A 35 years-old male patient was referred to your Institution due to a nodule on the palate with more than 15 years of evolution. In general physical examination noticed the presence of papules and café au lait (coffee with milk) pigmentation in many parts of the body (Figs. 1A, 1B e 1C). Intra oral examination found a swelling in the hard palate, resilient on palpation with an intact surface epithelium, asymptomatic and measuring three centimeters in diameter (Fig. 1D). The patient had poor hygiene condition, with many caries lesions, dental calculi and severe periodontal disease. Panoramic radiography showed the bad oral condition described and an enlarged mandibular canal, mandibular fora- men and mental foramen (Fig. 2).
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will be based on the anatomopathological study, howe- ver, we can suspect initially with a thorough anamne- sis, physical examination, and imaging studies. It is essential the complete excision of the lesion, avoiding common complications of surgery such as bleeding, infections, injuries to nerve structures, among others. Despite it is a benign neoplasm, it can be locally inva- sive presenting a risk of recurrence if not completely excised 8 .
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Thus we conclude that it is important to: (1) perform the clinical history and a thorough physical examination in all of our patients, (2) we must keep in mind all possible differential diagnoses before giving a definite one, (3) one must never forget prophylaxis for deep vein thrombosis in surgical patients, (4) not all skin redness equals infection, (5) venous thrombosis must be ruled out in every patient who presents a sudden increase in leg volume, (6) vascular ultrasound is an essential tool for diagnosis and (7) venous aneurysms do exist and they are not just varicose veins.
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During 2011, 334 patients went under pre-embarka- tion medical exam in the Maritime Health Service of Ma- drid, Spain, including anamnesis, physical examination and the measurement of some parameters established by our protocols, like glucose blood levels, total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol and triglycerides.
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The objective of the work is to study the clinical and haemodynamic evolution, over 1 year, in patients with femoropopliteal arterial pathology treated by means of atherectomy with the SilverHawk device. Materials and methods: Nineteen (19) patients were treated between December 2008 and May 2009, collecting data on sex, age, comorbidity and clinical degree, with prospective monitoring over 12 months of clinical symptoms, physical examination and ecodoppler, obtaining results on diameter and peak systolic velocity at different arterial levels.
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One imaging test cannot substitute history tak- ing and physical examination. In conjunction with clinical knowledge about the patient and a basic understanding of cardiac physiology, however, echocardiography study is essential for cardiovascular evaluation and follow up. Echocardiography is rapidly evolving. Future development of innovative techniques and consequent changes and improvements in the reports that referring physicians receive from E procedures are sure to come.
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The purpose of this study was to develop a Greek version of Achievement Motivation in Physical Education Test (AMPET) that could be applied to Greek educational settings. The conversion of AMPET was tested via confirmatory factor analysis and the use of Cronbach’s α measure. Analysis was based on the data collected from two different test taking sessions. In the first session, 41 students aged 13-21, took the test and the same group of students repeated the test after two weeks in order to test the reliability. The final Greek version of AMPET (after some modifications that took place based on the two pilot test sessions) was administered to 1333 students aged 12-16. The results of CFA showed that there was no evidence to reject Nishida’s structure of motivation learning factors and it can be reduced to a more economical model which adequately describes motivation learning in physical education.
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The problem of this research is determining the level of MEA of middle school seniors’. Mathematics test anxiety originates from fear and negative emotional reactions. Anxiety is associated with panic, nervousness, restlessness, helplessness, trembling and confusion that arise in students when mathematics or mathematics tests are mentioned (Ugodulunwa & Okolo, 2015). In this research, MEA means the scores that students got at “Mathematics Examination Anxiety Scale” (Şan, 2014). The sub-dimensions of the scale help to measure both facilitating and debilitating anxiety about the mathematics test. The higher scale score means the more debilitating MEA.
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This problem has been brought to the attention of the scientific community when dealing with quantum-mechanical events. In fact, an event simply hap- pens and this in a way that is not predictable. If we like to know more about this happening, paradigmatically a detection event, we need certain conditions through which the system that is detected becomes connected in such a way to an apparatus that we can infer something about the former and finally ascribe to it a property. Here, we are able to categorize. However, to categorize means precisely to establish a general class into which these and those things fall. In fact, a property is an equivalence class of different detection events (Auletta, & Wang, 2014: sec. 12.4). This short examination shows two important aspects: 1. Whatever property we ascribe, this is not such a simple process as Peirce may have thought about primary qualities but is in fact rooted in complex interac- tion between things (and also between ourselves and things). so that we cannot speak of a First in the context experience without a Second (and even a Third, what was also acknowledged by him, as mentioned); 2. The basic ontology of our world is resistant to categorization and can in fact be dealt with only in the context of experience. I fully accept Peirce’s criticism of Kant about the fact that reality is not such a passive and formless substrate that the German philosopher may have thought, since it is able to correct us. With his splendid words, “real is that which insists upon forcing its way to recognition as something other than the mind’s creation” (Peirce, CP 1.325); or also: “Where is the real, the thing independent of how we think it, to be found? There must be such a thing, for we find our opinions con- strained; there is something, therefore, which influences our thoughts, and is not created by them” (Peirce, 1871: 468; 1898: 170). Nev- ertheless, whatever categorization we impose on the world does not and cannot catch its intimate happenings and processes bypassing the way in which we frame them in our categorial apparatus.
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To determine the level of physical activity, the long form of the International Physical Activity Questionnaire (IPAQ), whose reliability and validity were tested for adults between 15 and 69 years of age in Turkey (Sağlam, 2010), was applied. The participants were asked about the physical activities they performed for at least 10 minutes a day in the last week, and the duration of their intensive physical activities, moderate-intensity activities, and walking were determined. The metabolic equivalent (MET) unit was used to indicate the level of physical activity. According to this, a person consumes 3.5 ml/kg/min of oxygen per body weight during rest (1 MET = 3.5 ml/kg/min). IPAQ results calculate the amount of energy that people spend in physical activity during the week in MET min/week, assuming 8 MET is spent for severe physical activity, 4 MET for moderate-intensity activity, and 3.3 MET for walking. As a result of the calculation, those whose physical activity level was <600 MET min/week were classified as inactive, >600 - 3000 MET min/week as minimum active, and <3000 MET min/week as HEPA active (Wanner et al 2016).
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(Group: Title) A term or terms denoting the specific physical format, if other than printed paper, in which a referenced work is issued. It tells the reader that the work being referenced exists in a medium that may have special requirements related to the use, acquisition, or storage of the work. Details of the particular medium, including the total number of physical pieces and features such as color and size, are placed in the Physical Description group. Designators include, but are not limited to: artifact, audiocassette, Braille, CD-ROM, DVD, filmstrip, Internet, microcard, microfiche, microfilm, motion picture, painting, sculpture, slide, transparency, videocassette, video disc. Meeting City See PLACE OF MEETING—CITY
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and certain psychological indicators (sports competition, body satisfaction, anxiety) 6-8 . The PAQ-C have acceptable reliability and convergent validity 9 . The mean of all items is used to indicate level of PA. A high score indicates higher levels of PA. Moreover, attempts to obtain cut-off points from PAQ-C final score have been reported for English children 10 . In addition, this questionnaire has adequate validity and reliability in other countries 9 , although the validity and reliability assessed varies by ethnicity and requires additional development to be a useful measure of physical activity in American and European children from diverse ethnic populations 11 . However, not enough is known about the capacity of PAQ-C to estimate PA measured objectively. Moreover, discrepancies and high variability in children’s PA measured by accelerometers around the world have been reported, which may introduce a bias in validation studies 12,13 . So transcultural validation of PA questionnaires will allow us to compare results among countries and a more reliable and valid assessment of PA in each country.
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stimulation on MEPs in quadriceps muscle (Deletis et al., 1992; Simonetta-Moreau et al., 1999). These studies showed that a peripheral electrical stimulus induced an increase in the amplitude of the motor response evoked by a TMS pulse at several inter-stimulus intervals. However, the stimulated nerves were the common peroneal, gastrocnemius medialis and tibial nerves. Therefore, it remains unknown whether an electrical pulse of the femoral nerve, which supplies innervation to the quadriceps, is able to modulate the cortical response of this muscle. This is of relevance since the quadriceps muscle is one of the most important lower limb muscles for a wide range of physical functions (Stevens- Lapsley et al., 2013), and the sensory inputs from this muscle may play an important role in its spinal and cortical control. For instance, poor peripheral nerve function has been associated with low and fast declining quadriceps strength in older adults (Ward et al., 2015), which may lead to impairments in balance (Moxley Scarborough et al., 1999), gait (Fukagawa et al., 1995) and an increased risk of falls (Moreland et al., 2004).
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El incremento de la AF en los jóvenes es un objetivo de la salud pública, sobre todo a la luz del aumento de las tasas de obesidad infantil (Chin & Ludwig, 2013). Los beneficios que la AF aporta a los jóvenes incluyen un aumento de la aptitud cardiorrespiratoria y la fuerza muscular, una composición corporal favorable, el aumento de la salud cardiovascular y metabólica, mayor densidad ósea y mejor salud mental (Physical Activity Guidelines Advisory Committee, 2008). Además de estos beneficios relacionados la salud y la condición física, tiene beneficios para con el aprendizaje, las funciones cognitivas, el rendimiento académico (Hillman, Erickson & Kramer, 2008; Center for Disease Control and Prevention, 2010) y el desarrollo social a través de las interacciones que se producen de cooperación y resolución de problemas (Bailey, 2006).
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Regarding the comparison of the two groups participating in this study to verify the impact of CLIL, the results showed a statistically signi ﬁ cant di ﬀ erence in the levels of MVPA in favour of the experimental group (CLIL). Based on the interviews, the greater attention paid by the students in that group is one possible explanation for these unexpected results. The introduction of English into PE might be directly connected to the students ’ paying more attention to the explanation given. This might in turn explain the increase in time spent on physical activities. Consequently, if the explanation time is optimised, and the time spent on activities is increased, it seems reasonable that the percentage of MVPA in the experimental group should have been greater than that of the control group due to the use of CLIL. This increase in attention is consistent with the ﬁ ndings of Baena, Gómez, and Granero (2017), who state that students participating in CLIL programmes were more motivated, or those of Fernández-Río, Hortigüela Alcalá, and Pérez Pueyo (2017), who found that the students who formed part of bilingual groups showed greater levels of responsibility. Additionally, the teacher ’ s use of communicative teaching strategies (verbal and body language) could o ﬀ er another explanation for the greater time spent on MVPA by the students in the CLIL group. Adaptation of the language used (adjusted to suit the students ’ level of English) and more use of body language are two strategies that can make explanations shorter and more easily under- stood, as proposed by Gómez and Jiménez (2012), Gruber (2015) and Salvador and Chiva (2017). Exploring this matter in more depth, both Ting (2011) and Zindler (2013) established that teachers who apply CLIL are more careful about the vocabulary and language structures they use to ensure e ﬀ ective communication, restricting themselves to more basic communicative messages that require the students to listen more attentively. However, these actions contrast with the excessive use of language learning materials, which, according to the study by Coral et al. (2017), could lead to a decrease in physical activity.
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radiographs, which state that, taking ethical aspects into consideration, such radiographs should be used as a complementary procedure of clinical examinations for the assessment of root surface ca- ries (Katz 1990; Flint et al. 1998; Amerise et al. 2001). It is acknowledged that the best complementary examination for research on caries, mainly interproximal caries, is radiographic examination; due to the interproximal radiographic technique in addition to the periapical radiographic examination (Katz 1986; Bloemendal et al. 2004). Furthermore, when the panoramic radiographs are technically well performed using modern X-ray equipment, such as elipsopantomography, it is possible to increase diagnostic accuracy for these lesions, particularly of the posterior region, as shown in this study. The main disadvantage of panoramic radiographs concerning their inherent limitation, due to the great distance between the planes of the object and the film, the many degrees of distortion during the orbit of the equipment, and to the presence of intensifying ecrans, was largely diminished by the new technology of modern equipment. An example of such equipment is the ORTOPHOS, which maintains the distance object/film the closest possible thanks to the reading performed by a microprocessor over the patients’ cranium and also to the recent technology of tablet grains used in the relation radiographic films/ intensifying ecrans.
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The following lesson plan “ “ Physical Appearance” has been written for first grade “students of “Antonio Torres Araujo”. This lesson plan aims to satisfy the need of young students of English, trying to offer an easy and interesting way of learning English and using it in their lives. In other words, the goal is to help students know how to describe to people using adjectives and the correct verb to be.
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PA not only improves aspects in relation with adult and physical health, but also contributes to obtain better results in the cognitive function and academic capacities (Dudley, 2012), so school stage is considered the best moment to engage youth people in PA (Andersen, 2006; Strong, 2005); the educational system and specifically Physical Education Teachers (PET) should contribute in this regard (Siedentop, 2009). For these reasons, different researches have been focused in the multiple benefits of active and healthy life in children and youth (Janssen, & LeBlanc, 2010; Janssen, Wong, Colley, & Tremblay, 2013; Strong, 2005). There is evidence that regular PA improves body composition, cardiorespiratory and muscular fitness (Dencker et al., 2006), bone health (Fulkerson et al., 2004) and metabolic health biomarkers among children and adolescents (Physical Activity Guidelines Advisory Committee, 2008; Simons-Morton, Parcel, O'Hara, Blair, & Pate, 1988). The most prevalent morphological consequence associated with PI and reduction of PA may be the changes in BC associated with enlargement of the adipose tissue or excessive adiposity (Guerra et al., 2006), which has two well defined categories such as overweight and obesity (Bray, 1985). Although, the prevalence of excessive thinness associated with eating disorders (for example anorexia) is a current concern during adolescence also (Hoek, 2006).
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Euvolemic hypotonic hyponatremia is the one of the syndromic presentations of secondary adrenal insuﬃciency, is often not accompanied with other manifestations of adrenal insuﬃciency but these patients do have symptoms and signs of involvement of another pituitary axis. This disease is clinical and biochemical indistinguishable from SIADH. A low threshold for suspicion, a thorough interrogation and physical examination looking for hypopituitarism signs and symptoms (absence or loss of secondary sexual characteristics, diminished libido, lack of morning erection in men, and secondary amenorrhea in women) in patients presenting with SIADH would expect to improve diagnosis with a serum morning cortisol measurement in these patients to avoid an inappropriate management. It's important to underscore the high prevalence of misinterpretation of thyroid hormone levels that lead to supplementation without prior hypophyseal-adrenal axis evaluation, and lack of adjustment of glucocorticoids during surgery and sickness in these patients, since addressing these unmet educational needs could improve outcomes and avoid increased costs derived from adrenal crisis that are preventable in such cases.
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A research instrument was designed, comprising more than 800 variables, applied by a Cuban MSc. in genetic counselling, in charge of the genetic clinical study and the physical and dysmorphic examination of each patient, as well as the pathogenesis and causal classification of the disability; a Cuban psychopedagogue, in charge of classifying the degree of intellectual disability, carrying out a psychosocial and pedagogical evaluation of the patient; a member of the armed forces in charge of group safety and the geographical reference of the situation of each person in the group in order to guarantee the continuity of the study and, finally, a general physician responsible for evaluating the integral health status of the persons under study and their families in their environment. This team was the first one in giving immediate response to the medical needs of the population. In Venezuela a significant peculiarity was the integration of social activists and the Cuban physicians of the Within the Neighborhood Mission (Misión Barrio Adentro). The Cuban physicians in Bolivia, in Saint Vincent and the Grenadines, the Cuban physicians of the Miracle and Cuban Medical Brigades and the community healthy women (health-promoter women in the community), like national physicians in Ecuador and Nicaragua, all incorporated to this project in the said countries.
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