Autoimmune Pancreatitis with Associated Ulcerative Colitis in a Teenager

Autoimmune pancreatitis (AIP) is a rare entity that is extremely uncommon in children. Its diagnosis is also a clinical challenge. This form of chronic pancreatitis often presents itself with obstructive jaundice and/or a pancreatic mass and it is sometimes misdiagnosed as pancreatic cancer. We describe the case of a 13-year-old boy with obstructive jaundice and a 4 cm mass in the head of the pancreas that was diagnosed as AIP with associated ulcerative colitis.info:eu-repo/semantics/publishedVersio

PEDAGOGICAL CONCEPTIONS AND PRACTICES OF YOUTH AND ADULT EDUCATION TEACHERS IN THE INCLUSION OF STUDENTS WITH INTELLECTUAL DISABILITY

Background: Youth and Adult Education (YAE) is a teaching modality in Brazil aimed at people who have not had access to mainstream school or not completed their schooling. Objective of the study was to characterise the pedagogical practices of teachers in the mainstream classroom and special education, working with students with intellectual disabilities at YAE. Method: Qualitative descriptive approach. Observations in classrooms and interviews with teachers. Data consolidated by content analysis and arranged in themes. Results: Teachers have difficulty meeting the student’s specific needs and developing pedagogical resources and strategies to promote access to knowledge. Conclusions: Need exists for greater collaboration between regular and special education teachers to organize the pedagogical planning enabling more assertive pedagogical practices. Article visualizations

Long‐Term Survival After Choriocarcinoma Transmitted by Liver Graft: A Successful Report in Pediatric Transplantation

Background: LT is the standard of care for many pediatric liver disorders. Although long-term outcomes have improved, some rare complications such as transmission of occult donor tumors have been reported. Case report: An adolescent diagnosed with tyrosinemia was submitted to LT from a previous healthy donor due to HCC. Almost 8 months after LT, the patient presented a nodular hepatic lesion. Clinically, he had mild weight loss, lower limb edema, and gynecomastia. Thorax CT found lesions in the left lung parenchyma, which showed no increased uptake in PET SCAN. Liver biopsy revealed a carcinoma with desmoplastic stroma. ISS was withdrawn, and palliative chemotherapy was started for presumptive HCC relapse. AFP remained normal, but HCG had reached unexpected values of 1984 IU/L. As we requested detailed information about the other organ recipients from the same donor, we found that one of them passed away due to disseminated tumor. Five months after the beginning of chemotherapy, the patient underwent resection of liver segments V and VI. Histological examination confirmed liver metastatic choriocarcinoma. At the time of writing, with 11 years of follow-up, the patient had sustained remission with no signs of relapse. Discussion: This case reports a diagnostic challenge in an adolescent with a particular unique background and a very rare pattern of tumor transmission. The authors aim to highlight the risk of cancer-bearing organs reveled post-LT and to testimony the experience of the successful outcome after a choriocarcinoma transmitted by liver graft.info:eu-repo/semantics/publishedVersio

Estudo da atribuição de sentido a processos de significação verbais e não verbais de sujeitos afasicos

Orientador: Maria Irma Hadler CoudryDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da LinguagemResumo: Esta Dissertação de Mestrado trata do estudo da atribuição de sentido, em situações discursivas vivenciadas no Centro de Convivência de Afásicos (CCA/IEL/FCM-UNICAMP), a processos1 de significação verbais e não verbais dos sujeitos afásicos envolvidos em episódios interativos, de que participam afásicos e não afásicos. Trata-se de um estudo que toma o sujeito afásico como um sujeito pragmático, ou seja, falante de uma língua natural que partilha uma série de pressupostos com os demais sujeitos que compõem uma comunidade lingüística/discursiva (Maingueneau, 1989), a despeito do fato de ter, abruptamente, a linguagem afetada pela afasia. Esta pesquisa analisa o trabalho lingüístico-cognitivo produzido/interpretado pelos sujeitos participantes desse grupo. Tem-se como hipótese que afásicos e não afásicos - que convivem sistematicamente - partilham de conhecimentos mútuos (verbais e não verbais), dos quais lançam mão para a determinação do intuito discursivo2, em situações interativas, o que abre ao sujeito afásico a possibilidade de compreender e se fazer compreender, condição para se manter como sujeito da e na linguagem. 1 A formulação processos de significação (Coudry & Possenti, 1983; Coudry, 1986/86) vem sendo estudada pela abordagem discursiva de Neurolingüística desde os primeiros trabalhos sobre afasia e tem como motivação teórico-clínica o fato de a afasia envolver em sua manifestação tanto processos verbais quanto não verbais. Em outras plavras, a afasia afeta a linguagem, a práxis e a relação com o corpo e a percepção. O sujeito afásico pode, às vezes, não conseguir manifestar-se verbalmente, mas pode conseguir fazê-lo por meio de gestos, desenhos, objetos, enfim, de recursos não verbais, na tentativa de interagir, de comunicar-se, de entender o que o outro diz/faz/pede/sugere, etc. Outros sujeitos afásicos precisam falar em voz alta enquanto realizam ações que envolvem objetos, tendo a linguagem nesse contexto, como já apontou Vygotsky (1984) para o desenvolvimento da linguagem, um efeito na organização das ações. 2 Segundo MIKHAIL BAKHTIN (1992), o intuito discursivo ou o querer-dizer do falante, que determina o todo e a amplitude do enunciado, é captado, sentido, compreendido pelo ouvinte em qualquer enunciado, vinculando-se à situação única da comunicação verbal, marcada por parceiros individuais, circunstâncias individuais e enunciados anterioresAbstract: This Master¿s Dissertation deals with the study of sense attribution, in discursive situations lived deeply in the Aphasic Center of Acquaintanceship of (CCA/IEL/FCM ¿ UNICAMP), to verbal and non verbal meaning processes of involved aphasics subjects in interactive episodes, which aphasic and non aphasic subjects participate in. It has to do with a study takes aphasic subject as a pragmatic subject, thus, natural speaker of one language that share a series of presupposed with the others subjects that compose a linguistic/discursive community (Maingueneau, 1989), in spite of having, abruptly, the language affected by aphasia. This research analyses the linguistic work produced/interpreted by the participant subjects of this group. It has as hypothesis that aphasics and non-aphasics subjects ¿ that coexist systematically ¿ share mutual knowledge (verbal and non verbal), of which they forgo for the determination of discursive intention (according to Mikhail Bakthin (1992), the discursive intention or the meaning of the speaker, determines the whole and the amplitude of the statement, it is caught, sensed, understood by the listener in any statement, linking itself to the unique situation of verbal communication, marked by individual partners, individual circumstances and previous statements), in interactive situations, which shows the aphasic subject the possibility of comprehending and making itself comprehended, condition to keep itsel as subject of and in the languageMestradoMestre em Linguístic

sFlt-1/PIGF no Diagnóstico Preditivo de Pré-eclâmpsia: Estudo de Impacto Económico em Portugal

Overview and Aims: The last decade brought relevant insights into the pathophysiology of preeclampsia (PE), namely the role of the circulating levels of placental growth factor (PlGF) and soluble Fms-like tyrosine kinase-1 (sFlt-1). The purpose of this study is to estimate the financial impact of introducing the sFlt-1/PlGF ratio for the evaluation of women with suspicion of PE in the Portuguese National Healthcare System (SNS). Study Design: budget impact study evaluating short-term costs associated with the introduction of the sFlt-1/PlGF ratio from the SNS payer’s perspective. The time horizon for the study is 1 year. Population: The target population consists of women presenting to the healthcare system with signs or symptoms su ggestive of preeclampsia (estimated in 8500 subjects). Methods: A decision-tree model was used to estimate the budget impact of the introduction of the sFlt-1/PlGF ratio in the SNS. The model compares the management costs in the current clinical practice (“no test” scenario) vs. current diagnostic procedures plus the sFlt-1/PlGF ratio (“test” scenario). Clinical inputs have been derived primarily from literature review and, where data was unavailable, expert opinion. Resources and unit costs have been obtained from Portugal-specific sources. Results: In the current standard practice (no test), total costs were estimated to be €9 863 264 (€1160 per patient), with unnecessary admissions representing about €3,5 million. Total costs in the test scenario sum up to €9 781 194 (€1150 per patient), representing a cost saving to the system of €82 070 (€10 per patient), mainly due to a reduction of false positives and related unnecessary hospitalizations of women not developing PE. Conclusions: There is favorable economic evidence about the introduction of the sFlt- 1/PlGF ratio in the SNS. The generated savings appear to offset the costs related to the test.info:eu-repo/semantics/publishedVersio

PTPN23 binds the dynein adaptor BICD1 and is required for endocytic sorting of neurotrophin receptors

Signalling by target-derived neurotrophins is essential for the correct development of the nervous system and its maintenance throughout life. Several aspects concerning the lifecycle of neurotrophins and their receptors have been characterised over the years, including formation of signalling-competent ligand-receptor complexes, their endocytosis and trafficking. However, the molecular mechanisms directing the sorting of activated neurotrophin receptors are still elusive. Previously, our laboratory identified Bicaudal-D1 (BICD1), a dynein motor adaptor, as a key factor for lysosomal degradation of brain-derived neurotrophic factor (BDNF) -activated TrkB and p75NTR in motor neurons. Here, using a proteomic approach, we identified protein tyrosine phosphatase, non-receptor type 23 (PTPN23), a member of the endosomal sorting complexes required for transport (ESCRT) machinery, in the BICD1 interactome. Molecular mapping revealed that PTPN23 is not a canonical BICD1 cargo; instead, PTPN23 binds the N-terminus of BICD1, which is also essential for the recruitment of cytoplasmic dynein. In line with the BICD1 knockdown phenotype, loss of PTPN23 leads to increased accumulation of BDNF-activated p75NTR and TrkB in swollen vacuole-like compartments, suggesting that neuronal PTPN23 is a novel regulator of the endocytic sorting of neurotrophin receptors

Genetic diversity of Bursaphelenchus cocophilus in South America

Molecular characterisation of Bursaphelenchus cocophilus, the causal agent of ‘red ring disease’, is imperative for efficient identification procedures in Brazil and Colombia, because quarantine species such as B. xylophilus and B. mucronatus are already listed in both countries. ITS-1/2 region and D2-D3 segment of LSU rDNA were used to characterise isolates of B. cocophilus obtained from coconut plantations in Brazil and Colombia. Results from ITS-1/2 and LSU rDNA regions showed that all isolates of B. cocophilus from Brazil and Colombia formed a monophyletic group. The LSU rDNA region indicated that all isolates formed a single monophyletic group with high Bayesian posterior probability (100%). This is the first study on ITS-1/2 for the characterisation of B. cocophilus populations. A species-specific primer was designed for identification of B. cocophilus

The evolution of the axonal transport toolkit

Neurons are highly polarized cells that critically depend on long‐range, bidirectional transport between the cell body and synapse for their function. This continual and highly coordinated trafficking process, which takes place via the axon, has fascinated researchers since the early 20th century. Ramon y Cajal first proposed the existence of axonal trafficking of biological material after observing that dissociation of the axon from the cell body led to neuronal degeneration. Since these first indirect observations, the field has come a long way in its understanding of this fundamental process. However, these advances in our knowledge have been aided by breakthroughs in other scientific disciplines, as well as the parallel development of novel tools, techniques and model systems. In this review, we summarize the evolution of tools used to study axonal transport and discuss how their deployment has refined our understanding of this process. We also highlight innovative tools currently being developed and how their addition to the available axonal transport toolkit might help to address key outstanding questions

Portuguese Prevalence of Pediatric Chronic Intestinal Failure

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