Total (fumarolic + diffuse soil) CO2 output from Furnas volcano.

Furnas volcano, in São Miguel island (Azores), being the surface expression of rising hydrothermal steam, is the site of intense carbon dioxide (CO2) release by diffuse degassing and fumaroles. While the diffusive CO2 output has long (since the early 1990s) been characterized by soil CO2 surveys, no information is presently available on the fumarolic CO2 output. Here, we performed (in August 2014) a study in which soil CO2 degassing survey was combined for the first time with the measurement of the fumarolic CO2 flux. The results were achieved by using a GasFinder 2.0 tunable diode laser. Our measurements were performed in two degassing sites at Furnas volcano (Furnas Lake and Furnas Village), with the aim of quantifying the total (fumarolic + soil diffuse) CO2 output. We show that, within the main degassing (fumarolic) areas, the soil CO2 flux contribution (9.2 t day-1) represents a minor (~15 %) fraction of the total CO2 output (59 t day-1), which is dominated by the fumaroles (~50 t day-1). The same fumaroles contribute to ~0.25 t day-1 of H2S, based on a fumarole CO2/H2S ratio of 150 to 353 (measured with a portable Multi-GAS). However, we also find that the soil CO2 contribution from a more distal wider degassing structure dominates the total Furnas volcano CO2 budget, which we evaluate (summing up the CO2 flux contributions for degassing soils, fumarolic emissions and springs) at ~1030 t day-1.

Tuberculosis screening and treatment compliance in human immunodeficiency virus patients.

This study aims to evaluate compliance of HIV patients to TB screening and treatment, identifying determinants for non-compliance. We reviewed clinical records of all HIV infected patients first attended in a Portuguese-Infectious-Unit from 2007-2010 (152 patients). Screening included: symptom inquiry, chest x-ray, TST/IGRA. In 2008 a protocol was established with a TB outpatient clinic allowing patients to choose where to perform screening (decentralization). All patients were offered screening, 69 (45.4%) accepted. Before decentralization, out of 78 patients, 20 (25%) accepted screening. After decentralization, out of 64 patients, 49 (76.6%) accepted screening. Decentralization was associated with higher levels of acceptance (p<0.001), having an AIDS-defining-disease (p=0.002) and being older (p=0.04) was associated with lower screening acceptance. LTBI was diagnosed in 14 and active-TB in 18 cases; 14 cases of active-TB were later diagnosed during hospital appointments. For active-TB, being on HAART was related with treatment adherence (p=0.03). In this population, improving health care access was important for screening compliance.

Topical application of mitomycin-C as an adjuvant treatment to bronchoscopic procedures in post-intubation tracheal stenosis.

INTRODUCTION: Post-intubation tracheal stenosis (PITS) continues to be challenging in terms of diagnosis, management and prevention. Recurrence is common because of excessive granulation tissue formation and an insidious process of scar contracture. Topical application of mitomycin-C (MMC) as an adjuvant treatment for endoscopic management of stenosis has shown good results. The authors aimed to evaluate the results of MMC topical application following bronchoscopic dilatation as an adjuvant in PITS treatment. METHODS: Retrospectively selected patients with PITS who had had rigid bronchoscopy (RB) dilatation followed by MMC application as adjuvant to endoscopic treatment. MMC in a concentration of 0.4 mg/ml was applied with a cotton stiletto around the stenotic lesion and granulation tissue for 3 minutes. RESULTS: Eleven patients with PITS, with a median initial tracheal stenosis of 75% of the lumen, underwent RB/MMC treatment. Mean MMC sessions performed/patient was 3.5, with good response and prolonged decrease in granulation tissue formation in 55% of cases, moderate in 18% and relapse in 27%. Mean stenosis improvement was 34%. CONCLUSIONS: Topical MMC application at 0.4 mg/ml concentration seems to be associated with good results as adjuvant in PITS management with decrease in granulation tissue and sustained improvement in lumen diameter.

Gastric epithelioid haemangioendothelioma.

Epithelioid haemangioendothelioma (EHE) is a rare tumour of vascular origin, characterised by celular proliferation, endotelial, epitelioid or hystiocitoid. It may develop in any organ, but it is more common in lung and liver. Surgery is the recommended treatment; however, in case of a potentially benign situation, an expectant attitude should be adopted. The case reports a 71-year-old female who underwent a laparotomy for a colonic adenocarcinoma. During surgery, a polypoid lesion in the dependency of the gastric wall was found incidentally, which was removed. Histopathology and immunohistochemical analysis confirmed the diagnosis of EHE. Gastric vascular neoplasms represent about 0.9-3.3% of all gastric tumours. Usually have a good prognosis, but due to the borderline biological behaviour of these tumours, it is important to have a detailed clinical evaluation at follow-up of these patients.