Francisco Alberto Severo de Almeida

Presentation and diagnosis of acute Q fever in Portugal — A case series

Q fever is a worldwide zoonotic infection caused by the obligate intracellular bacterium Coxiella burnetii that can course with acute or chronic disease. This series describes 7 cases of acute Q fever admitted in a Portuguese University Hospital between 2014 and 2015. All cases presented with hepatitis and had epidemiological history. Diagnosis was done by PCR on majority (5) and by serology and PCR in only 2. Serological tests can be negative in the initial period of the disease. Molecular biology methods by polymerase chain-reaction are extremely important in acute disease, allowing timely diagnosis and treatment.

The tuberculin skin test still matters for the screening of latent Tuberculosis infections among Inflammatory Bowel Disease patients

BACKGROUND AND AIMS There is a high risk of Tuberculosis among patients medicated with anti-tumour necrosis factor α (anti-TNFα) that can be mitigated by treating latent Tuberculosis infections (LTI). This study aimed to evaluate the performance of Tuberculin Skin test (TST) and Quantiferon-TB Gold in Tube (QFT-GIT) in a population of patients suffering from Inflammatory Bowel Diseases. METHODS The cohort analyzed in this study consisted of 250 patients, of whom 15% were therapy-naïve and 85% were medicated: 70% under immunosuppressive therapy and 30% on anti-TNFα. A LTBI was diagnosed following a positive result in either of the tests and their performance and concordance were evaluated. RESULTS Fifty-eight and 24 patients had a positive TST and QFT-GIT, respectively. In 72 (29%) patients LTBI was diagnosed, of whom 8 (21%) were therapy-naïve. TST had an overall higher sensitivity (81% vs. 35%) and a higher Negative Predictive Value (93% vs. 80%) when compared to QFT-GIT test; this superiority was consistently maintained irrespective of the presence and kind of backbone immunosuppressive therapies. The concordance between both tests was weak. CONCLUSIONS Our results underscore the need to maintain the TST on LTBI diagnosis in patients about to start or switch anti-TNFα therapy in an intermediate Tuberculosis incidence context.

English for Specific Purposes via Distance Learning: Opportunities for Academic and Professional Qualification

The objective of the course “English for Specific Purposes” (E.S.P), focusing on textual genres developed in a virtual environment, is to enable course participants in understanding and interpreting texts in the English language as well as involving the students of the Linguistics Course at UEG in mentoring activities. This paper discusses an extension project of E.S.P via Distance Learning in the State University of Goias-UEG that presents in its capillary a multicampi structure of 42 units. UEG aims at the integral formation of the human being to a socio-professional solidarity performance and the concern for the exercise of citizenship. This project reveals the UEG policy of engagement and participation in integrated development of the state of Goias besides aligning the purpose the university to prepare its students to participate in the Science Without Borders program.

Cranium-facial trauma by a cutting weapon

Craniofacial trauma caused by metallic objects is common in wars, personal conflict, and a variety of accidents. Causes may include firearms, cutting and thrusting weapons, metal, bone or dental fragments, all of which produce injury ranging from minor abrasions to extensive and severe fractures. This type of injury occurs mainly in young male adults aged between 19 and 30 years due to increased exposure to predisposing factors. Penetrating brain injury by low kinetic energy objects is uncommon. Most cases of craniofacial trauma involve cranial and orbit injury. At other times, the nervous system may be extensively involved, such as in a reported case involving asbestos fiber where the patient underwent craniotomy. Injury caused by gunshots, which have high kinetic energy, are more extensive and are frequent in major urban centers. The face is the most affected region in cases of personal violence. In Brazil 78.31% of homicides result from firearms and 10.96% of homicides result from cutting and thrusting weapons. Causes of cranial trauma are motor vehicle accidents (40.7%), aggression with or with no weapons (25.4%), and falls (24%)..

Commentary: Human Liver Flukes

We read with interest the paper by Harrington et al. (1) on “human liver flukes,” recently published in the Lancet Gastroenterology and Hepatology. They report that the prevalence of Fasciola hepatica in the inner Porto area of Portugal is 3.2% (1). These authors also state that this is a notably high prevalence (1). Fascioliasis, as a neglected tropical disease, commonly affects poor people from developing countries and occurs sporadically in Europe (2). In 1996, Dias et al. (3) reported a case of chronic fascioliasis in a patient with a 6-year history of intermittent biliary colic after having ingested uncooked wild watercress (3). Our group has performed a search in the database of Centro Hospitalar de S. João (CHSJ), from 1997 to 2017. CHSJ is the biggest hospital in the North of Portugal. This hospital is located in the city of Porto and serves a population of 1,700,000 inhabitants distributed by an approximate area of 2,040 km2. The results we have obtained diverge from the figures reported by Harrington et al. (1): during the last 20 years only four cases of fascioliasis have been recorded: one case in 1998, one case in 2003, and two cases in 2014. The high prevalence of fascioliasis reported by Harrington and colleagues (1) in comparison with the only sporadic occurrence of fascioliasis in our actual database search, suggests that the frequency of fascioliasis has largely decreased at least in Northern Portugal. This assumption is corroborated by the fact that Harrington et al. (1) based their conclusions on a review of Mas-Coma et al. from 1999 (4). Considering that this reference is older than 25 years and that the hygienic and living standards of the population of the North of Portugal evolved considerably in these years, as well as in keeping with Harrington et al. (1) who have, themselves, noted that the estimates of prevalence of human liver fluke infections are, in most cases, decades old and probably inaccurate, our up-to-date figures appear to reflect more reliably the actual situation. Although fascioliasis remains a public health problem in many areas of the world, we now provide actual information on the knowledge of the true distribution of F. haepatica in the inner Porto area of Portugal.

The nonobserved economy in the European Union

ABSTRACT To better understand the share of the nonobserved economy (NOE) in the European Union, especially on the PIIGS, we estimate, through the multiple indicators multiple causes model, the path between 1980 and 2013. The model includes (i) the tax burden (disaggregated into direct and indirect taxes), a proxy of regulation burden, the unemployment rate and self-employment as causes of the NOE economy; (ii) the GDP and the labour force participation ratio as indicators of the NOE economy. In particular, the estimated weight of NOE as a percentage of official GDP was always higher in the PIIGS group.

EDUCAÇÃO MEDIADA POR TECNOLOGIA DA INFORMAÇÃO E COMUNICAÇÃO: UMA INVESTIGAÇÃO EMPIRICA SOBRE O DESEMPENHO DE CURSO VIA WEB

Os avancos da tecnologia da informacao e da comunicacao tem influenciando as macro estrategias educacionais das instituicoes publicas e privadas, com a insercao no Plano de Desenvolvimento Institucional – PDI de politicas e diretrizes focadas na educacao a distância. Nesse sentido, nas instituicoes publicas de ensino superior, a educacao a distância – EAD evolui da construcao do conhecimento, via simples transmissao de informacoes por meio hipermidia e internet, para um modelo empreendedor de governanca estrategica fundamentada na cooperacao entre rede organizacionais de educacao, de tecnologia da informacao e comunicacao. Portanto, torna-se essencial o emprego de estruturas orgânicas flexiveis visando elevar a eficiencia e a eficacia do processo de ensino aprendizagem, mediante o uso da expertise funcional e das competencias tecnicas de seus recursos humanos. Neste contexto, entao, a partir de um instrumento de investigacao empirica aplicado em 110 alunos do curso de formacao de professores elaboradores de conteudos disciplinares, na modalidade de educacao a distância, da Universidade Estadual de Goias – Brasil, avalia-se, na percepcao do aluno, a performance do sistema de educacao a distância via web, no que se refere a metodologia de ensino, ao material didatico, aos recursos multimidias e a tutoria.