Electric vehicles in urban areas: test cases using a scenario simulator

Electric vehicles introduction will affect cities environment and urban mobility policies. Network system operators will have to consider the electric vehicles in planning and operation activities due to electric vehicles’ dependency on the electricity grid. The present paper presents test cases using an Electric Vehicle Scenario Simulator (EVeSSi) being developed by the authors. The test cases include two scenarios considering a 33 bus network with up to 2000 electric vehicles in the urban area. The scenarios consider a penetration of 10% of electric vehicles (200 of 2000), 30% (600) and 100% (2000). The first scenario will evaluate network impacts and the second scenario will evaluate CO2 emissions and fuel consumption.

Imported and autochthonous cases in the dynamics of dengue epidemics in Brazil

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.

Increase in cases of malaria in Mozambique, 2014: epidemic or new endemic pattern?

ABSTRACT OBJECTIVE To describe the increase in cases of malaria in Mozambique. METHODS Cross-sectional study conducted in 2014, in Mozambique with national weekly epidemiological bulletin data. I analyzed the number of recorded cases in the 2009-2013 period, which led to the creation of an endemic channel using the quartile and C-Sum methods. Monthly incidence rates were calculated for the first half of 2014, making it possible to determine the pattern of endemicity. Months in which the incidence rates exceeded the third quartile or line C-sum were declared as epidemic months. RESULTS The provinces of Nampula, Zambezia, Sofala, and Inhambane accounted for 52.7% of all cases in the first half of 2014. Also during this period, the provinces of Nampula, Sofala and Tete were responsible for 54.9% of the deaths from malaria. The incidence rates of malaria in children, and in all ages, have showed patterns in the epidemic zone. For all ages, the incidence rate has peaked in April (2,573 cases/100,000 inhabitants). CONCLUSIONS The results suggest the occurrence of an epidemic pattern of malaria in the first half of 2014 in Mozambique. It is strategic to have a more accurate surveillance at all levels (central, provincial and district) to target prevention and control interventions in a timely manner.

Acute myocardial infarction in chronic Chagas' cardiomyopathy: report of two cases with no obstructive coronary artery lesions

This report describes two patients with chronic Chagas' Heart Disease who developed clinical and laboratorial signs of myocardial infarction. Both patients presented sudden oppressive chest pain, without precipitating factor. In the first case, the highest MB-CK value was 65 IU, 22 hours after the beginning of the pain. On the second case, it was 77 IU at 18 hours after the beginning of the pain. In both cases ECG changes suggesting non-transmural infarction were present. The 99mTc PYP myocardial scintigram of the first case was positive. Coronary angiograms performed on the 18th and 9th day, respectively, after the acute infarction did not display obstructive lesions. Possible mechanisms causing myocardial infarction with normal coronary arteries in Chagas' Disease may include: embolic event's, particularly when there is associated congestive heart failure; coronary thrombosis and coronary spasms.

Histological and microbiological aspects of actinomycetoma cases in Venezuela

A ten year (1976-1986) review study of cases of Actinomycetoma in Venezuela was made through personal interview and clinical examinations, analysis of medical records of patients with actinomycetoma, histological studies of biopsy samples, as well as microbiological studies of isolates strain, also through out personal interviews with researchers and dermatologists who were sources of information on mycetoma cases. A total of 47 cases were recorded. As etiologic agent Actinomadura madurae was found in 20 cases - (42.5%), Nocardia brasiliensis in 13 cases (27.6%), Nocardia spp 7 cases (14.8%), Streptomyces somaliensis in 4 cases (8.5%), N. asteroides in 2 cases (4.2%) and N. otitidis caviarum, (N. caviae) in 1 case (2.1%). Most of the reported cases involved individuals living and working in rural areas, mostly males who outnumber females 4:1. The patients were 18 to 80 years old. A. madurae was reported as the most frequent etiologic agent. Most of the clinical cases were seen when the disease was well established. Twenty four of the forty seven cases reported were observed in Lara State, which represents a 51.0% of all the cases studied.

Pulmonary cavities colonized by actinomycetes: report of six cases

Six cases of a cavitary pulmonary ball formed by Actinomycetes are reported. They were observed in the state of Bahia, Brazil. All patients complained of cough and hemoptysis and the pathological study showed bronchiectasis and small cavities in the lungs. The lesions contained micro-colonies of Actinomyces, identified by morphology, staining properties and culture in two cases (thioglycolate media). In the six patients the disease was limited to the lungs. In one patient grains were found, within micro-abscesses in the surrounding parenchyma. Probably the invasion occurred due to ulceration of bronchial mucosa that was covered by granulation tissue. The author suggests that as in nocardiosis actinomycosys may have an invasive form, a saprophytic one may and colonize pulmonary cavities.

Non-venomous snake bite and snake bite without envenoming in a brazilian teaching hospital: analysis of 91 cases

A retrospective survey of 473 cases of snake bite admitted to a Brazilian teaching hospital from 1984 to 1990 revealed 91 cases of bite without envenoming and/or caused by non-venomous snakes. In 17 of these cases the snake was identified, and one patient was bitten by a snake-like reptile (Amphisbaena mertensii). In 43 cases diagnosis was made on clinical grounds (fang marks in the absence of signs of envenoming). The other 30 cases were of patients who complained of being bitten but who did not show any sign of envenoming or fang mark. Most cases occurred in men (66;73%), in the 10-19 years age group (26;29%), in the lower limbs (51/74;69%), between 6 A. M. and 2 P.M. (49;61%) and in the month of April (16; 18%). One patient bitten by Philodryas olfersii developed severe local pain, swelling and redness at the site of the bite, with normal clotting time. The patient bitten by Drymarcon corais was misdiagnosed as being bitten by a snake of the genus Bothrops, was given the specific antivenom, and developed anaphylaxis. One patient bitten by Sibynomorphus mikanii presented prolonged clotting time, and was also given antivenom as a case of Bothrops bite. Correct identification of venomous snakes by physicians is necessary to provide correct treatment to victims of snake bite, avoiding unnecessary distress to the patient, and overprescription of antivenom, which may eventually cause severe untoward effects.

Five cases of nosocomial and community-acquired legionnaires' disease in São Paulo, Brazil

Legionella sp has been emerging over the last decade as an important cause of pneumonia both hospital and community-acquired. Following an outbreak in a Renal - Transplant Unit stocked serum was tested for antibodies against Legionella pneumophila serogroup 1, and 5 cases of Legionnaires' Disease were reviewed. Two of the cases were nosocomial and three cases were community - acquired. Clinical and laboratorial aspects were similar to those expected for other causes of pneumonia, however jaundice was encountered in two cases. This study suggests that the real incidence of pneumonia caused by Legionella sp is being underestimated and the authors emphasize the importance of considering Legionnaires' Disease when empirically treating community - acquired pneumonia

Aspergillosis in immunocompromised children acute myeloid leukemia and bone marrow aplasia.: Report of two cases

Two cases of Aspergillosis in immunocompromised children are reported. Both were caused by Aspergillns flavus. Early diagnosis and treatment led to the remission of the process. One patient had acute myeloid leukemia; the fungus was isolated from the blood. The other patient with bone marrow aplasia, presented an invasive aspergillosis of the paranasal sinuses with dissemination of fungal infection; the diagnosis was obtained by histology and culture of biopsied tissue from a palatal ulceration.

Erythema nodosum: prospective study of 32 cases

The results of 32 cases studied lead us to the conclusion that erythema nodosum's investigation routine is very important, once in our retrospective study, the percentage of cases of unknown etiology was 69.4%, and in this prospective study it is 21.8%. In 10 cases (31.2%), more than one causing agent was suspected. Infections (bacterial, helminthic, fungal, by protozoa) were diagnosed in 26 cases, streptococcal infection having predominated (12 cases). Drugs-dipirone, aspirin, anovulatory - were suspected as causing agents in 13 cases. The association of erythema nodosum and histoplasmosis capsulata is described for the first time in Brazil. We consider erythema nodosum to be a complex syndrome which should be regarded as a manifestation of underlying diseases. The fact that all 32 subjects were women, 26 of them during menacme, suggests that particular hormonal media may favor the action of various processes (infections and drugs), precipitating erythema nodosum's clinical picture.

Paracoccidioidomycosis associated with acquired immunodificiency syndrome: report of seven cases

We report the clinical findings and evolution of seven patients (five men and two women), the majority of them intravenous drug users, with paracoccidioidomycosis associated to acquired immunodeficiency syndrome (AIDS). In four of the patients the paracoccidioidomycosis was restricted to the lung and in the three others was generalized with cutaneous involvement. Only two of them had lived recently in rural area, an indication of the possible reactivation of latent focal infection in the other five patients. The recognition of the role of cell-mediated immunity in host defense against Paracoccidioides brasiliensis leds to the prediction of a growing occurrence of the paracoccidioidomycosis-AIDS association in areas that are endemic for these diseases.