Agreement between premortem and postmortem diagnoses in patients with acquired immunodeficiency syndrome observed at a brazilian teaching hospital

Acquired immunodeficiency syndrome (AIDS) is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical) diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7%) autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition

EXPERIENCE IN THE EVALUATION OF CHILDREN WITH HEPATOSPLENOMEGALY AT A TEACHING AMBULATORY, SÃO PAULO, BRAZIL

Objectives: Describe cases of children with hepatosplenomegaly (HS) attended at the General Pediatric Teaching Ambulatory (AGER) of Instituto da Criança, São Paulo, identifying the main causes, evolution, necessity for hospitalization and/or referral to specialists. Methodology: Retrospective analysis of the records of children presenting HS on admission at AGER from September 1, 1993 to August 31, 1996. Results: Of the 89 children included (age range, 1 to 148 months; median, 24 months), 64 (72%) were referred from other services for HS investigation. Most common presenting complaints were: fever - 39 (44%); pallor - 26 (29%); weight loss - 21 (24%) and jaundice - 14 (16%). Main alterations noticed on physical examination were: pallor - 47 (53%) and short stature - 17 (19%). Anemia was diagnosed in 70 children (79%); 35 children (39%) had infections; 7 (8%) metabolic disorders and 5 (6%) neoplastic disorders. The most frequent infections were of the urinary tract - 9 (10%) and hepatitis A - 6 (7%).Thirty six children (40%) were referred to specialists, 17 of which were already diagnosed. Conclusions: Most of the children with HS present deficiency anemia associated with infections which the general pediatrician is able to diagnose. Persistence of unexplained HS for more than 2 months, especially when there is substantial volume enlargement or alteration in the organs consistency, is an indication for referral to specialists.

Standard commercial education robotic platform: intermediate solution to teaching robotics

Teaching robotics to students at the beginning of their studies has become a huge challenge. Simulation environments can be an effective solution to that challenge where students can interact with simulated robots and have the first contact with robotic constraints. From our previous experience with simulation environments it was possible to observe that students with lower background knowledge in robotics where able to deal with a limited number of constraints, implement a simulated robotic platform and study several sensors. The question is: after this first phase what should be the best approach? Should the student start developing their own hardware? Hardware development is a very important part of an engineer's education but it can also be a difficult phase that could lead to discouragement and loss of motivation in some students. Considering the previous constraints and first year engineering students’ high abandonment rate it is important to develop teaching strategies to deal with this problem in a feasible way. The solution that we propose is the integration of a low-cost standard robotic platform WowWee Rovio as an intermediate solution between the simulation phase and the stage where the students can develop their own robots. This approach will allow the students to keep working in robotic areas such as: cooperative behaviour, perception, navigation and data fusion. The propose approach proved to be a motivation step not only for the students but also for the teachers. Students and teachers were able to reach an agreement between the level of demand imposed by the teachers and satisfaction/motivation of the students.

Teaching accounting and management through business simulation

Everyday accounting and management teachers face the challenge of creating learning environments that motivate students. This chapter describes the Business Simulation (BS) experience that has taken place at the Polytechnic Institute of Porto, Institute of Accounting and Administration (IPP/ISCAP). The chapter presents students’ perceptions about the course and the teaching/learning approach. The results show that pedagogical methods used (competency-oriented), generic competencies (cooperation and group work), and interpersonal skills (organisational and communication skills) are relevant for future accounting professionals. In addition, positive remarks and possible constraints based on observation, staff meetings, and past research are reported. The chapter concludes with some recommendations from the project implementation

Developing writing skills in English language teaching through the use of blogs and e-mail at primary school level

Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teaching English as a Second / Foreign Language

Training and discovering corpus-based data driven exercices in english teaching (L2/FL) to native speakers of portuguese (L1)

Project submitted as part requirement for the degree of Masters in English teaching,

Candida bloodstream infection: data from a teaching hospital in Mato Grosso do Sul, Brazil

The incidence of Candida bloodstream infection has increased over the past years. In the Center-West region of Brazil, data on candidemia are scarce. This paper reports a retrospective analysis of 96 cases of Candida bloodstream infection at a Brazilian tertiary-care teaching hospital in the state of Mato Grosso do Sul, from January 1998 to December 2006. Demographic, clinical and laboratory data were collected from medical records and from the hospital's laboratory database. Patients' ages ranged from three days to 92 years, with 53 (55.2%) adults and 43 (44.8%) children. Of the latter, 25 (58.1%) were newborns. The risk conditions most often found were: long period of hospitalization, utilization of venous central catheter, and previous use of antibiotics. Fifty-eight (60.4%) patients died during the hospitalization period and eight (13.7%) of them died 30 days after the diagnosis of candidemia. Candida albicans (45.8%) was the most prevalent species, followed by C. parapsilosis (34.4%), C. tropicalis (14.6%) and C. glabrata (5.2%). This is the first report of Candida bloodstream infection in the state of Mato Grosso do Sul and it highlights the importance of considering the possibility of invasive Candida infection in patients exposed to risk factors, particularly among neonates and the elderly.

Rapid HIV diagnostic test in undocumented pregnant women applied at an inner-city teaching hospital

A significant number of Brazilian gestational-age women are still not tested for HIV, representing a high risk of transmission to their newborns. The current study sought to identify the number of pregnant women with no previous testing or undocumented for HIV referred to the Gynecology and Obstetrics Department of a Regional Teaching Hospital and included diagnosis of HIV infection determined by a rapid test and perinatal transmission in pregnancy. Medical records of all pregnant women admitted to hospital from January 2001 to December 2005 were reviewed. Pregnant women without HIV results were submitted to a rapid HIV test. Those who tested positive were further tested by ELISA and confirmed by indirect immunofluorescence assay (IIA) or Western blot (WB). The viral load from babies born to HIV-infected mothers was assessed by bDNA. Of the 16,424 pregnant women analyzed (6.6%), 1,089 were undocumented for HIV. Eleven women were positive in rapid testing and 10 were confirmed by ELISA, IIA or WB, with 0.9% seropositivity. Mother/infant pairs received zidovudine monotherapy prophylaxis and infant viral load was lower than 50 copies/mL. A higher number of pregnant women previously tested for HIV during antenatal care was verified, compared to that obtained nationwide.

The role of literature: english textbooks and literature in secondary teaching in Portugal

Trabalho de Projecto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Ensino de Inglês

Teaching mathematics using Massive Open Online Courses

Distance learning - where students take courses (attend classes, get activities and other sort of learning materials) while being physically separated from their instructors, for larger part of the course duration - is far from being a “new event”. Since the middle of the nineteenth century, this has been done through Radio, Mail and TV, taking advantage of the full educational potential that these media resources had to offer at the time. However, in recent times we have, at our complete disposal, the “magic wonder” of communication and globalization - the Internet. Taking advantage of a whole new set of educational opportunities, with a more or less unselfish “look” to economic interests, focusing its concern on a larger and collective “welfare”, contributing to the development of a more “equitable” world, with regard to educational opportunities, the Massive Open Online Courses (MOOCs) were born and have become an important feature of the higher education in recent years. Many people have been talking about MOOCs as a potential educational revolution, which has arrived from North America, still growing and spreading, referring to its benefits and/or disadvantages. The Polytechnic Institute of Porto, also known as IPP, is a Higher Education Portuguese institution providing undergraduate and graduate studies, which has a solid history of online education and innovation through the use of technology, and it has been particularly interested and focused on MOOC developments, based on an open educational policy in order to try to implement some differentiated learning strategies to its actual students and as a way to attract future ones. Therefore, in July 2014, IPP launched the first Math MOOC on its own platform. This paper describes the requirements, the resulting design and implementation of a mathematics MOOC, which was essentially addressed to three target populations: - pre-college students or individuals wishing to update their Math skills or that need to prepare for the National Exam of Mathematics; - Higher Education students who have not attended in High School, this subject, and who feel the need to acquire basic knowledge about some of the topics covered; - High School Teachers who may use these resources with their students allowing them to develop teaching methodologies like "Flipped Classroom” (available at http://www.opened.ipp.pt/). The MOOC was developed in partnership with several professors from several schools from IPP, gathering different math competences and backgrounds to create and put to work different activities such video lectures and quizzes. We will also try to briefly discuss the advertising strategy being developed to promote this MOOC, since it is not offered through a main MOOC portal, such as Coursera or Udacity.

Pig bite in Brazil: a case series from a teaching hospital

A retrospective survey done from 1987 till 1990 revealed that 23 patients bitten by pigs sought medical help at a teaching hospital in Uberlândia, in southeastern Brazil. Most cases (21) were from Uberlândia. The cases were evenly distributed by month and by year; most of them (14/16; 87.5%) occurred between 7. OOa.m. and 7.00 p. m. The male to female ratio was 6.7:1. Age ranged from 6 to 73 (mean 38.95 ± SD 22.06, median 36). The bites were more common on the upper limbs, particularly on the forearms. In 11(47.8%) cases the injury was described as deep. In most cases where information was available the injury was related to capture, transport or immobilisation ofthe pigfor slaughter. The following medical procedures were performed: local cleansing in 19(82.6%) cases, rabies vaccine (12; 52.2%), antirabies serum (2; 8.7%), suturing (6; 26.1%) and tetanus vaccine (12; 52.2%). There was no case of infection at the bite site, neither of rabies or tetanus. By our data, the annual incidence of pig bite in Uberlândia can be estimated to be about 1.5/100.000.

Codeship: Financing growth: Case study and Teaching note

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Making connections: engineering and language issues in teaching english for specific purposes

Tese apresentada para cumprimento dos requisitos necessários à obtenção do grau de Doutor em Línguas, Literaturas e Culturas