864 research outputs found
Supraorbital craniotomy to approach the sellar and the parasellar regions
We report on the experience with supraorbital minicraniotomy in a series of 36 operated cases with good results: 31 aneurysms, 4 pituitary adenomas, 1 anaplastic astrocytoma and 1 arachnoid cyst. One death occurred in this series. The technique is detailed. We conclude that the minicraniotomy is a safe method for the treatment of several parasellar pathologies.The efficacy must be evaluated in clinical trials concerning other approaches.Relatamos nossa experiĂȘncia com a minicraniotomia supraorbital em uma sĂ©rie de 36 pacientes operados, com resultados satisfatĂłrios. Foram operados 31 aneurismas 4 adenomas hipofisĂĄrios, um astrocitoma anaplĂĄsico e um cisto aracnĂłide. Houve um Ăłbito na sĂ©rie. A tĂ©cnica foi descrita em detalhes. Concluimos que a minicraniotomia Ă© um mĂ©todo seguro para o tratamento de vĂĄrias patologias parasselares, devendo ser avaliada a sua eficĂĄcia em estudos comparativos com as tĂ©cnicas tradicionais.Universidade Federal da Bahia Faculdade de MedicinaUniversidade Federal de SĂŁo Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL
AnĂĄlise da melhor alternativa terapĂȘutica para malformaçÔes arteriovenosas durais intracranianas
The material for this research consisted of 93 patients with dural arteriovenous malformations (DAVMs) who were studied retrospectively with regards to therapeutic success and failure, who had undergone either neurosurgery, or embolization or a combination of both methods and whose disease was located in the cavernous sinus, the superior sagittal sinus, the transverse-sigmoid sinus of the anterior fossa and the tentorium. Thus, it was possible to arrive at the following conclusions: treatment of the DAVMs must be indicated, jointly, by an interventionist neuroradiologist and a neurosurgeon; DAVMs of the transverse-sigmoid sinus were better treated when a combination of both methods was used; DAVMs of the tentorium were also better treated with a combined method; the endovascular method ensured only a 50% chance of therapeutic success for DAVMs of the superior sagittal sinus; DAVMs of the cavernous sinus are better treated when the endovascular method was used with a transvenous approach, relative to the transarterial approach.O material utilizado consistiu de 93 pacientes portadores de malformaçÔes arteriovenosas durais (MAVDs) estudados retrospectivamente em relação ao sucesso e ao fracasso terapĂȘutico submetidos aos mĂ©todos neurocirĂșrgico ou endovascular ou, ainda, combinação entre ambos, em que a doença se localizou nas regiĂ”es do seio cavernoso, do seio sagital superior, do seio transverso-sigmĂłide, da fossa anterior e do tentĂłrio. As conclusĂ”es foram as seguintes: o tratamento das MAVDs deve ser indicado pelo neurorradiologista intervencionista e pelo neurocirurgiĂŁo, conjuntamente; as MAVDs do seio transverso-sigmĂłide foram melhor tratadas atravĂ©s do mĂ©todo combinado; as MAVDs do tentĂłrio foram melhor tratadas atravĂ©s do mĂ©todo combinado; as MAVDs do seio sagital superior tratadas por mĂ©todo endovascular asseguraram apenas 50% de sucesso terapĂȘutico; as MAVDs do seio cavernoso sĂŁo melhor tratadas por mĂ©todo endovascular empregando-se a via transvenosa quando comparadas com a via transarterial.Universidade Federal de SĂŁo Paulo (UNIFESP), Escola Paulista de Medicina (EPM)Institute of GoiĂąniaUniversity of SĂŁo PauloUNIFESP, EPMSciEL
PrĂĄticas de marketing educacional nas escolas pĂșblicas
O presente trabalho tem como objetivo identificar prĂĄticas de Marketing Educacional nas escolas pĂșblicas.
Tendo por base razĂ”es pessoais, profissionais, teĂłricas e legais que justificam estudos sobre as prĂĄticas de Marketing Educacional nas escolas pĂșblicas, revĂȘ-se a literatura sobre a evolução do marketing (geral) atĂ© Ă emergĂȘncia do marketing societal e do Marketing Educacional.
Partindo dos normativos legais e da literatura, exploram-se as fontes de informação, a autonomia das escolas, a accountability, o planeamento estratĂ©gico e evidĂȘncias dessas prĂĄticas associadas ao Marketing Educacional. Para o efeito, optou-se, metodologicamente, por realizar uma pesquisa quantitativa atravĂ©s de um inquĂ©rito por questionĂĄrio realizado junto dos(as) diretores(as) dos agrupamentos de escolas e escolas nĂŁo agrupadas de Portugal Continental.
No que respeita aos principais resultados obtidos, Ă© possĂvel concluir que, apesar de haver evidĂȘncias de predominar a orientação da gestĂŁo para a âproduçãoâ do serviço educativo, hĂĄ prĂĄticas de Marketing Educacional nas escolas pĂșblicas. Contudo, as escolas tĂȘm ainda uma consciĂȘncia mĂope do que Ă© o Marketing Educacional, pois hĂĄ dĂ©fice na identificação e na implementação dessas prĂĄticas. Verifica-se que as escolas fazem estudos de suporte a decisĂ”es sobre oferta formativa, de avaliação institucional e de satisfação junto dos alunos e restante comunidade educativa. Definem e implementam estratĂ©gias nĂŁo sĂł para cumprir os normativos legais, mas tambĂ©m adequar os serviços aos alunos, tornando-os parte ativa da coprodução do serviço educativo.
Com base nas conclusÔes e nas opçÔes de concordùncia do(a)s diretores(as), foi delineado um plano de ação de intervenção de Marketing Educacional.This project aims to identify educational marketing practices in state schools.
Based on personal, professional, theoretical and legal reasons that justify studies on Educational Marketing practices in state schools, we'll be reviewing the literature on the evolution of marketing, and of general marketing until the emergence of Educational Marketing.
Starting from legal requirements and literature, we will explore information sources, school autonomy, accountability, strategic and practical evidence associated with Educational Marketing. For this purpose, it was decided, as far as methodology is concerned, to carry out a quantitative research through a survey with the School Directors/headmasters of the school groupings and schools in mainland Portugal.
Concerning the main results obtained, it is possible to conclude that, although there is evidence of a predominant management orientation towards the âproductionâ of the educational service, it is undeniable that there are Educational Marketing practices in state schools. However, schools still have a short-sighted awareness of what Educational Marketing is, as there is a deficit in identifying and implementing these practices. In fact, schools carry out surveys that support decisions on training courses, institutional assessment and satisfaction among students and the rest of the educational community. They define and implement strategies not only to comply with legal regulations, but also to adapt services to students, making them an active part of the co-production of the educational service.
Based on the headmasters' conclusions and agreement options, an Educational Marketing action plan was outlined.
KEYWORDS: Educational Marketing
Measuring and Estimating GFR and Treatment Effect in ADPKD Patients: Results and Implications of a Longitudinal Cohort Study
Trials failed to demonstrate protective effects of investigational treatments on glomerular filtration rate (GFR) reduction in Autosomal Dominant Polycystic Kidney Disease (ADPKD). To assess whether above findings were explained by unreliable GFR estimates, in this academic study we compared GFR values centrally measured by iohexol plasma clearance with corresponding values estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) and abbreviated Modification of Diet in Renal Disease (aMDRD) formulas in ADPKD patients retrieved from four clinical trials run by a Clinical Research Center and five Nephrology Units in Italy. Measured baseline GFRs and one-year GFR changes averaged 78.6±26.7 and 8.4±10.3 mL/min/1.73 m2 in 111 and 71 ADPKD patients, respectively. CKD-Epi significantly overestimated and aMDRD underestimated baseline GFRs. Less than half estimates deviated by <10% from measured values. One-year estimated GFR changes did not detect measured changes. Both formulas underestimated GFR changes by 50%. Less than 9% of estimates deviated <10% from measured changes. Extent of deviations even exceeded that of measured one-year GFR changes. In ADPKD, prediction formulas unreliably estimate actual GFR values and fail to detect their changes over time. Direct kidney function measurements by appropriate techniques are needed to adequately evaluate treatment effects in clinics and research
18FDG-PET and large vessel vasculitis: preliminary data on 25 patients
Objective: To evaluate the predictive value of clinical and biochemical features when compared to 18FDG-PET in the diagnostic work-up of large vessel vasculitis (LVV). Methods: Twenty-five patients underwent 18FDG-PET for the clinical suspect of LVV. All of them presented history of systemic symptoms lasting â„6 months and laboratoristic evidence of persistently high markers of inflammation. The patients were stratified according with: i) clinical manifestations, defined as presence of one or more ACR criteria for the classification of LVV; ii) laboratory investigations: Erythrocyte Sedimentation Rate (ESR) higher or lower than 50 mm/h, C-Reactive Protein (CRP) higher or lower than 2 mg/dl; iii) prednisone dose in the 4 weeks preceding PET examination. Results: The total number of positive PET was higher in the group without clinical ACR criteria and in the group with inflammation markers under the established cut-off. The number of scans consistent with LVV was higher in the groups presenting one or more clinical criteria for LVV but in those with very high ESR and CRP. In all the cases differences between groups were not statistically significative. A clear cut negative correlation between steroid dose and number of scans suggestive for LVV has been observed. Conclusions: Diagnosis of LVV remains challenging, especially in patients presenting with a constellation of non-specific symptoms and laboratory findings. In this study, both clinical and biochemical features show low correlation with a vasculitic pattern of FDG uptake. In our experience 18FDG-PET represents an useful diagnostic tool in early stages of LVV and a powerful instrument to follow the treatment responses
Down syndrome-recent progress and future prospects
Down syndrome (DS) is caused by trisomy of chromosome 21 (Hsa21) and is associated with a number of deleterious phenotypes, including learning disability, heart defects, early-onset Alzheimer's disease and childhood leukaemia. Individuals with DS are affected by these phenotypes to a variable extent; understanding the cause of this variation is a key challenge. Here, we review recent research progress in DS, both in patients and relevant animal models. In particular, we highlight exciting advances in therapy to improve cognitive function in people with DS and the significant developments in understanding the gene content of Hsa21. Moreover, we discuss future research directions in light of new technologies. In particular, the use of chromosome engineering to generate new trisomic mouse models and large-scale studies of genotype-phenotype relationships in patients are likely to significantly contribute to the future understanding of DS
First bounds on the very high energy gamma-ray emission from Arp 220
Using the Major Atmospheric Gamma Imaging Cherenkov Telescope (MAGIC), we
have observed the nearest ultra-luminous infrared galaxy Arp 220 for about 15
hours. No significant signal was detected within the dedicated amount of
observation time. The first upper limits to the very high energy -ray
flux of Arp 220 are herein reported and compared with theoretical expectations.Comment: Accepted for publication in Ap
MAGIC observations of very high energy gamma-rays from HESS J1813-178
Recently, the HESS collaboration has reported the detection of gamma-ray
emission above a few hundred GeV from eight new sources located close to the
Galactic Plane. The source HESS J1813-178 has sparked particular interest, as
subsequent radio observations imply an association with SNR G12.82-0.02.
Triggered by the detection in VHE gamma-rays, a positionally coincident source
has also been found in INTEGRAL and ASCA data. In this Letter we present MAGIC
observations of HESS J1813-178, resulting in the detection of a differential
gamma-ray flux consistent with a hard-slope power law, described as dN/(dA dt
dE) = (3.3+/-0.5)*10^{-12} (E/TeV)^{-2.1+/-0.2} cm^(-2)s^(-1)TeV^(-1). We
briefly discuss the observational technique used, the procedure implemented for
the data analysis, and put this detection in the perspective of multifrequency
observations.Comment: Accepted by ApJ Letter
Constraints on the steady and pulsed very high energy gamma-ray emission from observations of PSR B1951+32/CTB 80 with the MAGIC Telescope
We report on very high energy gamma-observations with the MAGIC Telescope of
the pulsar PSR B1951+32 and its associated nebula, CTB 80. Our data constrain
the cutoff energy of the pulsar to be less than 32 GeV, assuming the pulsed
gamma-ray emission to be exponentially cut off. The upper limit on the flux of
pulsed gamma-ray emission above 75 GeV is 4.3*10^-11 photons cm^-2 sec^-1, and
the upper limit on the flux of steady emission above 140 GeV is 1.5*10^-11
photons cm^-2 sec^-1. We discuss our results in the framework of recent model
predictions and other studies.Comment: 7 pages, 7 figures, replaced with published versio
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