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This paper is concerned with the switched observer design for a class of systems subject to locally Lipschitz non-linearities. By performing a suitable description of the estimation error dynamics into a linear parameter varying (LPV) system representation, sufficient conditions for the existence of a switching output injection gain are proposed such that the asymptotic stability of the estimation error is guaranteed. These conditions can be conveniently expressed by means of linear matrix inequalities (LMIs), which are easily computationally tractable. A numerical example is provided to show the favorable performance achieved by the proposed observer, which can be applied to a large class of non-linear systems.

Introduction: Nocardiosis is a rare bacterial infection caused by Nocardia spp. However, an increasing incidence has been described whereby data about epidemiology and prognosis are essential. Methods: A retrospective descriptive study was conducted among patients with positive Nocardia spp. culture, from January 2019 to January 2023, at a Terciary Hospital in Portugal. Results: Nocardiosis was considered in 18 cases with a median age of 63.8-years-old. At least one immunosuppressive cause was identified in 70% of patients. Five patients had Disseminated Nocardiosis (DN). The lung was the most common site of clinical disease (77.8%) and Nocardia was most commonly identified in respiratory tract samples. The most frequently isolated species were Nocardia nova/africana (n = 7) followed by Nocardia cyriacigeorgica (n = 3) and Nocardia pseudobrasiliensis (n = 3). The majority of the patients (94.4%) received antibiotic therapy, of whom as many as 55.6% were treated with monotherapy. The most frequently prescribed antibiotic was trimethoprim-sulfamethoxazole. Selected antimicrobial agents were generally effective, with linezolid and cotrimoxazole (100% Susceptibility [S]) and amikacin (94% S) having the most activity against Nocardia species. The median (IQR) duration of treatment was 24.2 (1‒51.4) weeks for DN; The overall one-year case fatality was 33.3% (n = 6) and was higher in the DN (66.7%). No recurrence was observed. Conclusion: Nocardiosis is an emerging infectious disease with a poor prognosis, particularly in DN. This review offers essential epidemiological insights and underscores the importance of gaining a better understanding of the microbiology of nocardiosis. Such knowledge can lead to the optimization of antimicrobial therapy and, when necessary, guide appropriate surgical interventions to prevent unfavorable outcomes.

Pithomyces, a dematiaceous fungus, is a common colonizer of dead leaves and stems of many different plants and is associated with facial eczema in some animals. We report a case of invasive fungal pulmonary disease by Pithomyces chartarum in a healthy, nonimmunocompromised patient. We aim to demonstrate our diagnostic and therapeutic approach and focus on the major challenges arising from the lack of scientific evidence regarding infection by this fungus in humans.

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Objective: To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. Methods: This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. Results: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B = 0.032, 95% confidence interval 0.015–0.049; p = 0.0003) and between the duration of HIV-1 infection and NARC (B = 0.039, 95% confidence interval 0.017–0.059; p = 0.0005). Conclusions: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population. Keywords: Aging, HIV-1 infection, Non-AIDS comorbidities

A encefalopatia/encefalite ligeira com lesão reversível do corpo caloso é uma entidade clínico-radiológica benigna rara, caracterizada por sintomas neurológicos inespecíficos associados a achados imagiológicos, em ressonância magnética, e lesão do corpo caloso. De etiopatogénese desconhecida, têm sido sugeridos vários desencadeadores (infeções, alterações metabólicas, fármacos, entre outros). Apresenta-se o caso de um homem de 44 anos, previamente saudável, admitido na urgência com quadro súbito de cefaleias, ataxia, mioclonias da face e disartria, em contexto de síndrome gripal. Após diagnóstico presuntivo de encefalite vírica iniciou aciclovir empiricamente, suspenso após ressonância magnética revelando lesões no corpo caloso. O doente evoluiu favoravelmente sem terapêutica dirigida, com resolução clínica em menos de uma semana e controlo imagiológico, aos dois meses, normal. Esta entidade, que exige diagnóstico diferencial entre condições benignas e outras, de pior prognóstico, é habitualmente diagnosticada por exclusão, não exige terapêutica dirigida e apresenta, quase universalmente, um desfecho favorável.

While state estimation techniques are routinely applied to systems represented by ordinary differential equation (ODE) models, it remains a challenging task to design an observer for a distributed parameter system described by partial differential equations (PDEs). Indeed, PDE systems present a number of unique challenges related to the space-time dependence of the states, and well-established methods for ODE systems do not translate directly. However, the steady progresses in computational power allows executing increasingly sophisticated algorithms, and the field of state estimation for PDE systems has received revived interest in the last decades, also from a theoretical point of view. This paper provides a concise overview of some of the available methods for the design of state observers, or software sensors, for linear and semilinear PDE systems based on both early and late lumping approaches.

Background: Tuberculosis (TB) is a multisystemic disease and a leading cause of infectious disease-related mortality worldwide. Objectives: This study aims to characterize patients with TB in a portuguese cohort. Methods: Retrospective analysis of files pertaining inpatients with TB admitted between 1/2005 - 12/2014. Data were analysed using χ2 or Fisher exact test (p 65 (p=0.005, OR=3.34) were associated with ETB. 48 patients were HIV-infected, with median CD4 count of 74.5 cells/µL (13-136), most cases occurring in the setting of new HIV diagnosis. HIV infection was statistically associated with disseminated (OR=12.64), pleural (OR=8.50), meningeal (OR=2.96) and lymphatic TB (OR=2.38). HIV negativity was associated with pulmonary (OR=4.08) and osteoarticular disease (OR=5.42). PTB was confirmed mainly by culture or PCR test plus smear (81.3%). ETB diagnosis was more complex. Clinical outcome was favourable (PTB 98.4%; ETB 94.0%). Eight patients died. Conclusions: TB remains an important healthcare issue in Portugal. Contact with TB-infected person and smoking (PTB) and HIV infection and age > 65 (ETB), were significant risk factors. HIV infection was associated with disseminated, pleural, meningeal and lymphatic disease.

This paper deals with robust state estimation for discrete-time, linear parameter varying (LPV) descriptor systems. It is assumed that all the system state-space matrices are affine functions of the uncertain parameters and both the parameters and their variations are bounded functions of time with known minimum and maximum values. First, necessary and sufficient conditions are proposed for admissibility and bounded realness for discrete linear time-varying (DLTV) descriptor systems. Next, two convex optimisation based methods are proposed for designing admissible stationary linear descriptor filters for LPV descriptor systems which ensure a prescribed upper bound on the ℓ2-induced gain from the noise signal to the estimation error regardless of model uncertainties. The proposed filter design results were based on parameter-dependent generalised Lyapunov functions, and full-order, augmented-order and reduced-order filters were considered. Numerical examples are presented to show the effectiveness of the proposed filtering scheme. In particular, the proposed approach was used to estimate the state variables of a controlled horizontal 2-DOF robotic manipulator based on noisy measurements.

Reconhecido como agente de doença veterinária, o Rhodococcus tem vindo a ser implicado num número crescente de infecções em doentes imunossuprimidos. Doente do sexo feminino, de 55 anos, com antecedentes de dermatomiosite diagnosticada um ano antes do episódio de doença actual, sob corticoterapia sistémica. Apresentava episódio recente de clínica respiratória com imagiologia sugestiva de embolização séptica, que evoluíra favoravelmente após antibioterapia. Passados 3 meses recorreu ao hospital com sinais inflamatórios da parede abdominal, sendo objectivado extenso abcesso intra-abdominal. Efectuou drenagem cirúrgica e iniciou antibioterapia empírica. Na cultura do pus cresceram bacilos gram positivo, descartados como contaminantes. A repetição da colheita de pus permitiu isolar Rhodococcus spp, tendo sido iniciado esquema combinado com ciprofloxacina e cotrimoxazol. Em ambulatório, após estudo adicional, foi diagnosticado adenocarcinoma gástrico, sendo a doente gastrectomizada e submetida a radioterapia e quimioterapia adjuvante, mantendo antibioterapia supressiva. As infecções em doentes imunossuprimidos requerem um elevado índice de suspeição para agentes atípicos, sendo fundamental o contacto próximo entre o clínico e o microbiologista. Known as an animal disease agent, Rhodococcus has been increasingly associated with infection in immunosuppressed patients. A 55 year-old female patient, diagnosed with dermatomyositis one year before and under corticosteroids, presented with respiratory symptoms and evidence of bilateral pulmonary nodules that responded well to a short course of antibiotics. Three weeks later she presented with inflammatory signs on the abdominal wall and a large intrabdominal abscess was diagnosed. The abscess was surgically drained and antibiotics were started. The pus culture grew gram positive bacilli, disregarded as contamination. Pus culture was repeated, revealing Rhodococcus spp, and antimicrobial therapy was altered to ciprofloxacin and cotrimoxazole. After hospital discharge the patient was diagnosed with gastric adenocarcinoma and underwent surgery, chemotherapy and radiotherapy, maintaining the antibiotic suppressive regimen. A close relationship between the treating physician and the microbiologist is beneficial in diagnosing infections by atypical pathogens in immunosuppressed patients.

Introdução: A tuberculose pulmonar pode cursar com diversas complicações. As fístulas bronco-pleuro-cutâneas consistem em comunicações anormais entre o brônquio, o espaço pleural e a pele. Caso Clínico: Apresentamos o caso de um homem, 47 anos, esquizofrénico, enviado ao Serviço de Urgência por toracalgia esquerda, tosse produtiva e emagrecimento. Apresentava-se caquético, sendo evidente um orifício cutâneo torácico latero-anterior esquerdo com drenagem purulenta, na qual o exame direto revelou bacilos ácido-álcool resistentes. A radiografia torácica evidenciava infiltrado heterogéneo bilateral. Foi internado com o diagnóstico de tuberculose pulmonar fistulizada. Na expetoração, a pesquisa de bacilos ácido-álcool resistentes foi igualmente positiva, sendo evidenciado Mycobacterium tuberculosis por reação de polimerase em cadeia e exame cultural. Iniciou terapêutica antituberculosa quádrupla apresentando evolução clínica favorável. Conclusões: A formação de fístulas bronco-pleuro-cutâneas é atualmente e em países desenvolvidos, uma complicação rara de tuberculose pulmonar. Assim, apesar da tuberculose ser frequente em Portugal, a raridade deste tipo de complicações torna pertinente a apresentação deste caso clínico.

Benzodiazepines are drugs usually used in anxiety disorders, dyssomnias, convulsions, muscle disorders, alcohol and other drugs detoxification, as well as in preoperative sedation/amnesia. Moreover, antidepressants are mainly indicated in depression and as co-therapeutic drugs in other psychiatric disorders. The use of benzodiazepines and antidepressants is associated with some health and public safety problems. Decreased of attention, concentration, reflexes, visual capacity, motor coordination and reasoning, associated with increased reaction time and lack of awareness of driving impairment among these drug users, contributes to the increased risk on traffic safety linked with these drugs. This risk may further increase with non-compliance of medical prescription, drug abuse or concomitant use of alcohol. The relationship between the use of psychoactive drugs and road traffic safety is, however, an extremely complex subject and has a primordial importance in the clarification of the role of benzodiazepine and antidepressant effects on driving skills. The prevention of driving under the influence of these drugs depends on the awareness, among doctors, of the risks associated with their use. Thus, the consciousness of medical prescription, as well as providing clear information to patients is extremely important.

A pneumonia adquirida na comunidade (PAC) é causa frequente de re-curso a Serviços de Urgência (SU), sendo a principal causa de sépsis em cuidados intensivos de adultos, com significativa morbi-mortalidade.1Uma das suas complicações, a pneumonia necrotizante, sendo rara, é grave e caracterizada por liquefação e necrose com cavitação do tecido pulmonar em áreas de consolidação parenquimatosa

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Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)