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Introduction: Multiple sclerosis is a chronic inflammatory disease, in which a diagnostic delay could reduce the available therapeutic options. Therefore, it is important to monitor the time to diagnosis and understand factors that may potentially reduce it. The objective of this study was to determine the time between the first symptoms and the diagnosis of multiple sclerosis and which factors may contribute to a diagnostic delay. Material and Methods: Cross-sectional multicenter study, with retrospective data analysis, conducted in five tertiary Portuguese hospitals. Patients were consecutively selected from each local multiple sclerosis patients´ database. Sociodemographic and initial clinical data were collected through a questionnaire. Date of final diagnosis and multiple sclerosis classification was obtained from clinical files. Results: A total of 285 patients were included with mean age at diagnosis of 36 years. The median time between first clinical manifestation and multiple sclerosis diagnosis was nine months (IQR 2 - 38). Diagnostic delay was associated with an older age (p < 0.001; r = 0.35), motor deficit at onset [26.5 months (IQR 4.5 - 56.5); p = 0.0005], higher number of relapses before diagnosis (p

This paper aims at studying the monotonic and cyclic plastic deformation behavior of DIN 34CrNiMo6 high strength steel. Monotonic and low-cycle fatigue tests are conducted in ambient air, at room temperature, using standard 8-mm diameter specimens. The former tests are carried out under position control with constant displacement rate. The latter are performed under fully-reversed strain-controlled conditions, using the single-step test method, with strain amplitudes lying between ±0.4% and ±2.0%. After the tests, the fracture surfaces are examined by scanning electron microscopy in order to characterize the surface morphologies and identify the main failure mechanisms. Regardless of the strain amplitude, a softening behavior was observed throughout the entire life. Total strain energy density, defined as the sum of both tensile elastic and plastic strain energies, was revealed to be an adequate fatigue damage parameter for short and long lives.

Transient Global Amnesia (TGA) was described for the first time more than 100 years ago and is an amnesic syndrome of sudden onset and complete remission within 24 hours. During the episode the patient’s behavior is normal except for the repetitive questioning about his immediate circumstances. TGA may be associated with emotional experiences, pain, exercise, exposure to cold water and sexual intercourse. Minor diagnostic procedures precipitating TGA such as gastroscopy or colonoscopy have been reported. We present a patient who developed TGA after gastroscopy, a rare complication of this procedure.

Guillain-Barré syndrome (GBS) is an autoimmune disease that leads to an axonal demyelination and/or degeneration of peripheral nerves through molecular mimicry. The usual pattern is an ascending areflexic motor paralysis with a distinct cerebral-spinal fluid (CSF) showing elevated protein level without accompanying pleocytosis. Diagnosis is essentially clinical, but the CSF studies and electrodiagnostic features may help confirming the diagnosis. Prognosis is usually good, with complete recovery in 80-85% of the cases. However, 10% will remain with permanent neurological damage and about 5% will die. Immunomodulation is the goal treatment, but supportive care is of the utmost importance in the treatment and prevention of complications. The purpose of this work was to review all GBS diagnosed between 1st January 1997 and 31st December 2001, in patients 18 or older admitted to Hospital Pedro Hispano (Portugal). During the 5-year study period, 62446 patients were admitted to hospital, of which 15 with GBS. Thirteen had a good evolution: 10 with total recovery over a period of a maximum of six months; one remain with serious neurological damage at 2 years of evolution and the remaining one died with a pure motor form of GBS (both had a previous gastrointestinal infection). The results of this review are in accordance with what is described in the literature, regarding incidence, epidemiological data and clinical behaviour.