Management of Chronic Staphylococcal Osteomyelitis of the Temporal Bone: The Use of Hyperbaric Oxygen

Hyperbaric oxygen (HBO) is an effective adjunct in the management of selected otolaryngologic problems including radiation-induced necrosis of the temporal hone, malignant external otitis, mandibular osteoradionecrosis and refractory osteomyelitis, soft tissue head and neck necrotizing fasciitis, compromised skin flaps and grafts, acute air or gas embolism, and otologic barotrauma. We describe the management of a patient with insidious Staphylococcus aureus osteomyelitis of the temporal bone by the use of HBO preoperatively and postoperatively in conjunction with surgical debridement. The possible application of angiogenic agents and tetracycline hone-labeling in combination with HBO therapy in the management of refractory neurotologic disease is discussed

Malignant and Nonmalignant Gene Signatures in Squamous Head and Neck Cancer

Genetic events specific to the pathogenesis of malignancy can offer clues to the tumorigenesis process. The objective of this study was to identify gene alterations that differentiate tumor and nontumor lesions in squamous head and neck cancer (HNSCC). DNA from 220 primary HNSCC with concurrently present tumor and nontumor lesions from the same patient was interrogated for genomic alterations of loss or gain of copy. Conditional logistic regression dealt with tumor and non-tumor records within a patient. Of 113 genes, 53 had univariate effects (P < 0.01), of which 16 genes remained in the multivariable model with P < 0.01. The model had a C-index (ROC) of 0.93. Loss of CDKN2B and gain of BCL6, FGF3, and PTP4A3 predicted tumor. Loss of BAK1 and CCND1 and gain of STCH predicted nontumor. This highly powered model assigned alterations in 16 genes specific for malignant versus nonmalignant lesions, supporting their contribution to the pathogenesis of HNSCC as well as their potential utility as relevant targets for further evaluation as markers of early detection and progression

Análise da Realização de Educação Ambiental em uma Rede Pública de Ensino: Contribuições de um Modelo Permanente e Coletivo

Environmental Education (EE) should be permanently and interdisciplinarly inserted in school curricula, promoting good environmental practices to students. When they experience environmental practices, they can acquire skills and criticality to act appropriately, at the environmental level. It is understood that the teachers involved in these processes are fundamental for the success of the activities. However, many EE activities occur in a decontextualized manner, limited to a theoretical or specific approach to environmental issues. It is important to check the way in which EE happens, especially in public education, evaluating its practices and results for school communities. This study verified the EE carried out in the Municipal Teaching Network of Novo Hamburgo/Brazil, with questionnaires and interviews applied to teachers. In this public network there is a teaching group in permanent formation in EE, called Collective Environmental Educator. The most frequent educational practices are associated with waste, the cultivation of vegetable gardens and the interaction between students and nature. These actions are well accepted by the community and result in improvements in the school environment. Some activities were observed that result in the solution of environmental problems of the communities involved. However, most of the actions carried out are limited to proposals for raising awareness, important for the area, but incipient in terms of solving local environmental problems. It is perceived the need for greater theoretical and reflective deepening in these formations, in order to understand and approach the environmental theme in all its breadth. The organization of these activities in the form of a Teaching Network, through the Collective Environmental Educator, can be a model for the development of EE in public education networks.A Educação Ambiental (EA) deve ser inserida permanente e interdisciplinarmente nos currículos escolares, promovendo boas práticas ambientais aos estudantes. Quando estes vivenciam práticas ambientais, podem adquirir competências e criticidade para agirem adequadamente, no plano ambiental. Compreende-se que os docentes envolvidos nestes processos são fundamentais para o sucesso das atividades. Porém, muitas atividades de EA ocorrem de maneira descontextualizada, limitando-se a uma abordagem teórica ou pontual dos temas ambientais. É importante verificar a maneira como a EA acontece, especialmente no ensino público, avaliando suas práticas e resultados para as comunidades escolares. Este estudo verificou a EA realizada na Rede Municipal Ensino de Novo Hamburgo/Brasil, com questionários e entrevistas aplicados à professores. Nesta rede pública há um grupo docente em formação permanente em EA, denominado Coletivo Educador Ambiental. As práticas educativas mais frequentes são associadas aos resíduos, ao cultivo de hortas e a interação entre estudantes e natureza. Essas ações possuem boa aceitação da comunidade e resultam em melhorias no ambiente escolar. Observaram-se algumas atividades que resultam na solução de problemas ambientais das comunidades envolvidas. No entanto, a maioria das ações realizadas limitam-se à propostas de conscientização ou sensibilização, importantes para a área, porém incipientes sob o ponto de vista da resolução de problemas ambientais locais. Percebe-se a necessidade de maior aprofundamento teórico e reflexivo nestas formações, de modo que se compreenda e aborde a temática ambiental em toda sua amplitude. A organização destas atividades sob a forma de Rede de Ensino, por meio do Coletivo Educador Ambiental, pode ser um modelo para o desenvolvimento da EA nas redes públicas de ensino

FORMAÇÃO INICIAL E CONTINUADA DE PROFESSORES DO COLETIVO EDUCADOR AMBIENTAL DE NOVO HAMBURGO/RS E SUA PERCEPÇÃO SOBRE AS PRÁTICAS EDUCATIVAS AMBIENTAIS REALIZADAS

RESUMOAs práticas de Educação Ambiental (EA) devem ser inseridas permanentemente e de maneira interdisciplinar nos currículos escolares, promovendo boas práticas ambientais aos estudantes. Quando estes educandos vivenciam práticas ambientais adequadas, podem adquirir competências e criticidade para agirem adequadamente, no plano ambiental. Compreende-se que os docentes envolvidos nestes processos são fundamentais para o sucesso das atividades. Torna-se importante verificar a maneira como a EA acontece, fundamentalmente no ensino público. O presente trabalho verificou a formação docente dos profissionais envolvidos com EA realizada na Rede Municipal de Ensino de Novo Hamburgo/RS, com questionários. Nesta rede pública há um grupo docente em formação permanente em EA, denominado Coletivo Educador Ambiental, do qual fazem parte os professores participantes da pesquisa. Foi verificada também a percepção destes docentes referente às práticas educativas ambientais realizadas, no âmbito do Coletivo Educador. O grupo entrevistado percebe as ações de EA desenvolvidas positivamente, em sua maioria, considerando que as mesmas fazem diferença nas comunidades envolvidas. Verifica-se a demanda por ações mais práticas e contínuas e a necessidade de condições favoráveis à realização da EA. Concluiu-se que desenvolver a EA por meio de um grupo docente em formação permanente, promovendo estas ações enquanto rede de ensino, é uma boa alternativa de inserção da EA na rede pública. Esta formatação atende duas orientações presentes tanto na Política Nacional de EA quanto nas Diretrizes Curriculares Nacionais para a EA: formação permanente dos recursos humanos envolvidos e o desenvolvimento de atividades permanentes e interdisciplinares, sem uma disciplina específica para esta finalidade.Palavras-chave: Coletivo educador. Educação ambiental. Ensino público. Formação docente. Práticas educativas ambientais.ABSTRACTEnvironmental Education (EE) practices should be inserted permanently and interdisciplinarily in school curricula, promoting good environmental practices for students. When these learners experience appropriate environmental practices, they can acquire the skills and criticality to act appropriately, in the environmental field. It is understood that the teachers involved in these processes are fundamental to the success of the activities. It becomes important to check how EA happens, fundamentally in public education. The present study verified the teacher training of the professionals involved with EE carried out in the Teaching Network of Novo Hamburgo/RS, with questionnaires. In this public network there is a teaching group in permanent formation in EE, called Collective Environmental Educator, which includes the participating teachers of the research. It was also verified the perception of these teachers regarding the environmental educational practices carried out, within the scope of the Educative Collective. The interviewed group perceives the actions of EE developed positively, in the majority, considering that they make a difference in the communities involved. There is a demand for more practical and continuous actions and the need for favorable conditions for EE. It was concluded that the development of EE through a teaching group in permanent formation, promoting these actions as a teaching network, is a good alternative for the insertion of EE into the public network. This format meets two guidelines in both the National EE Policy and the National Curricular Guidelines for EE: permanent training of the human resources involved and the development of permanent and interdisciplinary activities, without a specific discipline for this purpose.Keywords: Collective educator. Environmental education. Public education. Teacher training. Environmental education practices

The Built Environment and Universal Design: Are Architectural Competitions a Qualified Instrument to a Better Consideration of the Diversity Dimension Impairment?

Procedures of building planning and delivery are of crucial importance in generating better and more inclusive built enviroments (named “architecture” from here on) following the idea of Design for All/Universal Design. In contrast to other “products” of the everyday life, architecture is comparably complex in generation and maintenance, given the multitude of stakeholders involved in generation and operation, the longevity of interventions, the involved cost, and its role in ecological, economical and social dimension of mankind. Needless to say, architecture has a significant impact on society aspects, and thus also on the different diversity dimensions of societies. To ensure high quality in interventions toward the built enviroment, the instrument “architectural competitions” has been established decades, if not centuries ago. Today, usual architectural competitions target the call for high-quality design ideas or suggestions for specific requirements within the built enviroment. Architectural competitions differ in their scope, their procedural and organisational structure, the number of competition entries, and other methodological aspects. Typical timeframes for architectural competitions take 6 to 8 weeks of preperation work and 8 to 15 weeks of time for competition entry developments, and – in most cases – the winning project is intented to be realized/built. This paper presents concept, method, and results of an empirical study pertaining to the relation of architectural competitions and the consideration of Universal Design/Design for All aspects within the competition. Thereby, both the call for entries and the overall provided information, as well as a comparable large number of competition entries was examined in a structured process: In a first step, we generated a checklist template that targeted different aspects related to Universal Design/Design for All in the framework of the competition call for tender. The checklist was also adapted for evaluation of aspects of Design for All within examined competition entries. In a second step, recently conducted architectural competitions were selected. For these competitions we collected both the call for tender documents, as well as selected competition entries. Subsequently, the checklist was applied on the collected data, to generate both quantitative results and to identify good and bad practices regarding the consideration of universal design aspects within the competitions. 15 different architectural competitions and 76 competition entries were analyzed. The consideration of Universal Design aspects in the entries happened mostly rudimentary, but some specific best practice and worst practice cases could be identified. A major finding of the overall evaluation procedure is that – disappointingly – there is a lot of improvement potential for a better consideration of Design for All/Universal Design aspects in this early phase of building delivery processes

Abordagens cirúrgicas em mulheres com câncer de colo uterino: aspectos técnicos e epidemiológicos em um país da América Latina

The objective of this study is to disassemble, to expose, through scientific articles and government exposure, the main surgical techniques for the treatment of cervical-uterine cancer. And as a secondary objective, to analyze the epidemiology of the disease in Brazil. An in-depth search of articles was carried out in the Scientific Electronic Library Online (SciELO) and PubMed databases, with the following Health Sciences Descriptors (DeCS): Uterine cancer; Neoplasm; Malignancy. Articles were selected between the periods of 2018 to 2023, in Portuguese, to increase the level of relevance and quality of the review, given the scarcity of scientific studies on the subject. It is concluded from the analysis of these studies that the early detection of cervical cancer and the appropriate treatment, according to each case, can completely solve the complications of the disease. The choice of the best surgical procedure in the context of oncological surgery should be guided by the existing conditions and attributed to adjuvant therapies, for better results.El objetivo de este estudio es desmontar, exponer, a través de artículos científicos y exposición gubernamental, las principales técnicas quirúrgicas para el tratamiento del cáncer cérvico-uterino. Y como objetivo secundario, analizar la epidemiología de la enfermedad en Brasil. Se realizó una búsqueda exhaustiva de artículos en las bases de datos Scientific Electronic Library Online (SciELO) y PubMed, con los siguientes Descriptores de Ciencias de la Salud (DeCS): cáncer de útero; Neoplasma; Malignidad. Los artículos fueron seleccionados entre los períodos de 2018 a 2023, en portugués, para aumentar el nivel de relevancia y calidad de la revisión, dada la escasez de estudios científicos sobre el tema. Del análisis de estos estudios se concluye que la detección precoz del cáncer de cérvix y el tratamiento adecuado, según cada caso, pueden solucionar por completo las complicaciones de la enfermedad. La elección del mejor procedimiento quirúrgico en el contexto de la cirugía oncológica debe estar guiada por las condiciones existentes y atribuida a las terapias adyuvantes, para mejores resultados.Objetivo desse estudo é desmontar, é expor, por meio de artigos científicos e exposição governamentais, as principais técnicas cirúrgicas para o tratamento de câncer cérvico-uterino. &nbsp;E como objetivo secundário, analisar a epidemiologia da doença no Brasil. Foi realizada uma profunda pesquisa de artigos nas bases de dados Scientific Electronic Library Online (SciELO) e PubMed, com os seguintes Descritores em Ciências da Saúde (DeCS): Uterine cancer; Neoplasm; Malignancy. Foram selecionados artigos entre os períodos de 2018 a 2023, no idioma Português, para ampliar o nível de relevância e a qualidade da revisão, visto a escassez de estudos científicos sobre a temática. Conclui-se com a análise desses estudos que, a detecção precoce do câncer de colo de útero e o tratamento adequado, de acordo com cada caso, pode solucionar completamente as complicações da doença. A escolha do melhor procedimento cirúrgico no âmbito da cirurgia oncológica, deve ser instruída pelas condições existentes e atribuída a terapias adjuvantes, para melhores resultados

Identification of regulatory variants associated with genetic susceptibility to meningococcal disease.

Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes

Photofrin-mediated photodynamic therapy for treatment of early stage laryngeal malignancies

To evaluate the efficacy of PHOTOFRINmediated photodynamic therapy (PDT) for the treatment of Tis-T1N0M0 squamous cell carcinoma (SqCCa) of the larynx in patients not amenable to or who failed conventional head and neck treatment. This is a retrospective study of 26 patients with early stage Tis-T1 SqCCa of the larynx treated with PHOTOFRIN-mediated PDT. Intravenous PHOTOFRIN (porfimer-sodium) (dose 2.0 mg/kg) was administered outpatient, followed by intraoperative photoactivation at 630 nm via fiberoptic microlens surface delivery (surgical light dose 50–100 J/cm2) 48–60 h later. As much as 16 out of 26 patients (62%) have demonstrated complete remission (average follow-up 40 months). There were 10 patients who were noted to have partial remission with recurrence observed 2–33 months subsequently retreated with either repeated PDT therapy or conventional therapy. PHOTOFRIN-mediated photodynamic therapy can be used as a primary modality to treat Tis-T1N0M0 tumors of the larynx or for treatment for those who have failed prior surgery and/or radiation therapy. PDT allows for preservation of function and structure to maintain or improve voice with absence of systemic toxicity. Patients may have multiple drug administrations and laser light retreatment for local disease control