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We report a case of an 18-month-old boy with H factor deficiency with atypical presentation: recurrent acute otitis media and several maternal family members with autoimmune disorders (vitiligo, thyroiditis and immune trombocytopenia). Blood tests revealed low C3 and AH50, as well as low properdin and H factor. I factor was normal. CFH gene molecular test confirmed the H factor deficiency diagnosis. This child had none of the typical manifestations of this disorder, namely Neisseria meningitidis infection or renal disease (glomerulonephritis and atypical haemolytic uremic syndrome). Autoimmune family history and correct interpretation of blood tests' results were crucial for this diagnosis. info:eu-repo/semantics/publishedVersion

Introduction: Intensive insulin therapy is currently the main treatment in type I diabetes mellitus (DM) which includes multiple daily insulin injections (MDI) and continuous subcutaneous insulin infusion (CSII). The latter has become the preferred therapeutic mode, since it better mimics the physiological pancreatic action, althought there is limited evidence that supports its superiority to MDI. The aim of our study was to assess the effects of the transition from MDI to CSII in the intensive treatment of type 1 DM. Material and Methods: A retrospective longitudinal study was perfonned in MDI patients that transited to CSII between 2006 and 2014. Data were collected regarding to weight, HbA1c, plasma glucose, lipid profile, creatinine, weekly frequency of episodes of hypoglycemia and hyperglycemia and presence of microvascular complications. The effects of the transition to CSII were also compared according to the following subgroups: pre-CSII HbA1c (7.0%); age ( 35 years); gender (male versus female); BMI (25 kg/m2); duration of illness ( 15 years); total daily dose (TDD) of insulin ( 45 units of insulin); ISF ( 40) and microvascular complications (presence versus absence). Results: The sample included 85 patients, mean age 38 +/- 11 years, 50 (58.8%) female, with duration of the disease 21 +/- 9 years. There was a significant reduction in the frequency of hypo and hyperglycemia events after transition to CSII (3.0 +/- 5.0 vs 2 +/- 2.2 per week, p= 0.001 and 5.5 +/- 6.1 vs 2.5 +/- 2.6 per week, p = 0.05, respectively). We also observed a greater glycemic benefit in the subgroups of patients with poorer metabolic control (HbA1c > 7%) compared to those with HbA1c s

The primary objective of this study was to assess whether the topical administration of two neuroprotective drugs (brimonidine and somatostatin) could prevent or arrest retinal neurodysfunction in patients with type 2 diabetes. For this purpose, adults aged between 45 and 75 years with a diabetes duration ≥5 years and an Early Treatment of Diabetic Retinopathy Study (ETDRS) level of ≤35 were randomly assigned to one of three arms: placebo, somatostatin, or brimonidine. The primary outcome was the change in implicit time (IT) assessed by multifocal electroretinography between baseline and at the end of follow-up (96 weeks). There were 449 eligible patients allocated to brimonidine (n = 152), somatostatin (n = 145), or placebo (n = 152). When the primary end point was evaluated in the whole population, we did not find any neuroprotective effect of brimonidine or somatostatin. However, in the subset of patients (34.7%) with preexisting retinal neurodysfunction, IT worsened in the placebo group (P < 0.001) but remained unchanged in the brimonidine and somatostatin groups. In conclusion, the topical administration of the selected neuroprotective agents appears useful in preventing the worsening of preexisting retinal neurodysfunction. This finding points to screening retinal neurodysfunction as a critical issue to identify a subset of patients in whom neuroprotective treatment might be of benefit.

A Bacia Hidrográfica da Lagoa das Sete Cidades localiza-se no maciço com o mesmo nome, na região Nordeste da Ilha de São Miguel. Possui uma área de 445,5 ha e é constituída por duas sub-unidades, a Lagoa Azul (357,3 ha) e a Lagoa Verde (88,2 ha). A maior parte da bacia hidrográfica é ocupada principalmente por pasta-gens permanentes. Devido a problemas ligados ao uso agrícola desta bacia (carga animal e uso excessivo de adubo) a sua situação trófica tem vindo gradualmente a deteriorar-se. O índice de P (Lemunyon & Gilbert, 1993) foi criado para identificar especificamente as áreas onde é maior o risco de perda de fósforo do solo para as águas superficiais numa bacia hidrográfica. A sua aplicação permite referenciar no terreno as fontes difusas de poluição, uma vez que se baseia na avaliação por parcela dos factores (de origem e de transporte) considerados relevantes para a mobilização de nutrientes para a massa de água. Neste trabalho foram considerados como factores de origem os valores de P Olsen e as quantidades de adubo aplicadas (kg P2O5 ha-1ano-1) e como factores de transporte o potencial de escoamento (estimado a partir do declive), distância da parcela à linha de água e distância da parcela à massa de água (m). Com a adopção desta metodologia pretendeu-se identificar possíveis áreas de risco de perda de P e assim contribuir para o desenvolvimento de programas e/ou de planos de gestão adequados à bacia hidrográfica das Sete Cidades., The Sete Cidades catchment is located in the geological site with the same name, in the Northeast of the São Miguel Island. It has an 444,5 ha area and is formed by two sub units, the Blue Lagoon (357,3 ha) and the Green Lagoon (88,2 ha). The most part of the watershed is occupied by permanent pastures. Due to agriculture land use (animal pressure and excessive fertilization), its trophic condition is increasingly deteriorating. The P index was created by Lemunyon & Gilbert (1993) to identify the areas which most contributes to phosphorus losses from soil to the water bodies. Its application helps locating diffuse polluting sources, since it is based on the evaluation on a parcel basis of source and transports factors considered as relevant to the nutrient mobilization to the water mass. In this study are considered as source factors the P Olsen and applied fertilizer (kg P2O5 ha-1year-1), and as transport factors the leaching potential (as estimated from slope), distance from field to the water line and from field to the water body (m). With this methodology we intended to identify the risk of P loss areas and thus contribute to the development of programs and/or management plans addressed to the Sete Cidades watershed.

Um novo fenômeno de poesia oral e performática cresce no mundo contemporâneo: são os chamados slams – competições ou batalhas de poesias que dão vez e voz a poetas da periferia, os quais versam sobre as adversidades do seu cotidiano, abordando temas como racismo, violência, drogas, machismo, sexismo, sempre de teor crítico e engajado, que requerem a escuta, a reflexão e a politização do seu público- ouvinte. Os slammers incorporam as “vozes das margens” (HALL, 2003), as “vozes do Sul” (MOITA LOPES, 2006) ou as “vozes do corpo” (DE CERTEAU, 1994) e, nos palcos, atuam como agentes de letramentos de reexistência (SOUZA, 2011) ao declamarem poesias de sua própria autoria para cinco jurados escolhidos da plateia pelos organizadores do slam. Ao vencedor(a), livros! A brand new phenomenon of oral and performative poetry known as slam is currently flourishing. It is a competition in which poets from the suburbs have their voices to be heard and remark everyday adversities in a socially engaged way. Addressing themes such as racism, violence, drugs, chauvinism, and sexism, those battles require a politicized audience, a listening and an active thinking. The slammers incorporate “voices from the margin” (HALL, 2003), “from the South” (MOITA LOPES, 2006), or “from the body” (DE CERTEAU, 1994). Moreover, by reciting authorial poems to a panel of five judges chosen among members of the audience, slammers became agents of a literacy of re-existence (SOUZA, 2011). The winner takes the books!