Salmonellosis in Children at a Portuguese Hospital: A Retrospective Study.

INTRODUCTION: Salmonellosis represents a considerable health, social and economic burden in both high- and low-income countries. Recently, in Portugal, most cases of Salmonella infections have been reported in children under 15 years of age. The main aim of this study was to characterize, from an epidemiological, microbiological, and clinical perspective, cases of Salmonella isolation among children. MATERIAL AND METHODS: The authors performed a descriptive study using retrospective analysis of cases of salmonellosis, in pediatric age, at a Portuguese Level II Hospital, between January 2015 and July 2020. RESULTS: The population included a total of 63 children, of which 81% were Portuguese. Ethnicity was identified in 13 children, most of whom were African. The median age at diagnosis was four years old (3.5 - 9 years old). Despite the small number of cases per year in our study (11), one-third were severe enough to require hospitalization. Overall, 13% of patients were treated with antibiotics. In 63% of the isolates, serotype was identified: Salmonella Enteriditis (38%), Salmonella Typhimurium (22%), and Salmonella Typhi (3%). Antibiotic resistance rates were 19% for ampicillin and 6.4% for amoxicillinclavulanic acid and cotrimoxazole. No resistance to third-generation cephalosporins was found. CONCLUSION: Given the obtained results, we intend to improve knowledge on salmonellosis in Portugal and, consequently improve prevention strategies, treatment and its notification. Although the incidence of salmonellosis has been decreasing in recent years it is the second most frequent gastrointestinal infection in the European Union, contributing to significant rates of hospitalizations and use of antibiotics in Portugal.

Brown bowel syndrome: a rare malnutrition-related complication of bariatric surgery.

INTRODUCTION: Case report: we present the case of a 44-year-old male who presented with uncontrollable diarrhea, severe protein-calorie malnutrition and multiple vitamin deficiencies, along with peripheral neuropathy ten years after classic biliopancreatic diversion (BPD). He underwent nutritional support and had the surgery converted to a Roux-en-Y gastric bypass, with an uneventful outcome. The histopathology of the resected bowel revealed lipofuscinosis of the muscular layer compatible with brown bowel syndrome. Discussion: brown bowel syndrome is a rare complication of malnutrition that can be observed after BPD. It is associated with vitamin E deficiency. After recovery with nutritional support, a reoperation that elongates the common channel, and thus minimizes the degree of malabsorption, should be indicated in these cases.

INTRODUCCIÓN: Caso clínico: presentamos el caso de un paciente varón de 44 años que presentó diarrea incontrolable, desnutrición proteica-calórica severa y deficiencias de múltiples vitaminas, junto con neuropatía periférica diez años después de derivación biliopancreatica clásica (DBP). Se sometió a soporte nutricional y la cirugía se convirtió en un bypass gástrico en Y de Roux, con un resultado sin complicaciones. La histopatología del intestino resecado reveló una lipofuscinosis de la capa muscular compatible con el síndrome del intestino marrón. Discusión: el síndrome de intestino marrón es una complicación rara de la desnutrición que se puede observar después de la DBP. Se asocia a deficiencia de vitamina E. Después de la recuperación con soporte nutricional, se debe indicar una reoperación que alargue el canal común y, por lo tanto, minimice el grado de malabsorción en estos casos.

Recent insights on uncertainties present in integrated catchment water quality modelling.

This paper aims to stimulate discussion based on the experiences derived from the QUICS project (Quantifying Uncertainty in Integrated Catchment Studies). First it briefly discusses the current state of knowledge on uncertainties in sub-models of integrated catchment models and the existing frameworks for analysing uncertainty. Furthermore, it compares the relative approaches of both building and calibrating fully integrated models or linking separate sub-models. It also discusses the implications of model linkage on overall uncertainty and how to define an acceptable level of model complexity. This discussion includes, whether we should shift our attention from uncertainties due to linkage, when using linked models, to uncertainties in model structure by necessary simplification or by using more parameters. This discussion attempts to address the question as to whether there is an increase in uncertainty by linking these models or if a compensation effect could take place and that overall uncertainty in key water quality parameters actually decreases. Finally, challenges in the application of uncertainty analysis in integrated catchment water quality modelling, as encountered in this project, are discussed and recommendations for future research areas are highlighted.

Acrodermatitis dysmetabolica as a sign of methylmalonic aciduria decompensation.

Methylmalonic aciduria children must follow an adequate diet with low protein intake and should be regularly monitored to prevent complications. Although skin lesions like acrodermatitis enteropathica are rare in this disease, their appearance should be correlated with possible low plasma isoleucine level and it can be a sign of decompensation.

Retraction notice to "Obesity-Induced Increase in Tumor Necrosis Factor-α Leads to Development of Colon Cancer in Mice" Gastroenterology 2012;143:741-753.e4.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief and Deputy Editor-in-Chief following an investigation into the data that were presented in several figures within the article. A number of images used in this article are believed to be duplicated images. The authors stated that they inadvertently inserted images of the wrong blots in several of the figures, resulting in the duplications; however, they did not address all of the concerns raised. Because the editors were no longer confident in the conclusions of the article based on these incorrect data, a decision was made to retract the paper. All authors have been notified of this decision. The University of Campinas (UNICAMP) in São Paulo, Brazil was contacted regarding these concerns, but to date the journal has received no response.

Prevalence of gallbladder cancer In patients submitted to cholecystectomy: experience of the University Hospital, Faculty of Medical Sciences, State University of Campinas - UNICAMP. / Prevalência do câncer de vesícula biliar em pacientes submetidos à colecistectomia: experiência do Hospital de Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas ­ UNICAMP.

OBJECTIVE:: to evaluate the prevalence of gallbladder carcinoma in patients submitted to cholecystectomy for chronic cholecystitis at the University Hospital of the State University of Campinas. METHODS:: we conducted a retrospective prevalence study through the analysis of histological specimens from January 2010 to May 2015. RESULTS:: we analyzed 893 patient reports. Emergency cholecystectomies amounted to 144, and elective ones, 749 (16.2% and 83.8%, respectively). Regarding gender, 72.8% were female and 27.2% male. Gallbladder adenocarcinoma occurred in 12 patients (1.3%) and non-Hodgkin's lymphoma in one (0.1%). In patients with cancer, seven (53.8%) were associated with cholelithiasis and two (15.3%) with gallbladder polyps. CONCLUSION:: prevalence results of gallbladder adenocarcinoma in this study were similar to those of Western studies and the main risk factor was cholelithiasis, followed by the presence of gallbladder polyps.

Prevalência do câncer de vesícula biliar em pacientes submetidos à colecistectomia: experiência do Hospital de Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas - UNICAMP / Prevalence of gallbladder cancer In patients submitted to cholecystectomy: experience of the University Hospital, Faculty of Medical Sciences, State University of Campinas - UNICAMP

RESUMO Objetivo: estudar a prevalência do câncer de vesícula biliar em pacientes submetidos à colecistectomia no Hospital de Clínicas da Universidade Estadual de Campinas. Métodos: estudo de prevalência retrospectivo a partir da análise de laudos de espécimes histopatológicos de pacientes submetidos à colecistectomia, no período de janeiro de 2010 a maio de 2015. Resultados: foram analisados 893 laudos de pacientes submetidos à colecistectomia, dos quais 144 de urgência e 749 eletivas (16,2% e 83,8%, respectivamente). Segundo o sexo, 72,8% correspondiam ao feminino e 27,2%, ao masculino. Em 12 pacientes (1,3%) foi evidenciado o diagnóstico de adenocarcinoma de vesícula biliar e, em um (0,1%), o diagnóstico de linfoma não Hodgkin. Dos 13 pacientes com neoplasia, sete (53,8%) apresentaram colecistolitíase associada. Em dois doentes (15,3%) foi constatado pólipo de vesícula biliar. Sete (53,8%) doentes foram operados com a hipótese diagnóstica de neoplasia de vesícula biliar. Conclusão: a prevalência do adenocarcinoma de vesícula biliar no presente estudo foi semelhante à dos estudos ocidentais e o principal fator de risco foi a colecistolitíase, seguido pela presença de pólipos de vesícula biliar.

ABSTRACT Objective: to evaluate the prevalence of gallbladder carcinoma in patients submitted to cholecystectomy for chronic cholecystitis at the University Hospital of the State University of Campinas. Methods: we conducted a retrospective prevalence study through the analysis of histological specimens from January 2010 to May 2015. Results: we analyzed 893 patient reports. Emergency cholecystectomies amounted to 144, and elective ones, 749 (16.2% and 83.8%, respectively). Regarding gender, 72.8% were female and 27.2% male. Gallbladder adenocarcinoma occurred in 12 patients (1.3%) and non-Hodgkin's lymphoma in one (0.1%). In patients with cancer, seven (53.8%) were associated with cholelithiasis and two (15.3%) with gallbladder polyps. Conclusion: prevalence results of gallbladder adenocarcinoma in this study were similar to those of Western studies and the main risk factor was cholelithiasis, followed by the presence of gallbladder polyps.

Mucinous adenocarcinoma associated with chronic suppurative hidradenitis: Report of a case and review of the literature.

INTRODUCTION: Chronic suppurative hidradenitis (CSH) is a benign condition that can affect the perineal region and often leads to the formation of abscesses and fistulas. It is rare for CSH to undergo malignant degeneration into mucinous adenocarcinoma. PRESENTATION OF CASE: We report a case of a 55-year-old male patient with perineal CSH who suffered worsening long-term pain despite multiple surgical procedures to alleviate his symptoms. Pelvic magnetic resonance imaging (MRI) showed multiloculated cystic lesion on the left side wall of the distal rectum with gluteal extension. Pathological examination revealed mucinous adenocarcinoma. The patient underwent an abdominoperineal resection (APR) of the rectum with cutaneous muscle flap reconstruction. Although histopathological sections showed clear margins, the tumor recurred 6 months following surgery. DISCUSSION: Perineal mucinous adenocarcinoma arising in a patient with CSH is an extremely rare condition. This diagnosis is often difficult, due to the paucity of signs of malignant degeneration as well as the rarity of the disease itself. Surgical resection of the lesions is a well-established approach. In this case, diagnosing the tumor at such a late stage likely compromised his outcome. CONCLUSION: Malignant degeneration to mucinous adenocarcinoma must be suspected in patients with a history of long-term CSH. In such cases, local biopsies and a radiological examination, such as MRI can help in the diagnosis.

Gastrointestinal involvement in lipoid proteinosis: a ten-year follow-up of a brazilian female patient.

Lipoid proteinosis is a rare autosomal recessive disease characterized by the deposition of hyaline material in the skin and internal organs. The main clinical features are hoarseness and typical skin lesions. In this report we describe the endoscopic and radiologic findings in a Brazilian female patient presenting extensive gastrointestinal involvement and the evolution of the detected lesions in ten years of follow-up. Initial upper endoscopy and colonoscopy showed a similar pattern of multiple yellowish nodules throughout the esophagus, stomach, duodenum, and colons. Histological analysis confirmed the diagnosis of lipoid proteinosis. In addition, small bowel follow through demonstrated numerous well defined, round, small filling defects throughout the jejunum. Ten years later, the esophageal lesions remained the same, but none of the previous alterations were detected in the stomach, duodenum, and colons. In conclusion, lipoid proteinosis may affect all gastrointestinal organs with the same pattern of macroscopic and microscopic lesions. Some lesions may regress with increasing age.

Characterization of the hydraulic performance of a gully under drainage conditions.

During rainfall events with low return periods (1-20 years) the drainage system can provide some degree of protection to urban areas. The system design is based not only on good hydraulic performance of the surface and the sewer network but also on their linking elements. Although the linking elements are of utmost importance as they allow the exchange of flow between the surface and the sewer network, there is a lack of studies that thoroughly characterize them. One crucial structural part of those elements is the gully. State-of-the-art dual-drainage models often use simplified formulae to replicate the gully hydraulic behaviour that lacks proper validation. This work focuses on simulating, both numerically and experimentally, the hydraulic performance of a 0.6 × 0.3 × 0.3 [m] (L × W × D) gully located inside an 8 × 0.5 × 0.5 [m] rectangular channel. The numerical simulations are conducted with the OpenFOAM toolbox and validated with water level measurements in the Multiple-Linking-Element experimental installation located at the Laboratory of Hydraulics of the University of Coimbra. The results provide a complete three-dimensional insight of the hydraulic behaviour of the flow inside the gully, and discharge coefficient formulae are disclosed that can be directly applied in dual-drainage models as internal boundary conditions.

Rectal forceps biopsy procedure in cystic fibrosis: technical aspects and patients perspective for clinical trials feasibility.

BACKGROUND: Measurements of CFTR function in rectal biopsies ex vivo have been used for diagnosis and prognosis of Cystic Fibrosis (CF) disease. Here, we aimed to evaluate this procedure regarding: i) viability of the rectal specimens obtained by biopsy forceps for ex vivo bioelectrical and biochemical laboratory analyses; and ii) overall assessment (comfort, invasiveness, pain, sedation requirement, etc.) of the rectal forceps biopsy procedure from the patients perspective to assess its feasibility as an outcome measure in clinical trials. METHODS: We compared three bowel preparation solutions (NaCl 0.9%, glycerol 12%, mannitol), and two biopsy forceps (standard and jumbo) in 580 rectal specimens from 132 individuals (CF and non-CF). Assessment of the overall rectal biopsy procedure (obtained by biopsy forceps) by patients was carried out by telephone surveys to 75 individuals who underwent the sigmoidoscopy procedure. RESULTS: Integrity and friability of the tissue specimens correlate with their transepithelial resistance (r = -0.438 and -0.305, respectively) and are influenced by the bowel preparation solution and biopsy forceps used, being NaCl and jumbo forceps the most compatible methods with the electrophysiological analysis. The great majority of the individuals (76%) did not report major discomfort due to the short procedure time (max 15 min) and considered it relatively painless (79%). Importantly, most (88%) accept repeating it at least for one more time and 53% for more than 4 times. CONCLUSIONS: Obtaining rectal biopsies with a flexible endoscope and jumbo forceps after bowel preparation with NaCl solution is a safe procedure that can be adopted for both adults and children of any age, yielding viable specimens for CFTR bioelectrical/biochemical analyses. The procedure is well tolerated by patients, demonstrating its feasibility as an outcome measure in clinical trials.

RETRACTED: Obesity-induced increase in tumor necrosis factor-α leads to development of colon cancer in mice.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief and Deputy Editor-in-Chief following an investigation into the data that were presented in several figures within the article. A number of images used in this article are believed to be duplicated images. The authors stated that they inadvertently inserted images of the wrong blots in several of the figures, resulting in the duplications; however, they did not address all of the concerns raised. Because the editors were no longer confident in the conclusions of the article based on these incorrect data, a decision was made to retract the paper. All authors have been notified of this decision. The University of Campinas (UNICAMP) in São Paulo, Brazil was contacted regarding these concerns, but to date the journal has received no response.

Rare gastric inflammatory myofibroblastic tumor in an adult woman: a case report with review of the literature.

Inflammatory myofibroblastic tumor (IMT) of the stomach is extremely rare and its prognosis is unpredictable. We present a 37-year-old woman with a gastric IMT. She presented epigastric pain since 2 months, anemia and weight loss associated. Physical examination showed cutaneous pallor and mild abdominal tenderness in the epigastrium. Abdominal ultrasonography showed a tumor near the pancreas and the CT scan revealed that the lesion was arising from the stomach. Upper endoscopy showed a submucosal lesion of approximately 7.5 cm located in the posterior wall of the gastric body such as a gastrointestinal stromal tumor (GIST). The patient underwent a subtotal gastrectomy and Billroth I reconstruction. The histopathological and immunohistochemical analysis revealed an IMT that originated from the gastric wall.

Beneficial effects of vitamin C and vitamin E on reserpine-induced oral dyskinesia in rats: critical role of striatal catalase activity.

Oral dyskinesias are implicated in a series of neuropathologies and have been associated to an increase in oxidative stress. Several antioxidants, including vitamin E, decrease reserpine-induced oral dyskinesia (OD) in rodents and we have described a protective role of striatal catalase against the development of OD. The aim of this study was to verify the effects of vitamin C alone or in combination with vitamin E on reserpine-induced OD as well as to determine a possible role of catalase in the antidyskinetic property of these vitamins. Different doses of vitamin C attenuated reserpine-induced increase in OD. A similar treatment with an effective dose of vitamin C concomitant to an effective dose of vitamin E potentiated the antidyskinetic effect of both vitamins when administered alone. The administration of these vitamins alone produced an increase in striatal catalase activity that likewise was potentiated by their combined administration. In addition, the antidyskinetic property of vitamin E and vitamin C was abolished by a concomitant treatment with the catalase inhibitor aminotriazole. These results indicate a beneficial effect of these vitamins and reinforce the critical role of striatal catalase against the development of oral dyskinesias.

Estimativa da biomassa de raizes de duas espécies de Cecropia e sua relação com a associação ou não das plantas a formigas

Summary This paper proposes the hypothesis that ants associated with several species of Cecropia, besides their other possible role as allelopathic agents (sensu Janzen, 196S). are concentrating nutrients for the plants. This hypothesis was tested by comparing the development of the biomass of the root system through the ratio fresh root biomass/fresh stem biomass of an ant-associated species, C. concolor Willdenow, and an ant-free species, C. sciadophylla Martius. The results indicate that C. concolor has a mean ratio root/stem of 0,27 (n = 5), whereas in C. sciadophylla the same ratio is 0,50 (n = 5). a difference significant at the 5% level This trend, therefore, corroborates the initial hypothesis.

Resumo Este trabalho propõe a hipótese de que as formigas associadas com várias espécies do gênero Cecropia, além do outro possível papel como agentes alelopáticos (sensu Janzen, 1969), estariam concentrando nutrientes para as plantas. Esta hipótese foi testada pela comparação do desenvolvimento da biomassa radicular, através da razão peso fresco das raízes/peso fresco do caule, de uma espécie associada a formigas, C. concolor Willdenow, e uma espécie não-associada a formigas, C. sciadophylla Martius. Os resumidos indicam que C. concolor tem uma razão média raízes/caule de 0,27 (n = 5), enquanto em C. sciadophylla a mesma razão é de 0,50 (n = 5), uma diferença significativa ao nível de 5%. Esta tendência, portanto, corrobora a hipótese inicial.