998 resultados para Ellsworth
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Part 4, Fishes-Plates
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Part 3, Reptiles-Plates
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Part 1, Mammalia
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Part 6, Crustacea
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Part 4, Fishes-Text
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Part 5, Mollusca
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BACKGROUND: The risk/benefit profile of intravitreal melphalan injection for treatment of active vitreous seeds in retinoblastoma remains uncertain. We report clinical and electroretinography results after 6 months of one patient who has shown a favorable initial clinical response to intravitreal melphalan injections for treatment of refractory vitreous seeds. METHODS: Clinical case report. PATIENT: The patient presented at age 17 months with bilateral retinoblastoma [OD: International Classification (ICRB) group E, Reese-Ellsworth (R-E) class Vb; OS: ICRB D, R-E Vb] with no known prior family history. The right eye was enucleated primarily. The patient received systemic chemotherapy and extensive local treatment to the left eye. Ten months later, she presented with recurrent disease, including fine, diffuse vitreous seeds. Tumor control was established with intra-arterial chemotherapy and local treatment. Subsequent recurrence was treated with further intra-arterial chemotherapy, local treatment, and plaque radiotherapy with iodine-125. Persistent free-floating spherical vitreous seeds were treated with 4 cycles of intravitreal melphalan injection via the pars plana, with doses of 30, 30, 30, and 20 μg. RESULTS: After 6 months of follow-up, the left eye remained free of active tumor. Visual acuity was 20/40. Photopic ERGs amplitudes were unchanged compared with those recorded prior to the intravitreal injection treatments. CONCLUSIONS: Intravitreal melphalan injection for refractory spherical vitreous seeds of retinoblastoma with favorable tumor response is compatible with good central visual acuity and preservation of retinal function as indicated by photopic ERG recordings.
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Background Surgery of radiation-induced cataracts in children with retinoblastoma (RB) is a challenge as early intervention is weighted against the need to delay surgery until complete tumour control is obtained. This study analyses the safety and functional results of such surgery. Methods In a retrospective, non-comparative, consecutive case series, we reviewed medical records of RB patients </=14 y of age who underwent either external beam radiotherapy or plaque treatment and were operated for radiation-induced cataract between 1985 and 2008. Results In total, 21 eyes of 20 RB patients were included and 18 out of the 21 eyes had Reese-Ellsworth stage V or ABC classification group D/E RB. Median interval between last treatment for RB and cataract surgery was 21.5 months, range 3-164 months. Phacoaspiration was performed in 13 eyes (61%), extra-capsular cataract extraction in 8 (39%) and intraocular lens implantation in 19 eyes (90%). The majority of cases, 11/21 (52%), underwent posterior capsulorhexis or capsulotomy and 6/21 (28%) an anterior vitrectomy. Postoperative visual acuity was >/=20/200 in 13 eyes and <20/200 in 5 eyes. Intraocular tumour recurrence was noted in three eyes. Mean postoperative follow up was 90 months+/-69 months. Conclusions Modern cataract surgery, including clear cornea approach, lens aspiration with posterior capsulotomy, anterior vitrectomy and IOL implantation is a safe procedure for radiation-induced cataract as long as RB is controlled. The visual prognosis is limited by initial tumour involvement of the macula and by corneal complications of radiotherapy. We recommend a minimal interval of 9 months between completion of treatment of retinoblastoma and cataract surgery.
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Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained THIS WEEK: Iowa State Capitol and the Library of Congress Feature Artist’s Work BACKGROUND: Elmer Ellsworth Garnsey was primarily a muralist who painted on the East Coast from a studio in New York City. He was born in Holmdel, New Jersey, and took art training at the Art Students League and Cooper Union. Affiliations included the National Society of Mural Painters and the American Federation of the Arts. His work is in the Library of Congress, Boston Public Library, Memorial Hall at Yale University, City Art Museum of St. Louis, U.S. Custom House in New York City, and the State Capitol in Iowa.
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BACKGROUND: Although intra-retinal tumor has long been staged presurgically according to the Reese-Ellsworth (R-E) system, retinoblastoma differs from other pediatric neoplasms in never having had a widely accepted classification system that encompasses the entire spectrum of the disease. Comparisons among studies that consider disease extension, risk factors for extra-ocular relapse, and response to therapy require a universally accepted staging system for extra-ocular disease. PROCEDURE: A committee of retinoblastoma experts from large centers worldwide has developed a consensus classification that can encompass all retinoblastoma cases and is presented herein. Patients are classified according to extent of disease and the presence of overt extra-ocular extension. In addition, a proposal for substaging considering histopathological features of enucleated specimens is presented to further discriminate between Stage I and II patients. RESULTS: The following is a summary of the classification system developed-Stage 0: Patients treated conservatively (subject to presurgical ophthalmologic classifications); Stage I: Eye enucleated, completely resected histologically; Stage II: Eye enucleated, microscopic residual tumor; Stage III: Regional extension [(a) overt orbital disease, (b) preauricular or cervical lymph node extension]; Stage IV: Metastatic disease [(a) hematogenous metastasis: (1) single lesion, (2) multiple lesions; (b) CNS extension: (1) prechiasmatic lesion, (2) CNS mass, (3) leptomeningeal disease]. A proposal is also presented for substaging of enucleated Stages I and II eyes. CONCLUSIONS: The proposed staging system is the product of an international effort to adopt a uniform staging system for patients with retinoblastoma to cover the whole spectrum of the disease.
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This qualitative study explores practicing teachers' experiences of teaching in classrooms of diversity, that is, classrooms where students represent a variety of differences including race, culture, ethnicity, and class. More specifically, this study investigates the types of curricular and pedagogical practices teachers employ in their classrooms. This study attempts to make a contribution to the scholarship of critical pedagogy by drawing upon the works of critical pedagogues to make sense of participants' descriptions oftheir curricular and pedagogical practices. Four participants were involved in this study. Participants were elementary teachers in classrooms of difference in Ontario who contributed the primary sources of data by engaging in 2 individual interviews. Additional sources of data included a focus group meeting that 2 ofthe participants were able to attend, school board curriculum resource documents assisting teachers in teaching critically, as well as a research journal which the researcher kept throughout the study. The scholarship of critical pedagogy (Ellsworth, 1992; Giroux, 1993; McLaren, 1989) informs the analysis of participants' descriptions of their teaching experiences. Many of the participants did not engage in a practice of critical pedagogy. This study explores some of the challenges and possibilities of using critical pedagogy to create spaces in classrooms where teachers can build connections between the curriculum mandated by the government and the multiple identities and experiences that students bring into the classroom. This study concludes with a discussion on what teachers need to know to be able to begin creating equitable and educational experiences in classrooms of difference.
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El traumatismo craneoencefálico, es la epidemia silenciosa de nuestra época, que genera gastos en salud, en países como Estados Unidos, cercanos a los 60 billones de dólares anuales, y cerca de 400 billones en rehabilitación de los discapacitados. El pilar del manejo médico del trauma craneoencefálico moderado o severo, es la osmoterapia, principalmente con sustancias como el manitol y las soluciones hipertónicas. Se realizó la revisión de 14 bases de datos, encontrando 4657754 artículos, quedando al final 40 artículos después de un análisis exhaustivo, que se relacionaban con el manejo de la hipertensión endocraneana y terapia osmótica. Resultados: Se compararon diferentes estudios, encontrando gran variabilidad estos, sin homogenización en los análisis estadísticos, y la poca rigurosidad no permitieron, la recolección de datos y la comparación entre los diferentes estudios, no permitió realizar el meta-análisis y por esto se decidió la realización de una revisión sistemática de la literatura. Se evidenció principalmente tres cosas: la primera es la poca rigurosidad con la que se realizan los estudios clínicos; la segunda, es que aún falta mucha más investigación principalmente, la presencia de estudios clínicos aleatorizados multicéntricos, que logren dar una sólida evidencia y que genere validez científica que se requiere, a pesar de la evidencia clara en la práctica clínica; la tercera es la seguridad para su uso, con poca presencia de complicaciones para las soluciones salinas hipertónicas.
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Determina la relación entre el fenómeno educativo y los procesos de movilidad social y sostiene que las clases medias y bajas, aunque accedan a niveles superiores, no logran fácilmente obtener esas posiciones de privilegio. Analiza un estudio reciente en los Estados Unidos sobre los jefes en las grandes empresas, e indica la relación entre educación y éxito en los negocios. Analiza por qué la movilidad vertical por medio de la educación superior, es cada vez más un problema de dotación proporcionada por aportaciones privadas y de ayuda financiera distribuida por las mismas instituciones; los beneficios y ventajas que reciben las grandes Sociedades de sus donativos para el sostenimiento de los programas de escolaridad, por reclutar entre los graduados en los colegios y las Universidades los jefes de empresas.
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Current forest Free Air CO2 Enrichment (FACE) experiments are reaching completion. Therefore, it is time to define the scientific goals and priorities of future experimental facilities. In this opinion article, we discuss the following three overarching issues (i) What are the most urgent scientific questions and how can they be addressed? (ii) What forest ecosystems should be investigated? (iii) Which other climate change factors should be coupled with elevated CO2 concentrations in future experiments to better predict the effects of climate change? Plantations and natural forests can have conflicting purposes for high productivity and environmental protection. However, in both cases the assessment of carbon balance and how this will be affected by elevated CO2 concentrations and the interacting climate change factors is the most pressing priority for future experiments.