958 resultados para fever episodes
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Asthma is a chronic inflammatory disorder of the respiratory airways affecting people of all ages, and constitutes a serious public health problem worldwide (6). Such a chronic inflammation is invariably associated with injury and repair of the bronchial epithelium known as remodelling (11). Inflammation, remodelling, and altered neural control of the airways are responsible for both recurrent exacerbations of asthma and increasingly permanent airflow obstruction (11, 29, 34). Excessive airway narrowing is caused by altered smooth muscle behaviour, in close interaction with swelling of the airway walls, parenchyma retractile forces, and enhanced intraluminal secretions (29, 38). All these functional and structural changes are associated with the characteristic symptoms of asthma – cough, chest tightness, and wheezing –and have a significant impact on patients’ daily lives, on their families and also on society (1, 24, 29). Recent epidemiological studies show an increase in the prevalence of asthma, mainly in industrial countries (12, 25, 37). The reasons for this increase may depend on host factors (e.g., genetic disposition) or on environmental factors like air pollution or contact with allergens (6, 22, 29). Physical exercise is probably the most common trigger for brief episodes of symptoms, and is assumed to induce airflow limitations in most asthmatic children and young adults (16, 24, 29, 33). Exercise-induced asthma (EIA) is defined as an intermittent narrowing of the airways, generally associated with respiratory symptoms (chest tightness, cough, wheezing and dyspnoea), occurring after 3 to 10 minutes of vigorous exercise with a maximal severity during 5 to 15 minutes after the end of the exercise (9, 14, 16, 24, 33). The definitive diagnosis of EIA is confirmed by the measurement of pre- and post-exercise expiratory flows documenting either a 15% fall in the forced expiratory volume in 1 second (FEV1), or a ≥15 to 20% fall in peak expiratory flow (PEF) (9, 24, 29). Some types of physical exercise have been associated with the occurrence of bronchial symptoms and asthma (5, 15, 17). For instance, demanding activities such as basketball or soccer could cause more severe attacks than less vigorous ones such as baseball or jogging (33). The mechanisms of exercise-induced airflow limitations seem to be related to changes in the respiratory mucosa induced by hyperventilation (9, 29). The heat loss from the airways during exercise, and possibly its post-exercise rewarming may contribute to the exercise-induced bronchoconstriction (EIB) (27). Additionally, the concomitant dehydration from the respiratory mucosa during exercise leads to an increased interstitial osmolarity, which may also contribute to bronchoconstriction (4, 36). So, the risk of EIB in asthmatically predisposed subjects seems to be higher with greater ventilation rates and the cooler and drier the inspired air is (23). The incidence of EIA in physically demanding coldweather sports like competitive figure skating and ice hockey has been found to occur in up to 30 to 35% of the participants (32). In contrast, swimming is often recommended to asthmatic individuals, because it improves the functionality of respiratory muscles and, moreover, it seems to have a concomitant beneficial effect on the prevalence of asthma exacerbations (14, 26), supporting the idea that the risk of EIB would be smaller in warm and humid environments. This topic, however, remains controversial since the chlorified water of swimming pools has been suspected as a potential trigger factor for some asthmatic patients (7, 8, 20, 21). In fact, the higher asthma incidence observed in industrialised countries has recently been linked to the exposition to chloride (7, 8, 30). Although clinical and epidemiological data suggest an influence of humidity and temperature of the inspired air on the bronchial response of asthmatic subjects during exercise, some of those studies did not accurately control the intensity of the exercise (2, 13), raising speculation of whether the experienced exercise overload was comparable for all subjects. Additionally, most of the studies did not include a control group (2, 10, 19, 39), which may lead to doubts about whether asthma per se has conditioned the observed results. Moreover, since the main targeted age group of these studies has been adults (10, 19, 39), any extrapolation to childhood/adolescence might be questionable regarding the different lung maturation. Considering the higher incidence of asthma in youngsters (30) and the fact that only the works of Amirav and coworkers (2, 3) have focused on this age group, a scarcity of scientific data can be identified. Additionally, since the main environmental trigger factors, i.e., temperature and humidity, were tested separately (10, 28, 39) it would be useful to analyse these two variables simultaneously because of their synergic effect on water and heat loss by the airways (31, 33). It also appears important to estimate the airway responsiveness to exercise within moderate environmental ranges of temperature and humidity, trying to avoid extreme temperatures and humidity conditions used by others (2, 3). So, the aim of this study was to analyse the influence of moderate changes in air temperature and humidity simultaneously on the acute ventilatory response to exercise in asthmatic children. To overcome the above referred to methodological limitations, we used a 15 minute progressive exercise trial on a cycle ergometer at 3 different workload intensities, and we collected data related to heart rate, respiratory quotient, minute ventilation and oxygen uptake in order to ensure that physiological exercise repercussions were the same in both environments. The tests were done in a “normal” climatic environment (in a gymnasium) and in a hot and humid environment (swimming pool); for the latter, direct chloride exposition was avoided.
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Aims: This paper aims to address some of the main possible applications of actual Nuclear Medicine Imaging techniques and methodologies in the specific context of Sports Medicine, namely in two critical systems: musculoskeletal and cardiovascular. Discussion: At the musculoskeletal level, bone scintigraphy techniques proved to be a mean of diagnosis of functional orientation and high sensibility compared with other morphological imaging techniques in the detection and temporal evaluation of pathological situations, for instance allowing the acquisition of information of great relevance in athletes with stress fractures. On the other hand, infection/inflammation studies might be of an important added value to characterize specific situations, early diagnose of potential critical issues – so giving opportunity to precise, complete and fast solutions – while allowing the evaluation and eventual optimization of training programs. At cardiovascular system level, Nuclear Medicine had proved to be crucial in differential diagnosis between cardiac hypertrophy secondary to physical activity (the so called "athlete's heart") and hypertrophic cardiomyopathy, in the diagnosis and prognosis of changes in cardiac function in athletes, as well as in direct - and non-invasive - in vivo visualization of sympathetic cardiac innervation, something that seems to take more and more importance nowadays, namely in order to try to avoid sudden death episodes at intense physical effort. Also the clinical application of Positron Emission Tomography (PET) has becoming more and more widely recognized as promising. Conclusions: It has been concluded that Nuclear Medicine can become an important application in Sports Medicine. Its well established capabilities to early detection of processes involving functional properties allied to its high sensibility and the actual technical possibilities (namely those related with hybrid imaging, that allows to add information provided by high resolution morphological imaging techniques, such as CT and/or MRI) make it a powerful diagnostic tool, claiming to be used on an each day higher range of clinical applications related with all levels of sport activities. Since the improvements at equipment characteristics and detection levels allows the use of smaller and smaller doses, so minimizing radiation exposure it is believed by the authors that the increase of the use of NM tools in the Sports Medicine area should be considered.
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OBJECTIVE: To estimate the basic reproduction number (R0) of dengue fever including both imported and autochthonous cases. METHODS: The study was conducted based on epidemiological data of the 2003 dengue epidemic in Brasília, Brazil. The basic reproduction number is estimated from the epidemic curve, fitting linearly the increase of initial cases. Aiming at simulating an epidemic with both autochthonous and imported cases, a "susceptible-infectious-resistant" compartmental model was designed, in which the imported cases were considered as an external forcing. The ratio between R0 of imported versus autochthonous cases was used as an estimator of real R0. RESULTS: The comparison of both reproduction numbers (only autochthonous versus all cases) showed that considering all cases as autochthonous yielded a R0 above one, although the real R0 was below one. The same results were seen when the method was applied on simulated epidemics with fixed R0. This method was also compared to some previous proposed methods by other authors and showed that the latter underestimated R0 values. CONCLUSIONS: It was shown that the inclusion of both imported and autochthonous cases is crucial for the modeling of the epidemic dynamics, and thus provides critical information for decision makers in charge of prevention and control of this disease.
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Trabalho apresentado em XIII Congreso Internacional Galego-Portugués de Psicopedagoxía, Área 2 Conflictos y mediación escolar. Universidad da Coruña, 2 de Setembro de 2015.
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O texto expressa uma reflexão sobre a obra Triste Fim de Policarmo Quaresma, escrita em 1915, por Lima Barreto, escritor realista, brasileiro. Busca identificar nas narrativas e ações do seu narrador, um homem comum, as revoltas, mas também as esperanças dos homens comuns no recém criado regime republicano. Enfoca ainda que, apesar dos episódios narrados, dos personagens serem construções ficcionais do autor, nos remetem a personagens, diálogos e espaços do Rio de Janeiro que evocam a historia de um regime ditatorial de Floriano Peixoto, no alvorecer da Republica. Nesse regime, mostra o autor, que a insegurança, a insatisfação e o medo tomaram conta da população do Rio de Janeiro no começo do século XX. E Policarpo Quaresma, o personagem narrador da obra, sofrera as injustiças e arbitrariedades da ditadura do Marechal Floriano Peixoto. Diante disso, revela sua dor e plena desolação com a Republica, forma de governo pelo qual lutara e que ajudara a criar. Por fim, o texto procura mostrar que embora a literatura seja tecida com adornos da ficção, ela traduz a sociedade e o tempo no qual ela foi produzida, além de mostrar que o positivismo sustentava a pratica política da Republica brasileira.
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According to an ancient folkloric legend, Our Lady, stepping down from the sea, would have rided on a mule to the platform above the cliffs named Pedra da Mua at Lagosteiros'bay, near Espichel cape. Mule's footprints, regarded by fishermen as evidence, would be clearly recognizable on exposed surfaces of the rocks. Indeed there are footprints but from Dinosaurs of latest Jurassic, Portlandian age, this spectacular locality being specially rich in giant Sauropod tracks (that have seldom been found elsewhere in Europe). As we proceeded to its study, another locality with Dinosaur footprints, Lower Cretaceous (Hauterivian) in age, was found on the northern cliffs at Lagosteiros. It is probably the richest one in european Lower Cretaceous and the only of this age known in Portugal, so we decided to give priority to its study. Dinosaur tracks have been printed on calciclastic sands in a lagoonal environment protected by fringing coral reefs. There have been emersion episodes; beaches were frequented by Dinosaurs. Later on, the marine barremian ingression restablished a gulf and such animals could not come here any more. Under a paleogeographical viewpoint, the evidence of a marine regression near the end of Hauterivian is to be remarked. Five types of tracks and footprints have been recognized: - Neosauropus lagosteirensis, new morphogenus and species, tracks from a giant Sauropod, perhaps from Camarasaurus; with its proportions the total length of the author would be about 15,5 m. These are the only Sauropod tracks known till now in Europe's Lower Cretaceous. - tracks from a not so big quadruped, maybe a Sauropod (young individual?); however it is not impossible that they were produced by Stegosaurians or Ankylosaurians. -Megalosauropus (?Eutynichnium) gomesi new morphospecies, four Theropod tracks most probably produced by megalosaurs. - Iguanodon sp., represented by some footprints and specially by a set corresponding to the feet and tail from an individual standing in a rest position. - problematical, quite small-sized biped (maybe an Ornithopod related to Camptosaurus). Evidence points to a richer fauna than that known in barremian "Dinosaur sandstones" from a nearby locality, Boca do Chapim. Lagosteiros' association clearly indicates the predominance of herbivores, which required large amounts of vegetable food in the neighbourhood. This is an indirect evidence of the vegetal wealth, also suggested by associations of plant macrofossils, polen and spores found in early Cretaceous sediments at the same region. The relatively high proportion of Theropoda is related to the wealth of the whole fauna, which comprised a lot of the prey needed by such powerful flesh-eaters. The evidence, as a whole, points out to a warm and moist climate. All the tracks whose direction could be measured are directed to the southern quadrants, this being confirmed by the approximative direction of other footprints. Massive displacements (migration?) could take place during a brief emersion episode. This may result from the ingression of barremian seas, flooding the region and restablishing here a small gulf. Even if the arrival of the waters damaged certain footprints it has not destroyed them completely, thus allowing the preservation of such evidence from a remote past.
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Algarve Province, Southern Portugal, corresponds in part to a meso-cenozoic basin running along the coast from Cabo S. Vicente to beyond Spanish border. Structurally it is a big monocline plunging southwards much deformed mainly by two East-West longitudinal flexures. Lithostratigraphical and chronostratigraphical studies dealt specially with Jurassic formations. This and the geological mapping of the post-Hercynian sedimentary formations allow us to define the following units: Triassic-Lower Liassic Arenitos de Silves (Silves sandstones sensu P. Choffat, pro parte) - At their base the Silves sandstones (0-150m) are represented mainly by cross-bedded red sandstones. This unit is Upper Triassic (Keuper) in age, on the evidence of some Brachiopoda. Complexo margo-carbonatado de Silves (Silves marl-limestone complex=Silves sandstones sensu P. Choffat, pro parte) (80-200m) overlies the preceding, it may be reported to the Upper Triassic-Hettangian. It consists of a thick pelite-marl-dolomite-limestone series with many intercalations of greenstones. Since no fossils were found it is not possible to conclude whether it is still Hettangian or if it does correspond, in the whole or in part, already to the Sinemurian. Liassic Dolomitos e calcários dolomíticos de Espiche (Espiche dolomite-rocks and dolomitic-limestones) - The usually massive and finely crystalline or saccharoidal dolomites and dolomitic-limestones are the toughest strata of the Algarve margin giving rise to several hills. Its thickness attains in certain points 60 metres at least. Based on geometry and on lithological similarities with the carbonated complex of the northern basin of Tagus river (Peniche, São Pedro de Muel, Quiaios), this formation can be accepted as Sinemurian in age. As it happens with the carbonated complex, here also the first dolomite beds are non-isochronal throughout the region; upper time-limit of the dolomitic facies is either Lower Carixian, Lower Toarcian or even Lower Dogger. The dolomitization is secondary but not much later than sedimentation. However, between Cabo S. Vicente-Vila do Bispo there is evidence of an even later secondary dolomitization related to the regional fault complex. Calcário dolomítico com nódulos de silex da praia de Belixe (Belixe beach dolomitic-limestone with silex nodules) (50-55m) - Ascribed to Lower or Middle Carixian on the basis of Platypleuroceras sp., Metaderoceras sp. nov. and M. gr. Venarense. Calcário cristalino compacto com Protogrammoceras, Fuciniceras e ? Argutarpites de Belixe (Belixe compact crystalline limestone with Protogrammoceras, Fuciniceras and ? Argutarpites) (30m) - Ascribed to Lower Domerian. Middle and Upper Domerian are indicated but by a single specimen of ? Argutarpites. Calcários margosos e margas com Dactylioceras semicelatum e Harpoceratídeos de Armação Nova (Armação Nova marly limestones and marls with D. semicelatum and Harpoceratidae) (25m) -Ascribed to Lower Toarcian. Middle and Upper Toarcian formations are not known in the Algarve. Dogger Calcários oolíticos, c. corálicos, c. pisolíticos, c. calciclásticos, c. dolomíticos e dolomitos de Almadena (Almadena oolitic-limestones, coral-reef-limestones, pisolite-limestones, limeclastic-limestones, dolomitic-limestones and dolomite-rocks) (more than 50 metres), with lagoonal facies. Ascribed to Aalenian-Bathonian-? Callovian. Margas acinzentadas e calcários detríticos com Zoophycos da praia de Mareta (Mareta beach greyish marls and detritical limestones with Zoophycos) (40m) - Pelagic transreef facies with Upper Bajocian and Bathonian ammonites. Calcários margosos e margas da praia de Mareta (Mareta beach pelagic marly-limestones and marls) (110m) - Ascribed to the Callovian on its ammonites. Malm Near Cabo S. Vicente and Sagres the first Upper Jurassic level consists of a yellowish-brown nodular, compact, locally phosphated and ferruginous, sometimes conglomeratic, marly limestone (0,35-1,50m) containing a rich macrofauna, which includes: 1) Callovian forms unknown at Lower Oxfordian; 2) Upper Callovian forms that still survived in Lower and Middle Oxfordian; 3) Lower Oxfordian forms (Mariae and Cordatum Zones); 4) Lower and Middle Oxfordian forms (Mariae to Plicatilis Zone); 5) Middle Oxfordian forms (plicatilis Zone), and some ones appearing in Middle Oxfordian. This condensed deposit is therefore dated from Middle Oxfordian (Plicatilis Zone). The other Upper Jurassic lithostratigraphical units were also mapped but their detailed study is not presented in this work. Correlations between lithostratigraphical and chronostratigraphical scales from P. Choffat, J. Pratsch, C. Palain and from the author are stated. Further correlations are attempted between zonc scales of Carixian-Lower Toarcian and Upper Bajocian-Middle Oxfordian of France, Spain (Asturias, Iberian and Betic Chains), Argel (Orania) and Portugal (northern Tagus basin and Algarve). The study of pyritous fossil assemblages common in Upper Bathonian-Lower Callovian marly levels of the praia da Mareta seems to suggest that these sediments were deposited in a bay or in an almost closed coastal re-entrance virtually without deep water circulation. Although such conditions may occur at any depth one may suppose that these ones actually correspond to an infralittoral neritic environment. The thaphocoenosis collected there are almost entirely composed of nektonic (ammonites, Belemnites) and planktonic (Bositra) faunas. The sedentary (crinoids, brachiopods) or free (sea-urchins, gastropods) epibenthonic forms are very scarce; endobenthonic forms are not known. The palaeontological study of all Nautiloids and Ammonoids of the Liassic and Dogger is presented (except Kosmoceratidae and Perisphinctaceae). Among the thirty one taxa dealt with, one is new (Metaderoceras sp. nov.) and the great majority of the others has been identified for the first time in Algarve. Some others have never been reported before in Portuguese formations. The evolution, during Jurassic times, of the sedimentary basins of the Portuguese plate margin is described. The absence of Cephalopods in the very extensive marly and dolomitic limestones, partly marine, suggests that, during Lower Liassic, palaeogeography underwent no great changes. Dolomitic-limestone with silex nodules from Cabo S. Vicente contain the first ammonites recorded at the base of the Middle Liassic. This facies, although very common in Tethys, is unknown north of the Tagus. The faunal assemblage has a mediterranean to submediterranean character. Comparisons between faunal assemblage" from Algarve with the ones known north of the Tagus show that communications between Boreal Europe and Tethys, virtually non-existent during Lower and Middle Carixian, became very easy during Lower Domerian. In earlier Pliensbachian times two distinct seas were adjacent to the Iberian plate. One, an epicontinental sea with a tethyan fauna, extended southwards from the Meseta margin. Another, was a boreal sea; during its transgressive episodes boreal faunas attained into the basin north of the Tagus. During Middle Carixian and Lower Domerian, owing to simultaneous transgressions, these two seas joined together allowing faunal exchanges along the epicontinental areas which limited the emerging hercynian chains belts. During Liassic, the Algarve belonged undoubtedly to the tethyan submediterranean province. The area north of the Tagus, on the contrary, was a complex realm where subboreal and tethyan affinities alternatively prevailed. In the Algarve the first Middle Jurassic deposits do frequently show lateral thickness reductions as well as unconformities contemporaneous with other generalized disturbances on the sedimentation processes in other parts of Europe. By this time, near Sagres, a barrier reef developed separating lagoonal or ante-reef facies from the transreef pelagic zone. The presence of tethyan fauna, the abundance of Phylloceratidae and the absence of boreal forms allow us to consider the Algarve basin as a submediterranean province. The presence of Callovian pelagic fossiliferous formations in the Loulé area shows that during Middle Jurassic the marl-limestone transreef sedimentation was not confined to the western Algarve. They would extend eastwards where they only can be seen in the core of some anticlines. This is due to the progressive sinking of the meso-cenozoic formations as we proceed towards the South of the Sagres-Algoz-Querença flexure. In the whole of the Peninsule, and as for the Middle Callovian, an important regression can be clearly recognized on the evidence of an erosion surface which strikes obliquely the Middle and Upper Callovian strata. The geographic boundaries of the different faunal provinces are not changed by the presence of many Kosmoceratidae in the phosphate nodules since they are but a minority in comparison with the tethyan forms. An abstract model can be constructed showing that in Western Europe the Kosmoceratidae may have migrated South and westwards through a channel of the sea that linked Paris basin to Poitou and Aquitaine. By migrating between the Iberian meseta and the Armorican massif this fauna reached northern Tagus basin at the beginning of Upper Callovian (Athleta Zone); this south and southwest bound migration would have proceeded, allowing such forms to reach Algarve basin only in latest Callovian times (Lamberti Zone). This migration means that during Middle Jurassic a widely spread North Atlantic sea would exist, flooding the western part of Portugal up to the Poitou.
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The evolution of the Lusitanian Basin, localized on the western Iberian margin, is closely associated with the first opening phases of the North Atlantic. It persisted from the Late Triassic to the Early Cretaceous, more precisely until the end of the Early Aptian, and its evolution was conditioned by inherited structures from the variscan basement. The part played by the faults that establish its boundaries, as regards the geometric and kinematic evolution and the organization of the sedimentary bodies, is discussed here, as well as with respect to important faults transversal to the Basin. A basin evolution model is proposed consisting of four rifting episodes which show: i) periods of symmetrical (horst and graben organization) and asymmetrical (half graben organization) geometric evolution; ii) diachronous fracturing; iii) rotation of the main extensional direction; iv) rooting in the variscan basement of the main faults of the basin (predominantly thick skinned style). The analysis and regional comparison, particularly with the Algarve Basin, of the time intervals represented by important basin scale hiatuses near to the renovation of the rifting episodes, have led to assume the occurrence of early tectonic inversions (Callovian–Oxfordian and Tithonian–Berriasian). The latter, however, had a subsequent evolution distinct from the first: there is no subsidence renovation, which is discussed here, and it is related to a magmatic event. Although the Lusitanian Basin is located on a rift margin which is considered non-volcanic, the three magmatic cycles as defined by many authors, particularly the second (approx. 130 to 110 My ?), performed a fundamental part in the mobilization of the Hettangian evaporites, resulting in the main diapiric events of the Lusitanian Basin. The manner and time in which the basin definitely ends its evolution (Early Aptian) is discussed here. Comparisons are established with other west Iberian margin basins and with Newfoundland basins. A model of oceanization of this area of the North Atlantic is also presented, consisting of two events separated by approximately 10 My, and of distinct areas separated by the Nazaré fault. The elaboration of this synthesis was based on: - information contained in previously published papers (1990 – 2000); - field-work carried out over the last years, the results of which have not yet been published; - information gathered from the reinterpretation of geological mapping and geophysical (seismic and well logs) elements, and from generic literature concerning the Mesozoic of the west iberian margin.
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This paper is a summary of the results of the authors recent researches about the Western Iberian continental margin. During the Mesozoic, the margin is affected by two consecutive extensional phases interpreted as the result from two episodes of rifting in the Atlantic. Then during Cenozoic, subsidence was interrupted by compression and related deformation, specially during Eocene time. Ante-mesozoic basement controls the structural and sedimentary evolution of the margin.
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OBJECTIVE : To analyze studies that evaluated the role of infections as well as indirect measures of exposure to infection in the risk of childhood leukemia, particularly acute lymphoblastic leukemia. METHODS : A search in Medline, Lilacs, and SciELO scientific publication databases initially using the descriptors “childhood leukemia” and “infection” and later searching for the words “childhood leukemia” and “maternal infection or disease” or “breastfeeding” or “daycare attendance” or “vaccination” resulted in 62 publications that met the following inclusion criteria: subject aged ≤ 15 years; specific analysis of cases diagnosed with acute lymphoblastic leukemia or total leukemia; exposure assessment of mothers’ or infants’ to infections (or proxy of infection), and risk of leukemia. RESULTS : Overall, 23 studies that assessed infections in children support the hypothesis that occurrence of infection during early childhood reduces the risk of leukemia, but there are disagreements within and between studies. The evaluation of exposure to infection by indirect measures showed evidence of reduced risk of leukemia associated mainly with daycare attendance. More than 50.0% of the 16 studies that assessed maternal exposure to infection observed increased risk of leukemia associated with episodes of influenza, pneumonia, chickenpox, herpes zoster, lower genital tract infection, skin disease, sexually transmitted diseases, Epstein-Barr virus, and Helicobacter pylori . CONCLUSIONS : Although no specific infectious agent has been identified, scientific evidence suggests that exposure to infections has some effect on childhood leukemia etiology.
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The reef levels of the gulf of Skoura belong to the reef formation of the Upper Miocene of the South-Rifan straits. A detailed analysis of the vertical distribution of various forms of colonies has led to the establishment of precise coral morphologies zonation. This palaeoecological approach leads us to distinguish between two environments in the Skoura gulf, probably corresponding to two reef episodes. The palaeogeographical implications (relationships between the Atlantic ocean and the Mediterranean sea) will be pointed out.
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Tese de doutoramento, Teoria da Literatura, Universidade de Lisboa, Faculdade de Letras, 2003
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This study aimed to show, based on the literature on the subject, the potential for dispersal and establishment of the chikungunya virus in Brazil. The chikungunya virus, a Togaviridae member of the genusAlphavirus, reached the Americas in 2013 and, the following year, more than a million cases were reported. In Brazil, indigenous transmission was registered in Amapa and Bahia States, even during the period of low rainfall, exposing the whole country to the risk of virus spreading. Brazil is historically infested by Ae. aegypti and Ae. albopictus, also dengue vectors. Chikungunya may spread, and it is important to take measures to prevent the virus from becoming endemic in the country. Adequate care for patients with chikungunya fever requires training general practitioners, rheumatologists, nurses, and experts in laboratory diagnosis. Up to November 2014, more than 1,000 cases of the virus were reported in Brazil. There is a need for experimental studies in animal models to understand the dynamics of infection and the pathogenesis as well as to identify pathophysiological mechanisms that may contribute to identifying effective drugs against the virus. Clinical trials are needed to identify the causal relationship between the virus and serious injuries observed in different organs and joints. In the absence of vaccines or effective drugs against the virus, currently the only way to prevent the disease is vector control, which will also reduce the number of cases of dengue fever.
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The morpho-structural evolution of oceanic islands results from competition between volcano growth and partial destruction by mass-wasting processes. We present here a multi-disciplinary study of the successive stages of development of Faial (Azores) during the last 1 Myr. Using high-resolution digital elevation model (DEM), and new K/Ar, tectonic, and magnetic data, we reconstruct the rapidly evolving topography at successive stages, in response to complex interactions between volcanic construction and mass wasting, including the development of a graben. We show that: (1) sub-aerial evolution of the island first involved the rapid growth of a large elongated volcano at ca. 0.85 Ma, followed by its partial destruction over half a million years; (2) beginning about 360 ka a new small edifice grew on the NE of the island, and was subsequently cut by normal faults responsible for initiation of the graben; (3) after an apparent pause of ca. 250 kyr, the large Central Volcano (CV) developed on the western side of the island at ca 120 ka, accumulating a thick pile of lava flows in less than 20 kyr, which were partly channelized within the graben; (4) the period between 120 ka and 40 ka is marked by widespread deformation at the island scale, including westward propagation of faulting and associated erosion of the graben walls, which produced sedimentary deposits; subsequent growth of the CV at 40 ka was then constrained within the graben, with lava flowing onto the sediments up to the eastern shore; (5) the island evolution during the Holocene involves basaltic volcanic activity along the main southern faults and pyroclastic eruptions associated with the formation of a caldera volcano-tectonic depression. We conclude that the whole evolution of Faial Island has been characterized by successive short volcanic pulses probably controlled by brief episodes of regional deformation. Each pulse has been separated by considerable periods of volcanic inactivity during which the Faial graben gradually developed. We propose that the volume loss associated with sudden magma extraction from a shallow reservoir in different episodes triggered incremental downward graben movement, as observed historically, when immediate vertical collapse of up to 2 m was observed along the western segments of the graben at the end of the Capelinhos eruptive crises (1957-58).
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Our main objective is to estimate the additional health care costs to the Portuguese National Health Service (NHS) due to domestic violence against women. We collected information through a survey addressed to health care centres’ female users. Both victims and non-victims of violence were inquired. We estimate costs according to five different groups – consultation costs, health care treatment and therapeutic costs, costs of complementary and diagnostic exams, drugs costs and transport costs. The estimations have been split into two perspectives – the NHS perspective (public perspective) and private perspective of inquired women (out of pocket payments). The timeframe of our calculations is one year, referring to all costs generated by domestic violence situations in the last twelve months. Essentially costs were estimated through the product of total number of episodes by the average estimated price per episode. Additionally, for the private costs, we also considered the costs originated by income losses, the opportunity cost of time spent on health care treatments and the work inability caused by sickness. The results suggest that the victims of domestic violence’s additional demand for health care is valued €140 per annum, that is about 22% higher than health care costs of non-victims. These results match those of similar studies for the United States, taking account of per capita differences in health care spending. A large proportion (90%) of the additional costs associated with domestic violence is supported by the NHS, where consultations and drugs are the most important contributors of such costs. Health consequences of domestic violence result from losses in quality of life and worst health status of victims and correspond to additional permanent economic costs of domestic violence episodes.