explicitly considered, a self-consistent account of the local matrix atom correlations can be developed in which there are 1.68(9) bridging and 2.32(9) terminal oxygen atoms per phosphorus.

Optical spectroscopy and energy transfer of Er3+/Ce3+ in B2O3-doped bismuth-silicate glasses

Ce3+ and B2O3 are introduced into erbium-doped Bi2O3-SiO2 glass to enhance the luminescence emission and optic spectra characters of Er3+. The energy transfer from Er3+ to Ce3+ will obviously be improved with the phonon energy increasing by the addition of B2O3. Here, the nonradiative rate, the lifetime of the I-4(11/2) -> I-4(3/2) transition, and the emission intensity and bandwidth of the 1.5 mu m luminescence with the I-4(13/2) -> I-4(5/2) transition of Er3+ are discussed in detail. The results show that the optical parameters of Er3+ in this bismuth-borate-silicate glass are nearly as good as that in tellurite glass, and the physical properties are similar to those in silicate glass. With the Judd-Ofelt and nonradiative theory analyses, the multiphonon decay and phonon-assisted energy-transfer (PAT) rates are calculated for the Er3+/Ce3+ codoped glasses. For the PAT process, an optimum value of the glass phonon energy is obtained after B2O3 is introduced into the Er3+/Ce3+ codoped bismuth-silicate glasses, and it much improves the energy-transfer rate between Er3+ I-4(11/2)-I-4(13/2) and Ce3+ F-2(5/2) -> F-2(7/2), although there is an energy mismatch. (c) 2007 Optical Society of America.

Infrared-to-visible upconversion emissions in Er3+ doped TeO2-based oxyhalide glasses

The fluorescence and up-conversion spectral properties of Er3+-doped TeO2-ZnO and TeO2-ZnO-PbCl2 glasses suitable for developing optical fiber amplifier and laser have been fabricate and characterized. Strong green (around 527-550 nm) and red (around 661 nm) up-conversion emissions under 977 nm laser diode excitation were investigated, corresponding to H-2(11/2), S-4(3/2), --> I-4(15/2) and F-4(9/2) --> I-4(15/2) transitions of Er3+ ions respectively, have been observed and the involved mechanisms have been explained. The dependence of up-converted fluorescence intensity versus laser power confirm that two-photons contribute to up-conversion of the green-red emissions. The novelty of this kind of optical material has been its ability in resisting devitrification, and its promising optical properties strongly encourage for their further development as the rare-earth doped optical fiber amplifiers and upconversion fiber laser systems.