We describe the first case of juvenile nasopharyngeal angiofibroma receiving blood supply from caroticotympanic artery which resulted in catastrophic bleeding intraoperatively. The patient was an ...12-year-old boy with a Radkowski stage 3B JNA. We utilized preoperative embolization of feeders from external carotid artery though the surgeon failed to excise the tumor completely due to uncontrollable bleeding from the tumor. On retrospective analysis of angiography only the culprit feeder found. Tumor was excised in the second surgery conducted a week later. Although selective embolization of ICA branches are described in literature the data are sparse and so is the management of such cases.
The book hypothesizes that teaching philosophy needs to be rethought to deal with the urgent times we live in, breaking with the Eurocentric approach and the conception of rational humanity that ...underpins fascism and speciesism that destroy living conditions on the planet. With an ecological philosophical perspective, an understanding of the teaching of philosophy is defended in a way that is entangled with the context and the beings that, like us, make up the environment, having as teachers of life the soil, trees, herbs, bacteria, fungi, microorganisms and mangroves. A philosophizing-with connected with the future of life on the planet through lines of flight from the ideologies of superiority of a type of humanity, learning from the wisdom of the earth in the form of an ecosophy that articulates ethics, politics and aesthetics as dimensions of the same perception of existence.
Estudos sobre competência moral Bataglia, Patricia Unger Raphael; Alves, Cristiane Paiva; Parente, Elvira Mª P. Pimentel Ribeiro
04/2022
eBook
Odprti dostop
This work proposes to reflect on the application of moral dilemmas as a strategy for the development of the moral competence of children and young people, in educational environments, such as the ...school, bringing the relevance of the training process and pedagogical relationships experienced in the school environment . Each chapter presents the theoretical foundation as a support for the reader to understand the principles and objectives involved in the use of moral dilemmas for the development of moral competence. And so that they can use the dilemmas in their contexts, examples of dilemmas and forms of discussion are presented, constituting a very important tool for teaching in the construction of a peaceful and harmonious society.
Background and Objectives: Juvenile nasopharyngeal angiofibroma (JNA) is an angiomatous hamartoma of the nasal cavity. It is a benign but locally aggressive vascular tumor of the nasopharynx ...affecting adolescent males. Many surgical procedures are in practice, but the extended endonasal endoscopic (EEE) approach for JNAs is a suitable and effective technique. Materials and Methods: Fifteen adolescent patients having JNA who underwent extended endonasal endoscopic (EEE) surgery from January 2010 to January 2022 were studied retrospectively. Patients having residual and recurrent JNAs and those who underwent surgery other than EEE were excluded. Results: The average age of the patients was 18.3 years of age. A total of six patients (40%) each had stage V and IV while three patients (20%) had stage III JNAs. Gross total removal was achieved in eight (53.3%) patients and seven (43.7%) had partial removal. There was no per or postoperative mortality. All the patients had at least 3 years of postoperative follow-up and during follow-ups, seven patients were found to have residual tumors, and two had recurrences. Discussion: During the last decades, the endoscopic approach for the resection of JNAs has gained increasing popularity due to its obvious advantages over transfacial approaches. The magnified and angled field of view “behind the corner” helping in a more complete inspection for the resection and shorter hospitalization time makes it a better choice than the other approaches. Conclusions: Endoscopy is an excellent approach for primary JNA. It allows well visualization and precise removal of the angiofibroma. An endoscopic multiangle, multicorridor skull base approach including Denker’s anteromedial maxillotomy is suitable and preferable for the resection of extensive JNAs.
Text analytics runs through three theoretical fields ... of recognition. Taylor, Honneth and Butler ... approached to bring out the hypothesis that such theories are not enough to reach a utopian ...body, that is, a different political mobility as a result of the updates demanded in the contemporary world. It is here that Foucault's thought erupts. ... what is delineated, affirmed and desired in the text are other bodies for recognition in frank development. ... what is on stage is a genealogy of a long Erfindung, that is, of a long invention of Recognition, with a capital R. Such an invention, in turn, interposes itself between the fleeting flight of Minerva in the penumbra that insists on announcing itself and the dawns that remain to happen – Nietzsche, remembering Rigveda, said: “There are so many dawns that have not yet shone”. What possible dawns for another policy of recognition? What arises, from there, for the art of government, education and lives? Since Western Bildung, perhaps too tired for not recognizing itself, asks: where, how and why would the inclusion of unrecognized bodies be limited there? ... How many containers for the philosophy of education are there? And for thought? And for subjectivity? And for neoliberalism? And for the conscience that recognizes? And for the typified face that typifies the alien face? And for the body that will be abjected? And for the morbid gesture of the repetition of bureaucratic jouissance? And for so many strangers and excluded from this society?
Juvenile nasopharyngeal angiofibromas (JNAs) are benign lesions which arise from vascular pedicles in the nasal cavity and are almost exclusively found in adolescent males. Herein we describe a case ...of a 31-year-old patient presenting with altered mental status who was found to have a JNA emanating from the right SPA but with multiple solid components and an intracranial cyst. After pre-operative embolization, the patient was taken to the operating room for endoscopic resection and drainage of the intracranial cyst. His post-operative course was uncomplicated without any evidence of a CSF leak and with marked improvement in his mental status.
Objectives/Hypothesis
Somatostatin receptors (SSTRs) are highly expressed in neuroendocrine tumors and is exploited for its imaging and treatment. SSTRs expression is also demonstrated in diverse ...benign and malignant tumor cell types and proliferating peri‐tumoral vessels. Similarly, Juvenile Nasopharyngeal Angiofibroma (JNA) expresses different SSTRs and may be utilized for its imaging and treatment using DOTA, 1‐Nal3‐octreotide (DOTANOC)‐PET/CT scan.
Study Design
Prospective cohort.
Methods
Nineteen clinico‐radiologically diagnosed primary JNA patients underwent a 68Ga‐DOTANOC PET‐CT scan. Using a dedicated PET/CT scanner, a low‐dose head and neck spot CT scan was performed after 45 to 60 minutes of intravenous injection of 2 to 3 mCi(74–111 MBq) of DOTANOC. The primary objective was to assess the intensity and pattern of DOTANOC uptake in these patients.
Results
DOTANOC expression was noted in all cases (n = 19) of primary JNA (100%). The mean (SD) DOTANOC SUVmax ratio of tumor and background was 6.9+/−1.4(range, 3.8–9.5). Intra‐cranial extension in all 13/19 patients was prominently visualized due to the absence of DOTANOC uptake in the brain. Compared to the background all stages of JNA showed significant DOTANOC uptake (P < .0001). No difference in uptake between advanced‐stage tumors and early tumors was noted (P = .47). A statistically non‐significant negative trend was noted for decreasing uptake with increasing age (Spearman correlation coefficient, r = −0.19).
Conclusions
This first study of 68Ga‐DOTANOC‐PET/CT scan in JNA demonstrates consistent and reliable uptake activity in all patients irrespective of age and stage. This opens up possibilities to physiological diagnostic imaging with a promise of greater specificity and sensitivity and may have applications in ambivalent diagnostic situations such as the detection of recurrence.
Level of Evidence
3 Laryngoscope, 131:1509–1515, 2021
Surgical management of juvenile nasopharyngeal angiofibroma Wilson, Meghan N.; Nuss, Daniel W.; Zacharia, Brad E. ...
Operative techniques in otolaryngology--head and neck surgery,
March 2019, 2019-03-00, Letnik:
30, Številka:
1
Journal Article
Recenzirano
Juvenile nasopharyngeal angiofibromas are benign yet aggressive anterior skull base tumors that occur almost exclusively in male adolescents. Diagnosis is typically made through radiographic findings ...and clinical characteristics; biopsy is not recommended due to the vascular nature of the disease. As with most tumors, there is a spectrum of tumor extent and invasion. In juvenile nasopharyngeal angiofibromas, one of the most important components of extent is the vascular supply. Once the vascular supply is identified, a systematic approach to resection can be planned. The majority of these tumors can be excised endoscopically, and those approaches are the focus of this article.
This book is aimed at all people who believe in education and its emancipatory potential. Educators, school managers, students, researchers in the human sciences, education and, in particular, ...members of schools and educational experiences who are looking for alternatives, will find subsidies here so that they can reflect on the role of education in the face of contemporary challenges and on the emancipatory possibilities present in our civilization. The arguments are driven by the meeting of the main concepts of Jürgen Habermas' sociology and Jean Piaget's epistemology.
