SOFHIA: a CAD environment to design digital control systems

"Series Title: IFIP - The International Federation for Information Processing, ISSN 1868-4238"Petri Nets (PNs) prove to be an e cient methodology to model discrete-event systems with parallel activities. The main advantages lie on the graphical interface and on the availability of a set of techniques for formal analysis, including the validation and the test of the modelled system. A proposal to modify the normal PN behaviour is presented, which aims a fast speci cation of synchronous parallel digital systems, including both the data path and the control unit. A CAD environment, SOFHIA, was developed to model digital systems, to validate their properties and to simulate their behaviour. The environment includes the automatic generation of VHDL code to allow simulation and synthesis on existing CAD tools

Necrotizing Fasciitis and Middle Ear Infection

A fasceíte necrosante (FN) é uma doença rara em pediatria. Na maior parte dos casos surge como complicação de varicela, sendo a pele habitualmente a porta de entrada e o Streptococcus pyogenes o agente mais frequente. Os autores descrevem um caso clínico de uma criança de 8 anos, previamente saudável que, no contexto de uma otite média aguda medicada com um anti-inflamatório não esteróide (AINE), desenvolve uma infecção invasiva a Streptococcus 13 hemoliticus do grupo A

Climate change alters fish community size-structure, requiring adaptive policy targets

Size‐based indicators are used worldwide in research that supports the management of commercially exploited wild fish populations, because of their responsiveness to fishing pressure. Observational and experimental data, however, have highlighted the deeply rooted links between fish size and environmental conditions that can drive additional, interannual changes in these indicators. Here, we have used biogeochemical and mechanistic niche modelling of commercially exploited demersal fish species to project time series to the end of the 21st century for one such indicator, the large fish indicator (LFI), under global CO2 emissions scenarios. Our modelling results, validated against survey data, suggest that the LFI's previously proposed policy target may be unachievable under future climate change. In turn, our results help to identify what may be achievable policy targets for demersal fish communities experiencing climate change. While fisheries modelling has grown as a science, climate change modelling is seldom used specifically to address policy aims. Studies such as this one can, however, enable a more sustainable exploitation of marine food resources under changes unmanageable by fisheries control. Indeed, such studies can be used to aid resilient policy target setting by taking into account climate‐driven effects on fish community size‐structure

“A Good Death” - Palliative Surgery in Trisomy 18

A trissomia 18 caracteriza-se por múltiplas anomalias, incluindo doença cardíaca em 60 a 90% dos casos e elevada mortalidade. O mau prognóstico global, conduz habitualmente a uma politica de “cuidados mínimos” mas, paliar, é também nestas situações, um imperativo ético. Descreve-se o caso de uma recém-nascida sem diagnóstico pré natal, mas com confirmação por cariotipo, com cardiopatia, que condicionou insuficiência cardíaca congestiva e angústia respiratória crescente, inviabilizando alta hospitalar, como era desejo da família. Após consenso entre os pais e o corpo clínico responsável, foi decidida intervenção cirúrgica cardíaca paliativa, que possibilitou melhoria clínica e alta para o domicílio. Os autores defendem que a cirurgia cardíaca pode ser uma atitude a considerar em casos de trissomia 18, pois pode aliviar o sofrimento

Brain MRI in a patient with classical galactosemia: acute event of unilateral hemispheric cerebral edema

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Prevalence of iron deficiency anemia and iron deficiency in a pediatric population with inflammatory bowel disease

OBJECTIVES: Iron deficiency is the most common cause of anemia in children with inflammatory bowel disease, although the real prevalence is unknown. Intravenous iron is suggested as the first line treatment. This study aims to determine the prevalence of iron deficiency anemia in children with inflammatory bowel disease followed in a Pediatric Gastroenterology Unit of a tertiary center and to evaluate this unit's experience with intravenous iron. MATERIALS AND METHODS: A retrospective cohort study was designed involving children with inflammatory bowel disease followed in that unit between January 2001 and April 2016. Laboratory results were collected at the moment of diagnosis, after one-year follow-up and prior each IV iron administration performed during the study period. Anemia was defined according to World Health Organization criteria and the iron deficiency was defined using recent guidelines. RESULTS: Were studied 69 patients 71% had CD and 29% UC. 50.7% were female. Mean patient age at diagnosis was 13.3 years (range 1--17 years). Prevalence of ID and IDA at diagnosis was 76.8% and 43.5%, respectively. After one year follow-up, those values decreased to 68.1% (p=.182) and 21.7% (p=.002), respectively. Hemoglobin significantly increased (p<.001). Intravenous iron was administered to 92.8% of patients. No adverse reactions were reported. CONCLUSIONS: Intravenous iron is the first line in the treatment of Iron deficiency anemia in Inflammatory Bowel disease and it is safe and effective. Persistent anemia and iron deficiency are common.info:eu-repo/semantics/publishedVersio

Severe Influenza B Pneumonia Virus in a Newborn

A infecção por vírus influenza B é rara no período neonatal com uma incidência desconhecida. Relata-se o caso de uma recém-nascida de termo, reinternada ao nono dia de vida por quadro de má perfusão periférica, gemido, dificuldade alimentar e dificuldade respiratória com necessidade de ventila ção mecânica, óxido nítrico inalado e surfactante. A radiografia de tórax no primeiro dia apresentava infiltrado intersticial ligeiro, difuso. Esteve sob ventilação invasiva durante 11 dias e oxigenoterapia 15 dias, tendo tido alta ao 20º dia, clinicamente bem. É fundamental pensar em infecção por vírus influenza B quando existe história de possível contágio, e em mães sem imunização anti-influenza. Não há terapêutica aprovada neste grupo etário, devendo ser tomadas medidas de suporte, de contenção e prevenção da disseminação da infecção

Gangrena de Fournier numa Mulher

A fasceíte necrotizante dos tecidos infra-diafragmáticos (gangrena de Fournier) é uma grave infecção sinergística por agentes aeróbicos/anaeróbicos, com uma evolução clínica súbita e rápida de gangrena da fascia e sepsis generalizada, associada a elevada mortalidade. Trata-se de uma emergência médico-cirúrgica necessitando de tratamento intensivo englobando a correcção das anomalias hemodinâmicas, hidroelectrolí- ticas e metabólicas, antibioterapia dupla/tripla de largo espectro por via endovenosa, desbridamento cirúrgico agressivo do tecido necrótico infectado e correcção da determinante etiológica da gangrena. É frequente encontrar como factores de risco a diabetes mellitus, doença crónica hepática, doenças malignas, doenças imunológicas congénitas ou adquiridas, tratamento com fármacos imuno-supressores, alcoolismo crónico e má nutrição. As fontes infecciosas originais conducentes a uma gangrena de Fournier são geralmente abcessos da área peri-anal ou processos infecciosos genitourológicos. Embora a gangrena de Fournier seja muito menos frequente na mulher que no homem, é importante pensar nesse diagnóstico, de forma a proporcionar às doentes a possibilidade de tratamento com sucesso. Descreve-se o caso de uma gangrena de Fournier, determinada porumabscesso da fossa ísquio-rectal, numa mulher diabética e em tratamento de um penfigus vulgaris com fármacos imuno-supressores, com evolução fatal, possivelmente em resultado de diagnóstico e tratamento tardios

The Portuguese Severe Asthma Registry: Development, Features, and Data Sharing Policies

The Portuguese Severe Asthma Registry (Registo de Asma Grave Portugal, RAG) was developed by an open collaborative network of asthma specialists. RAG collects data from adults and pediatric severe asthma patients that despite treatment optimization and adequate management of comorbidities require step 4/5 treatment according to GINA recommendations. In this paper, we describe the development and implementation of RAG, its features, and data sharing policies. The contents and structure of RAG were defined in a multistep consensus process. A pilot version was pretested and iteratively improved. The selection of data elements for RAG considered other severe asthma registries, aiming at characterizing the patient's clinical status whilst avoiding overloading the standard workflow of the clinical appointment. Features of RAG include automatic assessment of eligibility, easy data input, and exportable data in natural language that can be pasted directly in patients' electronic health record and security features to enable data sharing (among researchers and with other international databases) without compromising patients' confidentiality. RAG is a national web-based disease registry of severe asthma patients, available at asmagrave.pt. It allows prospective clinical data collection, promotes standardized care and collaborative clinical research, and may contribute to inform evidence-based healthcare policies for severe asthma.info:eu-repo/semantics/publishedVersio

Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano, inland southern Italy

Dermatological remedies make up at least one-third of the traditional pharmacopoeia in southern Italy. The identification of folk remedies for the skin is important both for the preservation of traditional medical knowledge and in the search for novel antimicrobial agents in the treatment of skin and soft tissue infection (SSTI). Our goal is to document traditional remedies from botanical, animal, mineral and industrial sources for the topical treatment of skin ailments. In addition to SSTI remedies for humans, we also discuss certain ethnoveterinary applications. Field research was conducted in ten communities in the Vulture-Alto Bradano area of the Basilicata province, southern Italy. We randomly sampled 112 interviewees, stratified by age and gender. After obtaining prior informed consent, we collected data through semi-structured interviews, participant-observation, and small focus groups techniques. Voucher specimens of all cited botanic species were deposited at FTG and HLUC herbaria located in the US and Italy. We report the preparation and topical application of 116 remedies derived from 38 plant species. Remedies are used to treat laceration, burn wound, wart, inflammation, rash, dental abscess, furuncle, dermatitis, and other conditions. The pharmacopoeia also includes 49 animal remedies derived from sources such as pigs, slugs, and humans. Ethnoveterinary medicine, which incorporates both animal and plant derived remedies, is addressed. We also examine the recent decline in knowledge regarding the dermatological pharmacopoeia. The traditional dermatological pharmacopoeia of Vulture-Alto Bradano is based on a dynamic folk medical construct of natural and spiritual illness and healing. Remedies are used to treat more than 45 skin and soft tissue conditions of both humans and animals. Of the total 165 remedies reported, 110 have never before been published in the mainland southern Italian ethnomedical literature