scholarly journals Haemorrhage and intestinal lymphoma

2013 ◽  
pp. 32-36
Author(s):  
Attilia M. Pizzini ◽  
Annalisa Pilia ◽  
Mauro Silingardi ◽  
Ido Iori ◽  
Maria C. Gelli
Keyword(s):  
Coeliac Disease ◽  
Vitamin K ◽  
Small Bowel Resection ◽  
Biochemical Status ◽  
History Of ◽  
Spontaneous Haematoma ◽  
Intravenous Vitamin ◽  
Atypical Presentations ◽  
The Right

Background: The prevalence of coeliac disease is around 1% in general population but this is often unrecognised. The classical presentation of adult coeliac disease is characterized by diarrhoea and malabsorption syndrome, but atypical presentations are probably more common and are characterized by iron deficiency anaemia, weight loss, fatigue, infertility, arthralgia, peripheral neuropathy and osteoporosis. Unusual are the coagulation disorders (prevalence 20%) and these are due to vitamin K malabsorption (prolonged prothrombin time). Clinical case: A 64-year-old man was admitted to our Department for an extensive spontaneous haematoma of the right leg. He had a history of a small bowel resection for T-cell lymphoma, with a negative follow-up and he didn’t report any personal or familiar history of bleeding. Laboratory tests showed markedly prolonged prothrombin (PT) and partial-thromboplastin time (PTT), corrected by mixing studies, and whereas platelet count and liver tests was normal. A single dose (10 mg) of intravenous vitamin K normalized the PT. Several days before the patient had been exposed to a superwarfarin pesticide, but diagnostic tests for brodifacoum, bromadiolone or difenacoum were negative. Diagnosis of multiple vitamin K-dependent coagulationfactor deficiencies (II, VII, IX, X) due to intestinal malabsorption was made and coeliac disease was detected. Therefore the previous lymphoma diagnosis might be closely related to coeliac disease. Conclusions: A gluten free diet improves quality of life and restores normal nutritional and biochemical status and protects against these complications.

scholarly journals Bebês em creches nas zonas rurais do Brasil

2020 ◽  
Vol 6 (10) ◽  
pp. 264
Author(s):  
Patricia Maria Uchôa SIMÕES ◽  
Mariana Uchôa Simões BARBOSA
Keyword(s):  
Early Childhood ◽  
Early Childhood Education ◽  
Rural Areas ◽  
Rural Populations ◽  
Childhood Education ◽  
Daycare Centers ◽  
History Of ◽  
The Right ◽  
Educational Indicators

RESUMONo Brasil, a história da educação institucionalizada dos bebês inicia-se com instituições voltadas para o atendimento das populações mais pobres das cidades e está relacionada à industrialização e urbanização. Essa origem explica, em parte, a escassa oferta de Educação Infantil para as populações rurais, até hoje. O estudo debate a trajetória das creches das zonas rurais, analisa alguns dos indicadores educacionais e dados da implantação do Proinfância nessas áreas. As conclusões apontam para os avanços na legislação e a melhoria dos indicadores educacionais nas primeiras décadas desse século, também apresenta o Proinfância como uma alternativa para as zonas rurais, com a oferta de apoio aos municípios na construção de políticas de inclusão dos bebês em creche com maior qualidade de atendimento. Faz-se necessário a afirmação desses bebês como sujeitos de direitos, da sua educação como condição de cidadania e da especificidade da creche nas zonas rurais como direito à diferença.Bebês. Creche. Educação Infantil do Campo. Babies in daycare centers in rural BrazilABSTRACT In Brazil, the history of institutionalized baby education begins with institutions aimed at serving the poorest populations in cities and is related to industrialization and urbanization. This origin explains, in part, the scarce offer of Early Childhood Education for rural populations, even today. The study debates the trajectory of daycare centers in rural areas, analyzes some of the educational indicators and data on the implementation of Proinfância in these areas. The conclusions point to advances in legislation and the improvement of educational indicators in the first decades of this century, it also presents Proinfância as an alternative for rural areas, with the offer of support to municipalities in the construction of policies for the inclusion of babies in daycare centers with higher quality of care. It is necessary to affirm these babies as subjects of rights, their education as a condition of citizenship and the specificity of daycare in rural areas as the right to difference.Babies. Nursery. Rural Early Childhood Education. Bebés en guarderías en zonas rurales de BrasilRESUMEN En Brasil, la historia de la educación institucionalizada de bebes comienza con instituciones destinadas a servir a las poblaciones más pobres de las ciudades y está relacionada con la industrialización y la urbanización. Este origen explica, en parte, la escasa oferta de educación de la primera infancia para las poblaciones rurales, incluso hoy en día. El estudio debate la trayectoria de las guarderías en áreas rurales, analiza algunos de los indicadores educacionales y los datos sobre la implementación de “Proinfância” en estas áreas. Las conclusiones apuntan a avances en la legislación y la mejora de los indicadores educacionales en las primeras décadas de este siglo, también presenta a “Proinfância” como una alternativa para las zonas rurales, ofreciendo apoyo a los municipios en la construcción de políticas para la inclusión de bebés en guarderías con mejor calidad de cuidado. Es necesario afirmar que estos bebés son sujetos de derechos, su educación debe ser entendida como condición de ciudadanía y la especificidad de la guardería en las zonas rurales como un derecho a la diferencia.Bebés. Guardería. Educación de la primera infancia rural. Bambini in asili nele aree rurali del BrasileSINTESEIn Brasile, la storia dell'educazione al bambino istituzionalizzata inizia con istituzioni progettate per servire le popolazioni più povere delle città ed è legata all'industrializzazione e all'urbanizzazione. Questa origine spiega, in parte, l'offerta limitata di educazione della prima infanzia per le popolazioni rurali, anche oggi. Lo studio discute la traiettoria degli asili nelle aree rurali, analizza alcuni degli indicatori e dati educativi sull'attuazione di "Proinfância" in queste aree. Le conclusioni indicano i progressi della legislazione e il miglioramento degli indicatori educativi nei primi decenni di questo secolo, inoltre presenta "Proinfância" come alternativa alle aree rurali, offrendo supporto ai comuni nella costruzione di politiche per l'inclusione dei bambini negli asili nido con una migliore qualità delle cure. È necessario affermare che questi bambini sono soggetti di diritti, la loro educazione deve essere intesa come una condizione di cittadinanza e la specificità dell'assistenza all'infanzia nelle aree rurali come un diritto alla differenza.

Advocacy and Coordination of Services

1985 ◽  
Vol 2 (1) ◽  
pp. 8-14
Author(s):  
Wanda Jean Rainbolt
Keyword(s):  
Physical Educators ◽  
History Of ◽  
Adapted Physical Educators ◽  
The 1960S ◽  
The Many ◽  
The Right ◽  
Time And Energy ◽  
Consumer Advocates ◽  
Architectural Barriers

Adapted physical educators are spending much of their time and energy advocating for the right of all children and youth to a high quality of physical education service delivery and the elimination of attitudinal, aspirational, and architectural barriers experienced by handicapped persons. Prior to the 1960s, lawyers or legal advocates were the ones who would plead the cause for others. Since then, however, three types of advocates have evolved: citizen, professional, and consumer advocates. Adapted physical educators are professional advocates, but they must have an understanding of the other types of advocates. The purpose of this article is to acquaint adapted physical educators with the job function of advocacy, the history of advocacy, and the many roles advocates play.

Avascular necrosis of the jaw in multiple myeloma (MM) patients (pts) treated with bisphosphonates (BP)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18538-18538
Author(s):  
L. Curreli ◽  
A. D. Palmas ◽  
G. Latte ◽  
A. Murgia ◽  
A. Gabbas
Keyword(s):  
Oral Cavity ◽  
Progressive Disease ◽  
Alveolar Bone ◽  
High Dose ◽  
Allogenic Bone ◽  
History Of Disease ◽  
Aggressive Surgical Approach ◽  
History Of ◽  
The Right

18538 Background: Oral cavity avascular bone necrosis (ABN) has been recently reported as an emerging serious complication in pts receiving BP for the treatment of hypercalcemia related to MM or metastatic solid tumors. Methods: We report the cases of 6 pts with MM treated initially with pamidronate and later with zoledronic acid (ZA). Results: Pts characteristics : M/F 3/3; mean age 58.4 (46–78); 4 IgG κ,1 γ and 1 κ MM; 5 St IIIA and 1 IIIB; mean history of disease 61.3 mo. (23–103); 5 pts had a relapsing MM refractory to several lines of therapy but 1 pt had received only high dose dexametazone (D); 2 pts had received autologous stem cell transplantation and 1 pt allogenic bone marrow transplantation; mean n.° of BP doses was 41.3 (17–81). At the time of ABN onset all pts were receiving ZA along with, respectively: D (2 pts); cyclophosphamide plus D (1 pt), bortezomib plus D (2 pts) and oral melphalan (1 pt). ABN was localized in 2 pts at alveolar bone of the right maxilla and presented as an inflammation of the gum, followed by a painful bone exposure. In the other 4 pts ABN was localized at mandible and presented as dental abscesses followed in 2/4 pts by cutaneous fistulization. Treatment has included in all pts discontinuation of ZA, antibiotics, chlorhexidine mouthwashes, pain control, minor regional débridement, and bone trimming. In 1 pt a more aggressive surgical approach was attempted at an other Institution and postoperative course was complicated by massive haemorrhage and complete loss of chewing. Four pts dead with progressive disease with a mean overall survival after ABN presentation of 6 mo.; 2 pts are alive after 3 and 4 mo. after ABN presentation; however in all pts ABN significantly worsened quality of life. Conclusions: Oral cavity ABN is a severe complication in refractory MM pts receiving BP. Mechanisms of action of BP that determine a reduction in osteoclastic activity and an accumulation of nonvital osteocytes with microfractures of old mineral matrix appear to play an important role. However other causes may be involved as a long history of disease; an uncontrolled progressive disease; type and doses of previous and present therapies, primarily steroids; status of oral cavity and teeth of pts and possibly the n.° of doses of BP. No significant financial relationships to disclose.

scholarly journals Photodynamic Therapy as an adjunct in the Treatment of Medication-Related Osteonecrosis of the Jaw: A Case Report

2021 ◽  
Vol 12 (1) ◽  
pp. e12-e12
Author(s):  
Marcelo Vieira da Costa Almeida ◽  
Antonio C. Moura ◽  
Lúcia Santos ◽  
Luciana Gominho ◽  
Ully Dias Nascimento Távora Cavalcanti ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Case Report ◽  
Osteonecrosis Of The Jaw ◽  
Complete Regression ◽  
Antimicrobial Photodynamic Therapy ◽  
Clinical Protocols ◽  
History Of ◽  
Lesion Regression ◽  
The Right

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) corresponds to an adverse effect of the use of drugs such as bisphosphonates and denosumab. This condition is often associated with pain, infection, purulent secretion, paraesthesia, tooth mobility and halitosis, decreasing the patient’s quality of life. The management of MRONJ tends to be conservative, through the guidance of oral hygiene, antibiotic therapy and mouthwashes. However, the use of antimicrobial photodynamic therapy (aPDT) has shown promise in the treatment of these injuries. The purpose of this article is to report a case of MRONJ treatment associated with aPDT. Case Report: A 75-year-old patient, with a history of breast cancer and use of intravenous Zoledronic Acid, presented with bilateral MRONJ lesions in tuberosity on the right and left sides. Treatment was conservatively instituted with the use of aPDT as an adjuvant. After 12 aPDT sessions, complete regression of the lesion was observed. However, after two weeks, the presence of a new lesion was noted, this time in the anterior region of the maxilla. The same protocol previously established was followed and after two aPDT sessions, the patient returned with complete lesion regression. Conclusion: The use of aPDT may represent an important adjuvant within a set of clinical protocols in the treatment of MRONJ.

scholarly journals Clinical and imaging features of suspected pituitary apoplexy in a domestic rat

2020 ◽  
Vol 8 (2) ◽  
pp. e001062
Author(s):  
Stephen James Everest ◽  
Tobias Schwarz ◽  
David Walker ◽  
Kevin Eatwell ◽  
Katia Marioni-Henry
Keyword(s):  
Pituitary Apoplexy ◽  
Acute Onset ◽  
Postmortem Examination ◽  
Female Rat ◽  
Imaging Features ◽  
Gradient Echo ◽  
History Of ◽  
The Right ◽  
The Brain

A two-year-ten-month-old entire female fancy rat was evaluated for acute-onset neurological signs following a two-month history of lethargy and behavioural changes. Physical examination revealed generalised muscle atrophy. Neurological examination localised the lesion likely to the right thalamus based on suspected left unilateral hemineglect. The patient was euthanased over quality-of-life concerns, and postmortem MRI of the brain was performed, followed by postmortem examination. This showed a lesion in the region of the pituitary which was T1 hyperintense to the brain, T2 isointense to the white matter and hypointense on gradient echo sequences, suggesting subacute haemorrhage. The authors described the clinical presentation and imaging features (MRI) of suspected pituitary apoplexia secondary to a pituitary macroadenoma in an aged female rat. Of particular interest are the findings of unilateral hemineglect and blooming artefact on MRI gradient echo sequences that lead to suspicion of pituitary apoplexia confirmed on postmortem examination.

scholarly journals Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe

2013 ◽  
Vol 39 (5) ◽  
pp. 620-626 ◽  
Author(s):  
Geruza Alves da Silva ◽  
Daniel Ferracioli Brandao ◽  
Elcio Oliveira Vianna ◽  
Joao Batista Carlos de Sa Filho ◽  
Jose Baddini-Martinez
Keyword(s):  
Surgical Approach ◽  
Opportunistic Infections ◽  
Histopathological Analysis ◽  
Noninvasive Methods ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Atypical Presentations ◽  
The Right ◽  
Surrounding Parenchyma

Tuberculosis and cryptococcosis are infectious diseases that can result in the formation of single or multiple nodules in immunocompetent patients. Exposure to silica is known to raise the risk of infection with Mycobacterium tuberculosis. We report the case of an elderly man with no history of opportunistic infections and no clinical evidence of immunodeficiency but with a six-month history of dry cough and nocturnal wheezing. A chest X-ray revealed a mass measuring 5.0 × 3.5 cm in the right upper lobe. The diagnostic approach of the mass revealed tuberculosis. The histopathological analysis of the surrounding parenchyma reveled silicosis and cryptococcosis. Cryptococcosis was also found in masses identified in the mediastinal lymph nodes. The surgical approach was indicated because of the degree of pleuropulmonary involvement, the inconclusive results obtained with the invasive and noninvasive methods applied, and the possibility of malignancy. This case illustrates the difficulty inherent to the assessment of infectious or inflammatory pulmonary pseudotumors, the differential diagnosis of which occasionally requires a radical surgical approach. Despite the presence of respiratory symptoms for six months, the first chest X-ray was performed only at the end of that period. We discuss the possible pathogenic mechanisms that might have led to the combination of three types of granulomatous lesions in the same lobe, and we emphasize the need for greater awareness of atypical presentations of pulmonary tuberculosis.

Acute upper airway obstruction following Teflon injection of a vocal cord; the value of nebulized adrenaline and a helium/oxygen mixture in its management

1990 ◽  
Vol 104 (8) ◽  
pp. 654-655 ◽  
Author(s):  
Neil B. Solomons ◽  
Jonathan R. Livesey
Keyword(s):  
Airway Obstruction ◽  
Vocal Cord ◽  
Upper Airway ◽  
Vocal Cord Palsy ◽  
Upper Airway Obstruction ◽  
Oxygen Mixture ◽  
Post Operative Period ◽  
History Of ◽  
The Right

AbstractA 67-year-old man presented with a 45-year history of a weak voice. This was the result of polio which had left him with a right vocal cord palsy.The patient underwent a Teflon injection of the right vocal cord under general anaesthesia to improve the quality of his voice. In the immediate post-operative period, he suffered acute upper airway obstruction. The problem of acute upper airway obstruction following Teflon injection is considered and its management with nebulized adrenaline and a helium/oxygen mixture is discussed.

Great projects and crude realities

2015 ◽  
Vol 44 (2) ◽  
pp. 186-202 ◽  
Author(s):  
Miguel Ángel Giménez Martínez
Keyword(s):  
Catholic Church ◽  
First Century ◽  
The Other ◽  
Content Type ◽  
The Enlightenment ◽  
History Of ◽  
The One ◽  
The Right ◽  
Universal Schooling

Purpose – The purpose of this paper is to analyze the circumstances that have conditioned the development of education in Spain from the enlightenment to the present day. Design/methodology/approach – Multidisciplinary scientific approach that combines the interpretation of the legal texts with the revision of the doctrinal and theoretical contributions made on the issue. Findings – From the beginning of the nineteenth century, the history of education in Spain has been marked by constant fluctuations between the reactionary instincts, principally maintained by the Catholic Church and the conservative social classes, and the progressive experiments, driven by the enlightened and the liberals first, and the republicans and the socialists later. As a consequence of that, the fight for finishing with illiteracy and guaranteeing universal schooling underwent permanent advances and retreats, preventing from an effective modernization of the Spanish educative system. On the one hand, renewal projects promoted by teachers and pedagogues were inevitably criticized by the ecclesiastical hierarchy, obsessed with the idea of preserving the influence of religion on the schools. On the other hand, successive governments were weak in implementing an educational policy which could place Spain at the level of the other European and occidental nations. Originality/value – At the dawn of the twenty-first century, although the country has overcome a good part of its centuries-old backwardness, increasing economic difficulties and old ideological splits keep hampering the quality of teaching, gripped by neoliberal policies which undermine the right to education for all. The reading of this paper offers various historical clues to understand this process.

scholarly journals Cancer: New Needs, New Models. Is It Time for a Community Oncologist? Another Brick in the Wall

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1919
Author(s):  
Paolo Tralongo ◽  
Vittorio Gebbia ◽  
Sebastiano Mercadante ◽  
Roberto Bordonaro ◽  
Francesco Ferraù ◽  
...  
Keyword(s):  
Healthcare Outcomes ◽  
Intervention Models ◽  
Hospital Specialist ◽  
History Of ◽  
The Right ◽  
Clinical Conditions ◽  
Effective Drugs ◽  
Trained Health Professional

Over the last few decades, thanks to early detection, effective drugs, and personalized treatments, the natural history of cancer has radically changed. Thanks to these advances, we have observed how survival of cancer patients has increased, becoming an ever more important goal in cancer care. Effective clinical governance of survivorship care is essential to ensure a successful transition between active and post-treatment life, identifying optimization of healthcare outcomes and quality of life for patients as the primary objectives. For these reasons, potential intervention models must consider these differences to rationalize the available resources, including economic aspects. In this perspective, analyzing the different models proposed in the literature to manage this type of patients, we focus on the possible role of the so-called “community oncologist”. As a trained health professional, also focused on longevity, he could represent the right management solution in all those “intermediate” clinical conditions that arise between the hospital specialist, frequently overworked, and the general practitioner, often biased by the lack of specific expertise.

scholarly journals Kontroversi Penerapankurikulum 2013 dalam Kajian Filsafat Ilmu Berbasis Paradigma Kritical Neurman

2018 ◽  
Vol 1 (1) ◽  
pp. 19-38
Author(s):  
Ery Agus Priyono
Keyword(s):  
History Of Education ◽  
Social Reality ◽  
Quality Standards ◽  
Human Mind ◽  
Philosophical Study ◽  
Education Curriculum ◽  
Maximum Extent ◽  
History Of ◽  
The Right

AbstractThe history of education in Indonesia often changes, like every time there is a change of Minister of Education, always followed per period of the curriculum system. The Indonesian Education Curriculum since 1945 already exists, namely in 1947, 1952, 1964, 1968, 1975, 1984, 1994, 2004, and 2006. This impact on the quality of Indonesian education has not yet met clear and steady quality standards. A philosophical study is a means of thinking by empowering the human mind to the maximum extent possible, in a fundamental (radical), comprehensive, towards the objects of research. The critical paradigm used in this learning is an invention that is used to describe what is used by illusion, consequently, that social reality must always be criticized and evaluated, which is the right understanding. The results of this study are used to look at three aspects, namely: ontology aspects, epistemological aspects, and Axiological aspectsKey Words : Curriculum, 2006 and 2013 curriculum, Critical Paradigm.AbstraksiSejarah kurikulum pendidikan di Indonesia kerap berubah, ibarat setiap ada pergantian Menteri Pendidikan, selalu diikuti pergantian sistem kurikulum. Kurikulum Pendidikan Indonesia sejaktahun 1945, telah mengalami perubahan, yaitu pada tahun 1947, 1952, 1964, 1968, 1975, 1984, 1994, 2004, dan 2006. Hal ini berdampak pada mutu pendidikan Indonesia hingga kini belum memenuhi standar mutu yang jelas dan mantap. kajian filosofis adalah suatu sarana berfikir dengan memperdayakan akal manusia semaksimal mungkin, secara mendasar (radikal), menyeluruh (comprehensive) terhadap suatu entitas obyek kajian. Paradigma Kritikal yang digunakan dalam kajian ini mencoba mencari jawaban yang melampaui penampakan di permukaan saja yang seringkali didominasi oleh ilusi, konsekuensinya,bahwa realitas sosial itu harus senantiasa dikritisi dan dievaluasi, yang hasilnya adalah sebuah pemahaman yang jernih, pemahaman atas dasar kesadaran dan keyakinan. Hasil kajian ini dapata dilihat dari tiga aspek yaitu: aspek ontologi, aspek Epistemologis, dan aspek aksiologis.Kata kunci : Perubahan Kurikulum, kurikulum 2006 dan 2013, Paradigma Kritikal.

Sign in / Sign up

Export Citation Format

Share Document