ABSTRACT 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. Introduction spp However Methods culture 201 2023 Portugal Results 1 63.8yearsold. 638yearsold yearsold 63.8 years old. 63 8 old 63.8-years-old 70 . (DN) 77.8% 778 77 (77.8% samples novaafricana nova africana n 7 3 3. 94.4% 944 94 4 (94.4% 556 55 6 55.6 monotherapy trimethoprimsulfamethoxazole. trimethoprimsulfamethoxazole trimethoprim sulfamethoxazole. sulfamethoxazole trimethoprim-sulfamethoxazole effective 100% 100 (100 S [S] 94% (94 IQR (IQR 242 24 2 24. 1–51.4 1514 51 (1–51.4 oneyear year 333 33 33.3 66.7%. 667 66.7% 66 (66.7%) observed Conclusion nocardiosis necessary outcomes 20 202 8yearsold 63.8yearsold 638 63. (DN 77.8 (77.8 94.4 9 (94.4 5 55. 10 (10 [S (9 1–51. 151 (1–51. 33. 66.7 (66.7% 77. (77. 94. (94. (1 ( 1–51 15 (1–51 66. (66.7 (77 1–5 (1–5 (66. (7 1– (1– (66 (6

Resumo: A síndrome do intestino curto (SIC) é caracterizada por um estado de malabsorção de macro e micronutrientes que habitualmente se desenvolve após resseção de intestino delgado. Parece faltar uma correlação entre a quantidade de intestino ressecado e os sintomas desenvolvidos com a adaptação da estrutura e função intestinal. Reportamos o caso de um homem de 59 anos, submetido a resseção de 100 cm de intestino delgado tendo posteriormente desenvolvido síndrome de má absorção. Dos 95 dias de internamento hospitalar, várias complicações associadas à SIC ocorreram e de difícil gestão. Apesar de ser expectável um mau prognóstico, o doente apresentou melhoria significativa do estado nutricional após nutrição entérica e parentérica. À data de alta, apresentava um ganho ponderal de 9 kg. A SIC é uma patologia pouco reportada na literatura dado tratar-se de uma entidade complexa. Pretendemos com este caso reportar todo o processo de recuperação do doente e rever a fisiopatologia desta entidade.

Abstract: Short bowel syndrome (SBS) is characterized by a state of macro and micronutrient malabsorption which usually develops after small bowel resection. There is a weakly correlation between the amount of resected intestine and the clinical symptoms with the adaptation of bowel structure and function. We report a case of a 59-year-old man, who underwent a 100 cm small bowel resection developing malabsorption syndrome afterwards. Throughout the 95 days spent in hospital many complications of SBS with complex management arose. Although the patient was expected to have a poor prognosis, his nutritional status improved significantly through continuous parenteral and enteral nutrition. At discharge he had recovered carrying a 9 kg weight gain. SBS is a non-common disease reported in the literature as being a complex entity. The aim of this case is to report the process of the patient´s recovery and to provide a review of the physiopathology of this entity.

IgA Nephropathy (IgAN) is the most prevalent biopsy-proven primary glomerular disease worldwide. Historically, thrombotic microangiopathy (TMA) was associated with IgAN in cases of severe hypertension or advanced chronic kidney disease, but recent data suggest that complement activation plays a crucial role in the development of TMA in IgAN. We report a case of Crescentic IgAN with complement-mediated TMA (C-TMA) in a 27-year old male patient with a pathological missense mutation in heterozygosity in the CFH gene and a rare variant in the C3 gene, treated with steroids, cyclophosphamide and plasmapheresis without recovery of kidney function. We also discuss other treatment possibilities and kidney transplant options. Additionally, we will review the latest advances that are enhancing our understanding of the association between IgAN and TMA