Intraoperative Extracorporeal Irradiation for the Treatment of the Meningioma-Infiltrated Calvarium.

Objectives Complete removal of infiltrated bone is required to achieve a Simpson Grade 1 meningioma resection. Reconstruction of the resulting bone defect is typically achieved with a nonnative implant that can result in poor cosmesis, foreign body reaction, or infection. Extracorporeal irradiation and reimplantation of tumorous bone has been used for limb-sparing surgery with excellent results, but this treatment option is not routinely considered in meningioma surgery. We present a case of anterior fossa meningioma with tumorous overlying calvarium that was successfully managed with intraoperative extracorporeal irradiation and reimplantation. Design, Setting, and Participant A 37-year-old woman with persistent chronic headaches was found to have an anterior skull base meningioma with extension into the forehead frontal bone. Concurrently with mass resection, the bone flap was irradiated intraoperatively with 120 Gy. After resection of the tumor, the bone flap was replaced in its native position. Main Outcome Measures and Results Twenty-nine months postoperatively, the patient had an excellent cosmetic outcome with no radiographic evidence of tumor recurrence or significant bone flap resorption. Conclusion Intraoperative extracorporeal irradiation of tumorous calvaria during meningioma surgery is an effective, logistically feasible treatment option to achieve local tumor control and excellent cosmetic outcome

Adult Education in the End of the Century: A Reflective Review from Portugal

In this paper we review adult education policies in Portugal from 1974 until 1999, and we also try to provide a realistic portrait of the current situation. Our main aim is to give suggestions to guide researchers in this field of work

Expression in the human brain of retinoic acid induced 1, a protein associated with neurobehavioural disorders

Acknowledgements Funding was provided by the Wellcome Trust and Tenovus Scotland. Prof Fragoso is the recipient of a Post Doctoral Science without Borders grant from the Brazilian National Council for Scientific and Technological Development (CNPq, 37450/2012- 7). We also thank Aberdeen Proteomics for assistance with the western blots as well as the Microscopy and Histology Core Facility at the University of Aberdeen for confocal microscopy.Peer reviewedPublisher PD

Sports injuries patterns in children and adolescents according to their level of sports participation, age and maturation

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

COPD and cardiovascular disease

COPD is one of the major public health problems in people aged 40 years or above. It is currently the 4th leading cause of death in the world and projected to be the 3rd leading cause of death by 2020. COPD and cardiac comorbidities are frequently associated. They share common risk factors, pathophysiological processes, signs and symptoms, and act synergistically as negative prognostic factors. Cardiac disease includes a broad spectrum of entities with distinct pathophysiology, treatment and prognosis. From an epidemiological point of view, patients with COPD are particularly vulnerable to cardiac disease. Indeed, mortality due to cardiac disease in patients with moderate COPD is higher than mortality related to respiratory failure. Guidelines reinforce that the control of comorbidities in COPD has a clear benefit over the potential risk associated with the majority of the drugs utilized. On the other hand, the true survival benefits of aggressive treatment of cardiac disease and COPD in patients with both conditions have still not been clarified. Given their relevance in terms of prevalence and prognosis, we will focus in this paper on the management of COPD patients with ischemic coronary disease, heart failure and dysrhythmia.Novartis Portugal Novartisinfo:eu-repo/semantics/publishedVersio

Hematoproteinuria in a Lupic Patient with Diabetes: Which One is the Winner?

We report the case of a 46-year-old woman referred to nephrology consult for non-nephrotic proteinuria and hematuria.info:eu-repo/semantics/publishedVersio

Individualized Absolute Risk Calculations for Persons with Multiple Chronic Conditions: Embracing Heterogeneity, Causality, and Competing Events

Approximately 75% of adults over the age of 65 years are affected by two or more chronic medical conditions. We provide a conceptual justification for individualized absolute risk calculators for competing patient-centered outcomes (PCO) (i.e. outcomes deemed important by patients) and patient reported outcomes (PRO) (i.e. outcomes patients report instead of physiologic test results). The absolute risk of an outcome is the probability that a person receiving a given treatment will experience that outcome within a pre-defined interval of time, during which they are simultaneously at risk for other competing outcomes. This allows for determination of the likelihood of a given outcome with and without a treatment. We posit that there are heterogeneity of treatment effects among patients with multiple chronic conditions (MCC) largely depends on those coexisting conditions. We outline the development of an individualized absolute risk calculator for competing outcomes using propensity score methods that strengthen causal inference for specific treatments. Innovations include the key concept that any given outcome may or may not concur with any other outcome and that these competing outcomes do not necessarily preclude other outcomes. Patient characteristics and MCC will be the primary explanatory factors used in estimating the heterogeneity of treatment effects on PCO and PRO. This innovative method may have wide-spread application for determining individualized absolute risk calculations for competing outcomes. Knowing the probabilities of outcomes in absolute terms may help the burgeoning population of patients with MCC who face complex treatment decisions

Caracterização da cadeia produtiva de arroz no Tocantins.

Este trabalho teve por objetivo atualizar informações sobre a cadeia do arroz no estado do Tocantins, por meio de revisão bibliográfica, levantamento de dados de fontes oficiais e de pesquisa de campo com a finalidade de subsidiar discussões com os atores da cadeia produtiva do arroz em busca de diretrizes estratégicas de pesquisa e transferência de tecnologia para o desenvolvimento da orizicultura tocantinense

Addressing Health Disparities and Cultural Competency in Reproductive Health Through Active Learning in the University of Puerto Rico, School of Medicine

Introduction: Lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights which impact reproductive health. Previous pregnancy, induced abortion, and hormonal contraceptive use are common among women who report sex with women, regardless of self-identification as lesbian. LGBTQ have higher risk of smoking, use illicit drugs or have alcohol related problems. Methods: A faculty development training addressed methods and skills for teaching cultural competence and eliminate health disparities. Faculty facilitated a small group active learning activity, including a vignette and a reflective self-evaluation, for medical students to provide better health care services to LGBTQ women in childbearing age. A pre-test and post-test were administered. Analysis was performed using Statistix8.0. Results: A total of 115 second year medical students were included in the educational activity. Subjects included 101 students (87%) on the pretest and 104 students (90%) on the post-test. Subjects showed an overall improvement in knowledge (89% correct answers pre-test, 100% post-test, (