Mapeando

This paper is an autobiographical narrative. It presents maps of encounters that had influenced the relationship of the author with art and education. Considering the hybrid condition of being an artist, a teacher and a researcher, the author describes her trajectory through the main networks and organizations where she has worked: Association for Teachers of Expression and Visual Communication – APECV, International Society for Education Through Art – InSEA, Ibero American Network on Art Education – RIAEA.Este artigo é um relato autobiográfico. Apresenta mapas de encontros e desencontros que influenciaram a relação da autora com a arte e a educação. Tendo em conta a sua hibridez de artista, professora e investigadora, a autora relata o seu percurso pelas principais redes e organizações onde se integra: Associação de Professores de Expressão e Comunicação Visual -APECV, International Education Through Art- InSEA; Rede IberoAmericana de Educação Artística- RIAEA

Bile microbiota in primary sclerosing cholangitis : Impact on disease progression and development of biliary dysplasia

Objective The etiopathogenesis and risk for development of biliary neoplasia in primary sclerosing cholangitis (PSC) are largely unknown. Microbes or their metabolites have been suggested to play a role. To explore this potential microbial involvement, we evaluated the differences in biliary microbiota in PSC patients at an early disease stage without previous endoscopic retrograde cholangiography (ERC) examinations, advanced disease stage, and with biliary dysplasia or cholangiocarcinoma. Design Bile samples from the common bile duct were collected from 46 controls and 80 patients with PSC during ERC (37 with early disease, 32 with advanced disease, and 11 with biliary dysplasia). DNA isolation, amplification, and Illumina MiSeq sequencing were performed for the V1-V3 regions of the bacterial 16S rRNA gene. Results The most common phyla found were Bacteroidetes, Firmicutes, Proteobacteria, Fusobacteria, and Actinobacteria. The most common families were Prevotellaceae, Streptococcaceae, Veillonellaceae, Fusobacteriaceae, and Pasteurellaceae, and the most common genera were Prevotella, Streptococcus, Veillonella, Fusobacterium, and Haemophilus. The bacterial communities of non-PSC subjects and early stage PSC patients were similar. Alpha diversity was lower in patients with biliary dysplasia/cholangiocarcinoma than in other groups. An increase in Streptococcus abundance was positively correlated with the number of ERC examinations. Streptococcus abundance was also positively correlated with an increase in disease severity, even after controlling for the number of ERC examinations. Conclusions Our findings suggest that the aetiology of PSC is not associated with changes in bile microbial communities, but the genus Streptococcus may play a pathogenic role in the progression of the disease.Peer reviewe

Hypospadias: Factors Associated with Origin and Succesful Treament of this Anomaly

Hypospadia eli virtsaputken alahalkio on yksi tavallisimmista poikien synnynnäisistä epämuodostumista. Siinä virtsaputki aukeaa peniksen etupinnalle. Hoitona on leikkaus ja sen tavoitteena on aikaansaada ulkonäöltään ja toiminnaltaan normaali penis. Potilailla on väitetty olevan aikuisena tavallista useammin vaikeuksia sosiaalisten ja seksuaalisten kontaktien luomisessa sekä negatiivinen käsitys sukupuolielimistään. Hypospadian syy on monitekijäinen, sekä perinnöllisillä että ympäristöön liittyvilla tekijöillä lienee osuutensa. 1990-luvulla hypospadiant, siemennesteen laadun heikkenemisen ja kivesten kehityshäiriöiden väitettiin lisääntyneen ympäri maailman, myös Suomessa. Syyksi esitettiin elinympäristössämme esiintyvien naishormonien kaltaisesti vaikuttavien aineiden, kuten saasteet ja teollisuudessa käytetyt yhdisteet, lisääntyminen. Tämän tutkimuksen tavoitteena oli selvittää hypospadian ja sen hoidon vaikutuksia potilaan elämään aikuisena, epämuodostuman syntyyn liittyviä tekijöitä ja sen esiintyvyyttä Suomessa. Suuri osa aiemmin raportoiduista eroista hypospadiapotilaiden ja muiden miesten välillä johtuu poikkeavasta peniksen ulkonäöstä. Epätäydellinenkään lopputulos ei tee tyydyttävää sukupuolielämää mahdottomaksi. Leikkaus, johon liittyy vähän komplikaatioita tyydyttää potilasta parhaiten myös aikuisena. Tärkein potilaan tyytyväisyyteen vaikuttava tekijä on hyvä kosmeettinen leikkaustulos. Hypospadia osoittautui huomattavasti aikaisemmin tiedettyä yleisemmäksi (28.1/ 10 000 syntynyttä poikalasta) eikä se ole yleistynyt Suomessa ainakaan 1980-luvun alun jälkeen. Aiemmin kansainvälisesti verrattuna matalaksi raportoidun esiintyvyyden syynä oli hypospadiatapausten epäluotettava raportointi epämuodostumarekisteriin. Matala syntymäpaino, äidin nuoruus ja jokin muu epämuodostuma ovat hypospadialle altistavia raskauteen liittyviä tekijöitä. Jatkossa tarvitaan lisätietoa hypospadian ja sikiön pienipainoisuuden välisestä yhteydestä ja toisaalta tekijöistä, joilla pienipainoisuutta voitaisiin estää.In hypospadias, one of the most common congenital anomalies in boys, the urethral meatus is located on the ventral aspect of the penis or even on the perineum. It is caused by incomplete closure of the tissue on the undersurface of the penis. The etiology of hypospadias is probably multifactorial, involving genetic and environmental factors. The treatment is surgery, the aim being a penis with normal appearance and function. The aim of this study was to assess the effects of hypospadias and its surgical correction on the life of the patient as an adult. It was also sought to establish the occurrence of this anomaly. In the clinical part of our series the study population comprised of 64 patients operated for hypopadias at Tampere University Hospital between 1963 and 1976. In a study comparing the sexuality of hypospadias patients to that of patients operated on the genitals, 64 patients circumcised for phimosis were selected as age-matched controls. The patient records of hypospadias patients were analyzed retrospectively and a questionnaire was mailed to them in 1994. All patients treated for hypospadias before nine years of age among boys born 1970-1986 were identified from the Finnish National Hospital Discharge Registry for a study of temporal trends and geographical variation in the prevalence of hypospadias in Finland. In a study of pregnancy-related risk factors of hypospadias, all 490 boys born with hypospadias in Finland between 1996 and 2001 were selected from the Finnish Birth Defects Registry and 1470 age-matched male controls from the Finnish Medical Birth Registry. Information on pregnancy-related factors was obtained from the Medical Birth Registry. Significant differences were noted between hypospadias and phimosis patients in erectile and urinary function, as well as in satisfaction with penile appearance and surgical result. Problems in voiding and erection and especially poor cosmetic result were associated with dissatisfaction with the outcome. Many patients would have preferred a longer follow-up after surgery. The mean prevalence of hypospadias among boys born 1970-1986 was much higher than had previously been reported, 28.1 per 10,000 male live births. It remained constant throughout the study period. Nonetheless, there was substantial geographical variation in the prevalence of operated hypospadias. Birth weight, young maternal age and presence of some anomaly other than hypospadias were risk factors for the condition. A great proportion of the previously reported differences between hypospadias patients and other men arise from surgery on the male genitalia and the out-of-the-ordinary appearance it causes. Even patients with a less than perfect technical result are able to live a satisfactory sexual life. An operation with good short-term results and few complications satisfies the patient also as an adult. The overall appearance as perceived by the patient is the most important factor in producing a good result. The previously reported low prevalence of hypospadias was due to underreporting of cases to the Finnish Malformation Registry. The geographical variation in the prevalence of operated hypospadias has many possible explanations, although none of them were verified by methods we used. Future studies on the relationship between poor intrauterine growth and hypospadias are clearly called for. A nutritional factor might provide a mode of intervention for the prevention of this disorder