This paper focuses on the experience of the Rehabilitation Nucleus of the Construction Institute (NR-IC), integrated in the Faculty of Engineering of the University of Porto (FEUP) in the analysis, inspection, and diagnosis of structures with ancient defensive walls existing in Portugal. Aiming at promoting careful and heritage-respecting rehabilitation interventions, in line with the recommendations of ICOMOS (International Council on Monuments and Sites), the NR-IC has participated in several conservation and requalification projects. The development and implementation of a consolidated and holistic methodology of inspection and diagnosis aims to intervene in these historic structures by respecting their authenticity and integrity. In this context, this paper addresses two cases studies in different contexts and state of conservation: the Penedono Castle, in the countryside, and the Peniche Fortress in the sea shore.

“Twentieth-century building materials and construction techniques may often differ from traditional materials and methods of the past. There is a need to research and develop specific repair methods appropriate to unique types of construction.” Approaches for the Conservation of Twentieth-Century Architectural Heritage, Madrid Document 2011, ICOMOS. Natural deterioration caused by the ageing of the materials and their exposure to severe environmental conditions leads to a significant increase in the vulnerability of constructions. The conservation of reinforced concrete structures of the early 20th century brings challenges due to the specific characteristics of their construction processes. If at the structural level these processes are already somehow identified and linked to the systems of construction engineers such as Hennebique, Coignet, etc., at the level of decorative elements like ornaments, sculptures or others, their conservation deals with unknown techniques and requires greater care to maintain their authenticity and integrity. Reinforced concrete, which is made of cement and steel, forms a material with a reduced lifespan when compared to natural and traditional construction materials such as stone or timber. Among other sources, the degradation of reinforced concrete is often caused by the corrosion of embedded steel, responsible for important losses of material which become particularly critical in sculptural elements. When facing the need to make conservation interventions to preserve, rehabilitate, or restore degraded cultural heritage elements, several restrictions must be dealt with. Such restrictions are related to the safeguarding of the heritage’s cultural value and significance that must be weighed against safety and durability needs, as well as against the duration and budget constraints of the intervention. To assist the decision-making process about the type of interventions that can be carried out, an adequate balance of the several constraints must be sought. Therefore, in this paper, a two-step approach that can be integrated within the maintenance plan is proposed. The first step consists of a method to determine a case-by-case intervention index that gauges the referred criteria influencing the type of intervention. The referred index weighs the influence of several qualitative and quantitative criteria which are graded according to the characteristics of the cultural heritage element under analysis. The second step focuses on the development of maintenance indicators that can be used to assess the performance of the interventions that are carried out. This procedure was developed and implemented in the decision-making process related to the conservation of the decorative elements of a 20th-century building theatre in Portugal. A detailed analysis of the selected criteria for the intervention index and maintenance indicators is presented, as well as the advantages that might come from implementing the proposed procedure for the development of a sustainable conservation plan. A preliminary assessment of the maintenance indicators confirms that preventive measures decrease the number of repairs that are needed over time, meaning that the intervention index is correctly assessing the level of intervention required for a given decorative or sculptural element.

Masonry structures constitutes the urban core of several cities throughout the world, justifying the interest for the development of new testing techniques, capable of characterizing their main mechanical properties. The present paper approaches the in situ testing of stone masonry walls, describing the steps that led to the definition of a new compression test set-up. Said set-up was devised to be a modular and adaptable system, capable of being used in different types of walls, with different textures and unit types. Being self-balanced, the hereby-proposed scheme doesn´t introduce any new external loads into the whole building producing, at the same time, a uniform compression load. Throughout the paper, the peculiarities of masonry structures are mentioned, in order to justify some of the considerations taken into account in the development of the system. The results of an experimental campaign performed in an abandoned building in Oporto (Portugal) are presented, showing the outputs that can be extrapolated from the procedure, namely the characterization of the cyclic behavior of the walls and its deformability parameters.

Background: In several cancer models, it was shown that tumor mutation load correlates with response to immune checkpoint blockade therapy. However, whole exome sequencing of FFPE samples is not ideal for implementation on molecular pathology laboratories. In colorectal cancer (CRC), mutation load is correlated with microsatellite instability (MSI), which can therefore be used as surrogate marker for mutation load. In this study, we aimed at determining whether a target NGS-based mutation panel can be used for routine testing of mutation load in cancer, by assessing its performance in identifying MSI+ and MSI- CRC samples.

Background: Systemic reactions (SR) to subcutaneous innnnunotherapy (SCIT) are rare but potentially severe. The use of different definitions and classifications hampered comparability between studies.Aims: To determine the frequency of SR to SCIT with airborne allergens, and to characterise and classify them according to the WAO 2010 recommendations.Methods: Cross-sectional, retrospective study. Data on patients, immunotherapy and SR to SOT were collected from the SCIT record forms. During the study period, 22,332 SCIT injections were administered (3732 patients).Results: A total of 26 SR (0.1% of administrations) were recorded in 16 (0.6%) patients (median age 22 years, nine males, all with rhinitis and nine with asthma). Twenty-one (81%) SR occurred during the induction phase; eight (31%) in the first hour after administration. According to the WAO 2010 classification, 12 (46%) were grade 1 and 14(54%) were grade 2. Most grade 2 reactions occurred in asthmatics, presented as mild asthma symptoms and resolved without need for medical observation. Only two individuals without asthma presented grade 2 reactions, both with concurrent cutaneous and low respiratory symptoms; both required medical observation and treatment despite late onset; 82% (n=12) of grade 2 reactions were late. No grade 3-5 reactions were registered and only one patient needed adrenaline treatment. No risk factors for SR to SCIT were identified in this study.Conclusions: SCIT is a safe treatment when administered by trained staff. The WAO 2010 classification might be useful for retrospectively classifying the severity of reactions, although its usefulness in treatment decision needs further research. (C) 2013 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.

Objectives: Spondylodiscitis is a rare disease, more frequent in the male sex. Its incidence has increased associated with bacteriemias related to the use of intravenous devices and substances and increasing age of the population. The purpose of this work is to present 4 cases of spondylodiscitis at different locations with different pathogenic mechanisms. Methods: Retrospective analysis of 4 clinical files of patients admitted to the service of Internal Medicine. Results: Clinical case 1: A 63-year-old male patient presenting with cervicalgias with 1 month of evolution and progressive worsening that emerged after ophthalmic surgery. Cervical spondylodiscitis(C6–C7) was diagnosed, with blood cultures positive for Staphylococcus epidermidis. Clinical Case 2: A 66-year-old male patient with a history of type 2 diabetes mellitus, previous acute myocardial infarction and previous admissions for septicemia of unknown origin and pneumonia caused by Staphylococcus hominis. History of pain in the dorso-lumbar region with 2 months of evolution associated with weight loss of 10 kg in the same period. Dorsal spondylodiscitis (D9–D10) was diagnosed with blood cultures positive for S. hominis. Clinical case 3: A 62-year-old male patient with a history of type 2 diabetes mellitus, hypertension and Buerger disease. Previous hospitalization for urosepsis. Complaints of chills, diaphoresis and malaise. Lumbar pain that worsened in the previous 2 months. Spondylodiscitis was confirmed by magnetic resonance imaging (L5-S1). Blood cultures were positive for Staphylococcus aureus. Clinical case 4: A 58-year-old male patient with neurogenic bladder, carrier of a urethral catheter and recurrent urinary tract infections. Complaints of astenia, anorexia, weight loss, fever and lumbar pain. He was diagnosed with spondylodiscitis (L3-S1) associated with a subacute endocarditis mitral and aortic. Blood cultures were positive for Streptococcus sanguis. Conclusions: Although pain complaints associated with the spine are common, they are usually of mechanical/degenerative etiology. Nevertheless, it is important to exclude infectious diseases in order to avoid more serious complications as vertebral collapse and neurological disorders. The best way to reduce morbidity and mortality associated with this disease is to reduce the time between the beginning of symptoms and the institution of appropriate treatment. All patients listed in this abstract had a favorable evolution.

A 46-year-old man who underwent a liver transplant in 2001 for fulminant hepatitis of unknown etiology was diagnosed with a liver non-Hodgkin lymphoma (post-transplant lymphoproliferative disease) in 2011. Some months later, he developed an acute hepatocellular rejection that was treated with high doses of steroids.

To the Editor, Antibiotic hypersensitivity reactions are a major health concern as they can be a significant cause of morbidity and mortality, limit therapeutic options, and increase socio-economic costs. Diagnosis can be challenging, as great number of drugs can elicit different immune-mediated reactions. A combination of clinical history and different tests is generally necessary to confirm the diagnosis, since none has sufficient sensitivity to be used alone.1 In some non-immediate hypersensitivity reactions, the lymphocyte transformation test (LTT), which measures the in vitro proliferation of T lymphocytes in the presence of a suspected drug, can be the only tool to confirm the diagnosis.2 We report the case of a previously healthy 34-month-old girl who due to fever and odynophagia (interpreted as tonsillitis), was treated with amoxicillin without improvement. Three days later she began treatment with cefaclor, without result. She was then given two shots of penicillin, one in each buttock, with apyrexia after 48h. Two weeks later, in the same location where penicillin was administered, two nodular inflammatory lesions appeared, with progressive worsening (Figure 1). Due to the severity of these lesions, she was admitted to local hospital. Shortly after, she developed fever and was submitted to a surgical intervention at her buttocks for drainage of suspected abscess (not confirmed). Due to deterioration of her general status and suspected infectious panniculitis, she was transferred to our Central Hospital, and began flucloxacillin and clindamycin. Three days later, a diffuse exanthema (including both soles) appeared and an allergist was called. Flucloxacillin was stopped and the...