Salmonella enterica subsp houtenae serogroup O:16 in a HIV positive patient: case report

We described a case of salmonellosis in a 33-year old HIV-infected patient. The patient presented oral and esophageal candidiasis, intense epigastric and retrosternal pain. During the physical examination he was hypochloraemic, acyanotic, hypohydrated, anicteric and afebrile. Admittance laboratorial tests indicated: red cells 3.6 millions/mm³; hemoglobin, 10.1 g/dL; leukocyte count, 3,000/mm³, with 1% of eosinophils, 14% of non-segmented and 53% of segmented neutrophils and 31% of lymphocytes. The blood culture was positive for Salmonella enterica subsp houtenae serogroup O:16. This is probably the first human report of bacteremia due to Salmonella enterica subsp houtenae in Brazil associated to HIV-infected patient.

Oligodendroglioma in a patient with AIDS: case report and review of the literature

In the last years, new techniques of neuroimages and histopathological methods have been added to the management of cerebral mass lesions in patients with AIDS. Stereotactic biopsy is necessary when after 14 days of empirical treatment for Toxoplasma gondii encephalitis there is no clinical or neuroradiologic improvement. We report a woman with AIDS who developed a single focal brain lesion on the right frontal lobe. She presented a long history of headache and seizures. After two weeks of empirical treatment for toxoplasma encephalitis without response, a magnetic resonance image with spectroscopy was performed and showed a tumoral pattern with a choline peak, diminished of N-acetyl-aspartate and presence of lactate. A stereotactic biopsy was performed. Histopathological diagnosis was a diffuse oligodendroglioma type A. A microsurgical resection of the tumor was carried out and antiretroviral treatment was started. To date she is in good clinical condition, with undetectable plasma viral load and CD4 T cell count > 200 cell/uL.

Chagasic meningoencephalitis: case report of a recently included AIDS-defining illness in Brazil

Recently, reactivation of Chagas disease (meningoencephalitis and/or myocarditis) was included in the list of AIDS-defining illnesses in Brazil. We report a case of a 52-year-old patient with no history of previous disease who presented acute meningoencephalitis. Direct examination of blood and cerebrospinal fluid (CSF) showed Trypanosoma cruzi. CSF culture confirmed the diagnosis. Serological assays for T. cruzi and human immunodeficiency virus (HIV) were positive. Despite treatment with benznidazol and supportive measures, the patient died 24 hours after hospital admission. In endemic areas, reactivation of Chagas disease should always be considered in the differential diagnosis of meningoencephalitis among HIV-infected patients, and its presence is indicative of AIDS.

Paracoccidioidomycosis in organ transplant recipient: case report

Paracoccidioidomycosis is a common disease in Latin America but it is rare in organ transplant recipient patients. We report on a case of such mycosis in a renal transplant recipient. The patient presented with a large lung cavity on the left lower lobe, a rare radiological presentation of paracoccidioidomycosis. Unusual clinical and radiological manifestations of Paracoccidioides brasiliensis infection can occur in immunocompromised patients.

Murine (endemic) typhus in Brazil: case report and review

Murine typhus has been increasingly recognized worldwide and is becoming a relevant differential diagnosis in febrile conditions. In Brazil, murine typhus has never received much attention. We present a recently diagnosed case and a literature review that suggests that the disease could be more prevalent in Southeastern Brazil than acknowledged until now.

Orbital tuberculosis diagnosed by immunohistochemistry: case reports

PURPOSE: To describe three cases of orbital tuberculosis, with their clinical characteristics and respective diagnostic procedures, showing the importance of histopathology for the correct diagnosis. PATIENTS AND METHODS: Three patients diagnosed and treated for orbital tuberculosis, in the "Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo" during the years of 1999 and 2001. RESULTS: All of the patients were female and referred a chronic evolution of swelling of one eyelid associated or not with other symptoms. They had not HIV infection. Two of them had positive epidemiology for tuberculosis. However, the search for systemic evidence of the disease and staining for bacilli (Ziehl-Neelsen method) were negative in all three patients. In all the cases, only the biopsy with immunohistochemical analysis could confirm the diagnosis. COMMENTS: Orbital involvement is a rare ocular manifestation of tuberculosis. Even in a tertiary hospital, few cases, if any, are diagnosed per year. However, the global incidence and prevalence of M. tuberculosis infections is not under control yet, and it has been a serious public health problem. Thus, one must be aware of the possibility of tuberculosis among the orbital diseases.

Traumatic Clivus Epidural Hematoma: Case Report and Review of the Literature

BACKGROUND: Traumatic clival epidural hematoma is an extremely rare reported entity. CASE DESCRIPTION: We describe the case of a 26-year-old woman involved in a car accident who presented with a Glasgow Coma Scale score of 13, bilateral abducens palsy, bilateral numbness on the mandibular territory of the trigeminal nerve, and left hypoglossal palsy. Radiological examinations revealed a clival epidural hematoma. The patient was managed conservatively, with clinical improvement of her neurological condition. This is the first traumatic clival epidural hematoma reported in an adult. From a review of the literature, we found only 8 cases. CONCLUSION: The pathophysiology of these hematomas is still a subject of debate; occipitoatlantoaxial ligamentous instability may play a role in it. In one third of the cases, bilateral cranial nerve palsies were associated. Apparently, they have a benign outcome.

Oral cysticercosis: case report and review of the literature

Cysticercosis is a condition that occurs when man is infested by the larvae of Taenia solium, acting as an intermediate host instead of definitive. Oral cysticercosis is a rare event, and it represents a difficulty in clinical diagnosis. A case of oral cysticercosis in a 23-year-old white female who presented a painless swelling in the dorsal portion of the tongue is reported. An excisional biopsy was performed and histopathological examination revealed a cystic cavity containing the tapeworm.

Strategies to assess web resources credibility: results of a case study in primary and secondary schools from Portugal

In this paper, three approaches for the assessment of credibility in a web environment will be presented, namely the checklists model, the cognitive authority model and the contextual model. This theoretical framework was used to conduct a study about the assessment of web resources credibility among a sample of 195 students, from elementary and secondary schools in a municipality in Oporto district (Portugal). The practices that young people and children claim to use regarding the use of criteria for web resources selection will be presented. In addition, these results will be discussed and compared with the perceptions that these respondents have demonstrated for the use of criteria to establish or assess authorship, originality, or information resources structure. These results will be also discussed and compared with the perceptions that these respondents have demonstrated for the elements that make up each of these criteria.

Introducing numerical analysis tools in engineering: a Scilab user case in electronics course

Software tools in education became popular since the widespread of personal computers. Engineering courses lead the way in this development and these tools became almost a standard. Engineering graduates are familiar with numerical analysis tools but also with simulators (e.g. electronic circuits), computer assisted design tools and others, depending on the degree. One of the main problems with these tools is when and how to start use them so that they can be beneficial to students and not mere substitutes for potentially difficult calculations or design. In this paper a software tool to be used by first year students in electronics/electricity courses is presented. The growing acknowledgement and acceptance of open source software lead to the choice of an open source software tool – Scilab, which is a numerical analysis tool – to develop a toolbox. The toolbox was developed to be used as standalone or integrated in an e-learning platform. The e-learning platform used was Moodle. The first approach was to assess the mathematical skills necessary to solve all the problems related to electronics and electricity courses. Analysing the existing circuit simulators software tools, it is clear that even though they are very helpful by showing the end result they are not so effective in the process of the students studying and self learning since they show results but not intermediate steps which are crucial in problems that involve derivatives or integrals. Also, they are not very effective in obtaining graphical results that could be used to elaborate reports and for an overall better comprehension of the results. The developed tool was based on the numerical analysis software Scilab and is a toolbox that gives their users the opportunity to obtain the end results of a circuit analysis but also the expressions obtained when derivative and integrals calculations, plot signals, obtain vector diagrams, etc. The toolbox runs entirely in the Moodle web platform and provides the same results as the standalone application. The students can use the toolbox through the web platform (in computers where they don't have installation privileges) or in their personal computers by installing both the Scilab software and the toolbox. This approach was designed for first year students from all engineering degrees that have electronics/electricity courses in their curricula.

Cerebral aspergillosis due to Aspergillus fumigatus in AIDS patient: first culture - proven case reported in Brazil

Cerebral aspergillosis is a rare cause of brain expansive lesion in AIDS patients. We report the first culture-proven case of brain abscess due to Aspergillus fumigatus in a Brazilian AIDS patient. The patient, a 26 year-old male with human immunodeficiency virus (HIV) infection and history of pulmonary tuberculosis and cerebral toxoplasmosis, had fever, cough, dyspnea, and two episodes of seizures. The brain computerized tomography (CT) showed a bi-parietal and parasagittal hypodense lesion with peripheral enhancement, and significant mass effect. There was started anti-Toxoplasma treatment. Three weeks later, the patient presented mental confusion, and a new brain CT evidenced increase in the lesion. He underwent brain biopsy, draining 10 mL of purulent material. The direct mycological examination revealed septated and hyaline hyphae. There was started amphotericin B deoxycholate. The culture of the material demonstrated presence of the Aspergillus fumigatus. The following two months, the patient was submitted to three surgeries, with insertion of drainage catheter and administration of amphotericin B intralesional. Three months after hospital admission, his neurological condition suffered discrete changes. However, he died due to intrahospital pneumonia. Brain abscess caused by Aspergillus fumigatus must be considered in the differential diagnosis of the brain expansive lesions in AIDS patients in Brazil.

Gender differences in internet usage habits: a case study in higher education

The usage of information and communication technologies has been growing among students and teachers. In order to improve the use of the Internet as a tool to support teaching and learning it is necessary to understand the Internet usage habits of students. Thus, a study was conducted with 1397 students from five schools of the Polytechnic of Porto. The data was collected through an online questionnaire abd was analized by age range, gender and scientific field. In this paper,gender differences are analyzed and presented in 3 dimensions: type of Internet usage, communication tools and the role of the Internet tools in education.

Acute generalized exanthematous pustulosis (AGEP). Case report

Acute Generalized Exanthematous Pustulosis (AGEP) is a drug-induced dermatosis characterized by an acute episode of sterile pustules over erythematous-edematous skin. It is accompanied by an episode of fever, which regresses a few days after discontinuation of the drug that caused the condition or as a result of corticosteroid treatment. The main triggering drugs are antibiotics, mainly beta-lactam ones. Other medications, such as antifungal agents, non steroid anti-inflammatory drugs, analgesics, antiarrhythmic, anticonvulsant and antidepressant drugs, may also be responsible. Histologically, it is characterized by the existence of vasculitis, associated with non-follicular subcorneal pustules. A case of a Caucasian female outpatient unit of Dermatology with AGEP, who presented with generalized pustulosis lesions after the use of cephalosporin for urinary infection is related. The diagnosis was confirmed by the clinical and pathological correlations, the resolution of the dermatosis after discontinuation of the drug and use of systemic corticosteroid treatment, and the recurrence of the disorder after the introduction of a similar drug. The importance of the recognition of this drug-induced dermatosis is given by its main differential clinical and histological diagnoses: generalized pustular psoriasis and subcorneal pustulosis.

Designing video lectures for MOOC

Educational videos differ from other teaching and learning technologies as they allow the benefit of using visual perception. Video lectures are not new to education, however with the use of innovative video technologies they can improve academic outcomes and extend the reach of education. They may offer extraordinary new experiences for higher education institutions (HEI). Through them lecturers can provide information and contents to students, and if used creatively, video lectures can become a powerful technological tool in education, inside and outside classrooms. Inside a classroom it can motivate students and improve topics’ debate and outside it is a good support for students’ self- learning. In some cases they can be used to work some subjects standing behind, but needed to support actual courses contents, that students do not remember (or were not even taught), opening an “in front to the past door” that backs students self-study. The student-educator dynamic is changing. Students are expecting exceptional instruction and educators are expecting students to be more and more well informed about subjects from online viewing.This article explores some of the potential benefits and challenges associated with the use of video lectures in the teaching and learning process at higher education. We will also discuss some thoughts and examples for the use of teaching materials to enhance student’s learning and try to understand how video can act as powerful and innovative to enlighten teaching and learning (note that unfortunately, sometimes, the opposite is happening).