Computed tomography image quality of aortic stents in patients with aortic coarctation: a multicentre evaluation

Background: Stents are commonly used to treat aortic coarctation. The objective of this study was to evaluate the post-implantation computed tomography (CT) image quality of different stent types used to treat aortic coarctation. Methods: Adult and paediatric patients with stent-treated aortic coarctation who underwent contrast-enhanced CT were retrospectively included from three tertiary care centres. CT scans were subjectively scored for image quality using a 4-point scale (1 = unacceptable; 2 = poor; 3 = good; 4 = excellent). Furthermore, the amount of stent-induced blooming artefacts was measured as the percentage of the difference between outer and inner stent diameters over the outer stent diameter. Results: A total of 35 children and 34 adults implanted with 71 stents of six different types were included. The most commonly used stent type was the Cheatham Platinum stent (52 stents, 73%). The subjective image quality of the Cheatham Platinum stents was moderate with a score of 2.0±0.8 (mean ± standard deviation) in children and 2.3±0.6 in adults. The image quality in patients with Formula stents was 2.3±1.2. The Cheatham Platinum stents induced 34–48% blooming, the Formula stents 44–55%. The image quality in patients with the less commonly used Atrium Advanta V12, IntraStent, AndraStent and Palmaz stents was scored 3 (good) to 4 (excellent) with less blooming. The electrocardiographic gating and tube voltage (kVp) did not affect image quality. Conclusions: There is a substantial variation in CT image quality a

Inflammatory Monocytes Promote Perineural Invasion via CCL2-Mediated Recruitment and Cathepsin B Expression.

Perineural invasion (PNI) is an ominous event strongly linked to poor clinical outcome. Cells residing within peripheral nerves collaborate with cancer cells to enable PNI, but the contributing conditions within the tumor microenvironment are not well understood. Here, we show that CCR2-expressing inflammatory monocytes (IM) are preferentially recruited to sites of PNI, where they differentiate into macrophages and potentiate nerve invasion through a cathepsin B-mediated process. A series of adoptive transfer experiments with genetically engineered donors and recipients demonstrated that IM recruitment to nerves was driven by CCL2 released from Schwann cells at the site of PNI, but not CCL7, an alternate ligand for CCR2. Interruption of either CCL2-CCR2 signaling or cathepsin B function significantly impaired PNI in vivo Correlative studies in human specimens demonstrated that cathepsin B-producing macrophages were enriched in invaded nerves, which was associated with increased local tumor recurrence. These findings deepen our understanding of PNI pathogenesis and illuminate how PNI is driven in part by corruption of a nerve repair program. Further, they support the exploration of inhibiting IM recruitment and function as a targeted therapy for PNI. Cancer Res; 77(22); 6400-14. ©2017 AACR

Concepções de professores sobre inclusão escolar e interações em ambiente inclusivo: uma revisão da literatura Conceptions of teachers on school inclusion and inclusive environment interactions: a review of the literature

A educação inclusiva tem sido um desafio para diferentes profissionais que trabalham na promoção do desenvolvimento de alunos com deficiência. Estes têm a escola como um espaço fundamental para promover o desenvolvimento social, emocional e acadêmico, a partir de oportunidades de vivências estimuladoras da interação e mediação para a aprendizagem de significados e sentidos e que contribuem para processos de resiliência. Este estudo analisou o conteúdo de publicações nacionais da última década (2000-2010) sobre concepções de professores a respeito da inclusão de alunos com alguma necessidade educativa especial (NEE) e interações no contexto educacional inclusivo, também identificando fatores facilitadores e impeditivos da efetivação das diretrizes educacionais existentes. Após busca sistemática na Biblioteca Virtual em Saúde - Psicologia (BVS-PSI), com as palavras-chave: professor, educação inclusiva, interação, educação especial, escola, aprendizagem, concepções, deficiência intelectual, mediação, desenvolvimento e relacionamento, 29 artigos foram recuperados e lidos na íntegra. Verificou-se um predomínio de autores da área da Psicologia e de coletas de dados realizadas via entrevista e questionário. Os estudos apresentaram concepções sobre deficiência ligadas a características individuais que causam limitações. A falta de apoio de equipe especializada, de materiais didáticos e assistivos, de formação e preparo foram apontados como principais fatores que dificultam a efetivação dos princípios inclusivos. A literatura mostra a necessidade de capacitação dos professores. Diante disso, sugerem-se novos estudos sobre a saúde do professor e suas concepções sobre a inclusão escolar, além da necessidade de intervenções escolares baseadas na problematização dos determinantes sociais e históricos associados às deficiências apresentadas e ao mal-estar docente.<br>Inclusive education has been a challenge for different professionals engaged in promoting the development of students with disabilities. Schools have been an essential place for promoting social, emotional and academic development, because they enable opportunities for experiences that stimulate interaction and mediation of learning of significant content, while contributing towards resilience processes. This study analyzed the content of national studies published between 2000 and 2010 on teachers' conceptions of inclusion of pupils with educational needs and interactions in the context of inclusive education; it also aimed to identify factors that facilitate and hinder effectiveness of educational guidelines. After a systematic search of the BVS-PSI portal using the keywords teacher, inclusive education, interaction, special education, school, learning, conceptions, mental disability, mediation, development and relationship, 29 articles were encountered. There was a predominance of authors in the field of psychology. Data collection was conducted via interview and questionnaire. The studies showed deficiencies linked to concepts of individual characteristics that may cause limitations. The lack of support from specialized staff, teaching materials and assistive training and preparation were identified as the main factors hindering successful implementation of inclusive principles. The literature shows the need for teacher development. Given the results, the authors suggest further studies on the health of teachers, investigation into their conceptions of inclusion, as well as the need for intervention in schools considering historical and social determinants of disabilities and factors undermining teacher well-being