Large bilateral adrenal metastases in non-small cell lung cancer

BACKGROUND: The adrenal gland is one of the common sites of metastasis from primary lung cancer. Adrenal metastases are usually unilateral however bilateral adrenal metastases are seen in 10% of all lung cancer patients; of these 2–3% occurs at the initial presentation of non-small cell lung cancer. Secondary tumors can disrupt the structure and function of the adrenal. This can lead to adrenal hemorrhage, which constitutes a life threatening hazard for the patient. CASE PRESENTATION: A 59-year-old male presented with persisting abdominal pain. His initial work-up revealed significant anemia, an invasive process in the right upper lobe of the lung and large masses of heterogeneous texture, with hemorrhagic and necrotic elements in both adrenal glands. A biopsy confirmed it to be a large-cell carcinoma of the lungs. The patient developed severe leukocytosis akin to the paraneoplastic syndrome and died suddenly five days after the administration of chemotherapy. CONCLUSION: Intratumoral hemorrhage is a rare but life threatening complication of adrenal metastases and should be treated as soon as it has been diagnosed. If adrenalectomy is not feasible, combination chemotherapy should be applied as in metastatic disease. For choosing the appropriate chemotherapeutic regimen it is important to accurately achieve the diagnosis

«Οι ομάδες, οι συγκρούσεις στο σχολείο και η επίδρασή τους στη λήψη των αποφάσεων του συλλόγου διδασκόντων»

Η παρούσα εργασία έχει ως σκοπό να συμβάλλει στην έρευνα που αφορά τις διομαδικές συγκρούσεις στο σύλλογο διδασκόντων των σχολικών μονάδων και πως αυτές επιδρούν στη λήψη των αποφάσεων. Στο πλαίσιο αυτό διερευνώνται οι θεωρίες των ομάδων και η ιστορική τους εξέλιξη και η εφαρμογή τους στην εκπαίδευση, τα είδη των ομάδων που δημιουργούνται στις οργανώσεις, οι διομαδικές σχέσεις συνεργασίας, αντα-γωνισμού και σύγκρουσης, οι τύποι των συγκρούσεων στις οργανώσεις και ιδιαίτερα οι πηγές των συγκρούσεων στο χώρο του σχολείου. Επιπλέον διερευνώνται το στυλ διοίκησης, η διαδικασία και τα μοντέλα λήψης απόφασης και ιδιαίτερα οι αιτίες των συ-γκρούσεων στο σχολείο και πως οι συγκρούσεις αυτές επιδρούν στη λήψη των αποφάσεων του Συλλόγου Διδασκόντων. Τέλος πως οι συμμετοχικές αποφάσεις και η από κοινού συμφωνία όλων των ομάδων σε ένα πλαίσιο στρατηγικής για το σχολείο, που θα υλοποιηθεί τα επόμενα χρόνια κατά τη διάρκεια της θητείας του διευθυντή (στόχοι, όραμα, αξίες, κλίμα, κουλτούρα), μπορεί να οδηγήσει σε αποφυγή συγκρούσεων και διάλυση των ομάδων.This dissertation aims to contribute to research on intergroup conflicts in the Teachers' board of schools and how these affect the decision making process. In this context, we explore the theories of groups and their historical development and its application in education, types of groups created in organizations, intergroup cooperation, competition and conflict, types of conflicts in organizations and especially the conflict sources at school. In addition, the management style, process and decision making models, and in particular the causes of conflicts at school, are investigated and how these conflicts af-fect decision making by the Teachers' board. Finally how participatory decisions and the joint agreement of all the groups on a strategic framework for the school, which will be implemented in the coming years during the director's mandate (objectives, vision, val-ues, climate, culture), can lead to avoiding conflicts and dissolving groups

Novos paradigmas para a educação dos superdotados: a questão dos estudantes underachievers e com dupla excepcionalidade

[Extrato] A primeira década do século XXI chegou ao fim marcada pelo desenvolvimento de uma sociedade cada vez mais interconectada, mediada por tecnologias da informação e da comunicação e pelo sentimento de impotência diante da demanda de soluções que a atualidade exige. A contemporaneidade estabelece mudanças que ocorrem de maneira tão veloz, que já não se consegue mais definir, com a devida antecedência, as habilidades e competências necessárias para se viver e conviver satisfatoriamente...info:eu-repo/semantics/publishedVersio

LNCS

We construct a perfectly binding string commitment scheme whose security is based on the learning parity with noise (LPN) assumption, or equivalently, the hardness of decoding random linear codes. Our scheme not only allows for a simple and efficient zero-knowledge proof of knowledge for committed values (essentially a Σ-protocol), but also for such proofs showing any kind of relation amongst committed values, i.e. proving that messages m_0,...,m_u, are such that m_0=C(m_1,...,m_u) for any circuit C. To get soundness which is exponentially small in a security parameter t, and when the zero-knowledge property relies on the LPN problem with secrets of length l, our 3 round protocol has communication complexity O(t|C|l log(l)) and computational complexity of O(t|C|l) bit operations. The hidden constants are small, and the computation consists mostly of computing inner products of bit-vectors

Liver hydatid cyst perforated into the large bowel: a case report

Perforation of the liver hydatid cyst into hollow abdominal organs is an extremely rare complication. A case of two synchronous hydatid cysts in an old lady is presented. The patient had one multilobular cyst perforated into the right colon and another one uncomplicated located at the right ovary. She underwent partial cystectomy, omentoplasty, right hemicolectomy, and total hysterectomy, and had an uneventful recovery

Adjuvant Perioperative Intraperitoneal Chemotherapy in Locally Advanced Colorectal Carcinoma: Preliminary Results

Background and Aims. Intraperitoneal chemotherapy is a basic tool in the treatment of peritoneal malignancy. The purpose of the study is to investigate the effect of adjuvant perioperative intraperitoneal chemotherapy in the treatment of locally advanced colorectal cancer. Patients and Methods. Patients with T3 and T4 colorectal carcinomas that underwent R0 resection received either hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC group = 40 patients) or early postoperative intraperitoneal chemotherapy (EPIC group = 67 patients). The survival, the recurrences and the sites of recurrence were assessed. Results. The 3-year survival rate for HIPEC group was 100% and for EPIC group 69% (P = .011). Nodal infiltration was found to be the single prognostic indicator of survival. The incidence of recurrence in EPIC group was higher than in HIPEC group (P = .009). The independent indicators of recurrence were the use of HIPEC and the degree of differentiation (P < .05). Conclusions. Intraperitoneal chemotherapy, particularly HIPEC, as an adjuvant in locally advanced colorectal carcinomas appears to improve survival and decrease the incidence of recurrence

Preliminary Results of Hyperthermic Intraperitoneal Intraoperative Chemotherapy as an Adjuvant in Resectable Pancreatic Cancer

Background and Aims. 5-year survival in patients with pancreatic cancer is poor. Surgical resection is the only potentially curative resection. The results of adjuvant treatment either with chemotherapy or with radiotherapy have been contradictory and the incidence of local-regional recurrence remains high. If local-regional recurrence is controlled survival may be expected to increase. Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) may be used in order to control local-regional recurrences. The purpose of the study is to identify the effect of HIPEC in patients with pancreatic cancer undergoing potentially resection. Patients and Methods. From 2007–2011, 21 patients, mean age 69.4 ± 9.5 (50–86) years, underwent tumor resection, and HIPEC with gemcitabine. The hospital mortality and morbidity rate was 9.5% and 33.3%, respectively. 5-year and median survival was 23% and 11 months, respectively. The recurrence rate was 50% but no patient developed local-regional recurrence. No patient was recorded with gemcitabine-induced toxicity. Conclusions. This clinical study of 21 patients is the first to combine an R0 pancreas cancer resection with HIPEC. Increased morbidity and mortality from intraoperative gemcitabine was not apparent. Patients with pancreatic cancer undergoing potentially curative resection in combination with HIPEC may be offered a survival benefit. Data suggested that local-regional recurrences may be greatly reduced. Further studies with greater number of patients are required to confirm these findings