KRAS insertions in colorectal cancer: What do we know about unusual KRAS mutations?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Before dividing we have to add: inter-viewing the foregrounds of indigenous students

Students' cultural diversity is an important factor to consider in a mathematics education concerned with equity. We argue that the significance of mathematics education is not only given by the understanding of mathematical concepts but also by students' foreground, that is, the students' perception of their future possibilities in life as made apparent to the individual by his/her social-political context. For students in a cultural borderline position, different reasons and intentions for engaging in mathematics learning may be related to the construction of meaning in mathematics. Through inter-viewing Brazilian Indian students' foreground, we illuminate the different types of significance given to mathematics education in their particular situation.

Why Are We Writing? This is Math Class!

In this action research study of my classroom of 8th grade mathematics, I investigated writing in the content area. I have realized how important it is for students to be able to communicate mathematical thoughts to help gain a deeper understanding of the content. As a result of this research, I plan to enforce the use of writing thoughts and ideas regarding math problems. Writers develop skills and generate new thoughts and ideas every time they sit down to write. Writing evolves and grows with ongoing practice, and that means thinking skills mature along with it. Writing is a classroom activity which offers the possibility for students to develop a deeper understanding of the mathematics they are learning. Writing encourages students to reflect on and explore their reasoning and to extend their thinking and understanding. Students are often content with manipulating symbols and doing routine math problems, without ever reaching a deep and personal understanding of the material. My goal through this project was to help students understand why they were doing certain operations to solve math problems. Writing is an essential tool for thinking and is fundamental in every class, in every subject, and on every level of thinking; skills in writing must be practiced and refined, and students must have frequent opportunities to write across the curriculum. Communication in mathematics is not a simple and unambiguous activity.

URBAN WILDLIFE: CAN WE LIVE WITH THEM?

ABSTRACT: A survey of Extension Wildlife Specialists in the U.S. provided a basis for estimating the magnitude of urban wildlife damage and control in this country. Response to the 9-question mail questionnaire was good (76 percent) following the single mailing to all Extension Wildlife Specialists or people in similar positions listed in the national directory. The majority of questions were answered based upon the experiences and best estimates of these specialists for the interval October 1986-September 1987. Specialists had difficulty providing estimates of damage and costs of prevention and control; 57 percent were not able to provide any data on these topics. Several of the questions dealt with attitudes of people requesting urban wildlife information and/or assistance and wide ranges of responses were received to most of these questions. Most people (78 percent) appeared willing to implement prevention/control measures recommended by these specialists, more than half (61 percent) wanted the animal handled/removed by someone else, and only about 40 percent wanted the damage stopped regardless of cost. Also, slightly over half (55 percent) of clientele represented did not want the offending animal harmed in any way. These results were highly variable from state to state. Several differences were noted in overall responses regarding urban wildlife species. Requests for information were received most frequently for bats and snakes, but both of these groups of animals ranked very low in terms of actual damage reported. The most frequently mentioned groups of animals causing damage in urban areas were roosting birds (including pigeons, starlings, and sparrows), woodpeckers (especially flickers), tree squirrels, bats, and moles. In terms of actual dollar values of damage done, white-tailed deer and pocket gophers apparently caused the most estimated damage. Due to these differences, it is necessary to know which criteria are being used to make an assessment of the relative importance of animal damage control problems. Techniques for controlling urban wildlife damage, such as exclusion, live-trapping, repellents, and poisons, are compared and discussed in some detail in this paper. As urbanization occurs across the nation, concerns about urban wildlife damage will continue; in most cases, we can and will live among these creatures.

Monitoring Drug Use Among HIV/AIDS Patients in Brazil: Should we Combine Self-Report and Urinalysis?

Illicit drug use in HIV-infected patients can be linked to impairment of physical and mental health, low health-related quality of life, and suboptimal adherence to HIV treatment. This study aimed to evaluate the correlation of self-report illicit drug use, urinalysis for cocaine and cannabis metabolites, and severity of dependence among HIV-infected patients on antiretroviral therapy (ART) in a treatment center in Brazil. Four hundred and thirty-eight outpatients of an HIV referral center were interviewed and assessed for drug use (lifetime, last year and last month). Urinalysis was performed to detect the presence of cocaine and cannabis metabolites in urine samples. Overall agreement between self-report and urinalysis was almost 68% for cannabis and higher than 85% for cocaine. Positive urinalysis was significantly associated with more than once a week cannabis (p < .0001) and cocaine (p <.0001) use during the last-month. Severity of Dependence Scale (SDS) properly predicted positive cocaine urinalysis results (area under the curve [AUC] = .81, p = .0001). Frequency of cannabis and cocaine use, SDS score degree and positive urinalysis for both drugs were correlated. Our findings suggest that positive self-report is a reliable predictor of positive urine sample both for cannabis and cocaine, but since the agreement was not perfect, there is a role for urine drug screening in the care of patients with HIV-related conditions.

Coronary to Bronchial Artery Fistula: Are We Treating it Right?

Fistulas between coronary artery and bronchial artery may be present from birth, with few hemodynamic consequences, and may remain closed due to similarity of the filling pressures at these 2 sites.(1) They can also be secondary to pulmonary artery occlusive disease or chronic pulmonary inflammation.(2,3) These pulmonary changes may cause a dilation of the fistula and make it functional, causing angina pectoris by coronary steal syndrome, which is the most common symptom. The presentation may also be composed of episodes of hemoptysis, heart failure, and infective endocarditis. However, most patients remain asymptomatic. The ones that need treatment may not have a good response to the medical management, requiring an intervention. This can be done using embolization coils, stents grafts, and performing surgical ligation of the fistulas.(2-4) J INVASIVE CARDIOL 2012;24(11):E303-E304

Why do we not find polyps in the lungs? Bronchial mucosa as a model in the treatment of polyposis

The link between lower and upper airways has been reported since the beginning of 1800s. They share the same pseudostratified ciliated columnar epithelium lining and the concept of one airway, one disease is quite well widespread. Nasal polyposis and asthma share basically the same inflammatory process: predominant infiltration of eosinophils, mucus cell hyperplasia, edema, thickened basal membrane, polarization for Th2 cell immune response, similar pro-inflammatory mediators are increased, for example cysteinyl leukotrienes. If the lower and upper airways share a lot of common epithelial structural features so why is the edema in the nasal mucosa able to increase so much the size of the mucosa to the point of developing polyps? The article tries to underline some differences between the nasal and the bronchial mucosa that could be implicated in this aberrant change from normal mucosa to polyps. This paper creates the concept that there are no polyps with the features of nasal polyposis disease in the lower airway and through it is developed the hypothesis of the nasal polyps origin could partially lie on the difference between the upper and lower airway histology. (C) 2012 Elsevier Ltd. All rights reserved.

Whither lung EIT: Where are we, where do we want to go and what do we need to get there?

Breathing moves volumes of electrically insulating air into and out of the lungs, producing conductivity changes which can be seen by electrical impedance tomography (EIT). It has thus been apparent, since the early days of EIT research, that imaging of ventilation could become a key clinical application of EIT. In this paper, we review the current state and future prospects for lung EIT, by a synthesis of the presentations of the authors at the 'special lung sessions' of the annual biomedical EIT conferences in 2009-2011. We argue that lung EIT research has arrived at an important transition. It is now clear that valid and reproducible physiological information is available from EIT lung images. We must now ask the question: How can these data be used to help improve patient outcomes? To answer this question, we develop a classification of possible clinical scenarios in which EIT could play an important role, and we identify clinical and experimental research programmes and engineering developments required to turn EIT into a clinically useful tool for lung monitoring.

Can we predict which patients will evolve to chronic kidney disease after nephrectomy for cortical renal tumors?

Introduction: While some studies show that patients submitted to radical nephrectomy have a higher risk of developing chronic kidney disease (CKD), some studies report that carefully selected living kidney donors do not present a higher risk for CKD. Here, we aim to study predictive factors of CKD after radical nephrectomy. Materials and Methods: Between January 2006 to January 2010, 107 patients submitted to radical nephrectomy for cortical renal tumors at our institution were enrolled in this study. Demographic data were recorded, modified Charlson-Romano Index was calculated, and creatinine clearance was estimated using abbreviated Modification of Diet in Renal Disease (MDRD) study equation. Pathological characteristics, surgical access and surgical complications were also reviewed. The end-point of the current study was new onset estimated glomerular filtration rate (eGFR) less than 60 and less than 45 mL/minute/1.73 m(2). Results: Age, preoperative eGFR, Charlson-Romano Index and hypertension were predictive factors of renal function loss, when the end-point considered was eGFR lower than 60 mL/minute/1.73 m(2). Age and preoperative eGFR were predictive factors of renal function loss, when the end-point considered was eGFR lower than 45 mL/minute/1.73 m2. Moreover, each year older increased 1.1 times the risk of eGFR lower than 60 and 45 mL/minute/1.73 m(2). After multivariate logistic regression, only age remained as an independent predictive factor of eGFR loss. Conclusion: Age is an independent predictive factor of GFR loss for patients submitted to radical nephrectomy for cortical renal tumors.

Melanoma Staging Where Are We Now?

The seventh version of the American Joint Committee on Cancer (AJCC) Melanoma Staging guidelines, published in 2009, has significant revisions compared with the previous version. The current schema was based on the largest melanoma patient cohort analyzed to date and is the result of a multivariate analysis of 30,946 patients with stages I, II, and III melanoma and 7972 patients with stage IV melanoma. This article summarizes the findings and the new definitions included in the 2009 AJCC Melanoma Staging and Classification. The TNM categories and the stage groupings are defined. Changes in the melanoma staging system are summarized.