Carcinoma Verrucoso e Leucoplasia em um mesmo paciente: relato de caso clínico

The authors report a case of a 65 years-old female patient with two lesions that were present for 4 years. The patient did not smoke or drink alcohol. One of the lesions was proliferative, had verruciform and whiteness surface and was located in the buccal mucosa, at the right side; the other lesion was a plaque with irregular shape and white color and was located in tongue border, right side. The clinical vliagnosis was Oral Verrucous Carcinoma to the buccal mucosa and Leukoplakia to the border tongue lesion; both clinical diagnoses were confirmed by histopathologic exams. The patient was treated by surgery; after 6 months, she is well and recovering facial and tongue movement, with physiotherapy.Os autores descrevem o caso clínico de duas lesões presentes há mais de 4 anos, em uma paciente do sexo feminino, 65 anos de idade, que negou hábitos de tabagismo e etilismo. Uma das lesões encontrava-se em mucosa jugal, lado direito, exofítica, com superfície verrucóide e esbranquiçada; outra localizava-se na borda da língua, lado direito, em forma de placa branca. Os diagnósticos clínicos estabelecidos foram de Carcinoma Verrucoso para a lesão de mucosa jugal e de Leucoplasia para a lesão de língua, os quais foram confirmados no exame histopatológico. A paciente foi encaminhada para remoção cirúrgica de ambas as lesões. Decorridos 6 meses da cirurgia, a mesma encontra-se em bom estado de saúde geral, recuperando os movimentos faciais e linguais, através de fisioterapia

O habitus professoral e a educação especial: percepção dos professores de classe comum e sala de recursos multifuncional

This article analyzes the Inclusive Education from the Specialized Educational Service (SES) in Multifunctional Resources Classes (MRC) in the Municipal Teaching web in Novo Hamburgo/RS. It counted with the participation of 99 teachers in the regular classroom who worked as teachers of students with disabilities, pervasive developmental disorders, high ability/gifted and 30 MRC teachers in 2013. The data showed that the MRC teachers shown to have minor difficulties in working with students from the Special Education than the teachers of regular class. Through the identification of the teachers’ habitus of regular class, it was understood that the difficulties indicated by them derive from the fragility in their pedagogical training to work with students of Special Education. It is about a non-inclusive habitus, which is constituted from the internalization of teaching models based on the subject homogenization (all are equal) over the constitution of a new habitus, structural of a teaching model that recognizes the diversity for inclusion.Este artículo analiza la educación inclusiva desde la Atención Educacional Especializada (AEE) en Aula de Recursos Multifuncional (ARM) en la red de municipios de Enseñanza de Novo Hamburgo/RS. Hubo la participación de 99 profesores de aula común que actuaban en la docencia de alumnos con discapacidad, transtorno global del desarrollo y altas habilidades/superdotados y 30 profesoras de ARM en el año de 2013. Los datos señalaron que las profesoras de ARM demostraron poseer menores dificultades en trabajar con los alumnos de la Educación Especial que los profesores de aula común. Por medio de la identificación del habitus de los profesores de aula común, se pudo comprender que las dificultades indicadas por ellos resultan de la fragilidad en su formación pedagógica para trabajar con alumnos de la Educación Especial. Se trata de un habitus no-inclusivo, el cual se constituye desde la interiorización de modelos de enseñanza enmarcado por la homogeneización de los sujetos (todos son iguales) en detrimento de la constitución de un nuevo habitus, estructurante de un modelo de enseñanza que reconozca las diversidades para su inclusión.Este artigo analisa a educação inclusiva a partir do Atendimento Educacional Especializado (AEE) em Sala de Recursos Multifuncional (SRM) na rede municipal de Ensino de Novo Hamburgo/RS. Contou com a participação de 99 professores de classe comum que atuavam na docência de alunos com deficiência, transtorno global do desenvolvimento e altas habilidades/superdotação e 30 professoras de SRM no ano de 2013. Os dados apontaram que as professoras de SRM demonstraram possuir menores dificuldades em trabalhar com os alunos da Educação Especial do que os professores de classe comum. Por meio da identificação do habitus dos professores de classe comum, compreendeu-se que as dificuldades indicadas por eles decorrem da fragilidade em sua formação pedagógica para trabalhar com alunos da Educação Especial. Trata-se de um habitus não inclusivo, o qual se constituiu desde a interiorização de modelos de ensino pautado pela homogeneização dos sujeitos (todos são iguais) em detrimento da constituição de um novo habitus, estruturante de um modelo de ensino que reconheça as diversidades para sua inclusão

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Carcinoma Verrucoso e Leucoplasia em um mesmo paciente: relato de caso clínico

The authors report a case of a 65 years-old female patient with two lesions that were present for 4 years. The patient did not smoke or drink alcohol. One of the lesions was proliferative, had verruciform and whiteness surface and was located in the buccal mucosa, at the right side; the other lesion was a plaque with irregular shape and white color and was located in tongue border, right side. The clinical vliagnosis was Oral Verrucous Carcinoma to the buccal mucosa and Leukoplakia to the border tongue lesion; both clinical diagnoses were confirmed by histopathologic exams. The patient was treated by surgery; after 6 months, she is well and recovering facial and tongue movement, with physiotherapy.Os autores descrevem o caso clínico de duas lesões presentes há mais de 4 anos, em uma paciente do sexo feminino, 65 anos de idade, que negou hábitos de tabagismo e etilismo. Uma das lesões encontrava-se em mucosa jugal, lado direito, exofítica, com superfície verrucóide e esbranquiçada; outra localizava-se na borda da língua, lado direito, em forma de placa branca. Os diagnósticos clínicos estabelecidos foram de Carcinoma Verrucoso para a lesão de mucosa jugal e de Leucoplasia para a lesão de língua, os quais foram confirmados no exame histopatológico. A paciente foi encaminhada para remoção cirúrgica de ambas as lesões. Decorridos 6 meses da cirurgia, a mesma encontra-se em bom estado de saúde geral, recuperando os movimentos faciais e linguais, através de fisioterapia

The habitus professorial and special education: perceptions of common class teachers and resource room multifuncional

This article analyzes the Inclusive Education from the Specialized Educational Service (SES) in Multifunctional Resources Classes (MRC) in the Municipal Teaching web in Novo Hamburgo/RS. It counted with the participation of 99 teachers in the regular classroom who worked as teachers of students with disabilities, pervasive developmental disorders, high ability/gifted and 30 MRC teachers in 2013. The data showed that the MRC teachers shown to have minor difficulties in working with students from the Special Education than the teachers of regular class. Through the identification of the teachers’ habitus of regular class, it was understood that the difficulties indicated by them derive from the fragility in their pedagogical training to work with students of Special Education. It is about a non-inclusive habitus, which is constituted from the internalization of teaching models based on the subject homogenization (all are equal) over the constitution of a new habitus, structural of a teaching model that recognizes the diversity for inclusion

O habitus professoral e a educação especial: percepção dos professores de classe comum e sala de recursos multifuncional

This article analyzes the Inclusive Education from the Specialized Educational Service (SES) in Multifunctional Resources Classes (MRC) in the Municipal Teaching web in Novo Hamburgo/RS. It counted with the participation of 99 teachers in the regular classroom who worked as teachers of students with disabilities, pervasive developmental disorders, high ability/gifted and 30 MRC teachers in 2013. The data showed that the MRC teachers shown to have minor difficulties in working with students from the Special Education than the teachers of regular class. Through the identification of the teachers’ habitus of regular class, it was understood that the difficulties indicated by them derive from the fragility in their pedagogical training to work with students of Special Education. It is about a non-inclusive habitus, which is constituted from the internalization of teaching models based on the subject homogenization (all are equal) over the constitution of a new habitus, structural of a teaching model that recognizes the diversity for inclusion.Este artigo analisa a educação inclusiva a partir do Atendimento Educacional Especializado (AEE) em Sala de Recursos Multifuncional (SRM) na rede municipal de Ensino de Novo Hamburgo/RS. Contou com a participação de 99 professores de classe comum que atuavam na docência de alunos com deficiência, transtorno global do desenvolvimento e altas habilidades/superdotação e 30 professoras de SRM no ano de 2013. Os dados apontaram que as professoras de SRM demonstraram possuir menores dificuldades em trabalhar com os alunos da Educação Especial do que os professores de classe comum. Por meio da identificação do habitus dos professores de classe comum, compreendeu-se que as dificuldades indicadas por eles decorrem da fragilidade em sua formação pedagógica para trabalhar com alunos da Educação Especial. Trata-se de um habitus não inclusivo, o qual se constituiu desde a interiorização de modelos de ensino pautado pela homogeneização dos sujeitos (todos são iguais) em detrimento da constituição de um novo habitus, estruturante de um modelo de ensino que reconheça as diversidades para sua inclusão.Este artículo analiza la educación inclusiva desde la Atención Educacional Especializada (AEE) en Aula de Recursos Multifuncional (ARM) en la red de municipios de Enseñanza de Novo Hamburgo/RS. Hubo la participación de 99 profesores de aula común que actuaban en la docencia de alumnos con discapacidad, transtorno global del desarrollo y altas habilidades/superdotados y 30 profesoras de ARM en el año de 2013. Los datos señalaron que las profesoras de ARM demostraron poseer menores dificultades en trabajar con los alumnos de la Educación Especial que los profesores de aula común. Por medio de la identificación del habitus de los profesores de aula común, se pudo comprender que las dificultades indicadas por ellos resultan de la fragilidad en su formación pedagógica para trabajar con alumnos de la Educación Especial. Se trata de un habitus no-inclusivo, el cual se constituye desde la interiorización de modelos de enseñanza enmarcado por la homogeneización de los sujetos (todos son iguales) en detrimento de la constitución de un nuevo habitus, estructurante de un modelo de enseñanza que reconozca las diversidades para su inclusión

Short-Term, High-Dose Pamidronate-Induced Acute Tubular Necrosis: The Postulated Mechanisms of Bisphosphonate Nephrotoxicity

A 76-year-old man had biopsy-proven acute tubular necrosis (ATN) after intravenous administration of 3 doses of 60 mg of pamidronate (Aredia) over a 2-week period. Pamidronate was given to treat hypercalcemia of unknown etiology. Other potential causes of acute renal failure were excluded with appropriate investigations. The patient's preexisting renal impairment in the context of high-doses of pamidronate might have been a potentiating factor for nephrotoxicity. The ATN encountered in this patient resolved; however, short-term hemodialysis was needed. To the best of our knowledge, this is the first reported case of short-term, high-dose pamidronate-induced ATN in the absence of concomitant nephrotoxins. Although necrotic and apoptotic cell death after bisphosphonate administration has been seen in a variety of cells, the exact mechanism of nephrotoxicity is unknown. This report presents a case of pamidronate-induced ATN and discusses the potential mechanisms of bisphosphonate-induced nephrotoxicity

Studies on binding and mitogenic effect of insulin and insulin-like growth factor I in glomerular mesangial cells

The mesangial cells, as part of their smooth muscle cell function, are actively involved in regulating glomerular hemodynamics. Their overlying endothelium is fenestrated; therefore, these cells are directly exposed to plasma substances, including hormones such as insulin and insulin-like growth factor I (IGF-I). These peptides may contribute to the mesangial sclerosis and cellular hyperplasia that characterize diabetic glomerulopathy. We report herein the characterization of the receptors and the mitogenic effects of IGF-I and insulin on mouse glomerular mesangial cells in culture. The IGF-I receptor was characterized on intact cells. The Kd of the IGF-I receptor was 1.47 X 10(-9) M, and the estimated number of sites was 64,000 receptors/cell. The binding was time, temperature, and pH dependent, and the receptor showed down-regulation after exposure to serum. The expression of the receptor did not change on cells at different densities. The specific binding for insulin was too low to allow characterization of the insulin receptor on intact cells. However, it was possible to identify the insulin receptor in a wheat germ agglutinin-purified preparation of solubilized mesangial cells. This receptor showed the characteristic features of the insulin receptor, including pH dependence of binding and a curvilinear Scatchard plot. The mitogenic effects of insulin and IGF-I on mesangial cells were measured by the incorporation of [3H]thymidine into DNA. IGF-I was more potent than insulin. The half-maximal response to IGF-I stimulation occurred at 1.3 X 10(-10) M, and a similar increase with insulin was observed at concentrations in the range of 10(-7) M, suggesting that this insulin action was mediated through the IGF-I receptor. These data show that the mouse microvascular smooth muscle cells of the glomerulus express a cell surface receptor for IGF-I in vitro and that this peptide is a potent mitogen for these mesangial cells. It may, therefore, play a role in glomerular proliferative lesions. The insulin receptor is present in small numbers and does not mediate mitogenesis in mesangial cells

Les nécropoles de Vernègues (B.-du-Rh.). Deux ensembles funéraires du Haut-Empire à la périphérie d'une agglomération secondaire: La nécropole de l'Héritière : les vestiges architecturaux (A.R.C.)

National audienceLes nécropoles des Communaux de Saint-Cézaire et de l'Héritière ont été découvertes à l'occasion des travaux du TGV Sud-Est, à proximité du temple antique de Château-bas à Vernègues (Bouches-du-Rhône). Le bon état de conservation des 76 structures funéraires fouillées (fosses de crémation et sépultures), datées entre le milieu du Ier s. et le début du IIIe s., a permis une étude détaillée des offrandes et du déroulement des cérémonies accompagnant la crémation. Cette étude relance également la problématique sur la présence d'une agglomération secondaire autour du temple avec la découverte de ces deux nécropoles et de voies inédites

Les nécropoles de Vernègues (B.-du-Rh.). Deux ensembles funéraires du Haut-Empire à la périphérie d'une agglomération secondaire

The works of the South-East TGV near the ancient temple of Château-Bas at Vernègues ( Bouches-du-Rhône) gave the opportunity to discover the necropolis of the Communaux of Saint-Cézaire and l'Héritière. The good preservation state of 76 funeral structures ( cremation pits and burials) dug dated from the middle of the 1st century A.D. to the beguinning of the Illrd century A.D. allowed a precise study of the offerings and of the course of the ceremonies going along with the cremation. The study reopens the problematics of the existence of a secondary agglomeration around the temple with the discovery of these two necropolis and new roads.Les nécropoles des Communaux de Saint-Cézaire et de l'Héritière ont été découvertes à l'occasion des travaux du TGV Sud-Est, à proximité du temple antique de Château-bas à Vernègues (Bouches-du-Rhône). Le bon état de conservation des 76 structures funéraires fouillées (fosses de crémation et sépultures), datées entre le milieu du Ier s. et le début du IIIe s., a permis une étude détaillée des offrandes et du déroulement des cérémonies accompagnant la crémation. Cette étude relance également la problématique sur la présence d'une agglomération secondaire autour du temple avec la découverte de ces deux nécropoles et de voies inédites.Chapon Philippe, Bussière Jean, Delattre Liliane, Feugère Michel, Richier-Laurent Anne, Roth-Congès Anne, Villemeur Isabelle, Écard Philippe, Michel Denis. Les nécropoles de Vernègues (B.-du-Rh.). Deux ensembles funéraires du Haut-Empire à la périphérie d'une agglomération secondaire. In: Revue archéologique de Narbonnaise, tome 37, 2004. pp. 109-204