Fungal Meningitis in an Immunocompetent Patient

Cryptococcal meningitis is a rare entity among immunocompetent hosts but, when it occurs, it is associated with significant morbidity and mortality. Clinical presen- tation as well as the course of the disease is usually subtle and indolent with headache and altered mental status. The authors present the case of a 59-year-old man, who sought medical help with a 2-week history of headaches accompanied by nausea and visual and hearing disturbances. On admission the patient was afebrile, presented visual and hearing deficits and had a normal magnetic resonance image of the brain. A lumbar puncture was performed and microscopic examination of the cerebrospinal fluid revealed yeasts that were identified as Cryptococcus spp. and later, by means of molecular biology techniques, as Cryptococcus neoformans, var. grubii. The patient was treated with liposomal amphotericin B plus fluconazole for 28 weeks. At follow-up after 1 year the patient was asymptomatic and received fluconazole 400 mg/day as prophylactic therapy. The outcome of Cryptococcus infections in immunocompetent hosts is reported to be poor as a result of a delayed diagnosis and suboptimal initial antifungal therapy. The influence of the normal immune response is unclear

Laser scanned photodiodes (LSP) for image sensing

An optimized ZnO:Al/a-pin SixCl1-x:H/Al configuration for the laser scanned photodiode (LSP) imaging detector is proposed. The LSP utilizes light induced depletion layers as detector and a laser beam for readout. The effect of the sensing element structure, cell configuration and light source flux are investigated and correlated with the sensor output characteristics. Experimental data reveal that the large optical gap and the low conductivity of the doped a-SixC1-x:H layers are responsible by an induced inversion layer at the illuminated interfaces which blocks the carrier collection. These insulator-like layers act as MIS gates preventing image smearing. The physical background of the LSP is discussed

Advanced Directives and Living Will: A Case Report

Descreve-se o caso de uma mulher de 61 anos, com diagnóstico de neoplasia da mama em estadio IV. Na altura, recusou terapêutica. Recorre ao Serviço de Urgência, um ano após o diagnóstico, em mutismo, sendo que os exames complementares de diagnóstico revelaram uma lesão cerebral, interpretada como nova metástase. No seu processo clínico, tem uma diretiva antecipada de vontade. Este é um documento formal que explicita quais os cuidados que pretende ou não receber em final de vida. Apresentamos a descrição do caso, as indicações que a doente deixou expressas neste documento e uma reflexão acerca das diretivas antecipadas de vontade e de como estas devem ser integradas na prática clínica.info:eu-repo/semantics/publishedVersio

Crystallization and preliminary crystallographic studies of FoxE from Rhodobacter ferrooxidans SW2, an FeII oxidoreductase involved in photoferrotrophy

FoxE is a protein encoded by the foxEYZ operon of Rhodobacter ferrooxidans SW2 that is involved in Fe^II-based anoxygenic photosynthesis (`photoferrotrophy'). It is thought to reside in the periplasm, where it stimulates light-dependent Fe^II oxidation. It contains 259 residues, including two haem c-binding motifs. As no three-dimensional model is available and there is no structure with a similar sequence, crystals of FoxE were produced. They diffracted to 2.44 Å resolution using synchrotron radiation at the Fe edge. The phase problem was solved by SAD using SHELXC/D/E and the experimental maps confirmed the presence of two haems per molecule

Avaliação e Caraterização da Ação Inibitória de Iminociclitóis na Atividade α-Glucosidase de Enterócitos de Mamífero

A diabetes, em particular a diabetes mellitus tipo 2, constitui um distúrbio metabólico que se carateriza por glicemias aumentadas resultantes de diminuição da libertação e/ou ação da insulina. Os inibidores das α-glucosidases surgem como agentes de elevado interesse terapêutico uma vez que podem contribuir para a diminuição da absorção intestinal de glicose e, consequentemente, para um desagravamento da hiperglicemia. Alguns compostos da família iminociclitol são inibidores das α- glucosidases [1] e têm vindo a ser sintetizados diversos compostos novos que podem ser promissores e cuja ação sobre a atividade α-glucosidase de mamífero ainda não foi estudada. Neste trabalho procurou-se estudar a ação de alguns novos compostos da família iminociclitol (figura 1) na atividade α-glucosidase de enterócitos de mamífero, tendo-se também avaliado o grau de toxidade. O efeito dos pares dos enantiómeros foi também estudado

What do women know about testicular cancer? Exploratory study of a female university population

Poster 123 publicado em European Urology Supplements 11 (2012) 191–235.Introduction & Objectives: Testicular cancer (TC) is one of the most common malignancies in young population, and it appears to be increasing worldwide. The cure rate for TC now approaches 100%, but is negatively influenced by the delay in seeking medical attention. Sometimes it’s a man’s partner who spots a change in the testicle. Several publications have showed the importance of the partners in health. There is a lack of evidence about the importance of women, as partners, in the diagnosis of several pathologic processes in men, but we know that the healthy behavior is shaped by the partner. Our objective was to evaluate women’s knowledge about TC, as they can act as educators towards better men’s health. Material & Methods: We performed a survey of 13 questions concerning the awareness of TC and perceived importance of testicular self-examination in 307 women from the university. The questionnaire was sent to the institutional email of students, professors and other workers and the data were collected and then analyzed. Results: The mean age of our group was 26±8.3 years (range 18–58 years). Students were 74.6% (n = 229) of the sample and 25.7% (n = 79) were from the medical course. When asked if they had any knowledge about TC, 89.3% (n = 274) answered they had information about TC. Sixty-four (20.8%) of the participants knew someone with testicular cancer. Only 25% (n = 77) of the women answered correctly to the question about the age group most frequently seen with TC and 57.7% (n = 177) responded properly to the most frequent symptom of testicular cancer. When a paired analysis of the correct answers to the age group of TC and most frequent symptom only 24 (7.8%) of the subjects gave proper responses to every questions. A second part of the questionnaire was about testicular self-examination. Approximately half (50.5%) of the subjects, n = 155, referred knowledge about testicular examination. We used a Lickert-type scale to categorize the perceived importance of this examination from 1 (not important) to 10 (extremely important), with 69.4% (n = 213) considering that this was extremely important (10) and only one participant (0.3%) responded that it wasn’t important. Almost all participants (95.4%) answered that they would advise their male friends to perform testicular self-examination. Conclusions: In this study we have showed a low level of knowledge about TC. Despite this fact, the knowledge about this cancer, a great number of women considered important to men to perform testicular self-examination and were motivated to advise their male friends to perform it. Considering that partners may assume an important role in health promotion and education, maybe women, as the partner of patients in risk of having TC, can be a way of engaging healthy behaviors in men

Kaposi’s sarcoma, case report

O Sarcoma de Kaposi (SK) é um distúrbio angioproliferativo descrito como doença benigna de pessoas idosas. Divide- se em 4 tipos: O Clássico, epidémico, endêmico e iatrogénico. Os autores descrevem o caso de um homem caucasiano de 50 anos, português, que iniciou a sintomatologia 6 anos antes do internamento com lesões urticariformes na perna direita e perda ponderal de 10 kg em 6 meses. Por agravamento das lesões e aparecimento de púrpura nos membros inferiores recorreu ao hospital. O exame objetivo era normal à exceção de púrpuras dispersas com relevo, descamativas e violáceas na região plantar e restante membros inferiores, membros superiores e tronco. As serologias para o HIV 1 e 2 foram negativas a serologia viral para o Herpes virus humano 8 IGG foi positivo, PCR H8 positivo, a biópsia das lesões com histologia foi compatível com Sarcoma de Kaposi. Iniciou o 1º ciclo de Doxorrubicina lipossómica peguilhada e manteve seguimento em Hospital dia de Oncologia.info:eu-repo/semantics/publishedVersio