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Sample records for des accidents graves

  1. Safety apparatus for serious radioactive accidents (1962); Materiel d'intervention en cas d'accident radioactif grave (1962)

    Energy Technology Data Exchange (ETDEWEB)

    Estournel, R; Rodier, J [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

    1962-07-01

    In the case of a serious radioactive accident, radioactive dust and gases may be released into the atmosphere. It is therefore necessary to be able to evaluate rapidly the importance of the risk to the surrounding population, and to be able to ensure, even in the event of an evacuation of the Centre, the continuation of the radioactivity analyses and the decontamination of the personnel. For this, the Anti-radiation Protection Service at Marcoule has organised mobile detection teams and designed a mobile laboratory and a mobile shower-unit. After describing the duty of the mobile teams, the report gives a description of the apparatus which would be used at the Marcoule Centre in the case of a serious radioactive accident. The method of using this apparatus is given. (authors) [French] Lors d'un accident radioactif grave, des poussieres et des gaz radioactifs peuvent etre relaches dans l'atmosphere. II est alors indispensable d'evaluer rapidement l'importance du risque couru par les populations environnantes, et de pouvoir assurer, meme dans le cas de l'evacuation du Centre, la poursuite des analyses radioactives et la decontamination du personnel. Pour cela, le Service de Protection contre les Radiations du Centre de Marcoule a mis sur pied des equipes mobiles de detection et realise une semi-remorque laboratoire ainsi qu'une semi-remorque douches. Apres avoir defini la mission des equipes mobiles, le rapport donne la description du materiel d'intervention qui serait mis en oeuvre par le Centre de Marcoule dans le cas d'un accident radioactif grave. Il precis le mode d'utilisation de ce materiel. (auteurs)

  2. Épidémiologie des accidents domestiques graves de l'enfant admis en réanimation pédiatrique polyvalente à l'hôpital d'enfants de Rabat-Maroc

    Science.gov (United States)

    Rafai, Mostafa; Mekaoui, Nour; Chouaib, Naoufal; Bakkali, Hicham; Belyamani, Lahcen; El Koraichi, Alae; El Kettani, Salma Ech-Cherif

    2015-01-01

    Introduction Les accidents domestiques de l'enfant représentent un vrai problème de santé publique dans les pays industrialisés. Au Maroc, la priorité en santé publique est toujours donnée aux pathologies infectieuses, et bien qu'elle soit très peu décrite, la pathologie accidentelle de l'enfant devient de plus en plus fréquente dans notre pays avec une mortalité importante. L'objectif est de mettre le point sur la prévalence, la gravité, les aspects étiologiques, les facteurs de risque et les circonstances de survenue de ces accidents, ainsi que les moyens de prévention active et passive. Méthodes Enquête rétrospective descriptive sur une période de douze mois portant sur tous les enfants pris en charge pour accident domestique grave au service de réanimation pédiatrique polyvalente de l'hôpital universitaire d'enfants de Rabat. Résultats Parmi 698 admissions, 108 cas d'accidents domestiques graves ont étaient colligés (soit 15,5%), L’âge moyen des enfants était de 04ans tout accident confondu, avec un sex-ratio de 1,08 en faveur des garçons. L’évolution générale était marquée par le décès de 16 enfants (soit 14,8%) parmi 164 décès toute pathologie confondue au cours de la même période d’étude (soit 9,75% des décès) avec une durée moyenne d'hospitalisation de 04jours. les brûlures constituaient le premier accident dans notre série par 37cas, et elles étaient la première cause de mortalité par huit cas; par ailleurs, la population la plus à risque de brûlure était les nourrissons (67,6%). L'inhalation intrabronchique d’épingle à foulard (accident particulier dans notre contexte islamique) à été retrouvée chez six cas. Conclusion Les accidents domestiques de l'enfant constituent rarement une préoccupation de premier plan dans la population alors qu'ils sont parfois très graves et source d'une mortalité importante. Le meilleur traitement reste la prévention active et passive. PMID:26015848

  3. Prevention of the causes and consequences of a criticality accident - measures adopted in France; Prevention des causes et des consequences d'un accident de criticite - solutions adoptees en France

    Energy Technology Data Exchange (ETDEWEB)

    Fruchard, Y; Lavie, J M

    1966-07-01

    The question of safety in regard to criticality accident risks has two aspects: prevention of the cause and limitation of the consequences. These two aspects are closely connected. The effort devoted to prevention of the causes depends on the seriousness of the possible human psychologic and economic consequences of the accident. The criticality accidents which have occurred in the nuclear industry, though few in number, do reveal the imperfect nature of the techniques adopted to prevent the causes, and also constitute the only available realistic basis for evaluating the consequences and developing measures to limit them. The authors give a analysis of the known causes and consequences of past criticality accidents and on this basis make a number of comments concerning: the validity of traditional safety criteria, the probability of accidents for different types of operations, characteristic accidents which can serve as models, and the extent of possible radiological consequences. The measures adopted in France to limit the consequences of a possible criticality accident under the headings: location, design and lay-out of the installations, accident detection, and dosimetry for the exposed personnel, are briefly described after a short account of the criteria used in deciding on them. (author) [French] La surete relative aux risques d'accidents de criticite presente deux aspects: la prevention des causes et les parades aux consequences. Ces deux aspects sont tres lies. L'effort consenti a la prevention des causes decoule de l'importance des consequences humaines economiques et psychologiques possibles d'un eventuel accident. Les accidents de criticite survenus dans l'industrie nucleaire, malgre leur rarete, d'une part devoilent les imperfections des techniques de prevention des causes, d'autre part constituent la seule base realiste disponible d'evaluation des consequences et de mise au point des parades a ces consequences. Les auteurs presentent une analyse des

  4. Prevention of the causes and consequences of a criticality accident - measures adopted in France; Prevention des causes et des consequences d'un accident de criticite - solutions adoptees en France

    Energy Technology Data Exchange (ETDEWEB)

    Fruchard, Y.; Lavie, J.M

    1966-07-01

    The question of safety in regard to criticality accident risks has two aspects: prevention of the cause and limitation of the consequences. These two aspects are closely connected. The effort devoted to prevention of the causes depends on the seriousness of the possible human psychologic and economic consequences of the accident. The criticality accidents which have occurred in the nuclear industry, though few in number, do reveal the imperfect nature of the techniques adopted to prevent the causes, and also constitute the only available realistic basis for evaluating the consequences and developing measures to limit them. The authors give a analysis of the known causes and consequences of past criticality accidents and on this basis make a number of comments concerning: the validity of traditional safety criteria, the probability of accidents for different types of operations, characteristic accidents which can serve as models, and the extent of possible radiological consequences. The measures adopted in France to limit the consequences of a possible criticality accident under the headings: location, design and lay-out of the installations, accident detection, and dosimetry for the exposed personnel, are briefly described after a short account of the criteria used in deciding on them. (author) [French] La surete relative aux risques d'accidents de criticite presente deux aspects: la prevention des causes et les parades aux consequences. Ces deux aspects sont tres lies. L'effort consenti a la prevention des causes decoule de l'importance des consequences humaines economiques et psychologiques possibles d'un eventuel accident. Les accidents de criticite survenus dans l'industrie nucleaire, malgre leur rarete, d'une part devoilent les imperfections des techniques de prevention des causes, d'autre part constituent la seule base realiste disponible d'evaluation des consequences et de mise au point des parades a ces consequences

  5. Prevention of the Causes and Consequences of Criticality Accidents: Measures Adopted in France; Prevention des Causes et des Consequences d'un Accident de Criticite: Solutions Adoptees en France

    Energy Technology Data Exchange (ETDEWEB)

    Fruchard, Y.; Lavie, J. -M. [Commissariat a l' Energie Atomique, Paris (France)

    1966-05-15

    It is important to guard against the risk of criticality accidents by seeking to prevent their occurrence through the elimination of their causes and also by taking steps to provide against their consequences. These two aspects are closely linked since the efforts made to elaborate preventive procedures are dictated by the importance of the repercussions which such accidents are liable to have in the human, economic and psychological spheres. The criticality accidents which have occurred in the nuclear industry, though small in number, do reveal the imperfect nature of the techniques adopted to prevent them, and they constitute the only available realistic basis for evaluating their consequences and developing suitable precautionary techniques. The authors give a detailed analysis of the known causes and consequences of past criticality accidents and on this basis make a number of comments in connection with the validity of traditional safety criteria, the probability of accidents for different types of operation, the characteristic accidents capable of serving as models, and the extent of possible radiological consequences. The measures adopted in France to limit the consequences of a possible criticality accident (location, design and lay-out of installations, accident detection dosimetry for exposed personnel) are briefly described after a short account of the criteria used in deciding on them. Finally, the authors discuss the economic implications of adopting particular precautionary measures and of applying them uniformly, taking due account of the question of reliability. (author) [French] II est important de se proteger contre les risques d'accidents de criticite en tentant, d'une part, de prevenir les accidents eux-memes par l'elimination de leurs causes, d'autre part, de parer a leurs consequences. Ces deux aspects sont tres lies: l'effort portant sur la prevention des accidents decoule de l'importance de leurs consequences sur les plans humain, economique

  6. Prise en charge des traumatismes graves du rein

    Science.gov (United States)

    Lakmichi, Mohamed Amine; Jarir, Redouane; Sadiki, Bader; Zehraoui; Bentani; Wakrim, Bader; Dahami, Zakaria; Moudouni; Sarf, Ismail

    2015-01-01

    Les traumatismes graves du rein de grade III, IV et V selon la classification de l'Amercan Society for Surgery For Trauma (ASST) sont plus rares et se retrouvent dans 5% des cas en moyenne. Leur prise en charge est souvent délicate, nécessitant alors des centres expérimentés dotés de moyen adéquats d'imagerie (scanner spiralé). Cependant, durant ces dernières années, la prise en charge de ces traumatismes a évolué vers une attitude de moins en moins chirurgicale grâce à l’évolution des techniques de la radiologie interventionnelle, de l'endourologie et des moyens de surveillance aux urgences et de réanimation. L'objectif de cette étude est d’évaluer notre expérience dans la prise en charge des traumatismes rénaux de haut grade. Notre étude rétrospective porte sur 25 cas de traumatismes grave du rein de grade III, IV et V selon la classification de l'ASST, colligés entre Janvier 2002 et Juin 2009 au service d'urologie du centre Hospitalier Universitaire Mohammed VI, Université Cadi Ayyad de Marrakech, Maroc. Nous avons étudié les données épidémiologiques, les signes cliniques et biologiques à l'admission (état de choc hémorragique, taux d'hémoglobine), les données radiologiques (échographie et scanner), les lésions associées, la prise en charge thérapeutique et les complications. L’âge moyen de nos patients était de 24,9 ans 15 et 58 ans, avec une prédominance masculine (sex-ratio = 7, 3). Le rein droit était intéressé dans 15 cas (60%). Le traumatisme rénal était fermé dans 15 cas, et ouvert par arme blanche dans 10 cas. Huit patients se sont présentés en état de choc hémorragique (32%). Une anémie inférieur à 10g /100ml a été observée dans 10 cas (40%). L'uroscanner fait systématiquement à l'admission a retrouvé un grade III (10 cas), grade IV (13 cas) et grade V (2 cas). La prise en charge a consisté en une exploration chirurgicale avec néphrectomie chez 2 cas de Grade IV pour une instabilité h

  7. Radioiodine treatment of Grave's disease; Radiojodtherapie des Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Heidenreich, P.; Vogt, H.; Dorn, R.; Graf, G.; Kopp, J. [Klinik fuer Nuklearmedizin, Zentralklinikum Augsburg (Germany)

    2001-09-01

    In Germany radioiodine therapy of Grave's disease is performed in patients older than 20 years, after at least one year of unsuccessful antithyroid therapy, intolerance against antithyroid medication, recurrences after surgical interventions and small goiters. Hyperthyroidism is eliminated with an ablative dose concept (300 Gy) in more than 90% associated with rate of hypothyroidism in the outcome of also more than 90%. Adverse prognostic factors are an insufficient dose to the thyroid and/or concomitant antithyreoid medication. Radioiodine therapy in Germany must be an inpatient single time approach due to quality assurance and radiation protection reasons. The mean hospitalization is only 3-4 days with the patient being discharged at an annual dose of less than 1 mSv at 2 m distance (dose rate at discharge < 3,5 {mu}Sv/h at 2 m). An adjuvant treatment with cortisone is recommended in a simultaneous endocrine ophthalmopathy to prevent from deterioration. Radioiodine therapy of Grave's disease is cost effective with a low probability of side-effects and is not associated with an increased genetic or somatic risk. Therapy control and life span follow up has to be carried out by the expert physician legally responsible for the radioiodine therapy. (orig.) [German] Die Radiojodtherapie des Morbus Basedow wird in Deutschland, bei Patienten aelter als 20 Jahre, erst nach mindestens einjaehriger, erfolgloser thyreostatischer Therapie, bei Thyreostatikaunvertraeglichkeit, Rezidiven nach Operation und kleinen Strumen durchgefuehrt. Die Beseitigung der Hyperthyreose wird mit einem ablativen Dosiskonzept (300 Gy) in > 90%, verbunden mit einer Hypothyreoserate von ebenfalls > 90% erreicht. Prognostisch unguenstige Einflussfaktoren sind eine zu niedrig gewaehlte Herddosis und/oder eine begleitende Thyreostase. Aus Gruenden der Qualitaetssicherung und des Strahlenschutzes muss in Deutschland die Radiojodtherapie stationaer als Einzeittherapie durchgefuehrt werden. Die

  8. Les accidents aux AVK: étude rétrospective à propos de 30 cas ...

    African Journals Online (AJOL)

    Le but de cette étude est de ressortir les caractéristiques des patients présentant des accidents hémorragiques graves sous AVK et de mettre le point sur la prise en charge. Nous avons réalisé une étude rétrospective portant sur 30 malades, réalisée au service de réanimation de l'hôpital militaire Avicenne de Marrakech.

  9. Radiometric evaluation of graves of victims of the accident with Cesium 137 in Goiania, GO, Brazil: 25 years after

    International Nuclear Information System (INIS)

    Lage, Leonardo B.; Correa, Rosangela da S.; Santos, Eliane E. dos; Freitas-Junior, Ruffo

    2013-01-01

    Twenty-five years after the radiation accident in Goiania, this study aims to evaluate the radiological situation in the area demarcated by the graves of the victims of the accident with cesium-137. Radiometric survey was carried out on the surface that encompasses the four graves and vicinity, from a pre-established mesh. Dose rate measurements were carried out, using the IdentFINDER equipment, positioned at 1 m height from the ground. The values of dose rates at the points measured ranged from 0.03 to 0.07 μSv/h. This variation of dose rate is less than those obtained in the local graveyard and are in the range of background radiation observed in Goiania. Considering the results obtained 25 years after the accident, it was concluded that engineering barriers adopted at that time are effective, stating the place absolutely safe from a radiological point of view, both for the individual from the public as to the environment

  10. Miastenia grave y miastenia grave ocular

    Directory of Open Access Journals (Sweden)

    Rosa María Naranjo Fernández

    Full Text Available La miastenia grave es una enfermedad caracterizada por debilidad y fatiga de los músculos voluntarios debido a una trasmisión anómala a nivel de la unión neuromuscular. La prevalencia es aproximadamente de 5 casos/100 000 personas. La miastenia grave puede ser bulbar, ocular o generalizada.Existen formas clínicas en la infancia como son la miastenia neonatal transitoria, la miastenia congénita y la miastenia juvenil. Los músculos oculares, faciales y bulbares son los más frecuentes afectados por la enfermedad. Cuando los síntomas se limitan a la musculatura cercana al ojo se denomina miastenia grave ocular. Una vez el oftalmólogo diagnostica o sospecha la miastenia grave, un neurólogo generalmente dirige la comprobación y tratamiento. El papel del oftalmólogo continúa siendo importante, además de chequear la motilidad y disfunción palpebral y proporcionar el alivio sintomático para estos desórdenes, debe estar alerta a la posibilidad de ambliopía.

  11. Causes et facteurs de risque des accidents des engins a deux-roues ...

    African Journals Online (AJOL)

    Notre travail de recherche s'inscrit dans la problématique de la prise de risque routière, il visait à intégrer la recherche de sensations dans l'explication des accidents de la route chez les conducteurs adolescents de motos. 85 conducteurs de motos (15-25 ans) constituaient notre échantillon. Un questionnaire, composé de ...

  12. Pronostic des accidents vasculaires cerebraux en medecine interne ...

    African Journals Online (AJOL)

    Pronostic des accidents vasculaires cerebraux en medecine interne du C.H.U du Point G. D Traore, Syd Syd, N Sawadogo, A Sanogo, I Dembélé, M Cissoko, M Saliou, Y Fofana, N Doumbia, I Menta, A Kaya, M Dembélé, A.K. Traoré, A.T. Sidibé, H.A. Traoré ...

  13. Death by suicide in Graves' disease and Graves' orbitopathy

    DEFF Research Database (Denmark)

    Ferløv-Schwensen, Charlotte; Brix, Thomas Heiberg; Hegedus, Laszlo

    2017-01-01

    BACKGROUND: Graves' disease is associated with excess morbidity and mortality, but little is known about unnatural manners of death and the potential relation with Graves' orbitopathy. Here we investigate the risk of unnatural death in Graves' patients with orbitopathy (GO) and without (GD), comp...... in the pathophysiological mechanisms of suicidal behavior. Beyond independent confirmation, reasons for this need to be explored in order to introduce preventive measures....... with GD, and 3,965 with GO were identified and matched for age and gender with four subjects from the background population. Manner of death was identified and hazard ratios (HR) for mortality due to unnatural deaths (accident, suicide, violence/homicide, and unknown) were calculated using Cox regression...... analyses, adjusted for pre-existing somatic and psychiatric morbidity. RESULTS: In Graves' disease overall there was an increased risk of death from unknown unnatural manners [HR: 2.01 (95% confidence interval: 1.17-3.45); P=0.012] and of suicide, although the latter difference was not with certainty...

  14. Comportement mécanique du foie en contexte traumatique : Rupture et endommagement des tissus

    OpenAIRE

    CONTE, Cécile

    2012-01-01

    Chaque année en France, on dénombre environ 2000 cas de lésions de la région abdominale lors d'accidents de la route. Ces lésions sont très souvent sévères, mortelles dans 20% des cas, et nécessitent un traitement médical délicat, long et coûteux car il fait appel à la chirurgie dans un cas sur deux. Parmi ces lésions, celles du foie font partie des plus fréquentes mais aussi des plus graves à cause de leur risque hémorragique et sceptique élevé. Une voie d'amélioration de leur prévention pas...

  15. Evaluación de factores de riesgo en accidentes oculares graves infantiles Assessment of the risk factors for severe ocular accidents in children

    Directory of Open Access Journals (Sweden)

    Sahely Sixto Fuentes

    2010-09-01

    Full Text Available Objetivo: Evaluar factores de riesgo en accidentes oculares graves infantiles. Métodos: Se realizó una investigación aplicada, epidemiológica, descriptiva, longitudinal y prospectiva sobre accidentes oculares graves en el Servicio de Oftalmología del Hospital Pediátrico Provincial de Pinar del Río (2006-2007. El universo y muestra estuvo constituido por dos grupos de niños de 1- 20 años, ambos sexos y todas las etnias. Primer Grupo: Niños con accidente ocular grave, Segundo Grupo: Niños sin accidente ocular; determinándose una muestra total de 130 seleccionados mediante muestreo aleatorio simple. Fueron utilizados métodos empíricos y teóricos de investigación científica. Resultados: El trauma ocular representó el 87,8% de los ingresos de urgencia durante el período. Se encontró que el grupo etáreo de 9-12 años (40%, y sexo masculino (89,2% fueron los más afectados. Un 76,9% de los accidentados residía en zona rural. El 96,9% se encontraba fuera de la casa y sin compañía de adultos en el momento del trauma. Predominaron las familias con conocimientos y actitudes evaluados de regulares en relación a los accidentes oculares con un 57,7 % y 60,8% respectivamente. Conclusiones: Se constató elevada frecuencia de traumas oculares infantiles graves en Pinar del Río, precisando sus factores causales de riesgo y dificultades en la prevención de los mismos.Objective: To assess the risk factors for severe ocular accidents in children. Methods: An applied, epidemiological, descriptive, longitudinal and prospective research of the severe ocular accidents was conducted in the Ophthalmologic Service at "Pepe Portilla" Provincial Children Hospital, Pinar del Rio. The target group and the sample were comprised of two groups of children from 1 to 16 years old of both sexes and all ethnics. First group: children and adolescents suffering from severe ocular accidents. Second group: children and adolescents without ocular accidents; a

  16. Causes of Accidents Near Accelerators and Radiation Protection Arrangements; Causes d'accidents aupres des accelerateurs et dispositions de radioprotection

    Energy Technology Data Exchange (ETDEWEB)

    Joffre, H; Vialettes, H [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1968-07-01

    The authors present, first, some typical accidents mentioned in bibliography or happened in CEA Research Centers. The accidents are analysed to precise the main cause and get some experience. Then the authors study the interest of a centralized control for security, detection and signalling devices used near every important accelerator. (author) [French] Les auteurs presentent, tout d'abord, quelques accidents typiques rapportes dans la bibliographie ou survenus dans les Centres de Recherches du CEA. Ces accidents sont analyses pour en preciser la cause principale et en degager les enseignements. Enfin les auteurs etudient l'interet d'un controle centralise des dispositifs de securite, de detection et de signalisation mis en oeuvre aupres de tout accelerateur important. (auteur)

  17. evaluation des sequelles chez les victimes d'accidents de la ...

    African Journals Online (AJOL)

    19 déc. 2007 ... professionnelle : métier exercé et conditions d'exer- cice avant l'accident, conditions de reprise du tra- vail, modification des conditions du travail, voire reclassement ou licenciement. L'expert doit étudier « les gestes professionnels » c'est-à-dire ceux qui sont possibles à exécuter ou au contraire difficiles et.

  18. Aspects épidémiologiques des accidents vasculaires cérébraux (AVC) aux urgences de l'institut de cardiologie d'Abidjan (ICA)

    Science.gov (United States)

    N'goran, Yves N'da Kouakou; Traore, Fatou; Tano, Micesse; Kramoh, Kouadio Euloge; Kakou, Jean-Baptiste Anzouan; Konin, Christophe; Kakou, Maurice Guikahue

    2015-01-01

    Introduction L'objectif de notre étude était de décrire les caractéristiques sociodémographiques et les Facteurs de Risque cardio-Vasculaires (FRV) des patients admis pour accidents vasculaires cérébraux (AVC) dans un service autre que celui de la neurologie. Méthodes Étude transversale rétrospective sur une période de 2 ans (janv. 2010 et déc. 2011), réalisée aux urgences de l'institut de cardiologie d'Abidjan. Résultats Il s'agissait de 176 adultes avec un âge moyen de 60 ans, une prédominance féminine. Les facteurs de risque majeurs retrouvés étaient l'hypertension artérielle dans 86,4% des cas, le diabète dans 11,4% des cas, le tabagisme dans 2,2% des cas. Les motifs de consultation étaient la perte de connaissance dans 36,4% des cas, l'hémiplégie dans 31,8% des cas, les céphalées dans 17,4% des cas, les vertiges dans 10,9% et les palpitations dans 2,2% des cas. La tension artérielle systolique moyenne était à 174 mmHg, la tension artérielle diastolique moyenne était à 105 mmHg et la pression pulsée moyenne était à 70 mmHg. Les AVC étaient associés à une arythmie complète par fibrillation auriculaire dans 11,4% des cas. Les AVC ischémiques représentaient 84,1%. L’évolution aux urgences a été marquée par un décès dans 17% (30) des cas. Conclusion Les AVC constituent un problème majeur de santé publique. Malgré sa prédominance féminine, ils (AVC) touchaient 44% des hommes dans notre étude lorsqu'on sait qu'en Afrique l'activité sociale repose sur les hommes. Ils restent une pathologie grave par la forte létalité. PMID:26327997

  19. Part 1: The detection of criticality accidents in the Commissariat a l'Energie Atomique. Part 2: The Burst Slug Detection; 1. partie: la detection des accidents de criticite au Commissariat a l'Energie Atomique. 2. partie.: la detection des ruptures de gaines

    Energy Technology Data Exchange (ETDEWEB)

    Debrie, G; Lavie, J; Planque, M [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1964-07-01

    of the plant. The techniques developed during this programme can be subsequently adapted to easily solve problems of detection in other types of reactor. The main characteristics of the evolution of the various installations constructed or under construction is reflected in the continuous progress towards greater automation and the use of detectors working under higher and higher temperatures and pressures. Succeeding to the reactor G3 whose BSD installation was already highly automatic, the EDF reactors at Chinon use digital computers especially meant for BSD data processing. In the planned reactor EL 4, the BSD measurements will be processed with all the other control measurements in a centralized computer unit. The progressive pressure increase of the cooling gas (15 bars in G3, 25 bars in the Chinon reactors, 60 bars in EL 4) has required the development of electric precipitations able to separate and measure the fission products in the carbonic gas at temperatures reaching 300 C and under pressures as high as 60 bars. In spite of the severe conditions of utilisation, the various devices developed offer all the guarantees of safety and long life expectancy required for their use on BSD installations. (authors) [French] Dans toute installation ou est manipulee de la matiere fissile en quantite potentiellement superieure a la masse critique, existe, quelles que soient les precautions prises, un risque permanent d'excursion nucleaire accidentelle, pouvant entrainer une irradiation grave du personnel. La detection immediate suivie d'une evacuation rapide limite considerablement les risques d'irradiation dus aux produits de fission ou a la reaction nucleaire elle-meme si elle se poursuit. Les phenomenes physiques qui accompagnent une excursion nucleaire, demeurant insuffisants pour suivre l'alarme et pouvant preter a confusion, la necessite d'un appareillage approprie de la detection des accidents de criticite s'impose donc. Compte-tenu des caracteristiques des

  20. Aspect Epidemiologique des Sequelles de Brulures a Marrakech, Maroc, a Travers Deux Observations

    Science.gov (United States)

    Ettalbi, S.; Ibnouzahir, M.; Droussi, H.; Wahbi, S.; Bahaichar, N.; Boukind, E.H.

    2009-01-01

    Summary La brûlure est un accident qui reste toujours très fréquent au Maroc, ce qui fait d'elle un problème de la santé publique. Les brûlures, quand elles sont graves ou profondes, entraînent de façon quasi inéluctable des séquelles fonctionnelles et esthétiques. A travers deux observations de deux enfants présentant des séquelles de brûlures graves, ayant retenti péjorativement sur leurs scolarités, on a essayé de mettre en évidence quelques facteurs incriminés dans cette tragédie (feu, petites bouteilles de gaz et le manque d'infrastructure, du personnel médical et paramédical, du matériel ainsi que de la prévention) comme étant une grande cause dans la survenue de ces séquelles. Le but de notre travail est d'énumérer ces différents facteurs intriqués, ainsi que de proposer quelques solutions, tout en insistant sur la prévention. PMID:21991156

  1. Generalities on the dynamic behaviour of rapid reactors. Preliminary studies on Rapsodie; Generalites sur le comportement dynamique des piles rapides. Etudes preliminaires de rapsodie

    Energy Technology Data Exchange (ETDEWEB)

    Campan, J L; Chaumont, J P; Clauzon, P P; Ghesquiere, G; Leduc, J; Schmitt, A P; Zaleski, C P [Commissariat a l' Energie Atomique, Cadarache (France). Centre d' Etudes Nucleaires

    1963-07-01

    The study of the dynamic behaviour of fast reactors may be divided into three section: 1. Stability studies around equilibrium power only the linear case was examining. S. Transient studies in the case of usual reactor operation (shut down, scram, etc.) with thermal shocks evaluation, for instance. 3. Explosion studies, for the maximum credible accidents. This report presents the status of the studies performed at the 'Physics Research Department' at Cadarache. Methods used are detailed and illustrated with the results obtained on a preliminary metallic core of the Rapsodie Reactor. (authors) [French] Le comportement dynamique des piles rapides, se presente tout naturellement sous trois aspects: 1. Etude de stabilite autour d'un regime d'equilibre (nous nous sommes bornes ici au cas lineaire). 2. Etude de regimes transitoires lors des operations normales de pile (arret, arret d'urgence, etc.) avec evaluation des chocs thermiques par exemple. 3. Etude des regimes transitoires de caractere explosif lors des accidents les plus graves possibles. Ce rapport presente l'etat des etudes a la date du 20 decembre 1961 a la Section d'Etudes de Piles Rapides a CADARACHE. Les methodes employees ont ete detaillees et illustrees a partir des resultats obtenus sur une premiere version 'combustible metallique' de Rapsodie. (auteurs)

  2. Health problems raised by the elimination of radioactive wastes and nuclear accidents; Problemes sanitaires poses par l'elimination des dechets radioactifs et par les accidents nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    Jammet, H; Mechali, D; Dousset, M [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1964-07-01

    The rapid development of nuclear energy demands an urgent solution to the health problems arising from the discharge into the environment of radioactive residues produced by nuclear installations. - To be able to evaluate the risks run by the population and to fix tolerance limits for waste discharge, it is necessary to possess an exact knowledge of the course taken by the radioelements discharged, from their source until they reach man. The incorporation of radioelements in food cycles is the first risk to take into consideration. The factors involved in all stages of this transmission must be foreseen, whether they concern physical or biological media, because of their continuity and their interdependence. Finally, socio-economic and dietetic data must be collected in order that the risks and tolerance levels estimated are based on concrete and experimental rather than theoretical knowledge. The risk of nuclear accidents in the atomic industry, although very improbable, must be taken into consideration because of the seriousness of their consequences. The health problems arise in the field of professional hygiene on the one hand and in that of public hygiene on the other. In the first field the risk is two-fold and involves irradiation and contamination. The public sphere is reduced essentially to the risk of contamination by radioactive substances accidentally released in the surrounding medium. The health studies to be conducted in this field therefore include research not only on irradiation or contamination therapeutics but also on the transfer of radioelements from the accident site to man, mainly through food cycles, in their physical and in their biological components. Studies of this kind form the basis of decisions in the health field which would have to be taken in the case of an accident. (authors) [French] Le developpement rapide de l'energie nucleaire rend urgente la solution des problemes sanitaires poses par le rejet dans le milieu ambiant des

  3. African Journal of Neurological Sciences - 2009 Vol. 28 No 1

    African Journals Online (AJOL)

    Mots clés : Arbre, Accident, Chute, Mali, Rachis, Traumatisme ... Les chutes du haut d'un arbre sont des accidents graves et fréquents au MALI. ..... s'agir de traumatismes crâniens dans 39% des cas, de lésions musculo-squelettiques dans ...

  4. Accident vasculaire cérébral hémorragique du tronc cérébral suite à une éclampsie du post partum: à propos d’un cas et revue de la littérature

    OpenAIRE

    Ennaqui, Khadija; Makayssi, Assia; Boufettal, Houssine; Samouh, Naima

    2017-01-01

    Les accidents vasculaires cérébraux sont des accidents rares mais graves durant la grossesse et le post-partum, ils sont responsable d'une mortalité et d'une morbidité élevée, la pré éclampsie, l'éclampsie et les accidents vasculaires cérébraux sont significativement liés. Le dysfonctionnement endothélial, l'altération de l'autorégulation cérébrale, et l'hypertension sévère sont, probablement, la cause de nombreux accidents vasculaires cérébraux chez la femme enceinte et durant la période du ...

  5. Health problems raised by the elimination of radioactive wastes and nuclear accidents; Problemes sanitaires poses par l'elimination des dechets radioactifs et par les accidents nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    Jammet, H.; Mechali, D.; Dousset, M. [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1964-07-01

    The rapid development of nuclear energy demands an urgent solution to the health problems arising from the discharge into the environment of radioactive residues produced by nuclear installations. - To be able to evaluate the risks run by the population and to fix tolerance limits for waste discharge, it is necessary to possess an exact knowledge of the course taken by the radioelements discharged, from their source until they reach man. The incorporation of radioelements in food cycles is the first risk to take into consideration. The factors involved in all stages of this transmission must be foreseen, whether they concern physical or biological media, because of their continuity and their interdependence. Finally, socio-economic and dietetic data must be collected in order that the risks and tolerance levels estimated are based on concrete and experimental rather than theoretical knowledge. The risk of nuclear accidents in the atomic industry, although very improbable, must be taken into consideration because of the seriousness of their consequences. The health problems arise in the field of professional hygiene on the one hand and in that of public hygiene on the other. In the first field the risk is two-fold and involves irradiation and contamination. The public sphere is reduced essentially to the risk of contamination by radioactive substances accidentally released in the surrounding medium. The health studies to be conducted in this field therefore include research not only on irradiation or contamination therapeutics but also on the transfer of radioelements from the accident site to man, mainly through food cycles, in their physical and in their biological components. Studies of this kind form the basis of decisions in the health field which would have to be taken in the case of an accident. (authors) [French] Le developpement rapide de l'energie nucleaire rend urgente la solution des problemes sanitaires poses par le rejet dans le milieu ambiant des

  6. Introduction to Special Issue "War Graves / Die Bauaufgabe Soldatenfriedhof, 1914-1989"

    Directory of Open Access Journals (Sweden)

    Fuhrmeister, Christian

    2017-07-01

    Full Text Available Commemoration of the dead is intricately linked to the history of civilization itself. Consequently, art history (understood in a broad sense, encompassing architectural history, social history of art, aesthetics, political iconography, etc. is characterized by a long tradition of paying minute attention to Christian and profane iconography of chapels, epitaphs, and death dances; and to memorials, tombs, and other manifestations, particularly with regard to the Middle Ages and Early Modern Times. Twentieth century war graves, war cemeteries, memorial shrines, and burial sites of the fallen, however, have received only little attention. This assessment was the starting point of our joint endeavor: If the history of conflicts and wars, and the history of war death in particular, is such a major topic for the humanities at large, and especially for contemporary and cultural history, memory studies, etc., then the question arises to what degree art history can contribute to that ongoing discourse. Sketching a Potentially Global Field of Research Table of Contents Acknowledgements Sources and Materials Basic Research on War Graves and War Cemeteries in The Political Archive of the Federal Foreign Office in Berlin / Kriegsgräber im Politischen Archiv des Auswärtigen Amtes in Berlin The Archive of the German War Graves Commission in Kassel / Das Archiv des Volksbundes Deutsche Kriegsgräberfürsorge e. V. in Kassel War Graves, War Cemeteries, and Memorial Shrines since 1914: A Selected Bibliography Selected Printed Source Material

  7. Radiometric evaluation of graves of victims of the accident with Cesium 137 in Goiania, GO, Brazil: 25 years after; Avaliacao radiometrica das sepulturas das vitimas do acidente com o Cesio 137 em Goiania: 25 anos apos

    Energy Technology Data Exchange (ETDEWEB)

    Lage, Leonardo B.; Correa, Rosangela da S.; Santos, Eliane E. dos, E-mail: leonardobl@cnen.gov.br, E-mail: rcorrea@cnen.gov.br, E-mail: esantos@cnen.gov.br [Centro Regional de Ciencias Nucleares do Centro-Oeste (CRCN-CO/CNEN-GO), Abadia de Goias, GO (Brazil); Freitas-Junior, Ruffo, E-mail: uffojr@terra.com.br [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Programa de Mastologia

    2013-07-01

    Twenty-five years after the radiation accident in Goiania, this study aims to evaluate the radiological situation in the area demarcated by the graves of the victims of the accident with cesium-137. Radiometric survey was carried out on the surface that encompasses the four graves and vicinity, from a pre-established mesh. Dose rate measurements were carried out, using the IdentFINDER equipment, positioned at 1 m height from the ground. The values of dose rates at the points measured ranged from 0.03 to 0.07 μSv/h. This variation of dose rate is less than those obtained in the local graveyard and are in the range of background radiation observed in Goiania. Considering the results obtained 25 years after the accident, it was concluded that engineering barriers adopted at that time are effective, stating the place absolutely safe from a radiological point of view, both for the individual from the public as to the environment.

  8. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Ines Khochtali

    2010-01-01

    have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  9. Acidentes graves do trabalho na Capital do Estado de São Paulo (Brasil Serious on-the-job accidents in the City of S. Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Diogo Pupo Nogueira

    1981-02-01

    Full Text Available Em 1970, o Grupamento de Acidentes do Trabalho (GAT do INPS desenvolveu programa preventivo contra os acidentes de trabalho. Detalhes operacionais deste programa são descritos, e o resultado da investigação de 3.930 acidentes graves é analisado. Estes acidentes foram estudados quanto às seguintes variáveis: estado civil, faixa etária, sexo, profissão, tipo, conseqüências, fatores, dia da semana, hora do dia, horas decorridas do início do serviço, causas e número de lesões.In 1970, the Accidents On-the-Job Group of the National Institute of Social Security (INPS, began a special program for the prevention of on-the-job-accidents. The following factors were studied in 3,930 cases: age, sex, marital status, occupation, cause of accident, date of occurrence, time of occurrence, occurred how soon after beginning day's work, number and type of body lesions, limitation of working capacity.

  10. Cardiotoxicité des psychotropes

    OpenAIRE

    TAHIRI, Abdallah

    2013-01-01

    Même à dose thérapeutique, les médicaments psychotropes sont susceptibles d'engendrer des troubles du rythme cardiaque graves avec risque létal concourant à expliquer la pré valence de la mort subite dans la population psychiatrique. Les situations cliniques à risque telles que poly médication (des psychotropes entre eux ou d'un psychotrope avec un non psychotrope allongeur de QTc), interactions médicamenteuses aussi bien pharmacodynamiques que pharmacocinétiques, traitement pa...

  11. Death by Suicide in Graves' Disease and Graves' Orbitopathy: A Nationwide Danish Register Study.

    Science.gov (United States)

    Ferløv-Schwensen, Charlotte; Brix, Thomas Heiberg; Hegedüs, Laszlo

    2017-12-01

    Graves' disease (GD) is associated with excess morbidity and mortality, but little is known about unnatural manners of death and the potential relation with Graves' orbitopathy (GO). This study investigated the risk of unnatural death in Graves' patients with and without orbitopathy compared to matched control populations. This was a cohort study covering all adult Danes (≥18 years) diagnosed with GD or GO during 1995-2012. Median follow-up time was 7.9 years (range 0-17.5 years). Utilizing the Danish Register of Causes of Death and the Danish National Patient Registry, 28,461 subjects with GD and 3965 with GO were identified and matched for age and sex with four subjects from the background population. The manner of death was identified, and hazard ratios (HR) for mortality due to unnatural deaths (accident, suicide, violence/homicide, and unknown) were calculated using Cox regression analyses, adjusted for pre-existing somatic and psychiatric morbidity. In Graves' disease overall (GD + GO), there was an increased risk of death from unknown unnatural manners (HR = 2.01 [confidence interval (CI) 1.17-3.45], p = 0.012) and of suicide, although the latter difference was not with certainty statistically significant (HR = 1.43 [CI 1.00-2.04], p = 0.053). There was no significant difference in risk of death from suicide in GD subjects compared to their controls (HR = 1.27 [CI 0.85-1.89], p = 0.253). However, GO patients had a significantly higher risk of death from suicide (HR = 2.71 [CI 1.16-6.32], p = 0.022). Mortality by suicide was increased in Graves' disease overall, most significantly in patients with GO, also after adjustment for pre-existing somatic and psychiatric disease. These findings indicate that GD and GO may have a significant role in the pathophysiological mechanisms of suicidal behavior. Beyond independent confirmation, reasons for this need to be explored in order to introduce preventive measures.

  12. R and D relative to the serious accidents in the PWR type reactors: assessment and perspectives; R and D relative aux accidents graves dans les reacteurs a eau pressurisee: bilan et perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Bentaib, A.; Bonneville, H.; Caroli, H.; Chaumont, B.; Clement, B.; Cranga, M.; Koundy, V.; Laurent, B.; Micaelli, J.C.; Meignen, R.; Pichereau, F.; Plassart, D.; Van-Dorsselaere, P. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92 - Clamart (France); Ducros, G.; Journeau, Ch.; Magallon, D. [CEA Cadarache, 13 - Saint Paul lez Durance (France); Durin, M.; Studer, E. [CEA Saclay 91 - Gif sur Yvette (France); Seiler, J.M. [CEA Grenoble, 38 (France); Ranval, W. [Electricite de France (EDF), 75 - Paris (France)

    2006-07-01

    This document presents the current state of the research relative to the grave accidents realized in France and abroad. It aims at giving the most exhaustive possible and objective vision of this original field of research. He allows to contribute to the identification and to the hierarchical organization of the needs of R and D, this hierarchical organization in front of, naturally, to be completed by a strong lighting on needs in terms of safety analyses associated with the different risks and the physical phenomena, in particular with the support of probability evaluations of safety level 2, whose the level of sharpness must be sufficient not to hide, by construction, physical phenomena of which the limited knowledge leads to important uncertainties. Let us note that neither the safety analyses, nor the E.P.S. 2 are presented in this document. This report presents the physical phenomena which can arise during a grave accident, in the reactor vessel and in the reactor containment, their chain and the means allowing to ease the effects. The corresponding scenarios are presented to the chapter 2. The chapter 3 is dedicated to the progress of the accident in the reactor vessel; the degradation of the core in reactor vessel (3.1), the behavior of the corium in bottom of reactor vessel (3.2) the break of the reactor vessel (3.3) and the fusion in pressure (3.4) are thus handled there. The chapter 4 concerns the phenomena which can lead to a premature failure of the containment, namely the direct heating of gases of the containment (4.1), the hydrogen risk (4.2) and the vapor explosion (4.3). The phenomenon which can lead to a delayed failure from the containment, namely the interaction corium-concrete, is approached on the chapter 5. The chapter 6 is dedicated to the problems connected to the keeping back and to the corium cooling in reactor vessel and out of reactor vessel, namely the keeping back in reactor vessel by re-flooding of the primary circuit or by re

  13. Sports Accidents

    CERN Multimedia

    Kiebel

    1972-01-01

    Le Docteur Kiebel, chirurgien à Genève, est aussi un grand ami de sport et de temps en temps médecin des classes genevoises de ski et également médecin de l'équipe de hockey sur glace de Genève Servette. Il est bien qualifié pour nous parler d'accidents de sport et surtout d'accidents de ski.

  14. Compréhension de la violence à l'encontre des enfants au Rwanda ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Toutes les formes de violence (physique, émotionnelle et sexuelle) à l'encontre des enfants constituent une grave violation des droits de la personne et entraînent de profondes séquelles sur le plan mental et physique à court et à long terme (Étude du Secrétaire général des Nations Unies sur la violence contre les enfants).

  15. Alloimmunisation foeto-maternelle Rhésus grave à propos d'un cas ...

    African Journals Online (AJOL)

    Le dépistage des femmes à risque et l'utilisation d'Immunoglobulines anti D ont permis une réduction importante de l´incidence des accidents d'incompatibilité. La mesure du pic systolique de vélocité dans l'artère cérébrale moyenne a bouleversé la surveillance et la prise en charge prénatale des anémies foetales ...

  16. Gestion des parcours dans la province de Rhamna (Maroc) | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Au Maroc, les parcours font l'objet d'une grave dégradation, et cela a suscité des interventions publiques visant à réduire les pressions exercées sur les ressources naturelles et à favoriser une gestion durable. Dans la province de Rhamna, où l'on pratique depuis des générations la transhumance, les interventions n'ont ...

  17. Two adolescent patients with coexistent Graves' disease and Moyamoya disease in Korea.

    Science.gov (United States)

    Cheon, Chong Kun; Kim, Su Yung; Yoo, Jae-Ho

    2014-06-01

    Moyamoya disease is a cerebrovascular condition that results in the narrowing of the vessels of the circle of Willis and collateral vessel formation at the base of the brain. Although relationships between Graves' disease and cerebrovascular accidents in Moyamoya disease are obscure, the coexistence of the two diseases is noteworthy. Moyamoya disease has been rarely reported in adolescent patients with thyrotoxicosis. Recently, we encountered two adolescent Korean patients with Moyamoya disease associated with Graves' disease who presented with episodic right-sided hemiparesis and syncope. These two girls who had Graves' disease had no history of other diseases or head trauma. A thyroid function test revealed a euthyroid state and a high thyroid-stimulating hormone (TSH) receptor antibody titer at that time. The patients were diagnosed with Moyamoya disease based on brain magnetic resonance angiography and cerebral four-vessel angiography. The patients underwent cranial revascularization by encephalo-duroarterio-synangiosis as soon as a diagnosis was made, which resulted in successful symptom resolution. They fared well and had no additional neurological symptoms as of their last follow-up visits. Here, we report these two cases of confirmed Moyamoya disease complicated by Graves' disease with a review of the literature, and discuss the possible association between the two diseases. To our knowledge, this is the first report in South Korea on Moyamoya disease associated with Graves' disease in adolescents with a euthyroid.

  18. Évaluation de la dynamique de la transmission du Zika et des ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... mais a souligné que la transmission du Zika et ses conséquences graves continueront de représenter un important problème de santé publique. On enregistre encore des lacunes au niveau des connaissances liées à la dynamique de transmission écologique, ou aux facteurs qui ont une incidence sur la propagation du ...

  19. Ampleur et impact des évènements indésirables graves liés aux soins: étude d'incidence dans un hôpital du Centre-Est tunisien

    Science.gov (United States)

    Bouafia, Nabiha; Bougmiza, Iheb; Bahri, Fathi; Letaief, Mondher; Astagneau, Pascal; Njah, Mansour

    2013-01-01

    Introduction La prévention des événements indésirables représente une priorité de santé du fait de leur fréquence et de leur gravité potentielle. Ce travail a été mené afin d'avoir un diagnostic de la situation épidémiologique relative aux événements indésirables survenant dans notre hôpital. Méthodes Une étude prospective a été menée auprès de tous les patients qui ont été hospitalisés au CHU Farhat Hached - Sousse (Tunisie) sur une période d'un mois dans quatorze services de l'hôpital. La détection d'évènement indésirable grave (EIG) était basée sur les critères adoptés dans différentes études. Les tests T et Chi 2 ont été utilisés pour identifier les facteurs contribuant à l'apparition d'évènements indésirables. Résultats Au total, 162 EIG ont été identifiés pendant la période. 45% de ces évènements étaient des infections nosocomiales. Ces EIG ont eu comme conséquences un décès chez 9,2% des patients, la mise en jeu du pronostic vital de 26% des patients et la prolongation de la durée de séjour chez 61,7% d'entre eux. L'admission dans des circonstances particulières et l'exposition à des soins invasifs étaient identifiés comme des facteurs de risque potentiels EIG. Conclusion Le renforcement de la stratégie de gestion des risques sanitaires en ciblant préférentiellement le risque infectieux constitue une étape fondamentale dans l'amélioration de la sécurité des patients au sein de notre établissement de santé. PMID:24711868

  20. Des municipalités côtières du río de la Plata accroissent leur ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    9 juil. 2014 ... ... difficile de traduire des images satellites, des cartes géographiques, des graphiques climatiques et d'autres données scientifiques en une langue facile à comprendre. Pourriez-vous nous dire comment vous avez abordé cette difficulté ? F.A. On sent qu'il existe de graves problèmes de communication et ...

  1. Containment for Heavy-Water Gas-Cooled Reactors; Le Confinement des Reacteurs a Eau Lourde Refroidis par Gaz

    Energy Technology Data Exchange (ETDEWEB)

    Verstraete, P.; Lehmann, D.; Lafitte, R. [Bonard et Gardel, Ingenieurs-Conseils, Lausanne (Switzerland)

    1967-09-15

    par gaz sont passes en revue dans le but d'etablir les specifications des enceintes de confinement en fonction des conditions des sites disponibles en Suisse pour la construction de centrales nucleaires. Ces specifications sont etablies d'apres les taux de dose consideres comme admissibles pour les populations vivant aux environs de la centrale en cas d 'accident grave du reacteur, en se basant sur des conditions meteorologiques et demographiques representatives de la plupart des sites du pays. Differents modes de construction de l ' enceinte de confinement, prenant en consideration les conditions qui s'etablissent dans l'enceinte a la suite de l'accident maximal concevable du reacteur, sont consideres. Les enceintes etudiees sont les suivantes: beton precontraint; beton precontraint avec coupole d'acier; beton precontraint avec peau d' etancheite interieure en acier; acier avec ecran lateral en beton pour la protection contre les radiations; et double confinement. Le degre d'etancheite des enceintes etudiees a ete considere comme une caracteristique lie e au mode de construction particulier et non comme une valeur prescrite en vue de laquelle la construction devait etre adaptee. Les caracteristiques d'etancheite de chaque enceinte sont estimees et les prix de chaque construction ont ete determines sur la base de plans precis avec le concours de diverses entrepises specialisees. L'estimation de l'efficacite des differentes enceintes, sous l'an gle de la securite, a ete faite en prenant en consideration differentes procedures en cas d' accident parmi lesquelles on citera principalement le rejet atmospherique, au travers de filtres adequats, et la decontamination de l 'atmosphere de l 'enceinte par recyclage dans des batteries de filtres. Une dizaine de cas, correspondant a differentes combinaisons de modes de construction et procedures en cas d'accident, font l 'objet d'une comparaison tres detaillee qui a ete realisee grace a un programme pour ordinateur electronique

  2. Temporal relationship between onset of Graves' ophthalmopathy and onset of thyroidal Graves' disease

    NARCIS (Netherlands)

    Wiersinga, W. M.; Smit, T.; van der Gaag, R.; Koornneef, L.

    1988-01-01

    The temporal relationship between the onset of Graves' ophthalmopathy and the onset of thyroidal Graves' disease was evaluated in 125 consecutive patients with Graves' ophthalmopathy. Thyroidal Graves' disease--past or present--was clinically evident in 99 patients (79%): hyperthyroidism in 3 cases.

  3. Les accidents de la vie courante chez l’enfant à Dakar: à propos de 201 cas

    Science.gov (United States)

    Mohamed, Azhar Salim; Sagna, Aloïse; Fall, Mbaye; Ndoye, Ndeye Aby; Mbaye, Papa Alassane; Fall, Aimé Lakh; Diaby, Alou; Ndour, Oumar; Ngom, Gabriel

    2017-01-01

    Les accidents de la vie courante (AcVC) sont fréquents chez l’enfant et peuvent être à l’origine de lésions handicapantes et de décès. L’objectif de notre travail était d’étudier les aspects épidémiologiques et lésionnels des AcVC à Dakar. C’est une étude transversale descriptive menée du 1er Janvier 2013 au 30 juin 2013. Les enfants victimes d’accidents domestiques, d’accidents de sport et de loisirs ou d’accidents scolaires ont été inclus. Nous avons étudié des paramètres généraux et des paramètres ayant trait à chaque type d’AcVC. Deux cent et un enfants ont été inclus, ce qui représentait 27% des consultations aux urgences. Il y avait 148 garçons et 53 filles. Les enfants de moins de 5 ans étaient les plus touchés (37,8%). Le football et le jeu de lutte étaient les grands pourvoyeurs d’AcVC. Les AcVC survenaient principalement à domicile (58,2%) et dans les aires de sport et de loisirs (31,8%). Les fractures prédominaient dans les différents types d’AcVC: 54,9% des accidents domestiques, 68,8% des accidents de sport et de loisirs et 40% des accidents scolaires. Au plan épidémiologique, nos résultats sont superposables à la littérature. Les fractures prédominent à l’opposé de la littérature où les contusions sont prépondérantes. Le jeu de lutte est le plus grand pourvoyeur de ces fractures après le football. La connaissance des aspects épidémiologiques et lésionnels permet de mener des campagnes de prévention des AcVC à Dakar. PMID:29187941

  4. Cooperation in the Event of Nuclear Accidents; Cooperation en Matiere d'Accidents Nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    Bresson, G. [CEA, Centre d' etudes nucleaires, de Fontenay-aux-Roses (France)

    1969-10-15

    This paper is concerned only with the action to be taken in respect of an individual directly affected by an accident and not with the more general measures relating to the population as a whole. Keeping the same sequence of ideas, the paper deals with nuclear establishments and cites criteria for classifying them; hence only the relationship between the establishment and the hospital, and between the radiation protection experts and medical personnel, is discussed. The complex organization of emergency measures, reception of the victim of the accident, and the treatment possibly required should be based on standard practice and published material, both national and international, allowance being made for the characteristics of each sector. A ''flexible'' plan of co-ordination is given as an illustration. Action must be taken in such cases at the site of the accident, inside and outside the establishment, and above all at the hospital. All categories of persons are involved in the process, i.e. fellow-workers, management, specialized services, and medical personnel, each with their own part to play. The manpower and equipment brought into service therefore vary, and depend upon the internal and external relations maintained by the establishment. The measures envisaged should provide for the transport, reception and treatment of those involved in the accident. An existing organization of this kind is described as an illustration. Finally, no action can be of value without full knowledge of the facts and thorough training of the personnel. Some clearly defined ideas on the.subject are considered under this heading. (author) [French] Le memoire ne traite que de la conduite a tenir envers un accidente et non du probleme, plus general, des mesures relatives a une population. Dans le meme ordre d'idees, l'etude porte sur les etablissements nucleaires et leurs criteres de classement; il ne s'agit donc que des liaisons entre retablissement et l'hopital et entre les

  5. Erythropoïétine recombinante, traitement de l'anémie grave d'un ...

    African Journals Online (AJOL)

    Un nourrisson de 25 mois présentant un paludisme grave forme anémique décompensé avec un taux d'hémoglobine de 1,9 g/dl dont les parents sont des Témoins de Jéhovah a été traité par de l'EPOr en lieu et place d'une transfusion sanguine. En effet, les parents étaient contre la transfusion sanguine en raison de leur ...

  6. Major accident analyses for experimental zero-power fast reactor assemblies; Analyse des accidents graves pouvant survenir dans les reacteurs experimentaux a neutrons rapides de puissance zero; Analiz krupnoj avarii dlya ehksperimental'ny kh reaktornykh ustanovok nulevoj moshchnosti na bystrykh nejtronakh; Analisis de los accidentes graves que pueden producirse en los reactores experimentales rapidos de potencia cero

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, G.; Barts, E. W.; Kapil, S.; Tomabechi, K. [Argonne National Laboratory, Argonne, IL (United States)

    1962-03-15

    systems with the very soft neutron-energy spectra characteristic of large oxide power breeders. (author) [French] Les auteurs ont etudie la possibilite, le mecanisme et les consequences de la fusion et autres accidents nucleaires graves dans les reacteurs experimentaux a neutrons rapides de puissance zero, du type ZPR-III, a coeur divise. Cette etude a ete completee par une evaluation de l'importance de l'effet Doppler sur un grand nombre de reacteurs de ce type. Les auteurs demontrent qu'il est fort peu probable qu'une fusion se produise, du fait que la conjonction des circonstances qui pourraient la provoquer est difficilement realisable. L'expose du mecanisme de fusion est suivi de l'analyse des resultats de calculs couples neutronique-hydrodynamiqu e relatifs a deux reacteurs de puissance zero. On a choisi pour cette etude un coeur de 1200 l, qui correspond a un reacteur relativement grand a coeur normal. L'etude a egalement porte sur un coeur plus petit ayant un coefficient cavitaire plus important, qui pourrait presenter un plus grand danger. Chaque systeme a eu un comportement en fonction du temps tout a fait different. Si un accident grave survient dans un reacteur de puissance zero, les atomes de {sup 235}U, isoles dans les plaques d'uranium enrichi, s'echauffen t tres rapidement tandis que le reste du coeur demeure pratiquement froid; il y a ainsi formation d'un gaz du {sup 235}U qui donne lieu a la pression de rupture. Les auteurs expliquent l'adaptation qu'ils ont faite du code AX-I de neutronique-hydrodynamiqu e pour l'appliquer a un gaz de Van der Waals. Une autre modification importante de l'equation d'etat utilisee dans ce code consiste a employer une equation du type Mie-Grueneisen, derivee de la theorie de l'etat solide. Cette modification permet d'evaluer de facon plus satis- faisante le terme de pression pour les coeurs de composition variable. Du fait que les plaques en uranium fortement enrichi d'un reacteur de puissance zero s'echauffent plus

  7. Traumatisme crânien grave et transport héliporté: étude prospective lorraine

    OpenAIRE

    Humbert , Hervé

    2000-01-01

    Non disponible / Not available; Les modalités de prise en charge médicale préhospitalière doivent prendre en compte l'impact essentiel des facteurs d'agression cérébrale secondaire d'origine systémique sur le pronostic des traumatismes crâniens graves. Ainsi tout patient traumatisé crânien avec un score de Glasgow inférieur ou égal à 8 doit bénéficier d'une intubation orotrachéale et d'une ventilation contrôlée, d'un monitorage de la SpO2 er de la PETCO2 et éventuellement d'un remplissage. L'...

  8. Inventaire des cavités souterraines abandonnées et cartographie des dangers qui leur sont liés

    Directory of Open Access Journals (Sweden)

    Claire ARNAL

    1994-12-01

    Full Text Available Un inventaire national des cavités souterraines abandonnées, des accidents de sol qui leur sont imputables et de leurs conséquences dommageables a été réalisé à l’échelle de 1/1 000 000 en 1993 et 1994 par le BRGM pour le ministère de l’Environnement (Direction de la Prévention des Pollutions et des Risques. Il a conduit à élaborer des documents cartographiques de synthèse et à définir des niveaux de dangers dont la localisation permettra de lancer des études plus détaillées en vue d’assurer la sécurité des personnes et des biens

  9. Aspects épidémiologiques, diagnostiques et thérapeutiques des ...

    African Journals Online (AJOL)

    Cette étude avait pour but de renforcer la prise en charge des plaies faciales graves ... l'intervention d'un autre spécialiste, à côté du chirurgien maxillo-facial. ... to reinforce the management of severe facial injuries at the Teaching Hospital ...

  10. Contribution of prototypic material tests on the Plinius platform to the study of nuclear reactor severe accident; Contribution des essais en materiaux prototypiques sur la plate-forme Plinius a l'etude des accidents graves de reacteurs nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    Journeau, Ch

    2008-01-15

    The PLINIUS experimental platform at CEA Cadarache is dedicated to the experimental study of nuclear reactor severe accidents thanks to experiments between 2000 and 3500 K with prototypic corium. Corium is the mixture that would be formed by an hypothetical core melting and its mixing with structural materials. Prototypical corium has the same chemical composition as the corium corresponding to a given accident scenario but has a different isotopic composition (use of depleted uranium,...). Research programs and test series have been performed to study corium thermophysical properties, fission product behaviour, corium spreading, solidification and interaction with concrete as well as its coolability. It was the frame of research training of many students and was realized within national, European and international collaborations. (author)

  11. Catastrophes et consommation des substances psychoactives

    Directory of Open Access Journals (Sweden)

    Krivokapić Žilijeta

    2009-01-01

    Full Text Available (francuski Les catastrophes, les accidents, les stress, les traumatismes sont des expériences négatives de vie accompagnées de changements physiologiques, cognitifs, émotionnels et comportementaux. Les stratégies les plus courantes inefficaces à résoudre les expériences de vie négatives sont: l' agression - ouverte (physique et / ou verbale, passive et latente, le retrait social, le placage, la dépression, l'impuissance, l' isolement et l' abus de médicaments, en particulier de drogues. Les personnes se trouvant dans des situations stressantes essayent de s' aider elles-mêmes souvent en recourant à des substances qui procurent une amélioration de leur état et suppriment le malaise momentané. Cette 'thérapie par auto-thérapie' comporte de graves risques La personne qui, après une période de consommation de ces substances devenaient dépendante, manifeste des changements visibles au niveau physique et psychologique. Elle se dérobe à ses obligations, rompt avec les activités auxquelles elle prenait plaisir autrefois de même qu' avec ses loisirs et ses intérêts; elle change des amis, ses relations familiales et amicales deviennent pauvres et remplies de nombreux conflits; elle devient moins critique et plus manipulative, commence à mentir, trompe pour dissimuler sa toxicomanie, rejoint un groupe de ses semblables, se livre à des activités criminogènes, de plus en plus se dégrade physiquement. L' alcool qui, étant le plus accessible et par conséquent généralement 'la première mesure d' auto-thérapie', a un impact particulièrement dévastateur sur l' organisme sensible au point de vue psycho-physique. Nous assistons à de nombreuses difficultés et des problèmes qui, à la suite de la consommation d' alcool, aggravent ceux liés à des expériences des événements traumatisants. De même l' efficacité de certains comprimés de réduire les tensions ou d' améliorer l' état du patient conduit fréquemment

  12. Graves' disease following subacute thyroiditis.

    Science.gov (United States)

    Nakano, Yoshishige; Kurihara, Hideo; Sasaki, Jun

    2011-12-01

    Subacute thyroiditis is a painful, inflammatory disease frequently accompanied with fever. It is suspected to be a viral infectious disease, while Graves' disease is an autoimmune disease. Thus, there appears to be no etiological relationship between the two diseases. A total of 25,267 thyroid disease patients made their first visits to our thyroid clinic during a period of 24 years between 1985 and 2008. Among them, subacute thyroiditis and Graves' disease accounted for 918 patients (3.6%) and 4,617 patients (18.2%), respectively. We have encountered 7 patients (one male and six female) with subacute thyroiditis followed by Graves' disease in this period (0.15% of the 4,617 patients with Graves' disease and 0.76% of the 918 patients with subacute thyroiditis). The age ranges were 40~66 years (mean 48.7 years) at the onset of subacute thyroiditis. The intervals between the onsets of subacute thyroiditis and Graves' disease were 1~8 months (mean 4.7 months). Because Graves' disease was preceded by subacute thyroiditis, the signs and symptoms of both diseases were evident together in the intervening period. The diagnosis of Graves' disease in those patients is always difficult because of atypical signs and symptoms and an unclear onset time. The causes of the Graves'disease that followed subacute thyroiditis are still unknown. However, the inflammatory nature of subacute thyroiditis may lead to the activation of the autoimmune response in susceptible subjects, resulting in the onset of Graves' disease. Graves' disease should be suspected when a high blood level of thyroid hormone persists after subacute thyroiditis.

  13. Genetics Home Reference: Graves disease

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Graves disease Graves disease Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Graves disease is a condition that affects the function of ...

  14. Material effects on multiphase phenomena in late phases of severe accidents of nuclear reactors; Effets des materiaux sur les phenomenes multiphasiques se produisant lors des phases avancees d'accident grave de reacteur nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Seiler, J.M.; Froment, K

    2003-07-01

    This paper reviews and presents work carried out in the French Atomic Energy Commission (CEA) on the subject of nuclear severe accidents, i.e. those which are accompanied by melting of the nuclear core material. The emphasis is on the (crucial) thermodynamic and material behaviour of corium melts in the solidus-liquidus temperature interval, which is linked to the thermal hydraulic description. A global model approach is proposed. The work is presented in the context of the overall international effort in the area. (authors)

  15. Saint-Laurent-des-Eaux plant - Report on the complementary safety assessment of nuclear facilities in the light of the Fukushima accident

    International Nuclear Information System (INIS)

    2011-01-01

    This CSA (Complementary Safety Assessment) analyses the robustness of the Saint-Laurent-des-Eaux plant to extreme situations such as those that led to the Fukushima accident and proposes a series of improvements. Robustness is the ability for the plant to withstand events beyond the level for which the plant was designed. Robustness is linked to safety margins but also to the situations leading to a sudden deterioration of the accident sequence. Safety is not only a matter of design or of engineered systems, it is also a matter of organization. So issues like EDF's crisis organization, the organization of radiation protection, and work organization via subcontracting are also taken into consideration. The creation of a nuclear rapid action force (FARN) is proposed: this will be a national emergency force made up of specialized teams equipped to intervene in less than 24 hours on a nuclear site hit by an accident. This report is divided into 8 main chapters: 1) features of the site, 2) earthquake risk, 3) flooding risk, 4) risks due to other extreme natural disasters, 5) the loss of electrical power supplies and of heat sink, 6) management of severe accidents (accidents with core melt), 7) task subcontracting policy, 8) synthesis and list of improvements. 4 following appendices review: EDF's crisis organization, the FARN, radiation protection organization and accidental event trees. (A.C.)

  16. Brulure par Plaque de Bistouri Electrique: a Propos de Quatre Cas

    Science.gov (United States)

    Khales, A.; Achbouk, A.; Belmir, R.; Cherkab, L.; Ennouhi, M.A.; Ababou, K.; Ihrai, H.

    2010-01-01

    Summary La brûlure par plaque de bistouri électrique est un accident rare mais grave par la profondeur de la lésion et par sa localisation, surtout quand qu’elle survient dans un contexte chirurgical dont le vécu reste difficile de la part du malade et du chirurgien. Cette brûlure bien que imprévisible reste grave par la profondeur et la localisation de la brûlure et par sa survenue dans un contexte opératoire, chez des patients malades. La prise en charge de la brûlure doit se faire en milieu spécialisé. La prévention reste le seul moyen d’éviter ce type d’accident. PMID:21991216

  17. Thyroid surgery for Graves' disease and Graves' ophthalmopathy.

    Science.gov (United States)

    Liu, Zi Wei; Masterson, Liam; Fish, Brian; Jani, Piyush; Chatterjee, Krishna

    2015-11-25

    Graves' disease is an autoimmune disease caused by the production of auto-antibodies against the thyroid-stimulating hormone receptor, which stimulates follicular cell production of thyroid hormone. It is the commonest cause of hyperthyroidism and may cause considerable morbidity with increased risk of cardiovascular and respiratory adverse events. Five per cent of people with Graves' disease develop moderate to severe Graves' ophthalmopathy. Thyroid surgery for Graves' disease commonly falls into one of three categories: 1) total thyroidectomy, which aims to achieve complete macroscopic removal of thyroid tissue; 2) bilateral subtotal thyroidectomy, in which bilateral thyroid remnants are left; and 3) unilateral total and contralateral subtotal thyroidectomy, or the Dunhill procedure. Recent American Thyroid Association guidelines on treatment of Graves' hyperthyroidism emphasised the role of surgery as one of the first-line treatments. Total thyroidectomy removes target tissue for the thyroid-stimulating hormone receptor antibody. It controls hyperthyroidism at the cost of lifelong thyroxine replacement. Subtotal thyroidectomy leaves a thyroid remnant and may be less likely to lead to complications, however a higher rate of recurrent hyperthyroidism is expected and revision surgery would be challenging. The choice of the thyroidectomy technique is currently largely a matter of surgeon preference, and a systematic review of the evidence base is required to determine which option offers the best outcomes for patients. To assess the optimal surgical technique for Graves' disease and Graves' ophthalmopathy. We searched the Cochrane Library, MEDLINE and PubMed, EMBASE, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). The date of the last search was June 2015 for all databases. We did not apply any language restrictions. Only randomised controlled trials (RCTs) involving participants with a diagnosis

  18. Le paludisme grave d’importation chez l’adulte: étude rétrospective de treize cas admis en réanimation à Marrakech

    Science.gov (United States)

    El Mezouari, El Mostafa; Belhadj, Ayoub; Ziani, Mohamed; Boughanem, Mohamed; Moutaj, Redouane

    2016-01-01

    Le paludisme d’importation est une affection de plus en plus fréquente en zone non endémique. Les formes graves représentent 10 % des cas de paludisme à Plasmodium falciparum. Au Maroc, plus de 50 cas de paludisme sont enregistrés chaque année dont 83 % à P. falciparum. Ont été inclus dans l’étude tous les patients ayant développé un paludisme grave, admis au service de réanimation durant la période comprise entre le 1er Novembre 2009 et le 31 décembre 2015. Les principales données épidémiologiques, les motifs d’admission, la prise en charge et l’évolution ont été étudiés. Treize patients sont retenus. L’âge moyen est de 31 ans. Tous les patients ont séjourné en afrique subsaharienne et étaient non-immuns. La chimioprophylaxie était adéquate dans 33% des cas. Le délai moyen entre le début des symptômes et l’instauration du traitement était de six jours. La parasitémie moyenne initiale était de 12 %. Les motifs d’admission en réanimation étaient un coma (15%), une convulsion (07%), une détresse respiratoire (07%), une prostration (07%), une insuffisance rénale (07%), un choc associé à un ictère et une acidose (07%) et enfin une insuffisance rénale conjuguée à un coma (07%). Tous les patients ont reçu un traitement par la quinine intraveineuse avec une dose de charge dans 100 % des cas. Le taux de mortalité était de 23 %. Les causes du décès étaient dues à la défaillance multi viscérale et au syndrome de détresse respiratoire aigu. La mortalité des formes graves du paludisme reste élevée. L’adéquation de la chimioprophylaxie associée à la précocité du diagnostic et du traitement permettrait d’améliorer significativement le pronostic de cette parasitose. PMID:28292141

  19. Hashimoto's thyroiditis following Graves' disease.

    Science.gov (United States)

    Umar, Husaini; Muallima, Nur; Adam, John M F; Sanusi, Harsinen

    2010-01-01

    Both Graves' disease and chronic thyroiditis (Hashimoto's thyroiditis) are autoimmune diseases of thyroid gland. Graves' disease is caused by stimulation of TSH receptor located on the thyroid gland by an antibody, which is known as TSH receptor antibody (TRAb). Furthermore, this may lead to hyperplasia and hyperfunction of the thyroid gland. On the contrary, the cause of Hashimoto's thyroiditis is thought due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently brings damage and atrophy to thyroid gland. Approximately 15-20% of patients with Graves' disease had been reported to have spontaneous hypothyroidism resulting from the chronic thyroiditis (Hashimoto's disease). Pathogenesis for chronic thyroiditis following anti-thyroid drug treatment in patients with Graves' disease remains unclear. It has been estimated that chronic thyroiditis or Hashimoto's disease, which occurs following the Graves' disease episode is due to extended immune response in Graves' disease. It includes the immune response to endogenous thyroid antigens, i.e. thyroid peroxidase and thyroglobulin, which may enhance lymphocyte infiltration and finally causes Hashimoto's thyroiditis. We report four cases of chronic thyroiditis (Hashimoto's disease) in patients who have been previously diagnosed with Graves' hyperthyroidism. In three cases, Hashimoto's thyroiditis occurs in 7 to 25 years after the treatment of Grave's disease; while the other case has it only after few months of Grave's disease treatment. The diagnosis of Hashimoto's disease (chronic thyroiditis) was based on clinical manifestation, high TSHs level, positive thyroid peroxidase antibody and thyroglobulin antibody, and supported by positive results of fine needle aspiration biopsy. Moreover, the result of histopathological test has also confirmed the diagnosis in two cases. All cases have been successfully treated by levothyroxine treatment.

  20. Isolement et identification des levures.

    Directory of Open Access Journals (Sweden)

    S. DOMERCQ

    1967-06-01

    Full Text Available La fermentation du moût de raisin est assurée par les levures qui se trouvent sur la pellicule du raisin, sur les rafles, et aussi, par celles qui envahissent le matériel de vendange et de vinification dès que la récolte est commencée. L'apparition deLa fermentation du moût de raisin est assurée par les levures qui se trouvent sur la pellicule du raisin, sur les rafles, et aussi, par celles qui envahissent le matériel de vendange et de vinification dès que la récolte est commencée. L'apparition des signes de la fermentation est spontanée. La fermentation est rapide dans la majorité des cas, si elle devient trop violente et que la température s'élève dangeureusement, il faut la « canaliser », la calmer. Des accidents peuvent se produire; des arrêts de fermentation laissant des sucres non fermentés pouvant être attaqués par d'autres microorganismes, des développements de levures formant des substances nuisibles à la qualité; par la suite, il s'agit d'obtenir la stabilité du vin, en particulier, éviter les refermentations des vins doux. L'étude de ces problèmes nécessite une étude préliminaire, celle des levures responsables de la fermentation alcoolique du jus de raisin, qui ne peut être faite que sur des cultures pures, isolées au préalable à l'aide de prélèvements soigneusement réalisés.s signes de la fermentation est spontanée. La fermentation est rapide dans la majorité des cas, si elle devient trop violente et que la température s'élève dangeureusement, il faut la « canaliser », la calmer. Des accidents peuvent se produire; des arrêts de fermentation laissant des sucres non fermentés pouvant être attaqués par d'autres microorganismes, des développements de levures formant des substances nuisibles à la qualité; par la suite, il s'agit d'obtenir la stabilité du vin, en particulier, éviter les refermentations des vins doux. L'étude de ces problèmes nécessite une étude pr

  1. Thyroid cancer in Graves' disease: is surgery the best treatment for Graves' disease?

    Science.gov (United States)

    Tamatea, Jade A U; Tu'akoi, Kelson; Conaglen, John V; Elston, Marianne S; Meyer-Rochow, Goswin Y

    2014-04-01

    Graves' disease is a common cause of thyrotoxicosis. Treatment options include anti-thyroid medications or definitive therapy: thyroidectomy or radioactive iodine (I(131) ). Traditionally, I(131) has been the preferred definitive treatment for Graves' disease in New Zealand. Reports of concomitant thyroid cancer occurring in up to 17% of Graves' patients suggest surgery, if performed with low morbidity, may be the preferred option. The aim of this study was to determine the rate of thyroid cancer and surgical outcomes in a New Zealand cohort of patients undergoing thyroidectomy for Graves' disease. This study is a retrospective review of Waikato region patients undergoing thyroid surgery for Graves' disease during the 10-year period prior to 1 December 2011. A total of 833 patients underwent thyroid surgery. Of these, 117 were for Graves' disease. Total thyroidectomy was performed in 82, near-total in 33 and subtotal in 2 patients. Recurrent thyrotoxicosis developed in one subtotal patient requiring I(131) therapy. There were two cases of permanent hypoparathyroidism and one of permanent recurrent laryngeal nerve palsy. Eight patients (6.8%) had thyroid cancer detected, none of whom had overt nodal disease. Five were papillary microcarcinomas (one of which was multifocal), two were papillary carcinomas (11 mm and 15 mm) and one was a minimally invasive follicular carcinoma. Thyroid cancer was identified in approximately 7% of patients undergoing surgery for Graves' disease. A low complication rate (<2%) of permanent hypoparathyroidism and nerve injury (<1%) supports surgery being a safe alternative to I(131) especially for patients with young children, ophthalmopathy or compressive symptoms. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  2. Les accidents du travail dans le transport urbain en commun de la ville province de Kinshasa, République Démocratique du Congo: une étude transversale descriptive

    Science.gov (United States)

    Wangata, Jemima; Elenge, Myriam; De Brouwer, Christophe

    2014-01-01

    Introduction Le transport en commun urbain constitue un secteur où les travailleurs sont très exposés aux accidents du travail. Cette étude visait une description épidémiologique des accidents du travail dans le secteur informel du transport en commun à Kinshasa en vue d'apporter les pistes d'amélioration de la sécurité des travailleurs dans cette activité. Méthodes Un questionnaire sur les accidents du travail, administré en Décembre 2012 a permis d'explorer les tendances significatives entre les accidents et leurs circonstances, leurs facteurs associés, leurs conséquences au sein d'une population des travailleurs (n = 472) du transport en commun à Kinshasa. Résultats Durant les 12 derniers précédant l’étude 76.5% des travailleurs ont connu au moins un accident du travail, 54,8% ont connu un arrêt d'au moins 1jour. Les accidents liés à la circulation routière étaient plus important suivis des chutes. Les facteurs ayant montré des différences significatives étaient le travail sous l'influence de l'alcool et le port des équipements de protection individuelle. Les plaies (46,3%) et les contusions (39,4%) étaient les lésions les plus courantes. Les membres supérieurs (51,3%) et inférieurs (30,7%) étaient les plus atteints. 76,6% des travailleurs ont assumé seuls leur prise en charge médicale. Conclusion L'incidence des accidents du travail dans ce secteur est très élevée. La mise en place d'une politique de prévention et gestion de différents facteurs associés ainsi qu'un système de déclaration d'accidents est nécessaire dans ce secteur. Les patrons ainsi que les politiques devraient veiller à une prise en charge médicale correcte pour des travailleurs accidentés. PMID:25667703

  3. Envenimation scorpionique compliqué d'un accident vasculaire cérébral ischemique

    Science.gov (United States)

    Bibiche, Youssef; Berdai, Adnan; Labib, Smael; Harandou, Mustapha

    2015-01-01

    Les piqûres de scorpion sont dans un certain nombre de pays, un accident fréquemment rencontré, et un risque grave. Au Maroc, les données épidémiologiques établies par le centre anti-poison (CAPM) montrent que les piqûres scorpioniques se placent en tête de toutes les intoxications relevées par le centre (60%). Les envenimations scorpioniques posent un grand problème de santé publique. L'apparition de signes neurologiques lors d'une envenimation scorpionique témoigne d'une envenimation grave et correspond au stade III de l’échelle de sévérité. Nous rapportons le cas d'une envenimation scorpionique compliqué d'un Accident vasculaire cérébral ischémique (AVCI) chez un enfant. PMID:26175806

  4. Envenimation scorpionique compliqué d'un accident vasculaire ...

    African Journals Online (AJOL)

    Les piqûres de scorpion sont dans un certain nombre de pays, un accident fréquemment rencontré, et un risque grave. Au Maroc, les données épidémiologiques établies par le centre anti-poison (CAPM) montrent que les piqûres scorpioniques se placent en tête de toutes les intoxications relevées par le centre (60%).

  5. Current Concepts in Graves' Disease

    Science.gov (United States)

    Girgis, Christian M.; Champion, Bernard L.; Wall, Jack R.

    2011-01-01

    Graves' disease is the most common cause of hyperthyroidism in the developed world. It is caused by an immune defect in genetically susceptible individuals in whom the production of unique antibodies results in thyroid hormone excess and glandular hyperplasia. When unrecognized, Graves' disease impacts negatively on quality of life and poses serious risks of psychosis, tachyarrhythmia and cardiac failure. Beyond the thyroid, Graves' disease has diverse soft-tissue effects that reflect its systemic autoimmune nature. Thyroid eye disease is the most common of these manifestations and is important to recognise given its risk to vision and potential to deteriorate in response to radioactive iodine ablation. In this review we discuss the investigation and management of Graves' disease, the recent controversy regarding the hepatotoxicity of propylthiouracil and the emergence of novel small-molecule thyroid-stimulating hormone (TSH) receptor ligands as potential targets in the treatment of Graves' disease. PMID:23148179

  6. Return on experience on nuclear accidents

    International Nuclear Information System (INIS)

    Barre, Bertrand

    2015-09-01

    After a presentation of the International Nuclear and radiological Events Scale (INES scale), of its levels and criteria, this article proposes brief recalls of some nuclear accidents which occurred in nuclear reactors: Chalk River in Canada (1952), Windscale in England (1957), the universal Canadian reactor (NRU in 1958), the SL1 reactor of the Idaho National Laboratory in the USA (1961), the Swiss Lucens reactor (1969), Saint-Laurent des Eaux in France (1969 and 1980). More detailed descriptions are then given for the Three Mile Island accident in 1979, the Chernobyl accident in 1986, and the Fukushima accident in 2011. The main causes of these accidents are identified: loss of control of chain reaction, cooling defect on a stopped reactor, cooling defect on an operated reactor. Some lessons are drawn from these facts, and some characteristics of the EPR are outlined with respect with problems encountered in these accidents

  7. Influence de l’hypoperfusion cérébrale à la phase initiale du traumatisme crânien grave. Etude rétrospective en région Lorraine

    OpenAIRE

    Derlon , Vincent

    2015-01-01

    Non disponible / Not available; Introduction: le traumatisme crânien grave (TCG) est un enjeu majeur de santépublique, dont les premières heures de la prise en charge sont cruciales. Un des objectifsest alors de limiter l’hypotension artérielle et son corollaire l’hypoperfusion cérébrale.Toutefois, les études existantes à ce sujet sont anciennes.Objectif: nous avons voulu réévaluer l’influence de l’hypoperfusion cérébrale { la phaseaiguë du traumatisme crânien grave sur le devenir neurologiqu...

  8. Prise en charge des traumatismes graves du rein | Lakmichi | Pan ...

    African Journals Online (AJOL)

    Une surveillance active clinique, biologique, et radiologique a été préconisée dans 23 cas (92%). Le scanner de contrôle fait à J7, a objectivé une stabilisation des lésions dans 17 cas et la constitution d'un urinome dans 2 cas drainé par sonde double J. Une néphrectomie d'hémostase était nécessaire dans 4 cas de grade ...

  9. Safety report concerning the reactor Pegase - volume 1 - Description of the installation - volume 2 - Safety of the installations; Rapport de surete du reacteur pegase - tome 1 - Description des installations - tome 2 - Surete des installations

    Energy Technology Data Exchange (ETDEWEB)

    Lacour, J. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Legoin, P. [S.E.M. Hispano-Suiza, 92 - Colombes (France)

    1964-07-01

    In the first volume: This report is a description of the reactor Pegase, given with a view to examine the safety of the installations. The Cadarache site at which they are situated is briefly described, in particular because of the consequences on the techniques employed for building Pegase. A description is also given of the original aspects of the reactor. The independent loops which are designed for full-scale testing of fuel elements used in natural uranium-gas-graphite reactor systems are described in this report, together with their operational and control equipment. In the second volume: In the present report are examined the accidents which could cause damage to the Pegase reactor installation. Among possible causes of accidents considered are the seismicity of the region, an excessive power excursion of the reactor and a fracture in the sealing of an independent loop. Although all possible precautions have been taken to offset the effects of such accidents, their ultimate consequences are considered here. The importance is stressed of the security action and regulations which, added to the precautions taken for the construction, ensure the safety of the installations. (authors) [French] Dans le volume 1: Ce rapport est une description du reacteur Pegase, afin d'examiner la surete des installations. Le site de CADARACHE ou elles sont situees, a ete sommairement decrit, en particulier, a cause des consequences sur les techniques mises en oeuvre pour la realisation de Pegase. Nous nous sommes egalement attache a decrire les aspects originaux du reacteur. Les boucles autonomes destinees a tester en vraie grandeur des elements combustibles de la filiere uranium naturel graphite-gaz, ainsi que leurs dispositifs de controle et d'exploitation, figurent egalement dans ce rapport. Dans le volume 2: Dans le present rapport, nous examinons des accidents pouvant endommager des installations du reacteur Pegase. Les origines d'accidents examines

  10. Safety report concerning the reactor Pegase - volume 1 - Description of the installation - volume 2 - Safety of the installations; Rapport de surete du reacteur pegase - tome 1 - Description des installations - tome 2 - Surete des installations

    Energy Technology Data Exchange (ETDEWEB)

    Lacour, J [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Legoin, P [S.E.M. Hispano-Suiza, 92 - Colombes (France)

    1964-07-01

    In the first volume: This report is a description of the reactor Pegase, given with a view to examine the safety of the installations. The Cadarache site at which they are situated is briefly described, in particular because of the consequences on the techniques employed for building Pegase. A description is also given of the original aspects of the reactor. The independent loops which are designed for full-scale testing of fuel elements used in natural uranium-gas-graphite reactor systems are described in this report, together with their operational and control equipment. In the second volume: In the present report are examined the accidents which could cause damage to the Pegase reactor installation. Among possible causes of accidents considered are the seismicity of the region, an excessive power excursion of the reactor and a fracture in the sealing of an independent loop. Although all possible precautions have been taken to offset the effects of such accidents, their ultimate consequences are considered here. The importance is stressed of the security action and regulations which, added to the precautions taken for the construction, ensure the safety of the installations. (authors) [French] Dans le volume 1: Ce rapport est une description du reacteur Pegase, afin d'examiner la surete des installations. Le site de CADARACHE ou elles sont situees, a ete sommairement decrit, en particulier, a cause des consequences sur les techniques mises en oeuvre pour la realisation de Pegase. Nous nous sommes egalement attache a decrire les aspects originaux du reacteur. Les boucles autonomes destinees a tester en vraie grandeur des elements combustibles de la filiere uranium naturel graphite-gaz, ainsi que leurs dispositifs de controle et d'exploitation, figurent egalement dans ce rapport. Dans le volume 2: Dans le present rapport, nous examinons des accidents pouvant endommager des installations du reacteur Pegase. Les origines d'accidents examines comprennent la seismicite

  11. Auto-estima na forma inativa da oftalmopatia de Graves Inactive Graves' ophthalmopathy and self-esteem

    Directory of Open Access Journals (Sweden)

    Carlos Henrique de Toledo Magalhães

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar a auto-estima dos pacientes com oftalmopatia de Graves na fase inativa. MÉTODOS: Foram avaliados 30 pacientes portadores de oftalmopatia de Graves, eutireoideanos, na fase inativa, com idade variando entre 26 e 65 anos, média 43 ± 11,0 anos, denominado grupo estudo e 39 indivíduos que não apresentavam oftalmopatia de Graves, com idade variando entre 18 e 67 anos, média de 41 ± 13,4 anos, selecionados na população geral denominado grupo controle. Para avaliar a auto-estima foi utilizada a escala de auto-estima Rosenberg Unifesp-EPM aplicada por meio de entrevista. Os valores dos escores de auto-estima nos dois grupos estudados foram comparados pelo teste não paramétrico de Mann-Whitney. O mesmo teste foi aplicado com objetivo de comparar os resultados obtidos no grupo oftalmopatia de Graves considerando a gravidade da doença. RESULTADOS: Não foi observada alteração com significância estatística na auto-estima dos pacientes com oftalmopatia de Graves (p=0,057. O grupo estudo apresentou, em média, valores inferiores de auto-estima, comparado ao grupo controle. Não houve diferença da auto-estima entre os pacientes dos subgrupos leve e moderado-grave (P=0,2710. CONCLUSÃO: A oftalmopatia de Graves na fase inativa não afetou a auto-estima dos pacientes, no grupo estudado.PURPOSE: To assess the self-esteem of Graves' ophthalmopathy patients in the inactive phase. METHODS: Thirty euthyroid patients were evaluated in the inactive phase of disease with age ranging from 26 to 65 years, average of 43 ± 11,0 years, called study group and 39 individuals without Graves' ophthalmopathy with age ranging from 18 to 67 years, average of 41 ± 13,4 years, selected from the general population called control group. To evaluate the self-esteem the Rosenberg UNIFESP/EPM self-esteem scale, applied by means of an interview, was utilized. The self-esteem scores in the two studied groups were compared by means of the non

  12. Optimal management of Graves orbitopathy: a multidisciplinary approach

    NARCIS (Netherlands)

    Soeters, M. R.; van Zeijl, C. J. J.; Boelen, A.; Kloos, R.; Saeed, P.; Vriesendorp, T. M.; Mourits, M. P.

    2011-01-01

    Graves' thyroid disease is a relatively common disorder in endocrinology and general internal medicine practice. Graves' hyperthyroidism is mediated by circulating stimulating autoantibodies. Up to 60% of patients with Graves' hyperthyroidism develop some form of Graves' orbitopathy. Immune

  13. Radiation hazards in the neighbourhood of uranium reactors; Dangers des rayonnements aupres des piles a uranium

    Energy Technology Data Exchange (ETDEWEB)

    Joffre, H [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1956-07-01

    Radiation hazards near uranium reactors may be divided in two groups. Hazards when the reactor is normally operating: {gamma} radiation from hot uranium or air contamination by fission gases, {gamma} radiation or contamination by the coolant (air, nitrogen, heavy-water), {gamma} radiation from radioisotopes. Hazards in the case of an accident: presence of hot uranium in the atmosphere, soil contamination. (author) [French] Les dangers d'irradiation aupres des piles a uranium sont a classer essentiellement en deux groupes. Les dangers existant aupres d'une pile exploitee normalement: irradiation {gamma} par l'uranium irradie ou contamination de l'air par des gaz de fission, irradiation {gamma} ou contamination par les fluides de refroidissement (air, azote, eau lourde), irradiation {gamma} par les radioelements fabriques. Les dangers en cas d'accident survenant a un reacteur en fonctionnement, ayant pour consequence : la presence dans l'air d'uranium irradie, la contamination du sol. (auteur)

  14. [Not Available].

    Science.gov (United States)

    El Ketani, A; Amir, F; Ali, T B; Hamdani, M; Zaghloul, K

    2006-12-31

    Les enfants célèbrent la fête de Achoura au Maroc par des jeux de feu, ce qui occasionne des blessures oculaires plus au moins graves. Nous rapportons 15 observations de malades traités au Service d'Ophtalmologie Pédiatrique de l'Hôpital 20 Août 1953 de Casablanca. L'âge moyen des patients était de 12 ans et demi, avec des extrêmes de 3 et 25 ans. Les pétards, la première cause des accidents (50%), ont occasionné des contusions oculaires avec parfois un oedème de Berlin (deux cas). L'atteinte oculaire par fusée a occasionné un éclatement de globe et une plaie de paupière. Les bombes de carbone ont été responsables de brûlures de deuxième degré palpébrales et conjonctivo-cornéennes avec de multiples corps étrangers cornéens profonds. Les «étoiles» et la limaille de fer ont provoqué des brûlures cornéennes moins graves avec des corps étrangers superficiels. Les pistolets à bille ont été responsables de contusions oculaires. La réglementation de vente des jeux de feu et la sensibilisation du grand public par les moyens audiovisuels permettraient de prévenir ces blessures oculaires.

  15. Les Lesions Oculaires Par Jeu de Feu au Cours de Achoura

    Science.gov (United States)

    El Ketani, A.; Amir, F.; Ali, T.B.; Hamdani, M.; Zaghloul, K.

    2006-01-01

    Summary Les enfants célèbrent la fête de Achoura au Maroc par des jeux de feu, ce qui occasionne des blessures oculaires plus au moins graves. Nous rapportons 15 observations de malades traités au Service d'Ophtalmologie Pédiatrique de l'Hôpital 20 Août 1953 de Casablanca. L'âge moyen des patients était de 12 ans et demi, avec des extrêmes de 3 et 25 ans. Les pétards, la première cause des accidents (50%), ont occasionné des contusions oculaires avec parfois un oedème de Berlin (deux cas). L'atteinte oculaire par fusée a occasionné un éclatement de globe et une plaie de paupière. Les bombes de carbone ont été responsables de brûlures de deuxième degré palpébrales et conjonctivo-cornéennes avec de multiples corps étrangers cornéens profonds. Les «étoiles» et la limaille de fer ont provoqué des brûlures cornéennes moins graves avec des corps étrangers superficiels. Les pistolets à bille ont été responsables de contusions oculaires. La réglementation de vente des jeux de feu et la sensibilisation du grand public par les moyens audiovisuels permettraient de prévenir ces blessures oculaires. PMID:21991053

  16. Les manifestation oculaires des troubles primitifs du metabolisme des lipides: Étude clinique, génétique et anatomo-pathologique

    Directory of Open Access Journals (Sweden)

    D. Klein

    1955-01-01

    Full Text Available Les lipidoses constituent un groupe d'affections systématisées, caractérisées par une surcharge lipidique des tissus (en premier lieu du système réticulo-endothélial, accessoirement aussi de divers parenchymes. Le processus qui est à la base de ces "thèsaurismoses" consiste en une perturbation primitive du métabolisme des graisses et des substances apparentées, aboutissant à une infiltration lipidique des organes et entraînant des troubles cliniques variés et souvent très graves. La participation prépondérante du système nerveux central et de l'oeil aux désordres cliniques represente un des aspects les plus importants de la pathologie des lipidoses. Toutes ces affections, excepté la maladie de Hand-Schüller-Christian, offrent en outre un intérêt considérable à cause du rôle primordial que joue l'hérédité comme facteur étiologique. On peut distinguer trois principaux types de lipidoses, groupés d'aprés les substances thésaurisées: les lipidoses à phosphatides, qui peuvent être subdivisées en A. les idioties amaurotiques (surcharge en gangliosides et B. la maladie de Niemann-Pick (sphingomyélines; les lipidoses à cérébrosides (cérasine représentées par la maladie de Gaucher; les lipidoses à cholestérol ou xanthomatoses.

  17. Grave's disease 1835-2002.

    Science.gov (United States)

    Weetman, A P

    2003-01-01

    This brief review describes the history of Graves' disease, starting with the original descriptions by Parry, Graves and von Basedow. The true aetiology of the disorder was uncovered in the 1950s and 1960s, based on the search for a novel thyroid stimulator which turned out to be an immunoglobulin G autoantibody. Assays for these thyroid stimulatory antibodies have been continually refined and their epitopes on the thyroid stimulating hormone receptor are increasingly well characterized. We also understand far more about the genetic and environmental susceptibility factors that predispose to disease, and even thyroid-associated ophthalmopathy has now been better defined as primarily a T-cell-mediated disease resulting from cytokine stimulation of orbital fibroblasts. These advances should improve treatment options for Graves' disease in the foreseeable future.

  18. Prise en charge en soins primaires des troubles liés à l’usage d’alcool et de la consommation à risque

    Science.gov (United States)

    Spithoff, Sheryl; Kahan, Meldon

    2015-01-01

    Résumé Objectif Présenter aux médecins de soins primaires des renseignements et des conseils fondés sur des données probantes concernant la prise en charge de la consommation à risque et des troubles liés à l’usage d’alcool (TUA). Sources des données Nous avons entrepris une recherche documentaire non systématique à l’aide d’expressions de recherche en anglais, notamment primary care; screening, interventions, management et treatment; et at-risk drinking, alcohol use disorders, alcohol dependence et alcohol abuse; ainsi que des interventions spécifiques en médecine et en counseling pertinentes aux soins primaires. Principaux messages Dans le cas de patients ayant une consommation à risque ou un TUA, les médecins devraient offrir du counseling et, au besoin (p. ex. les patients dont le TUA est de modéré à grave), prescrire et connecter. Counseling : Offrir à tous les patients ayant une consommation à risque une brève séance de counseling et un suivi. Offrir à tous les patients ayant un TUA des séances de counseling et un suivi constant (fréquent et régulier). Prescrire : Offrir des médicaments (disulfiram, naltrexone, acamprosate) à tous les patients ayant un TUA de modéré à grave. Connecter : Encourager les patients souffrant d’un TUA à suivre des programmes de counseling de jour ou en résidence et d’adhérer à des groupes d’entraide. S’il est indiqué de le faire, demander une consultation pour le patient auprès d’un spécialiste en médecine des dépendances, de services concurrents en santé mentale et en toxicomanie ou une thérapie spécialisée pour traumatisme. Conclusion Les médecins de famille peuvent prendre en charge efficacement les patients qui ont une consommation à risque ou des TUA.

  19. Follow up of Graves' Opthalmopathy after radioiodine therapy

    International Nuclear Information System (INIS)

    Miah, M.S.R.; Paul, A. K.; Rahman, H.A.

    2002-01-01

    Graves' ophthalmopathy may first appear or worsen during or after treatment for hyperthyroidism. We followed up 158 Graves' hyperthyroid patients treated with radioiodine of which 49 had Grave's' ophthalmopathy during presentation in Nuclear Medicine Centre, Khulna during the period from 1995 to 2000. The aim of our study is to see the effect of radioiodine in Graves' ophthalmopathy. All the patients received radioiodine at fixed dose regime ranged from 7 mCi to 12 mCi. The duration of follow up was at least 12 months Graves' ophthalmopathy patients, 4 (4/49 i.e., 8.2%) showed exaggeration of ophthalmopathy and the rest (45/49 i.e., 91.8%) remained unchanged. None of ophthalmopathy developed among any of Graves' hyperthyroid or disappeared after radioiodine treatment during follow up period. From the study we concluded that eye changes in Graves' hyperthyroidism remain unchanged or exaggerated after radioiodine therapy and needs ophthalmologist care.(author)

  20. Calculation programme for the accidental transients in reactors of the gas-graphite type; Programme de calcul des transitoires accidentels des piles de la filiere graphite-gaz

    Energy Technology Data Exchange (ETDEWEB)

    Henri, Ch.; Bayard, J.P. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1964-07-01

    The study of the behaviour of the fuel during certain incidents or accidents in reactors is closely connected to the study of the changes in temperature. This document describes in the first part the main physical phenomena governing the kinetics of the accident. The aim is to know the temperatures at all points and at all times during the irregular regime which can follow the initial stable regime. In the second part an explanation is given of the numerical methods used. (authors) [French] L'etude du comportement du combustible lors de certains incidents ou accidents de pile est etroitement liee a l'etude de l'evolution des temperatures. Dans sa premiere partie, ce document decrit les phenomenes physiques principaux intervenant dans la cinetique de l'accident. Le but recherche est la connaissance des temperatures en tout point et a tout instant d'un regime varie, faisant suite a un regime initial stable. Dans la deuxieme partie les methodes numeriques employees sont explicitees. (auteurs)

  1. Analyses d'accidents : une nécessité pour les analyses de danger et l'intervention en situation d'urgence ?

    OpenAIRE

    Pineau , Jean-Philippe; Abiven , Françoise; Lechaudel , Jean-François; Mavrothalassitis , Guy

    1993-01-01

    Lors d'accidents industriels mettant en jeu des explosions, des incendies ou des émissions de produits toxiques ou inflammables dans l'environnement, les effets à prendre en compte s'expriment en termes d'impulsions de pression, de projections de débris, de flux thermiques et de rejets de produits toxiques dans l'air, les eaux et les sols. Dans sa première partie, le présent article présente les conclusions consécutives à l'analyse de différents types d'accidents survenus en France et met en ...

  2. Chimie des processus biologiques

    OpenAIRE

    Fontecave, Marc

    2014-01-01

    Cours : Chimie biologique radicalaire : de l’origine de l’ADN au métabolisme d’aujourd’hui Il est généralement admis que les radicaux libres, espèces chimiques très réactives, sont des poisons pour les systèmes vivants qui ont élaboré des mécanismes efficaces pour s’en protéger et s’en débarrasser lorsqu’ils viennent à se former, par accident. Par exemple ce qu’on appelle communément le stress oxydant est une situation caractérisée par une accumulation de radicaux issus de l’oxygène moléculai...

  3. [Thyroid cancer in patients with Grave's Disease].

    Science.gov (United States)

    Mssrouri, R; Benamr, S; Essadel, A; Mdaghri, J; Mohammadine, El H; Lahlou, M-K; Taghy, A; Belmahi, A; Chad, B

    2008-01-01

    To evaluate the incidence of thyroid carcinoma in patients operated on for Graves' disease, to identify criteria which may predict malignancy, and to develop a practical approach to determine the extensiveness of thyroidectomy. Retrospective study of all patients who underwent thyroidectomy for Graves' disease between 1995 and 2005. 547 patients underwent subtotal thyroidectomy for Graves' disease during this period. Post-operative pathology examination revealed six cases of thyroid cancer (1.1%). All six cases had differentiated thyroid carcinoma (papillary carcinoma in 3 cases, follicular carcinoma in 2 cases and papillo-follicular carcinoma in 1 case). The indication for initial thyroidectomy was a palpable thyroid nodule in 3 cases (50%), failure of medical treatment for Grave's disease in 2 cases (33%), and signs of goiter compression in 1 case (17%). Five patients underwent re-operative total thyroidectomy. This study shows that while malignancy in Grave's disease is uncommon, the presence of thyroid nodule(s) in patients with Grave's disease may be considered as an indication for radical surgery. The most adequate radical surgery in this situation is to perform a total thyroidectomy.

  4. Case series

    African Journals Online (AJOL)

    abp

    10 juin 2014 ... appliquer de la glace et à effectuer une mobilisation précoce de l'articulation dès l'arrêt de la douleur. Les hémorragies extériorisées peu graves étaient traitées par une pression locale continue. Tous les accidents étaient notés sur un cahier que le médecin consultait au cours des rendez-vous trimestriels.

  5. PRISE EN CHARGE DES PATIENTS DIABETIQUES AGES

    Directory of Open Access Journals (Sweden)

    Bernard BAUDUCEAU

    2017-05-01

    Full Text Available La prise en charge des patients diabétiques âgés est devenue aujourd’hui un véritable problème de santé publique du fait de l’augmentation du nombre des malades. Dans cette population, les complications du diabète sont plus graves et s’intriquent avec les manifestations plus spécifiquement gérontologiques. L’évaluation gériatrique standardisée est indispensable pour définir la situation de chaque malade selon son degré d’autonomie et de dénutrition, ses fonctions cognitives et son environnement social. Les objectifs thérapeutiques doivent être individualisés en fonction de la présentation clinique du patient. L’insulinothérapie est fréquemment incontournable et nécessite l’éducation du patient ou de son entourage. La prise en charge des patients diabétiques âgés doit éviter un trop grand laxisme chez une personne restée en bonne santé mais aussi un activisme déraisonnable chez les sujets fragiles en raison du risque hypoglycémique.

  6. Notes on Glasinac: The chronology of princely graves

    Directory of Open Access Journals (Sweden)

    Vasić Rastko

    2009-01-01

    Full Text Available Princely graves of the Iron Age represent a particular phenomenon in archaeology, which is constantly the subject of interest. They are usually dated to the end of the 6th and the beginning of the 5th century. The author discusses the chronology of princely graves in the Central Balkans and analyses their appearance in each part of this territory: on the Glasinac plateau, in Serbia, Kosovo and Metohija, Montenegro, North Albania and Nordwest Bulgaria. He concludes that they date from the middle of the 7th to the middle of the 4th century, depending on the cultural and socio-economic situation in the respective area. In the middle of the 7th century princely graves in the true sense of the word were known only on the Glasinac plateau, in the Ilijak necropolis. At the end of the 7th and in the beginning of the 6th century they still appear on Glasinac, though in greater number and in various parts of the plateau. In northwest Bulgaria a grave dating to the second half of the 7th century was found, which would, according to grave goods, correspond to the Glasinac princely graves. On the other hand, there are no princely graves in Serbia and north Albania from that time but some outstanding warrior graves are known, belonging possibly to the chiefs of smaller warlike bands, whose power was limited. Princely graves from Arareva gromila on Glasinac, Pilatovići by Požega and Lisijevo Polje by Berane date to the beginning of the second half of the 6th century, and according to their characteristics represent princes, whose power and wealth were considerable and known to the neighbours. Culmination of the rise of the princes in this region was demonstrated by the graves from Novi Pazar, Atenica, and Pećka banja, which date to the end of the 6th and the first quarter of the 5th century. Some decades later there are several rich graves, e.g. the recently discovered grave from Velika Krsna, which could belong to a prince, but can not be compared with the

  7. Effect of 131I therapy on outcomes of Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Wang Renfei; Tan Jian; Zhang Guizhi; Yin Liang

    2011-01-01

    Objective: To analyze the correlation between the therapeutic effect of Graves' hyperthyroidism and the outcomes of Graves' ophthalmopathy after 131 I therapy, and to explore the effect of 131 I treatment on turnout of Graves' ophthalmopathy. Methods: Six hundreds and fifty-two patients of Graves' disease accompanied with Graves' ophthalmopathy, received one-time 131 I treatment according to routine procedure. We recorded exophthalmometer readings, the signs and symptoms of eyes before therapy. Regular follow-up and appraisal of curative effect were carried out. Results: At least six months after 131 I therapy, the effective rate of Graves' hyperthyroidism and Graves' ophthalmopathy were 94.3% and 73.3% respectively. The total effective rate of hyperthyroidism with ophthalmopathy was 71.2%. There was a significant correlation between the prognosis of Graves' ophthalmopathy and therapeutic efficacy of hyperthyroidism (r=0.302, P 131 I therapy (χ 2 =0.296, P>0.05). Conclusions: The key to treat Graves' ophthalmopathy is the cure of Graves' hyperthyroidism through 131 I therapy. The timely diagnosis and replacement treatment of hypothyroidism can effectively avoid the aggravation of Graves' ophthalmopathy after 131 I therapy. (authors)

  8. [Serum glycosaminoglycans in Graves' disease patients].

    Science.gov (United States)

    Winsz-Szczotka, Katarzyna B; Olczyk, Krystyna Z; Koźma, Ewa M; Komosińska-Vassev, Katarzyna B; Wisowski, Grzegorz R; Marcisz, Czesław

    2006-01-01

    The aim of the study was to determine the blood serum sulfated glycosaminoglycans (GAGs) and hyaluronic acid (HA) concentration of Graves' disease patients before treatment and after attainment of the euthyroid state. The study was carried out on the blood serum obtained from 17 patients with newly recognised Graves' disease and from the same patients after attainment of the euthyroid state. Graves' patients had not any clinical symptoms neither of ophthalmopathy nor pretibial myxedema. GAGs were isolated from the blood serum by the multistage extraction and purification using papaine hydrolysis, alkali elimination, as well as cetylpyridium chloride binding. Total amount of GAGs was quantified by the hexuronic acids assay. HA content in obtained GAGs sample was evaluated by the ELISA method. Increased serum concentration of sulfated GAGs in non-treated Graves' disease patients was found. Similarly, serum HA level in untreated patients was significantly elevated. The attainment of euthyroid state was accompanied by the decreased serum sulfated GAGs level and by normalization of serum HA concentration. In conclusion, the results obtained demonstrate that the alterations of GAGs metabolism connected with Graves' disease can lead to systemic changes of the extracellular matrix properties.

  9. Antiphospholipid antibody syndrome complicated by Grave's disease.

    Science.gov (United States)

    Takahashi, Ayumi; Tamura, Atsushi; Ishikawa, Osamu

    2002-12-01

    The report describes a woman with primary antiphospholipid antibody syndrome complicated with Grave's disease. Developing symptoms included a small cutaneous nodule on her finger and subsequently ecchymotic purpura on the cheeks, ears, buttocks and lower legs. Histological examinations showed thrombosed vessels in the dermis without or with hemorrhage, respectively. Laboratory investigation revealed positive lupus anticoagulant and immunogenic hyperthyroidism due to Grave's disease. There is a close relationship between the cutaneous manifestation of antiphospholipid antibody syndrome and the activities of Grave's disease and a possible link of antiphospholipid antibody syndrome with Grave's disease was suggested both by the etiology of the disease as well as the disease activity.

  10. Graves' disease and Thyroid anaplasic carcinoma

    International Nuclear Information System (INIS)

    Guerrero E, Helena; Quintero A, Flor Maria; Carmona C, Antonio

    1992-01-01

    A case of a 34 year-old patient is presented, who was diagnosed with Graves' disease and developed a thyroid anaplastic carcinoma from a clinically detected nodular mass. The incidence of thyroid cancer associated with Graves' disease is revisited

  11. Prevalence des hemolysines chez les donneurs de sang de groupe ...

    African Journals Online (AJOL)

    Objectifs : Déterminer la fréquence et le titre des hémolysines anti-A et anti-B dans la population des donneurs O et de prédire de l'intérêt de la systématisation de leur recherche chez tous les donneurs O par l'évaluation du risque d'accident transfusionnels liés aux hémolysines. Méthodologie : Etude prospective au ...

  12. Outcome of very long-term treatment with antithyroid drugs in Graves' hyperthyroidism associated with Graves' orbitopathy

    NARCIS (Netherlands)

    Elbers, Laura; Mourits, Maarten; Wiersinga, Wilmar

    2011-01-01

    It is still debated which treatment modality for Graves' hyperthyroidism (GH) is most appropriate when Graves' orbitopathy (GO) is present. The preference in our center has been always to continue antithyroid drugs for GH (as the block-and-replace [B-R] regimen) until all medical and/or surgical

  13. Postoperative hypocalcemia after thyroidectomy for Graves' disease.

    Science.gov (United States)

    Pesce, Catherine E; Shiue, Zita; Tsai, Hua-Ling; Umbricht, Christopher B; Tufano, Ralph P; Dackiw, Alan P B; Kowalski, Jeanne; Zeiger, Martha A

    2010-11-01

    It is believed that patients who undergo thyroidectomy for Graves' disease are more likely to experience postoperative hypocalcemia than patients undergoing total thyroidectomy for other indications. However, no study has directly compared these two groups of patients. The aim of this study was to determine whether there was an increased incidence or severity of postoperative hypocalcemia in patients who underwent thyroidectomy for Graves' disease. An institutional review board-approved database was created of all patients who underwent thyroidectomy from 1998 to 2009 at the Johns Hopkins Hospital. There were a total of 68 patients with Graves' disease who underwent surgery. Fifty-five patients who underwent total thyroidectomy were randomly selected and served as control subjects. An analysis was conducted that examined potential covariates for postoperative hypocalcemia, including age, gender, ethnicity, preoperative alkaline phosphatase level, size of goiter, whether parathyroid tissue or glands were present in the specimen, and the reason the patient underwent surgery. Specific outcomes examined were calcium levels on postoperative day 1, whether or not patients experienced symptoms of hypocalcemia, whether or not Rocaltrol was required, the number of calcium tablets prescribed upon discharge, whether or not postoperative tetany occurred, and calcium levels 1 month after discharge. Each outcome was analyzed using a logistic regression. Graves' disease patients had a significantly (p-value Graves' disease and no patient in the control group were readmitted with tetany (p = 0.033). There was a trend, though not significant, toward patients with Graves' disease having a higher prevalence of hypocalcemia the day after thyroidectomy and 1 month later. Patients with Graves' disease are more likely to require increased dosages of calcium as well as experience tetany postoperatively than patients undergoing total thyroidectomy for other indications. This suggests that

  14. Thyroid carcinoma in Graves' disease: A meta-analysis.

    Science.gov (United States)

    Staniforth, Joy U L; Erdirimanne, Senarath; Eslick, Guy D

    2016-03-01

    The incidence of thyroid carcinoma is increasing worldwide. Graves' disease is the most common hyperthyroid disease. Studies have suggested an increased risk of thyroid malignancy in Graves' disease: there has not yet been a meta-analysis to allow quantitative comparison. The purpose of this study was to determine the risk of thyroid carcinoma in Graves' disease, and to gather information on the histological subtypes of carcinoma and the co-existence of thyroid nodules. Several databases and article reference lists were searched. Inclusion criteria included appropriate diagnostic criteria for thyroid conditions and a diagnoses of carcinoma based on histology. 33 studies were selected, all reporting on surgically-resected specimens. The event rate of thyroid carcinoma in Graves' disease was 0.07 (95% CI 0.04 to 0.12). There was no data to allow comparison with patients without hyperthyroid diseases. There was no increase in the odds of developing carcinoma in Graves' disease compared to toxic multinodular goitre and toxic uninodular goitre. 88% of thyroid carcinomas in Graves' disease were papillary, with solitary papillary micro-carcinoma (diameter 10 mm or less) comprising 23% of all detected thyroid carcinomas. Patients with Graves' disease and co-existing thyroid nodules were almost 5 times more likely to be diagnosed with thyroid carcinoma than those without nodules. Thyroid malignancy in Graves' disease requiring surgical treatment should be considered as likely as in other hyperthyroid diseases needing surgical treatment. Clinicians should consider screening selected patients with Graves' disease for nodules whilst being aware of potentially over-diagnosing papillary micro-carcinoma. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  15. Study of top reflooding in case of severe accident and in particular oxidation of Uranium, Zirconium, Oxygen melts; Etude du renoyage par le haut en cas d'accident grave et en particulier oxydation des melanges (U,Zr,O)

    Energy Technology Data Exchange (ETDEWEB)

    Brunet-Thibault, E

    2006-12-15

    In 1979, the Three Mile Island (TMI) accident occurred in United States and accelerated research activities in the field of severe accidents. Severe accident management procedures imply massive water injections to flood the core. The work of this thesis bent principally over this reflooding. The first part of the study concerns the core oxidation enhancement during the reflooding phase which leads to a rough increase of the concentration of burnable hydrogen in the containment. This is why the study carried on the analysis of the contribution of the oxidation of U-Zr-O mixtures, towards the total production of hydrogen during reflooding. In the second part, the study concerns top flooding modelling i.e.: with injection of water in the hot legs. Here, we attempted to define bases and realize a model allowing to describe this type of reflooding. These models were validated on the simulation of the parameter with MAAP4 code. (author)

  16. PREGO (presentation of Graves' orbitopathy) study

    DEFF Research Database (Denmark)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio

    2015-01-01

    BACKGROUND/AIMS: The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. METHODS: Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres...

  17. Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism

    DEFF Research Database (Denmark)

    Wiersinga, Wilmar; Žarković, Miloš; Bartalena, Luigi

    2018-01-01

    OBJECTIVE: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH). DESIGN: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers f...

  18. Epidemiology and prevention of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.; Bartalena, Luigi

    2002-01-01

    Graves' ophthalmopathy is clinically relevant in approximately 50% of patients with Graves' disease, severe forms affecting 3%-5% of patients. Two age peaks of incidence are observed in the fifth and seventh decades of life, with slight differences between women and men. The disease is more frequent

  19. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

    NARCIS (Netherlands)

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J.; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M.; Adamidou, Fotini; Anagnostis, Panagiotis; Ayvaz, Goksun; Azzolini, Claudio; Boschi, Antonella; Bournaud, Claire; Clarke, Lucy; Currò, Nicola; Daumerie, Chantal; Dayan, Colin; Fuhrer, Dagmar; Konuk, Onur; Marinò, Michele; Morris, Daniel; Nardi, Marco; Pearce, Simon; Pitz, Susanne; Rudovsky, Gottfried; Vannucchi, Guia; Vardanian, Christine; von Arx, Georg

    2016-01-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mech anisms of the disease. Treatment should rely on a thorough assessment of the

  20. Graves' Disease

    Science.gov (United States)

    ... 2011 survey of clinical practice patterns in the management of Graves' disease. Journal of Clinical Endocrinology and Metabolism. 2012 Dec;97( ... 30 a.m. to 5 p.m. eastern time, M-F Follow Us NIH… Turning Discovery Into ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  1. Mouse Models of Graves' Disease

    OpenAIRE

    Nagayama, Yuji

    2005-01-01

    Graves' disease is characterized by overstimulation of the thyroid gland with agonistic autoantibodies against the thyrotropin (TSH) receptor, leading to hyperthyroidism and diffuse hyperplasia of the thyroid gland. Our and other laboratories have recently established several animal models of Graves' hyperthyroidism with novel immunization approaches, i.e., in vivo expression of the TSH receptor by injection of syngeneic living cells co-expressing the TSH receptor and major histocompatibility...

  2. TSHR intronic polymorphisms (rs179247 and rs12885526) and their role in the susceptibility of the Brazilian population to Graves' disease and Graves' ophthalmopathy.

    Science.gov (United States)

    Bufalo, N E; Dos Santos, R B; Marcello, M A; Piai, R P; Secolin, R; Romaldini, J H; Ward, L S

    2015-05-01

    Intronic thyroid-stimulating hormone receptor polymorphisms have been associated with the risk for both Graves' disease and Graves' ophthalmopathy, but results have been inconsistent among different populations. We aimed to investigate the influence of thyroid-stimulating hormone receptor intronic polymorphisms in a large well-characterized population of GD patients. We studied 279 Graves' disease patients (231 females and 48 males, 39.80 ± 11.69 years old), including 144 with Graves' ophthalmopathy, matched to 296 healthy control individuals. Thyroid-stimulating hormone receptor genotypes of rs179247 and rs12885526 were determined by Real Time PCR TaqMan(®) SNP Genotyping. A multivariate analysis showed that the inheritance of the thyroid-stimulating hormone receptor AA genotype for rs179247 increased the risk for Graves' disease (OR = 2.821; 95 % CI 1.595-4.990; p = 0.0004), whereas the thyroid-stimulating hormone receptor GG genotype for rs12885526 increased the risk for Graves' ophthalmopathy (OR = 2.940; 95 % CI 1.320-6.548; p = 0.0083). Individuals with Graves' ophthalmopathy also presented lower mean thyrotropin receptor antibodies levels (96.3 ± 143.9 U/L) than individuals without Graves' ophthalmopathy (98.3 ± 201.9 U/L). We did not find any association between the investigated polymorphisms and patients clinical features or outcome. We demonstrate that thyroid-stimulating hormone receptor intronic polymorphisms are associated with the susceptibility to Graves' disease and Graves' ophthalmopathy in the Brazilian population, but do not appear to influence the disease course.

  3. La prise en charge du traumatisé crânien grave : de la littérature au centre d'éveil

    OpenAIRE

    Phelix , Laury

    2010-01-01

    Non disponible / Not available; Le traumatisme crânien est une pathologie qui se définit par une atteinte cérébrale ou du tronc cérébral suite à un choc direct ou indirect.En France, la principale étiologie recensée est les accidents de la voie publique avec comme population cible des personnes jeunes appartenant à tranche d'âge des 15-25 ans. L'incidence des traumatismes crâniens est de 281 pour 100 000 habitants.Suite à ce traumatisme, le patient peut se trouver dans le coma. Généralement, ...

  4. Study of top reflooding in case of severe accident and in particular oxidation of Uranium, Zirconium, Oxygen melts; Etude du renoyage par le haut en cas d'accident grave et en particulier oxydation des melanges (U,Zr,O)

    Energy Technology Data Exchange (ETDEWEB)

    Brunet-Thibault, E

    2006-12-15

    In 1979, the Three Mile Island (TMI) accident occurred in United States and accelerated research activities in the field of severe accidents. Severe accident management procedures imply massive water injections to flood the core. The work of this thesis bent principally over this reflooding. The first part of the study concerns the core oxidation enhancement during the reflooding phase which leads to a rough increase of the concentration of burnable hydrogen in the containment. This is why the study carried on the analysis of the contribution of the oxidation of U-Zr-O mixtures, towards the total production of hydrogen during reflooding. In the second part, the study concerns top flooding modelling i.e.: with injection of water in the hot legs. Here, we attempted to define bases and realize a model allowing to describe this type of reflooding. These models were validated on the simulation of the parameter with MAAP4 code. (author)

  5. Nodular Graves' disease with medullary thyroid cancer.

    Science.gov (United States)

    Khan, Shoukat Hussain; Rather, Tanveer Ahmed; Makhdoomi, Rumana; Malik, Dharmender

    2015-01-01

    Co-existence of thyroid nodules with Graves' disease has been reported in various studies. 10-15% of such nodules harbor thyroid cancer with papillary thyroid cancer being the commonest. Medullary thyroid cancer (MTC) in nodules associated with Graves' disease is rare. On literature survey, we came across 11 such cases reported so far. We report a 62-year-old female with Graves' disease who also had a thyroid nodule that on fine-needle aspiration cytology and the subsequent postthyroidectomy histopathological examination was reported to be MTC.

  6. WASA-BOSS. Development and application of Severe Accident Codes. Evaluation and optimization of accident management measures. Subproject E. Improvement of the lower head model in MELCOR and calculations in connection with the FUKUSHIMA accident. Final report; WASA-BOSS. Weiterentwicklung und Anwendung von Severe Accident Codes. Bewertung und Optimierung von Stoerfallmassnahmen. Teilprojekt E. Verbesserung des Lower Head-Modelles fuer MELCOR und MELCOR-Rechnungen zu Fukushima. Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Kretzschmar, Frank; Dietrich, Philipp; Gabriel, Stephan; Miassoedov, Alexei

    2016-12-15

    The knowledge of the key phenomena, which govern the chronological sequence of a core melt accident, is a crucial precondition for the development of SAMGs (Severe Management Guides) to avoid and mitigate the radiological consequences for the population and the environment. In the frame of a dissertation a new model has been coupled with MELCOR, which describes the thermal interaction of a core melt with the RPV (reactor pressure vessel) wall in the lower plenum. This model allows a better description of this phenomenon. The method to couple extern programs with MELCOR had been already developed and used in a former dissertation at KIT-IKET. The model has been validated recalculating according experiments in the LIVE facility. Afterwards a defined accident scenario has been calculated for a German generic KONVOI power plant. 12 months after the start of the project a MELCOR input has been developed using data delivered by the Ruhr university of Bochum (subproject ''Simulation des Unfalls in Fukushima-Daichi zur Bewertung des Stoerfall-Analysecodes ATHLET-CD''). The results of this simulation have made a contribution to review the current understanding of the FUKUSHIMA sequence. HZDR and KIT-IKET have agreed in the course of the project, that KIT-IKET will develop a MELCOR input of a german generic KONVOI power plant following an ATHLET-CDinput of HZDR. Using this MELCOR input, a comparative analysis has been performed.

  7. [Association Budd Chiari syndrome, antiphospholipid syndrome and Grave's disease].

    Science.gov (United States)

    Mouelhi, Leila; Chaieb, Mouna; Debbeche, Radhouane; Salem, Mohamed; Sfar, Imene; Trabelsi, Sinda; Gorgi, Yosr; Najjar, Taoufik

    2009-02-01

    Antiphospholipid syndrome is revealed by Budd Chiari syndrome in 5% of the cases. Antiphospholipid syndrome is characterized by venous or arterial thrombosis, foetal loss and positivity of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I. Anticardiolipin antibodies was reported in auto-immune thyroid disorders, particularly in Grave's disease. Antiphospholipid syndrome associated to Grave's disease was reported in only three cases. To describe a case report of association of Grave's disease and antiphospholipid syndrome. We report the first case of Grave's disease associated with antiphospholipid syndrome, revealed by Budd Chiari syndrome. Our observation is particular by the fact that it is about a patient presenting a Grave's disease associated with antiphospholipid syndrome revealed by Budd Chiari syndrome. This triple association has never been reported in literature. Although association between antiphospholipid syndrome and Grave's disease was previously described, further studies evaluating the coexistence of these two affections in the same patient would be useful.

  8. Corrélats des enquêtes conjointes des services de protection de l'enfance et des services de police sur les abus sexuels d'enfants : résultats de l'Étude canadienne sur l'incidence des signalements de cas de violence et de négligence envers les enfants 2008

    Directory of Open Access Journals (Sweden)

    L. Tonmyr

    2015-01-01

    Full Text Available Introduction : Dans cette étude, nous examinons la fréquence des enquêtes conjointes menées par les services de protection de l'enfance et les services de police dans les cas d'abus sexuels en comparaison des autres types de maltraitance. Nous examinons également les associations, dans les enquêtes conjointes, entre les caractéristiques relatives à l'enfant, celles relatives au pourvoyeur de soins de l'enfant, celles relatives aux mauvais traitements eux-mêmes et celles relatives à l'enquête, en nous intéressant plus particulièrement aux enquêtes sur les abus sexuels. Méthodologie : Nous avons analysé par régression logistique les données de l'Étude canadienne sur l'incidence des signalements de cas de violence et de négligence envers les enfants 2008. Résultats : D'après les données, les enquêtes conjointes portent en premier lieu sur les abus sexuels (55 %, puis sur la violence physique, la négligence et la violence psychologique. La corroboration des mauvais traitements, les mauvais traitements graves, le placement, l'intervention des tribunaux de la jeunesse et l'orientation d'un membre de la famille vers des services spécialisés sont plus fréquents quand les services de police participent à l'enquête. Conclusion : Cette étude vient bonifier l'information limitée dont on dispose sur les corrélats des enquêtes conjointes menées par les agences de protection de l'enfance et les services de police. D'autres recherches devront être effectuées pour déterminer l'efficacité de ces enquêtes conjointes.

  9. Effect of abnormal thyroid function on the severity of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Prummel, M. F.; Wiersinga, W. M.; Mourits, M. P.; Koornneef, L.; Berghout, A.; van der Gaag, R.

    1990-01-01

    Many clinicians have the impression that treatment of thyroid dysfunction ameliorates ophthalmopathy in Graves' disease. The aim of our study was to relate thyroid function to the severity of Graves' ophthalmopathy. We studied 90 patients with Graves' ophthalmopathy and Graves' hyperthyroidism in

  10. Ultrasonographic Features of Papillary Thyroid Carcinoma in Patients with Graves' Disease

    Science.gov (United States)

    Chung, Jin Ook; Cho, Dong Hyeok; Chung, Dong Jin

    2010-01-01

    Background/Aims To characterize ultrasonographic findings in papillary thyroid carcinoma (PTC) combined with Graves' disease. Methods Medical records and ultrasonographic findings of 1,013 patients with Graves' disease and 3,380 patients without Graves' disease were analyzed retrospectively. A diagnosis of PTC was based on a pathologic examination. Results The frequency of hypoechogenicity was lower in patients with PTC and Graves' disease than in patients with PTC alone (p Graves' disease was significantly higher than in those with PTC alone (p Graves' disease was characterized by more ill-defined borders and less frequency of overall calcification, punctate calcification, and heterogeneous echogenicity, although the difference was not statistically significant. Conclusions Our results suggest that patients with Graves' disease more frequently have atypical PTC findings on ultrasonography. PMID:20195406

  11. The Eye/Brain Radioactivity Ratio for Assessment of Graves Ophthalmopathy

    International Nuclear Information System (INIS)

    Lee, B. W.; Sung, S. K.; Suh, K. S.; Park, W.; Choi, D. J.; Kim, J. S.

    1988-01-01

    In Graves' disease, changes in orbital tissue and structure are caused by inflammatory infiltration, which induces increase of capillary permeability and breakdown of blood-tissue barriers. Using the uptake of 99m Tc-DTPA in inflammatory lesion, Eye/Brain radioactivity ratios in brain scintigraphy were evaluated in 15 normal controls and 40 Graves' patients. The results were as follows; 1) Eye/Brain radioactivity ratio was significantly higher in Graves' ophthalmopathy group than in control group (p 99m Tc-DTPA brain scintigraphy may be useful to determine the activity of Graves' ophthalmopathy and whether treatment of Graves' ophthalmopathy is necessary or not.

  12. Forme mixte de gale grave sur terrain de depigmentation cosmetique volontaire: A propos d’un cas au Centre Hospitalier Universitaire (CHU de Parakou (Benin [Mixed form of grave scabies on voluntary cosmetic depigmation land: About a case at the Parakou (Benin University Hospital Center (UHC

    Directory of Open Access Journals (Sweden)

    Christiane Koudoukpo

    2017-11-01

    Full Text Available Severe forms of scabies are rare. They are more contagious, posing a public health problem during an epidemy in institution. The magnitude of the depigmenting cosmetic practice, a true phenomenon of society today, is at the origin of the recrudescence of certains infectious diseases in their rare forms like severe scaby. We report the first case of mixed form of severe at Parakou University Hospital Center. The body treatment with an antiscabious medicine associated with the disinfection of bedding, led to a total recovering. RÉSUMÉ Les formes graves de la gale sont rares. Elles sont plus contagieuses, posant un problème de santé publique lors d’épidémie en institution. L’ampleur de la pratique cosmétique dépigmentante, véritable phénomène de société de nos jours est à l’origine de la recrudescence de certaines pathologies infectieuses dont des formes rares de gale grave. Nous rapportons le premier cas de forme mixte de gale grave sur terrain de dépigmentation cosmétique volontaire chez une jeune femme de 21 ans au CHU de Parakou. Le traitement corporel par un antiscabieux associé à la désinfection de la literie, a conduit à une guérison totale.

  13. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    International Nuclear Information System (INIS)

    Takamatsu, J.; Hosoya, T.; Naito, N.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients

  14. Aspects epidémiologiques des accidents domestiques de l'enfant à ...

    African Journals Online (AJOL)

    2. Clinics in Mother and Child Health. Tableau 1: Types d'accidents domestiques retrouvés. Type d'accident. Nombre. Pourcentage. Chute. 26. 46,4. Intoxication au pétrole. 9. 16,1. Brûlure. 5. 8,9. Coupure. 5. 8,9. Corps étranger. 4. 7,1. Collusion avec un objet contondant. 4. 7,1. Morsure. 2. 3,7. Suffocation. 1. 1,8. Total. 56.

  15. Significance of changes of serum FT3, FT4, s-TSH, TGA, TPO-Ab levels in patients with non-Graves' hyperthyroidism and Graves' disease

    International Nuclear Information System (INIS)

    Zhang Lindi; Xu Changde; Xu Huogen; Wang Wei; Zhang Jie; Nie Shufen; Gu Zhenqi; Zeng Jihua

    2006-01-01

    Objective: To investigate the clinical significance of the changes of thyroid-related hormones (FT 3 , FT 4 , s-TSH, TGA, TPO-Ab) levels in patients with Graves' and non-Graves' hyperthyroidism. Methods: Serum FT 3 , FT 4 , TGA, TPO-Ab (with RIA) and s-TSH (with IRMA) were determined in 43 patients with non-Graves' hyperthyroidism, 29 patients with Graves' disease and 40 controls. Results: In both groups of hyperthyroid patients, the serum levels of FT 3 (15.01 ± 11.01 pg/ml in the non - Graves' group and 15.23 ± 9.57pg/ml in the Graves' group), FT 4 (38.30 ± 19.82, 38.87 ± 17.39pg/ml), TGA(33.89 ± 22. 43%, 49.72 ± 20.55% ) and TPO-Ab (1319.24 ± 1037.78, 2023.24 ± 621.00IU/ml) were significantly higher than those (FT 3 , 6.76 ± 2.01pg/ml, FT 4 16.16 ± 2.58pg/ml, TGA 6.76 ± 2.01%, TPO-Ab 0.01 ± 0.01IU/ml) in the controls (all P 3 , FT 4 and s-TSH levels in both groups were not significantly different from each other. Conclusion: In this study, serum TGA and TPO -Ab levels were lower in patients with non-Graves' hyperthyroidism than those in patients with Graves' disease. (authors)

  16. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer.

    Science.gov (United States)

    Yu, Hea Min; Park, Soon Hyun; Lee, Jae Min; Park, Kang Seo

    2013-09-01

    Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  17. Épidémiologie des brûlures de la main chez les enfants vus dans le Centre National des Brûlés et de Chirurgie Plastique de Casablanca, Maroc

    Science.gov (United States)

    Rafik, A.; Lahlou, M.; Diouri, M.; Bahechar, N.; Chlihi, A.

    2015-01-01

    Summary Les brûlures de la main chez l’enfant constituent une source de séquelles invalidantes. A cet régard, la conservation et la restauration complète de la fonction de la main demeurent le but primordial de la prise en charge. Afin de répertorier les caractéristiques épidémiologiques, cliniques et évolutives des mains brûlées, nous avons réalisé une étude rétrospective étalée sur 4 ans, de janvier 2011 à janvier 2015. Cette étude a permis de colliger les cas de 313 enfants atteints de brûlure de la main vus dans le Centre National des Brulés et de Chirurgie Plastique du CHU Ibn Rochd de Casablanca. La majorité des brûlures touche les enfants de 3 à 6 ans (70% des cas), avec une légère prédominance masculine. La principale cause des brûlures survenant à cet âge est l’ébouillantement. Les brûlures par flamme représentent 33% des cas, celles par électricité 4,5%. Les brûlures chimiques et par contact sont anecdotiques (1 cas chacune). L’accident survient le plus souvent à domicile. Soixante douze pour cent des brûlures ont guéri spontanément. Afin de diminuer l’incidence de ces accidents, une approche préventive faite de sensibilisation et d’éducation devrait faire partie du cursus scolaire. PMID:27777543

  18. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [/sup 99m/Tc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  19. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [ 9 -9μTc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  20. Avancée dans la prévention des « chutes de plain-pied » au travail Progress in the prevention of occupational “falls on the same level”. Proposed operational definition of a new category: “Motion perturbation accidents (MPAs” Avances en la prevención de « caídas al mismo nivel » en el trabajo. Propuesta de la definición operacional de una nueva categoría : « los Accidentes con Perturbación del Movimiento (APM »

    Directory of Open Access Journals (Sweden)

    Sylvie Leclercq

    2010-11-01

    Full Text Available La chute de plain-pied reste un accident du travail fréquent et grave. La terminologie qualifiant ces accidents est variée, relativement imprécise et n’intègre pas la diversité des accidents rencontrés sous les différentes appellations. L’intérêt de considérer une catégorie d’accidents du travail avec perturbation du mouvement (APM est tout d’abord mis en évidence à partir de divers extraits de récits d’accidents. Un modèle est ensuite proposé pour les APM montrant que, dans ces cas particuliers d’accident la blessure est souvent la conséquence de l’association fortuite entre l’énergie du mouvement perturbé de la victime et un élément matériel rendu blessant de par ses propriétés et appelé a posteriori un « danger circonstanciel ». Enfin, le raisonnement qui sous-tend la classification de ces accidents est explicité. Il apparaît notamment que la prévention ciblant les causes immédiates de la blessure est difficile voire impossible dans les cas d’APM en raison principalement des exigences inhérentes au travail et de contraintes que ferait peser sur l’entreprise l’application de cette prévention. La prévention à la source du risque tend alors à devenir la seule possible. Ainsi, de banal, l’APM devient un révélateur de dysfonctionnements au sein du système de production.Falls on the same level remain frequent and serious occupational accidents. The terminology used to describe these accidents is varied and somewhat imprecise. Moreover it does not integrate the variety of accidents with different names. The advantage of considering an occupational accident category with motion perturbation (MPA is demonstrated, based on extracts from various occupational accident accounts. A model is then proposed for MPAs that shows that in these specific cases of accidents, the injury often results from a fortuitous association between the victim’ perturbed motion energy and a physical element that

  1. Hyperparathyroidism after radioactive iodine therapy for Graves disease

    International Nuclear Information System (INIS)

    Esselstyn, C.B. Jr.; Schumacher, O.P.; Eversman, J.; Sheeler, L.; Levy, W.J.

    1982-01-01

    The association of external ionizing radiation to the head and neck and the subsequent development of hyperfunctioning parathyroid glands has been documented in recent years. This also has been demonstrated experimentally in animals. Despite the numbers of patients with Graves disease who have been treated with radioactive iodine, there are no reports in the literature of parathyroid surgery for hyperparathyroidism secondary to earlier treatment with radioactive iodine for Graves disease. This report describes the operative and pathologic findings in four patients with hyperparathyroidism. These patients had previously been treated with radioactive iodine for Graves disease. The pathologic findings at surgery included in three cases a single enlarged hyperplastic gland consistent with a parathyroid adenoma. One patient had hyperplasia of all four glands. The two largest glands and halves of the two remaining glands were removed. In a long-term follow-up of children and adolescents treated with radioactive iodine for Graves disease, Levy and Schumacher found calcium elevations in 10 of 159 patients. The increased incidence of hyperparathyroidism following radioactive iodine treatment for Graves disease in children and adolescents would seem several times higher than normal. Whether adults who have radioactive iodine treatment for Graves disease have a similar increase incidence is not known. Meanwhile it would seem reasonable to suggest that patients whose hyperthyroidism is treated with radioactive iodine should have their serum calcium levels determined at 5-year intervals

  2. Graves' disease: diagnostic and therapeutic challenges (multimedia activity).

    Science.gov (United States)

    Kahaly, George J; Grebe, Stefan K G; Lupo, Mark A; McDonald, Nicole; Sipos, Jennifer A

    2011-06-01

    Graves' disease is the most common cause of hyperthyroidism in the United States. Graves' disease occurs more often in women with a female:male ratio of 5:1 and a population prevalence of 1% to 2%. A genetic determinant to the susceptibility to Graves' disease is suspected because of familial clustering of the disease, a high sibling recurrence risk, the familial occurrence of thyroid autoantibodies, and the 30% concordance in disease status between identical twins. Graves' disease is an autoimmune thyroid disorder characterized by the infiltration of immune effector cells and thyroid antigen-specific T cells into the thyroid and thyroid-stimulating hormone receptor expressing tissues, with the production of autoantibodies to well-defined thyroidal antigens, such as thyroid peroxidase, thyroglobulin, and the thyroid-stimulating hormone receptor. The thyroid-stimulating hormone receptor is central to the regulation of thyroid growth and function. Stimulatory autoantibodies in Graves' disease activate the thyroid-stimulating hormone receptor leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Below-normal levels of baseline serum thyroid-stimulating hormone receptor, normal to elevated serum levels of T4, elevated serum levels of T3 and thyroid-stimulating hormone receptor autoantibodies, and a diffusely enlarged, heterogeneous, hypervascular (increased Doppler flow) thyroid gland confirm diagnosis of Graves' disease (available at: http://supplements.amjmed.com/2010/hyperthyroid/faculty.php). This Resource Center is also available through the website of The American Journal of Medicine (www.amjmed.com). Click on the “Thyroid/Graves' Disease” link in the “Resource Centers” section, found on the right side of the Journal homepage. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Resolution of Graves' disease after renal transplantation.

    Science.gov (United States)

    Lee, Yvonne; Butani, Lavjay; Glaser, Nicole; Nguyen, Stephanie

    2016-06-01

    We report a case of an adolescent boy with Down's syndrome and ESRD on hemodialysis who developed mild Graves' disease that was not amenable to radioablation, surgery, or ATDs. After 14 months of observation without resolution of Graves' disease, he successfully received a DDRT with a steroid minimization protocol. Thymoglobulin and a three-day course of steroids were used for induction and he was started on tacrolimus, MMF, and pravastatin for maintenance transplant immunosuppression. One month after transplantation, all biochemical markers and antibody profiling for Graves' disease had resolved and remain normal one yr later. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Graves disease hyperthyroidism and glycometabolism

    International Nuclear Information System (INIS)

    Sun Qiting; Zhao Deshan

    2010-01-01

    The Patients with Graves disease hyperthyroidism are often accompanied by disorder of glycometabolism. β-cell dysfunction and insulin resistance play a main role in this disease, while the immune and genetic factors are also relevant with the disease. The blood glycose level can become normal gradually with the recovery of thyroid hormone after 131 I and antithyroid drug treatment. Therefore, the blood glycose level could be improved and complications could be prevented by early treatment in the patients with Graves disease hyperthyroidism accompanied with glycometabolism disorder is helpful for improving the blood glycose level. (authors)

  5. Microchimerism in Graves' Disease

    Science.gov (United States)

    Galofré, Juan C.

    2012-01-01

    Microchimerism is the presence of cells from one individual in another genetically distinct individual. Pregnancy is the main cause of natural microchimerism through transplacental bidirectional cell trafficking between mother and fetus. The consequences of pregnancy-related microchimerism are under active investigation. However, many authors have suggested a close relationship linking fetal microchimerism and the development of autoimmune diseases. It has been more than ten years now since the demonstration of the presence of a significant high number of fetal microchimeric cells residing in thyroid glands from operated patients with Graves' disease. This intrathyroidal fetal microchimerism is an attractive candidate mechanism for the modulation of Graves' disease in pregnancy and the postpartum period. PMID:22577597

  6. World health day - 7th april, 2004 "road safety is no accident"

    Directory of Open Access Journals (Sweden)

    S C Saxena

    2004-06-01

    Full Text Available In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April. To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They also contributed to spreading the message that such injuries can be prevented. In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April. To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They also contributed to spreading the message that such injuries can be prevented. The accident is defined as unexpected, unplanned event envolving injury, disability or death. The accidents occur in almost all countries. The most alarming fact is that accidents kill more young trained adults between 15-24 years of age group of males, mainly among two wheelers. All sorts of accidents kill more than 5 million

  7. World health day - 7th april, 2004 "road safety is no accident"

    Directory of Open Access Journals (Sweden)

    S C Saxena

    2006-06-01

    Full Text Available In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April.To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They alsocontributed to spreading the message that such injuries can be prevented.In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April.To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They alsocontributed to spreading the message that such injuries can be prevented.t '            ■The accident is defined as unexpected, unplanned event envolving injury, disability or death. The accidents occur in almost all countries. The most alarming fact is that accidents kill more young trained adults between 15-24 years of age group of males, mainly among two wheelers. All sorts of accidents

  8. [Interventions for mental health sequelae of accidents].

    Science.gov (United States)

    Angenendt, J

    2014-06-01

    Emergency psychology and psychotraumatology deal with the psychological sequelae of traumatic experiences, i.e., the prevention and early intervention of posttraumatic mental health disorders. Accidents are the most prevalent traumatic events in the general population that may result in a range of severe trauma and adjustment disorders. Accidents happen suddenly, unexpectedly, and can gravely threaten health, personal integrity, and life. The prevalence of intermittent and chronic psychiatric disorders in the aftermath of severe accidents varies between 5 and 30 %. Victims suffer from unknown and frightening posttraumatic symptoms, often irreversible handicaps as a consequence of their injuries, impairments in everyday functioning, and negative impact on the quality of life. The direct and indirect burden for society is high. Comprehensive secondary prevention, starting with early detection and early intervention of post-accident disorders, is not well established in clinical care. In case of severe accidental injuries, emergency and medical treatment has absolute priority. But all too often, severe mental health problems remain undetected in later treatment phases and therefore cannot be addressed adequately. In primary care, knowledge of specific psychodiagnostic and treatment options is still insufficient. Prejudices, denial, and fear of stigmatization in traumatized victims as well as practical constraints (availability, waiting time) in the referral to special evidence-based interventions limit the access to adequate and effective support. This overview presents the objectives, concepts, and therapeutic tools of a stepped-care model for psychological symptoms after accidental trauma, with reference to clinical guidelines.

  9. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Hea Min Yu

    2013-09-01

    Full Text Available Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  10. Human Factors Aspects of Aircraft Accidents

    Science.gov (United States)

    1982-10-01

    invaatiaaamanta traa important« : chainaa da grand entratian avion, revision daa motaura at banca d’aaaala, reviaion daa Equipements nEceaaitant daa...defectueux. Sur le plan des accidents d’apparells militaires, qui sort quelque peu de ma specia- lite, les renseignements disponibles dans la presse ...Undoubtedly, a compelling reason for staying with the aircraft was to try to regain pitch attitude control in view of a large audience of press and

  11. Heat exchanges during the re-flooding of a water reactor core - within the framework of the 'reference accident'; Echanges thermiques lors du renoyage d'un coeur de reacteur a eau - dans le cadre de 'l'accident de reference'

    Energy Technology Data Exchange (ETDEWEB)

    Andreoni, Daniel

    1975-11-28

    After a brief presentation of reported studies made in different countries and regarding the so-called 'reference accident', this research thesis reports the study of reactor re-flooding when the reactor is completely dried and heating elements have reached a temperature between 300 and 900 C, with a constant water flow rate entering the test section, with a constant dissipated electrical power, and by using very simple geometries. After a first part addressing the experimental study, the author reports the development of conduction calculation codes used to compute the flow extracted by the two-phase flow, present the thermal-hydraulic code used to compute local values and to study the correlation of the upstream area exchange coefficient. The author finally reports an analysis of the different existing models and the study of a re-flooding model [French] La presente etude est consacree a l'un des aspects de la surete des reacteurs a eau sous pression, et plus precisement a l'accident tres important qui consiste en une perte de fluide caloporteur (Loss of Coolant Accident - 'LOCA'). Le but de l'etude est de fournir des renseignements necessaires a l'interpretation des experiences effectuees sur des grappes, de donner une correlation de coefficient d'echange dans la zone aval, et de donner aussi un modele de progression du front de trempe pour les analyses de surete. Une etude bibliographique preliminaire nous a permis de faire le point sur les experiences entreprises concernant le refroidissement de secours. Ensuite, les chapitres suivants seront decrits: 1) Le chapitre II, consacre a l'etude experimentale (boucle, sections d'essais, resultats globaux). 2) Le chapitre III ou seront presentes les codes de calcul de conduction, necessaires au calcul du flux extrait par le melange diphasique, le code de thermohydraulique necessaire au calcul des grandeurs locales et l'etude de la correlation du coefficient d'echange de la zone aval. 3) Enfin le chapitre IV ou, apres

  12. Analyse Pharmaceutique de la prescription des antibiotiques au service des brules et chirurgie plastique de l'Hopital Militaire d'Instruction Mohammed V, Maroc

    Science.gov (United States)

    Benziane, H.; Karfo, R.; Siah, S.; Taoufik, J.

    2011-01-01

    Summary L'infection est longtemps restée la principale cause de mortalité chez le brûlé grave. Ce travail a pour but d'évaluer la prescription des antibiotiques dans notre Service des Brûlés et Chirurgie Plastique, au regard du dossier d'autorisation de mise sur le marché (Résumé des caractéristiques du produit). Tous les patients sous antibiothérapie, au Service des Brûlés et Chirurgie Plastique de l'Hôpital Militaire d'Instruction Mohammed V de Rabat, Maroc, durant la période janvier 2008/mai 2009, ont été inclus. Il s'agit d'une étude rétrospective qui a analysé 41 dossiers de patients. Les antibiotiques utilisés par le service appartiennent à différentes familles. Les plus utilisés sont les bêta-lactamines (65%), glycopeptides (10,5%), aminosides (9%), quinolones (7%) et colistine (4,3%), avec 4,2% pour les autres classes d'antibiotiques (métronidazole 500 mg en perfusion, fluconazole injectable 100 mg/50 ml, rifampicine 600 mg en perfusion, sulfadiazine argentique crème, acide fusidique 2% crème, etc.); 70% des prescriptions sont non documentées. La voie injectable est prépondérante (89%). En tout, 227 ordonnances nominatives d'antibiothérapie ont été analysées: la posologie et les contre-indications ont été respectées par rapport à l'autorisation de mise sur le marché. Trois cas d'interactions médicamenteuses ont été relevés (fluconazole-rifampicine, fluconazole-Saccharomyces boulardii, amikacine-vancomycine). Ce constat montre l'importance de l'analyse pharmaceutique des prescriptions des antibiotiques dans un service utilisant des antibiotiques de la réserve hospitalière, donc actifs mais très toxiques. PMID:22396670

  13. F-18-FDG PET of the thyroid in Graves` disease; F-18-FDG-PET der Schilddruese bei Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Boerner, A.R.; Voth, E.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Koeln Univ. (Germany); Wienhard, K.; Wagner, R. [Max-Planck-Institut fuer Neurologische Forschung, Koeln (Germany)

    1998-12-31

    This study evaluates F-18-FDG PET of the thyroid in Graves` disease. Methods: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG uptake was higher in Graves` disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. Conclusion: Thus F-18-FDG PET is likely to give information on the biological activity of Graves` disease as well as on early radiation effects. (orig.) [Deutsch] Ziel: Diese Studie evaluiert F-18-Fluoro-Deoxy-Glukose (F-18-FDG) PET der Schilddruese bei Patienten mit M. Basedow. Methoden: 30 Patienten wurden am Tag vor Radioiod-Therapie, 15 Patienten am 3.-10. Tag nach Radioiodtherapie untersucht. 20 Patienten mit Kopf/Halstumoren und normaler Schilddruesenfunktion dienten als Kontrollgruppe. Ergebnisse: Die F-18-FDG-Aufnahme in der Schilddruese war signifikant hoeher bei Patienten mit M-Basedow im Vergleich zu den Kontrollen. Sie stieg mit hoeheren, antithyreoidalen Antikoerpern und sank bei laengerer I-131-Halbwertzeit. Es bestand eine Korrelation einer reduzierten Glukose-Utilisation bei hoeherer absorbierter Schilddruesendosis nach Radioiod-Therapie. Schlussfolgerung: Damit erscheint die F-18-FDG-PET-Untersuchung zur biologischen Aktivitaetsbeurteilung des M. Basedow und Darstellung von fruehen Strahleneffekten geeignet. (orig.)

  14. Neonatal Graves' Disease with Maternal Hypothyroidism.

    Science.gov (United States)

    Akangire, Gangaram; Cuna, Alain; Lachica, Charisse; Fischer, Ryan; Raman, Sripriya; Sampath, Venkatesh

    2017-07-01

    Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a mother with hypothyroidism during pregnancy and remote history of Graves' disease. Infant was treated with a combination of methimazole, propranolol, and potassium iodide for 4 weeks. Thyroid function improved after 8 weeks of treatment with full recovery of thyroid function, disappearance of thyroid-stimulating antibodies, and resolution of failure to thrive and conjugated hyperbilirubinemia. This case provides several clinical vignettes as it is a rare, severe, presentation of an uncommon neonatal disease, signs, symptoms, and clinical history presented a diagnostic challenge for neonatologists and endocrinologists, normal newborn screen was misleading, and yet timely treatment led to a full recovery.

  15. [Neonatal hyperthyroidism and maternal Graves disease].

    Science.gov (United States)

    Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

    2015-04-01

    The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Psychiatric manifestations of Graves' hyperthyroidism: pathophysiology and treatment options.

    Science.gov (United States)

    Bunevicius, Robertas; Prange, Arthur J

    2006-01-01

    Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism. Other symptoms associated with the disease are goitre, ophthalmopathy, and psychiatric manifestations such as mood and anxiety disorders and, sometimes, cognitive dysfunction. Graves' hyperthyroidism may result in these latter manifestations via the induction of hyperactivity of the adrenergic nervous system. This review addresses the psychiatric presentations, and their pathophysiology and treatment, in patients with hyperthyroidism, based on literature identified by a PubMed/MEDLINE database search. Although the focus is on mental symptoms associated with Graves' disease, it is not always clear from the literature whether patients had Graves' disease: in some studies, the patients were thought to have Graves' disease based on clinical findings such as diffuse goitre or ophthalmopathy or on measurements of thyroid antibodies in serum; however, in other studies, no distinction was made between Graves' hyperthyroidism and hyperthyroidism from other causes. Antithyroid drugs combined with beta-adrenoceptor antagonists are the treatments of choice for hyperthyroidism, as well as for the psychiatric disorders and mental symptoms caused by hyperthyroidism. A substantial proportion of patients have an altered mental state even after successful treatment of hyperthyroidism, suggesting that mechanisms other than hyperthyroidism, including the Graves' autoimmune process per se and ophthalmopathy, may also be involved. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta-adrenoceptor antagonists, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.

  17. The Role of Oxidative Stress on the Pathogenesis of Graves' Disease

    Directory of Open Access Journals (Sweden)

    Miloš Žarković

    2012-01-01

    Full Text Available Graves' disease is a most common cause of hyperthyroidism. It is an autoimmune disease, and autoimmune process induces an inflammatory reaction, and reactive oxygen species (ROSs are among its products. When balance between oxidants and antioxidants is disturbed, in favour of the oxidants it is termed “oxidative stress” (OS. Increased OS characterizes Graves' disease. It seems that the level of OS is increased in subjects with Graves' ophthalmopathy compared to the other subjects with Graves' disease. Among the other factors, OS is involved in proliferation of orbital fibroblasts. Polymorphism of the 8-oxoG DNA N-glycosylase 1 (hOGG1 involved in repair of the oxidative damaged DNA increases in the risk for developing Grave's disease. Treatment with glucocorticoids reduces levels of OS markers. A recent large clinical trial evaluated effect of selenium on mild Graves' ophthalmopathy. Selenium treatment was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, compared to placebo.

  18. Hickam's dictum: Myasthenia Gravis presenting concurrently with Graves' disease.

    Science.gov (United States)

    Sehgal, Shekhar; Rebello, Roshan; Wolmarans, Louise; Elston, Marianne

    2017-09-07

    We present two patients with Graves' disease and concurrent myasthenia gravis. The impact of the dual diagnosis on the clinical course and the potential for a delayed diagnosis of myasthenia gravis is discussed. Patient 1, a 28-year-old man was diagnosed with Graves' disease following his second respiratory arrest. His history was strongly suggestive of a second pathology. Patient 2, a 66-year-old Cantonese woman with established Graves' disease presented with thionamide-related neutropaenia. Examination revealed bilateral ptosis and right lateral rectus palsy. Both patients had thyrotoxicosis secondary to Graves' disease with concurrent myasthenia gravis. Although neuromuscular weakness is common in Graves' disease, coexisting myasthenia gravis (MG) is rare and can cause profound morbidity. Ocular signs in both diseases may cause diagnostic confusion although ptosis suggests coexisting MG. In both cases, the thyrotoxicosis delayed the diagnosis of MG. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Vitamin D and Graves' disease: a meta-analysis update.

    Science.gov (United States)

    Xu, Mei-Yan; Cao, Bing; Yin, Jian; Wang, Dong-Fang; Chen, Kai-Li; Lu, Qing-Bin

    2015-05-21

    The association between vitamin D levels and Graves' disease is not well studied. This update review aims to further analyze the relationship in order to provide an actual view of estimating the risk. We searched for the publications on vitamin D and Graves' disease in English or Chinese on PubMed, EMBASE, Chinese National Knowledge Infrastructure, China Biology Medical and Wanfang databases. The standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for the vitamin D levels. Pooled odds ratio (OR) and 95% CI were calculated for vitamin D deficiency. We also performed sensitivity analysis and meta-regression. Combining effect sizes from 26 studies for Graves' disease as an outcome found a pooled effect of SMD = -0.77 (95% CI: -1.12, -0.42; p Graves' disease were more likely to be deficient in vitamin D compared to the controls (OR = 2.24, 95% CI: 1.31, 3.81) with a high heterogeneity (I2 = 84.1%, p Graves' disease.

  20. Determination of radioactive risks connected with the working of a nuclear plant; Evaluation des risques radioactifs lies au fonctionnement d'une installation nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Lavie, J M; Doury, A [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

    1960-07-01

    Numerous problems which are posed by the evaluation of the radioactive risks linked to the working of a nuclear plant are new problems which have not yet been satisfactorily solved. In these conditions this study must be considered only as a preliminary approach whose essential aims are the following: - development and synthesis of the existing data; - rapid determination of conservative and usable orders of greatness for the security factors, both for normal working and in the case of an accident. The most probable typical accidents are reviewed together with the nature of the resulting risks and the principal factors on which these risks depend. Among these factors, one of the most important is atmospheric diffusion which is studied in some detail using the analytic model due to Sutton. A logical graphical presentation increasing the flexibility in the use of the results and presents the responsible authorities with a flexible, practical and rapid means of evaluating the risks involved starting from a sufficiently general system of initial and simultaneously valid conditions (types of accident, atmospheric conditions). (author) [French] De nombreux problemes souleves par l'evaluation des risques radioactifs lies au fonctionnement d'une installation nucleaire sont des problemes nouveaux qui n'ont pas encore recu de solution satisfaisante. Dans ces conditions cette etude ne doit etre consideree que comme une premiere approche dont les objectifs essentiels sont les suivants: - mise au point et synthese de donnees existantes; - determination rapide d'ordres de grandeur conservatifs et utilisables de valeurs de securite, tant en fonctionnement normal qu'en cas d'accident. Les accidents types les plus probables sont passes en revue ainsi que la nature des risques qui en decoulent et les principaux facteurs dont dependent ces risques. Parmi ces facteurs, l'un des plus importants est la diffusion atmospherique qui fait l'objet d'une etude particuliere a l'aide du modele

  1. Thymic hyperplasia in a patient with Grave's disease.

    Science.gov (United States)

    Hamzaoui, Amira A; Klii, Rim R; Salem, Randa R; Kochtali, Ines I; Golli, Mondher M; Mahjoub, Silvia S

    2012-02-09

    Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 46-year old woman with Graves' disease and thymic hyperplasia.

  2. La mise en œuvre de la Convention des Nations Unies sur la lutte contre la désertification au Burkina Faso

    OpenAIRE

    Lynda Hubert Ta

    2017-01-01

    Parmi les instruments internationaux issus de la Conférence des Nations Unies sur l’environnement et le développement ou Sommet de la Terre, qui s’est tenue en 1992 à Rio de Janeiro (Brésil), la Convention des Nations Unies sur la lutte contre la désertification a été adoptée à Paris le 17 juin 1994. 193 États l’ont ratifiée. En effet, reconnaissant la désertification comme un problème environnemental, social et économique grave et persistant, malgré les efforts de la communauté international...

  3. ECONOMIC COSTS ASSOCIATED WITH MOTORBIKE ACCIDENTS IN KATHMANDU, NEPAL

    Directory of Open Access Journals (Sweden)

    Diksha Sapkota

    2016-12-01

    Full Text Available Background: Road traffic accidents, considered as global tragedies, are in increasing trend however, the safety situation is very severe in developing countries incurring substantial amount of human, economic and social costs. Motorcycle crashes, the commonest form, occur mostly on economically active population. However, there is limited coverage of studies on economic burden of motorcycle crashes. This study aims to estimate the total cost and DALYs lost due to motorbike accidents among victims of Kathmandu Valley.Materials and Methods: Retrospective cross-sectional study was conducted among the patients having history of motorbike accidents within past twelve months and at least 3 months from the date of data collection. Interview was conducted using proforma among 100 victims of accidents and their care giver in case of death from November 15, 2014 to May 15, 2015. Cost estimation of motorbike accident was done based on human capital approach. Data collection tool was pretested and collected data were analyzed by SPSS and Microsoft excel. Results: Males (79% belonging to the economically productive age group shared the highest proportion among total accidents victims. Most common reason for accidents was reported to be poor road condition (41%. Indirect cost was found to be significantly higher than direct costs highlighting its negative impact on economy of family and nation due to productivity loss. Total Disability Adjusted Life Years (DALYs lost per person was found to be 490 years and national estimation showed large burden of motorbike accidents due to huge DALY loss.Conclusions: For low resource countries like Nepal, high economic costs of motorbike accidents can pose additional burden to the fragile health system. These accidents can be prevented, and their consequences can be alleviated. There is an urgent need for reinforcement of appropriate interventions and legislation to decrease the magnitude of it and its associated grave

  4. CFD simulations in the nuclear containment using the DES turbulence models

    International Nuclear Information System (INIS)

    Ding, Peng; Chen, Meilan; Li, Wanai; Liu, Yulan; Wang, Biao

    2015-01-01

    Highlights: • The k-ε based DES model is used in the nuclear containment simulation. • The comparison of results between different turbulent models is obtained. • The superiority of DES models is analyzed. • The computational efficiency with the DES turbulence models is explained. - Abstract: Different species of gases would be released into the containment and cause unpredicted disasters during the nuclear severe accidents. It is important to accurately predict the transportation and stratification phenomena of these gas mixtures. CFD simulations of these thermal hydraulic issues in nuclear containment are investigated in this paper. The main work is to study the influence of turbulence model on the calculation of gas transportation and heat transfer. The k-ε based DES and other frequently used turbulence models are used in the steam and helium release simulation in THAI series experiment. This paper will show the superiority of the DES turbulence model in terms of computational efficiency and accuracy with the experimental results, and analyze the necessities of DES model to simulate the large-scale containment flows with both laminar and turbulence regions

  5. CFD simulations in the nuclear containment using the DES turbulence models

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Peng [School of Engineering, Sun Yat-Sen University, Guangzhou (China); Chen, Meilan [China Nuclear Power Technology Research Institute, Shenzhen (China); Li, Wanai, E-mail: liwai@mail.sysu.edu.cn [Sino-French Institute of Nuclear Engineering & Technology, Sun Yat-Sen University, Guangzhou (China); Liu, Yulan [School of Engineering, Sun Yat-Sen University, Guangzhou (China); Wang, Biao [Sino-French Institute of Nuclear Engineering & Technology, Sun Yat-Sen University, Guangzhou (China)

    2015-06-15

    Highlights: • The k-ε based DES model is used in the nuclear containment simulation. • The comparison of results between different turbulent models is obtained. • The superiority of DES models is analyzed. • The computational efficiency with the DES turbulence models is explained. - Abstract: Different species of gases would be released into the containment and cause unpredicted disasters during the nuclear severe accidents. It is important to accurately predict the transportation and stratification phenomena of these gas mixtures. CFD simulations of these thermal hydraulic issues in nuclear containment are investigated in this paper. The main work is to study the influence of turbulence model on the calculation of gas transportation and heat transfer. The k-ε based DES and other frequently used turbulence models are used in the steam and helium release simulation in THAI series experiment. This paper will show the superiority of the DES turbulence model in terms of computational efficiency and accuracy with the experimental results, and analyze the necessities of DES model to simulate the large-scale containment flows with both laminar and turbulence regions.

  6. The clinical value of serum thyrotrophin receptor antibody level in patients with Graves ophthalmopathy

    International Nuclear Information System (INIS)

    Wang Chaodian; Shi Yuhong; Yan Bing

    2013-01-01

    Objective: To explore the value of serum thyrotrophin receptor antibody (TRAb) on the pathological mechanism of Graves ophthalmopathy. Methods: Two hundred and nineteen newly diagnosed Graves disease patients who were divided into Graves ophthalmopathy group (n=121) and without Graves ophthalmopathy group (n=98) were tested serum concentration with thyroid function, thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and TRAb. According to the consensus statement of the European Group on Graves ophthalmopathy, clinical activity score (CAS) and severity evaluation were carried out on Graves ophthalmopathy patients. Results: There was no significant difference in serum concentration of free thyroxine (FT 4 ), free triiodothyronine (FT 3 ), TPOAb and TRAb between the Graves ophthalmopathy group and the without Graves ophthalmopathy group. Serum concentration of TRAb was not correlated with the severity and CAS of Graves ophthalmopathy. Conclusions: The CAS and the severity of Graves ophthalmopathy were irrelevant to the serum concentration of TRAb. Therefore, the correlation between TRAb and Graves ophthalmopathy still needs further study. (authors)

  7. Thymic hyperplasia in a patient with Grave's disease

    Directory of Open Access Journals (Sweden)

    Hamzaoui Amira A

    2012-02-01

    Full Text Available Abstract Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 46-year old woman with Graves' disease and thymic hyperplasia.

  8. Collisions entre véhicules et animaux en liberté : état des lieux à partir d'une enquête au sein de la police

    OpenAIRE

    Lehaire, François; Morelle, Kevin; Lejeune, Philippe

    2013-01-01

    Les accidents de la route impliquant des animaux sauvages sont de plus en plus nombreux. En se basant sur les données recueillies par les zones de police en Wallonie, il est possible d’avoir une vision plus claire de la problématique. Dans le cas du cerf et du sanglier, il apparaît clairement que la hausse des accidents est liée à l’augmentation de leurs populations.

  9. Standardization of 131I therapy for Graves disease

    International Nuclear Information System (INIS)

    Tang Jianlin; Li Yuying; Gao Liuyan; Tang Xiuping; Hu Hongyong

    2011-01-01

    Objective: To establish the normative and standard measures, to ensure medical safety and quality of care of the patients with Graves disease treated by 131 I therapy. Methods: Formulating and strictly implementing the medical organizational and technical measures of 131 I therapy for Graves disease and regular follow-up. Results: Receiving 131 I treatment of 104 patients, follow-up 6-36 months, no adverse events, the cure rate of 59.6%, the efficient rate is 99.9%. Conclusion: It is important guarantee for the medical quality and safety to standardize the 131 I therapy of Graves disease. (authors)

  10. Compensation for damages in case of a nuclear accident; L'indemnisation des prejudices en cas d'accident nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Leger, M. [CEA Saclay, 91 - Gif sur Yvette (France)

    2011-01-15

    This article presents the system of compensation for damages in case of a nuclear accident. This system of civil liability for nuclear damage, as a specific regime, departs on several points from the common rules of civil liability, in order to provide an adequate and equitable compensation for the damages suffered by the victims of nuclear accidents. The French system of civil liability for nuclear damage results from two International Conventions integrated in French law (Paris convention 1960 and Brussels convention 1963) and the French law of 1968, October 30 on civil liability in the area of nuclear energy. These texts define the conditions under which a nuclear operator could be held liable in case of a nuclear accident. The protocols to amend the Paris and Brussels Conventions of 2004, not yet come into force, are also presented. They ensure that increased resources are available to compensate a greater number of victims of a nuclear accident. (author)

  11. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  12. Graves' disease in Albanian children.

    Science.gov (United States)

    Gjikopulli, A; Tomori, Sonila; Kollçaku, L; Hoxha, P; Grimci, Lindita; Ylli, Zamira

    2014-01-01

    Graves' disease (GD) accounts for 10-15% of thyroid disorders in patients less than 18 years of age. It is the most common cause of thyrotoxicosis in children and accounts for at least 95% of cases in children. Pediatric Treatment of Graves' disease consists of anti-thyroid drugs, radioactive iodide and thyroidectomy but the optimal treatment of GD in children is still controversial. To review treatment outcome of pediatric Graves' disease in Albania. Descriptive review of 15 children with Graves' disease, diagnosed from Jan.2007 to Dec. 2013, at the Division of Pediatric Endocrinology, Department of Pediatrics, University Hospital Centre "Mother Teresa", Albania was performed. All patients, mean age 10.56 ± 3.37 years, (range 2.02-16.09 years) were presented with goiter and increased serum FT4, mean 39.80 ± 16.02 ng/mL, (range 21.0-74.70 ng/mL), serum FT3, mean 12.98 ± 3.45 pg/mL, (range 6.90 -17.90 pg/mL) and suppressed TSH levels, mean 0.02 ± 0.01 mUI/L, (range 0.01-0.05 mUI/L). Anti TSH Receptor were positive in 100% of patients mean value 6.51 ± 3.61 UI/mL (range 1.63 - 14.10 UI/mL). Anti-thyroglobulin and Anti-TPO antibodies were positive in 60% and 46.6% respectively. Clinical course of 15 patients after treatment with anti-thyroid drugs mainly MMI for 3.19 ± 1.48 (range 0.60 - 6.20) years is as follows: seven (46.66%) underwent remission, five out of seven (71.41%) who underwent remission, relapsed. Three of them (20%) were treated with I(131), and two (13.3%) underwent to total thyroidectomy. MMI was the most common first line therapy in the presented patients with Graves' disease. Remission rate was 46.66% after an average 1.48 ± 0.71 years (range 0.60 - 2.70 years) of treatment with anti-thyroid drugs. Remission period was 2.70 ± 0.36 years (2.1 - 3.1 years) Relapse occurred in 71.41% of patient. I(131) and thyroidectomy were used as second line therapy in the present study.

  13. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    International Nuclear Information System (INIS)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa

    1994-01-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after 131 I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after 131 I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after 131 I therapy.(author)

  14. Un projet de développement forestier au Niger : problèmes d'adaptation des objectifs initiaux aux contraintes de réalisation

    OpenAIRE

    Clément, Jean

    1986-01-01

    Comme tous les pays du Sahel, le Niger est affronté à de graves problèmes de désertification et de déboisement dont les causes sont diverses : sécheresses successives,intensification du paturage provoquée par l'accroissement des troupeaux, consommation accrue de bois de feu... Sur la base d'une population totale de 6 OOO OOO habitants, la consommation de bois de feu peut être estimée à environ 4 OOO OOO m3 qu'il faut comparer aux 3 OOO OOO m3 d'accroissement en volume annuel des peuplements n...

  15. [Diagnostic difficulties in Grave's orbitopathy--case report].

    Science.gov (United States)

    Jedrzejowski, Maciej; Grzesiuk, Wiesław; Szwejda, Elzbieta; Bar-Andziak, Ewa

    2004-03-01

    Graves' orbitopathy is caused by intraorbital inflammatory reaction due to autoimmune thyroid disease. In most cases the diagnosis is based on the coexistence of typical eye signs and hyperthyroidism symptoms. In presented case, the absence of thyroid dysfunction implicated performance of differential diagnosis. Among many available diagnostic tools nuclear magnetic resonance seems to be the most accurate in confirmation of diagnosis of Graves' orbitopathy.

  16. Graves disease with ophthalmopathy following radiotherapy for Hodgkin's disease

    International Nuclear Information System (INIS)

    Jacobson, D.R.; Fleming, B.J.

    1984-01-01

    The number of patients achieving long-term survival following neck irradiation for Hodgkin's disease and other malignancies is increasing. Paralleling this increase in survivors is the development of late complications of the therapy itself. Eleven patients have previously been reported who developed Graves ophthalmopathy 18 months to seven years after receiving neck radiotherapy for nonthyroidal malignancies. The seven patients who had HLA typing were all HLA-B8 negative, despite the reported association of the HLA-B8 antigen with Graves disease. A patient who is HLA-B8 positive who developed Graves ophthalmopathy and hyperthyroidism nine years after receiving mantle radiotherapy for Hodgkin's disease is reported. It is recommended that Graves disease be included among the thyroid diseases that receive consideration during follow-up of patients who have received mantle radiotherapy

  17. Diagnosis of Grave's disease with pulmonary hypertension on chest CT.

    Science.gov (United States)

    Lee, Hwa Yeon; Yoo, Seung Min; Kim, Hye Rin; Chun, Eun Ju; White, Charles S

    To evaluate the diagnostic accuracy of chest CT findings to diagnose Grave's disease in pulmonary hypertension. We retrospectively evaluated chest CT and the medical records of 13 patients with Grave's disease with (n=6) or without pulmonary hypertension (n=7) and in 17 control patients. Presence of iso-attenuation of diffusely enlarged thyroid glands compared with adjacent neck muscle on non-enhanced CT as a diagnostic clue of Grave's disease, and assessment of pulmonary hypertension on CT has high diagnostic accuracy. Chest CT has the potential to diagnose Grave's disease with pulmonary hypertension in the absence of other information. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Graves' disease with special reference to radiation therapy

    International Nuclear Information System (INIS)

    Seegenschmidt, M. H.; Heyd, R.; Esser, J.; Mould, R.F.

    2006-01-01

    Graves' disease, although not malignant, nevertheless can lead to serious events such as permanent loss of vision if it remains untreated. This review article describes the clinical symptoms of the disease, includes a commentary on the Graves' disease subgroup of thyroid-associated orbitipathy (TAO), and defines clinical activity scoring systems which grade the severity of the disease in patients (clinical activity, NOSPECS and LEMO scoring ). An review of radiotherapy in the 1980s is followed by a summary of the 2003 German national survey on radiotherapy for Graves' disease. Radiation therapy technique is then described and discussed. Case histories are from the Alfred Krupp Hospital in Essen. (author)

  19. The Fukushima accident: radiological consequences and first lessons. Proceedings; L'accident de Fukushima: consequences radiologiques et premiers enseignements. Recueil des presentations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-02-15

    This document brings together the available presentations given at the conference organised by the French society of radiation protection about the Fukushima accident, its radiological consequences and the first lessons learnt. Sixteen presentations (slides) are compiled in this document and deal with: 1 - Accident progress and first actions (Thierry Charles, IRSN); 2 - Conditions and health monitoring of the Japanese intervention teams (Bernard Le Guen, EDF); 3 - The Intra Group action after the Fukushima accident (Michel Chevallier, Groupe Intra; Frederic Mariotte, CEA); 4 - Processing of effluents (Georges Pagis, Areva); 5 - Fukushima accident: impact on the terrestrial environment in Japan (Didier Champion, IRSN); 6 - Consequences of the Fukushima accident on the marine environment (Dominique Boust, IRSN); 7 - Territories decontamination perspectives (Pierre Chagvardieff, CEA); 8 - Actions undertaken by Japanese authorities (Florence Gallay, ASN); 9 - Japanese population monitoring and health stakes (Philippe Pirard, InVS); 10 - Citizen oversight actions implemented in Japan (David Boilley, ACRO); 11 - Implementation of ICRP's (International Commission on Radiological Protection) recommendations by Japanese authorities: first analysis (Jacques Lochard, CIPR); 12 - Control of Japan imported food stuff (David Brouque, DGAL); 13 - Questions asked by populations in France and in Germany (Florence-Nathalie Sentuc, GRS; Pascale Monti, IRSN); 14 - Labour law applicable to French workers working abroad (Thierry Lahaye, DGT); 15 - Protection of French workers working in Japan, Areva's experience (Patrick Devin, Areva); 16 - Fukushima accident experience feedback and post-accident nuclear doctrine (Jean-Luc Godet, ASN)

  20. Højfolkets Grave

    DEFF Research Database (Denmark)

    2007-01-01

    For the special exhibition 'Højfolkets Grave - Oak Coffins from Borum Eshøj' on Moesgaard Museum in 2007: The development of 3D graphics which was displayed on a big screen in the exhibition. The animation shows - in a very stylistic way - the design principles behind the construction of Bronze Age...

  1. Guidelines for the treatment of childhood-onset Graves' disease in Japan, 2016.

    Science.gov (United States)

    Minamitani, Kanshi; Sato, Hirokazu; Ohye, Hidemi; Harada, Shohei; Arisaka, Osamu

    2017-01-01

    Purpose behind developing these guidelines: Over one decade ago, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (Japan Thyroid Association (JTA)) were published as the standard drug therapy protocol for Graves' disease. The "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" were published to provide guidance on the treatment of pediatric patients. Based on new evidence, a revised version of the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (JTA) was published in 2011, combined with the "Handbook of Radioiodine Therapy for Graves' Disease 2007" (JTA). Subsequently, newer findings on pediatric Graves' disease have been reported. Propylthiouracil (PTU)-induced serious hepatopathy is an important problem in pediatric patients. The American Thyroid Association's guidelines suggest that, in principle, physicians must not administer PTU to children. On the other hand, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2011" (JTA) state that radioiodine therapy is no longer considered a "fundamental contraindication" in children. Therefore, the "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" required revision.

  2. Premature hair greying may predict reduced bone mineral density in Graves' disease.

    LENUS (Irish Health Repository)

    Leary, A C

    2012-02-03

    BACKGROUND: Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves\\' disease. AIMS: To determine whether premature greying is associated with reduced BMD in women with Graves\\' disease and in control women, and to examine whether premature greying is more common in Graves\\' disease. METHODS: Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves\\' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD. RESULTS: Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves\\' disease, but not among control women. Multiple regression confirmed this difference between Graves\\' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves\\' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14). CONCLUSION: Premature greying may be a weak marker for reduced BMD in women with a history of Graves\\' disease, but it is not a marker in normal women.

  3. Des recommandations probantes pour surveiller l’innocuité des antipsychotiques de deuxième génération chez les enfants et les adolescents

    Science.gov (United States)

    Pringsheim, Tamara; Panagiotopoulos, Constadina; Davidson, Jana; Ho, Josephine

    2012-01-01

    HISTORIQUE : Au Canada, l’utilisation d’antipsychotiques, notamment les antipsychotiques de deuxième génération (ADG), a augmenté de façon considérable depuis cinq ans chez les enfants ayant des troubles de santé mentale. Ces médicaments ont le potentiel de causer de graves complications métaboliques et neurologiques lorsqu’on les utilise de manière chronique. OBJECTIF : Synthétiser les données probantes relatives aux effets secondaires métaboliques et neurologiques précis associés à l’usage d’ADG chez les enfants et fournir des recommandations probantes sur la surveillance de ces effets secondaires. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse systématique des essais cliniques contrôlés des ADG auprès d’enfants. Ils ont fait des recommandations à l’égard de la surveillance de l’innocuité des ADG d’après un modèle de classification fondé sur le système GRADE (système de notation de l’évaluation et de l’élaboration des recommandations). Lorsque les données probantes n’étaient pas suffisantes, ils fondaient leurs recommandations sur le consensus et l’avis d’experts. Un groupe consensuel multidisciplinaire a analysé toutes les données probantes pertinentes et est parvenu à un consensus à l’égard des recommandations. RÉSULTATS : Les recommandations probantes portant sur la surveillance de l’innocuité des ADG figurent dans les présentes lignes directrices. Les auteurs indiquent la qualité des recommandations relatives à des examens physiques et tests de laboratoire précis à l’égard de chaque ADG à des moments déterminés. CONCLUSION : De multiples essais aléatoires et contrôlés ont permis d’évaluer l’efficacité de bon nombre des ADG utilisés pour traiter les troubles de santé mentale en pédiatrie. Toutefois, leurs avantages ne sont pas sans risques : on observe à la fois des effets secondaires métaboliques et neurologiques chez les enfants traités au moyen d

  4. Predictive factors of thyroid cancer in patients with Graves' disease.

    Science.gov (United States)

    Ren, Meng; Wu, Mu Chao; Shang, Chang Zhen; Wang, Xiao Yi; Zhang, Jing Lu; Cheng, Hua; Xu, Ming Tong; Yan, Li

    2014-01-01

    The best preoperative examination in Graves' disease with thyroid cancer still remains uncertain. The objectives of the present study were to investigate the prevalence of thyroid cancer in Graves' disease patients, and to identify the predictive factors and ultrasonographic features of thyroid cancer that may aid the preoperative diagnosis in Graves' disease. This retrospective study included 423 patients with Graves' disease who underwent surgical treatment from 2002 to 2012 at our institution. The clinical features and ultrasonographic findings of thyroid nodules were recorded. The diagnosis of thyroid cancer was determined according to the pathological results. Thyroid cancer was discovered in 58 of the 423 (13.7 %) surgically treated Graves' disease patients; 46 of those 58 patients had thyroid nodules, and the other 12 patients were diagnosed with incidentally discovered thyroid carcinomas without thyroid nodules. Among the 58 patients with thyroid cancer, papillary microcarcinomas were discovered in 50 patients, and multifocality and lymph node involvement were detected in the other 8 patients. Multivariate regression analysis showed younger age was the only significant factor predictive of metastatic thyroid cancer. Ultrasonographic findings of calcification and intranodular blood flow in thyroid nodules indicate that they are more likely to harbor thyroid cancers. Because the influencing factor of metastatic thyroid cancers in Graves' disease is young age, every suspicious nodule in Graves' disease patients should be evaluated and treated carefully, especially in younger patients because of the potential for metastasis.

  5. Carsim : un système pour convertir des textes en scènes tridimensionnelles animées

    NARCIS (Netherlands)

    Nugues, P.; Dupuy, S.; Egges, A.

    2004-01-01

    Cet article décrit un système de conversion de textes en scènes tridimensionnelles animées. Les textes sont des constats d’accidents de voitures rédigés par un des conducteurs. Le processus de conversion comporte de deux étapes. Un premier module d’extraction d’informations crée une description

  6. Pendant la visite de M. Krasucki Grave accident du travail dans le tunnel du LEP

    CERN Multimedia

    Ration, Jean

    1985-01-01

    In the LEP tunnel, where M. Krasucki came some hours before, an accident occured and a worker was seriously injuried, but its days do not seem in danger (together with another article about the visit of M. Krasucki)

  7. Analyse des conditions de travail des travailleurs intérimaires Analysis of the Working Conditions of Temporary Workers. Explaining These Workers’ Vulnerability to Occupational Accidents Análisis de las condiciones de trabajo de los trabajadores temporales. Cómo explicar la vulnerabilidad de estos trabajadores a los accidentes laborales ?

    Directory of Open Access Journals (Sweden)

    Rachid Belkacem

    2012-11-01

    Full Text Available Cet article analyse les conditions de travail des intérimaires. Il s’appuie sur les résultats d’une étude réalisée en 2008/2009 et financée par la Direction régionale du travail, de l’emploi et de la formation professionnelle – région Lorraine. Cette recherche a été organisée autour de deux travaux de terrain : une enquête par questionnaires et des entretiens semi-directifs menés auprès d’intérimaires détachés dans l’industrie et/ou le BTP. Cet article montre que la vulnérabilité des intérimaires aux accidents du travail est forte comparativement aux salariés permanents des entreprises. Cette dernière s’explique par des conditions de travail relativement plus difficiles. Ces travailleurs doivent s’adapter très souvent dans l’urgence à des contextes de travail différents et évolutifs.This paper analyzes the main characteristics of the working conditions of temporary workers in France. It examines the data from a large study conducted in 2008/2009 and financed by the Regional Labor Department of Lorraine (DRTEFP- Lorraine. Our research was organized around two surveys involving temporary workers in industry and/or construction and civil engineering. This article shows that temporary employees’ vulnerability to occupational accidents is higher than that of companies’ permanent employees. This vulnerability can be explained by relatively more difficult working conditions. Quite often, these workers must quickly adapt to different and evolving work contexts.Este artículo analiza las condiciones de trabajo de los trabajadores temporales en Francia. El mismo se apoya en los resultados de un estudio realizado en 2008/2009, financiado por la Dirección Regional del Trabajo, Empleo y Formación Profesional –Región Lorraine. Esta investigación ha sido organizada sobre la base de dos trabajos de terreno : encuesta y entrevistas a trabajadores temporales vinculados a la industria y/o al BTP. Este art

  8. Immunoreactive 'TSH' in urinary concentrates of Graves' disease patients

    International Nuclear Information System (INIS)

    Van Herle, A.; Orgiazzi, J.; Greipel, M.A.; Slucher, J.A.; Honbo, K.S.; Hopital de l'Antiquaille, 69 - Lyon

    1978-01-01

    A double antibody radioimmunoassay was used to analyse immunoreactive thyrotrophin in urinary concentrates from fourteen patients with hyperthyroidism due to Graves' disease, in three subjects with primary hypothyroidism, and in six normal subjects. Immunoreactive thyrotrophin was detectable in eleven subjects with Graves' disease, in one subject with primary hypothyroidism, and in four normal subjects. The mean urinary thyrotrophin concentration was significantly higher in Graves' disease (492+-99.9μU/24h(SEM)(n=11)) than in normal subjects (177+-26.4μU/24h(SEM)(n=4)(P [de

  9. Rituximab in relapsing Graves' disease, a phase II study

    NARCIS (Netherlands)

    Heemstra, Karen A.; Toes, Rene E.; Sepers, Jan; Pereira, Alberto M.; Corssmit, Eleonora P.; Huizinga, Tom W. J.; Romijn, Johannes A.; Smit, Johannes W.

    2008-01-01

    Conventional therapies for Graves' disease, consisting of medical therapy or radioiodine are unsatisfactory, because of limited efficacy and adverse events. Interventions aimed at the underlying autoimmune pathogenesis of Graves' disease may be worthwhile to explore. We therefore performed a

  10. Graves' Disease Pharmacotherapy in Women of Reproductive Age.

    Science.gov (United States)

    Prunty, Jeremy J; Heise, Crystal D; Chaffin, David G

    2016-01-01

    Graves' disease is an autoimmune disorder in which inappropriate stimulation of the thyroid gland results in unregulated secretion of thyroid hormones resulting in hyperthyroidism. Graves' disease is the most common cause of autoimmune hyperthyroidism during pregnancy. Treatment options for Graves' disease include thioamide therapy, partial or total thyroidectomy, and radioactive iodine. In this article, we review guideline recommendations for Graves' disease treatment in women of reproductive age including the recent guideline from the American College of Obstetricians and Gynecologists. Controversy regarding appropriate thioamide therapy before, during, and after pregnancy is reviewed. Surgical and radioactive iodine therapy considerations in this patient population are also reviewed. In patients who may find themselves pregnant during therapy or develop Graves' disease during their pregnancy, consideration should be given to the most appropriate treatment course for the mother and fetus. Thioamide therapy should be used with either propylthiouracil or methimazole at appropriate doses that target the upper range of normal to slightly hyperthyroid to avoid creating hypothyroidism in the fetus. Consideration should also be given to the adverse effects of thioamide, such as agranulocytosis and hepatotoxicity, with appropriate patient consultation regarding signs and symptoms. Individuals who wish to breastfeed their infants while taking thioamide should receive the lowest effective dose. Surgery should be reserved for extreme cases and limited to the second trimester, if possible. Radioactive iodine therapy may be used in nonpregnant individuals, with limited harm to future fertility. Radioactive iodine therapy should be withheld in pregnant women and those who are actively breastfeeding. Clinicians should keep abreast of developments in clinical trials and evidence-based recommendations regarding Graves' disease in reproductive-age women for any changes in evidence

  11. [Rituximab: a new therapeutic alternative in Grave's disease].

    Science.gov (United States)

    Tello-Winniczuk, Nina; Díaz-Jouanen, Efraín

    2011-01-01

    Graves' disease is the most frequent cause of hyperthyroidism, affecting mainly young aged women, with an etiology of autoimmune basis. One of its manifestations, Graves' ophthalmopathy whose pathophysiology is unknown, represents one of the greatest therapeutic challenges in these patients, because they require aggressive treatment with steroids and multiple subsequent reconstructive surgeries in certain cases. It also represents a high burden to the health system. Drugs targeting B cells have been very effective for many autoimmune diseases. Rituximab is a murine humanized monoclonal antibody against CD20 + cells currently being studied in various autoimmune diseases including Graves' disease. The objective of this paper is to expose possible mechanisms by which rituximab could act in both hyperthyroidism and ophthalmopathy of Graves' disease, as well as the experience with its use acquired so far. The employment of rituximab in recently diagnosed patients or with mild ophthalmopathy is questionable with the evidence available today however, we think that it may have a role in refractory cases or those who have a contraindication for steroid use.

  12. Management of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.

    2007-01-01

    Management of Graves' ophthalmopathy is preferably done in a multidisciplinary setting. Smoking is associated with worse disease outcome. (131)I therapy for hyperthyroidism can also worsen ophthalmopathy, especially if administered during active disease or to patients who smoke or have severe

  13. Enhancement of soluble CD28 levels in the serum of Graves' disease.

    Science.gov (United States)

    Sun, Zhongwen; Yi, Lixian; Tao, Hong; Huang, Jingfang; Jin, Zhenghong; Xiao, Yang; Feng, Caiyun; Sun, Jing

    2014-01-01

    Graves' disease is an autoimmune disease of the thyroid gland mediated by T cells. CD28, a member of costimulatory molecules, plays a pivotal role in regulating T-cell responses. Plasma-soluble CD28 is one form of CD28 in peripheral blood. To investigate the concentrations of soluble CD28 in patients with Graves' disease, we used a sensitive dual monoclonal antibody sandwich enzyme-linked immunosorbent assay (ELISA) to detect the soluble form of CD28. Our results suggested that mean concentrations of soluble CD28 in plasma of patients with Graves' disease were 1.79 ±1.52 ng/ml, and levels of soluble CD28 in healthy subjects were only 0.83 ±1.35 ng/ml. Concentrations of soluble CD28 detected in patients with Graves' disease were significantly higher than those of healthy subjects (p Graves' disease. Therefore, aberrant elevation of plasma-soluble CD28 in patients with Graves' disease may reflect the dysregulation of immune system, and may serve as a useful biomarker in Graves' disease diagnosis.

  14. Graves' disease and toxic nodular goiter - radioiodine therapy; Morbus Basedow und Autonomie - Radioiodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Schicha, H.; Dietlein, M. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2002-04-01

    At the 15th conference on the human thyroid in Heidelberg in 2001 the following aspects of the radioiodine therapy of benign thyroid disorders were presented: General strategies for therapy of benign thyroid diseases, criterions for conservative or definitive treatment of hyperthyroidism as first line therapy and finally preparation, procedural details, results, side effects, costs and follow-up care of radioiodine therapy as well as legal guidelines for hospitalization in Germany. The diagnosis Graves' hyperthyroidism needs the decision, if rather a conservative treatment or if primary radioiodine therapy is the best therapeutic approach. In the USA 70-90% of these patients are treated with radioiodine as first line therapy, whereas in Germany the conservative therapy for 1-1.5 years is recommended for 90%. This review describes subgroups of patients with Graves' disease showing a higher probability to relapse after conservative treatment. Comparing benefits, adverse effects, costs, and conveniences of both treatment strategies the authors conclude that radioiodine therapy should be preferred as first line therapy in 60-70% of the patients with Graves' hyperthyroidism. (orig.) [German] In dem vorliegenden Beitrag wird ueber die Radioiodtherapie gutartiger Schilddruesenerkrankungen referiert. Dies betrifft gesetzliche Regelungen in Deutschland, grundlegende Ueberlegungen zur Therapie benigner Schilddruesenerkrankungen, die Diskussion konservative versus definitive Therapieindikation der Hyperthyreose und schliesslich die Themenkomplexe Vorbereitung, Durchfuehrung, Ergebnisse, Nebenwirkungen und Komplikationen, Kosten sowie Nachsorge der Radioiodtherapie. Im Vordergrund steht die Abgrenzung der konservativen Therapieindikation gegenueber der primaeren Radioiodtherapie des Morbus Basedow in Deutschland. Waehrend in den USA 70-90% der Morbus-Basedow-Faelle primaer mit Radioiodtherapie behandelt werden, wird in Deutschland bei 90% zunaechst ein

  15. Epidemiological survey of graves' disease in Tianjin area

    International Nuclear Information System (INIS)

    Gao Shuo; Fang Peihua; Lai Zemin; Chen Bingzhong; Lu Tizhang; Zhou Yinbao; Tan Jian; Ni Xiaoyan

    2002-01-01

    Objective: To study the incidence of Graves' disease and associated factors. Methods: From 1997.4 to 1999.12, by using cluster and stratified sampling, total of 31530 people aged 6 years and over were surveyed epidemiologically for Graves' disease in five districts and one county of Tianjin area where the study subjects had been resided for at least one year. The researching team consisted of endocrinologists, epidemiologists and technicians and was divided into three branches, they served as investigators, professional experts and technicians, respectively. The serum thyroid hormones, thyroid antibodies, iodine in table salt, urine iodine and B-US were examined for the suspected cases, the final diagnoses were concluded by the professional experts. Results: Eighty-nine patients with Graves' disease were confirmed, 26 (0.166%) of them were males and 63(0.397%) of them were females, the total incidence was 0.282%. The incidence significantly associated with sex (female higher than male, P<0.001), age (50-60 group for male and 30-40 group for female higher than others, P<0.001) and family history (the patients with vs without family history, P<0.001). The survey showed an ascending trend of incidence of Graves' disease, along with decreasing of goiter rate and increasing of iodine contents in table salt and in urine. Further research work should be pursued. Conclusion: This study may provide some theoretical basis for prevention and treatment of Graves' disease

  16. Promouvoir des systèmes alimentaires sains

    International Development Research Centre (IDRC) Digital Library (Canada)

    fdieudonne

    d'hypertension, de maladie cardiaque, de diabète et d'accidents vasculaires cérébraux. Le CRDI contribut aux efforts déployés pour réduire la consommation de sel, de sucre et de gras : Au Costa Rica, des objectifs de réduction de la consommation de sel ont été établis en s'appuyant sur les résultats de la recherche.

  17. HYPOTHÈSES SUR L'ORIGINE DES BRUITS DU COEUR ET DES ACCIDENTS DE DÉCOMPRESSION EN PLONGÉE : LA CAVITATION

    OpenAIRE

    Venet , Richard

    2007-01-01

    Nous avons proposé, dans un travail antérieur, l'hypothèse d'un phénomène de cavitation à l'origine des bruits de Korotkoff. Encouragés par l'aphorisme de MacDonald comme quoi le phénomène de cavitation est plus fréquent qu'on peut le penser dans le système cardio-vasculaire, nous avons appliqué la théorie de Womersley aux enregistrements hémodynamiques exposés dans la littérature médicale. L'enregistrement simultané des pressions du ventricule gauche (PVG), de l'aorte (PAo) et de l'oreillett...

  18. Changes of hepatofibrosis markers in Graves' disease

    International Nuclear Information System (INIS)

    Zhou Feihua; Xu Haifeng; Zhou Runsuo; Gao Feng; Wang Lei

    2006-01-01

    Objective: To study the changes of hepatofibrosis markers (IV-C, PC III, HA, LN) in Graves' disease. Methods: Serum levels of hepatofibrosis were measured with RIA in 40 patients with Graves' disease (CD) before any treatment and 35 patients with Graves' disease after successful anti-thyroid drug therapy as well as in 30 controls. Results: The serum IV-C and PC III levels in GD patients were significant higher than those in controls before treatment (P<0.01). After successful treatment, the IV-C, PC III levels dropped markedly (vs before treatment, P<0.01). However, there were no significant differences among the serum HA, LN levels in all the subjects tested. Conclusion: Serum levels of IV-C and PC III increased markedly with hyperthyroidim. When IV-C and PC III levels were taken for assessment of degree of hepatofibeosis, GD must be ruled out first. (authors)

  19. Grave's Disease and Primary Biliary Cirrhosis—An Unusual and Challenging Association

    OpenAIRE

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2013-01-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial.

  20. Grave's Disease and Primary Biliary Cirrhosis-An Unusual and Challenging Association.

    Science.gov (United States)

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2014-03-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial.

  1. Smoking and other lifestyle factors and the risk of Graves' hyperthyroidism.

    Science.gov (United States)

    Holm, Ingrid A; Manson, Joann E; Michels, Karin B; Alexander, Erik K; Willett, Walter C; Utiger, Robert D

    2005-07-25

    Hyperthyroidism caused by Graves' disease is common in women, yet little is known about risk factors for the disease. We sought to determine whether lifestyle factors, including smoking, alcohol consumption, physical activity level, and body mass index, are risk factors for Graves' hyperthyroidism. This analysis was conducted using data from the Nurses' Health Study II, among 115109 women aged 25 to 42 at entry. Incident reports of women with Graves' hyperthyroidism, confirmed to have the disorder, were included. During 1 328 270 person-years of follow-up, incident diagnoses of Graves' hyperthyroidism were confirmed in 543 women; the 12-year incidence was 4.6 per 1000 women. Cigarette smoking was a predictor of Graves' hyperthyroidism. The hazard ratio among current smokers was 1.93 (95% confidence interval [CI], 1.54-2.43), and among past smokers it was 1.27 (95% CI, 1.03-1.56), after adjusting for recent pregnancy, parity, and other variables. Among current smokers, the hazard ratio increased with the intensity of smoking and was 2.63 (95% CI, 1.71-4.04) among women who smoked 25 or more cigarettes daily. Obesity was associated with a decreased risk of Graves' hyperthyroidism. The hazard ratio for the disorder among women with a body mass index of 30 kg/m(2) or higher was 0.68 (95% CI, 0.49-0.92). Alcohol intake and physical activity level were not associated with risk of Graves' hyperthyroidism. Smoking is a risk factor for Graves' hyperthyroidism in women. Obesity may be associated with a reduced risk, although weight loss as the first manifestation of hyperthyroidism cannot be excluded.

  2. Primary biliary cirrhosis associated with Graves' disease in a male patient.

    Science.gov (United States)

    Suzuki, Yuji; Ishida, Kazuyuki; Takahashi, Hiroshi; Koeda, Norihiko; Kakisaka, Keisuke; Miyamoto, Yasuhiro; Suzuki, Akiko; Takikawa, Yasuhiro

    2016-04-01

    Primary biliary cirrhosis (PBC), which predominantly affects women, has been associated with various autoimmune diseases. Although hypothyroidism accompanying PBC is well documented, the concomitance of PBC and hyperthyroidism is rare. Herein, we report the case of a 62-year-old man who was diagnosed with PBC several years after the development of Graves' disease. This is the first case of a male patient developing PBC with Graves' disease. Both serum alanine aminotransferase levels and serum thyroid hormone levels were normalized after the administration of thiamazole for Graves' disease. However, the cholestatic liver enzyme abnormalities continued, indicating that the PBC was actualized by the administration of thiamazole. After starting ursodeoxycholic acid treatment, cholestatic liver enzyme abnormalities improved. Taken together, when a cholestatic pattern of liver enzymes is observed during follow-up for Graves' disease, an association between Graves' disease and PBC should be considered as a differential diagnosis.

  3. [Not Available].

    Science.gov (United States)

    Ettalbi, S; Ibnouzahir, M; Droussi, H; Wahbi, S; Bahaichar, N; Boukind, E H

    2009-06-30

    La brûlure est un accident qui reste toujours très fréquent au Maroc, ce qui fait d'elle un problème de la santé publique. Les brûlures, quand elles sont graves ou profondes, entraînent de façon quasi inéluctable des séquelles fonctionnelles et esthétiques. A travers deux observations de deux enfants présentant des séquelles de brûlures graves, ayant retenti péjorativement sur leurs scolarités, on a essayé de mettre en évidence quelques facteurs incriminés dans cette tragédie (feu, petites bouteilles de gaz et le manque d'infrastructure, du personnel médical et paramédical, du matériel ainsi que de la prévention) comme étant une grande cause dans la survenue de ces séquelles. Le but de notre travail est d'énumérer ces différents facteurs intriqués, ainsi que de proposer quelques solutions, tout en insistant sur la prévention.

  4. Grave's Disease and Primary Biliary Cirrhosis—An Unusual and Challenging Association

    Science.gov (United States)

    Shetty, Shiran; Rajasekaran, Senthilkumar; Venkatakrishnan, Leela

    2013-01-01

    Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepatitis, or primary biliary cirrhosis. The cause of jaundice in Grave's disease is multifactorial. PMID:25755537

  5. Communication non verbale et dysfonctionnement exécutif post-traumatique : étude multimodale de corpus conversationnels vidéoscopés de 17 patients traumatisés crâniens graves, de 17 interlocuteurs fixes et de 34 témoi

    OpenAIRE

    Sainson, Claire

    2012-01-01

    L’altération des fonctions exécutives, consécutive à un traumatisme crânien grave, engendre d’importantes perturbations de l’utilisation du langage en contexte. Ces dysfonctionnements interactionnels bouleversent de façon durable l’équilibre familial et tiennent assurément une part importante dans le pronostic de réinsertion socio-familiale voire professionnelle. L’objectif général de cette étude est l’amélioration de l’évaluation des troubles, en considérant un aspect systématiquement néglig...

  6. SUBTOTAL THYROIDECTOMY IN THE MANAGEMENT OF GRAVE'S DISEASE.

    Science.gov (United States)

    Vincent, P J; Garg, M K; Singh, Y; Bhalla, V P; Datta, S

    2001-07-01

    Treatment options for Grave's disease include radio-iodine ablation, which is the standard treatment in the USA, antithyroid drug therapy, which is popular in Japan, and surgery, which is commonly employed in Europe and India. There are very few reports about the outcome of surgery in Grave's disease in the Indian setting. Surgery for Grave's disease is an attractive option in under developed countries to cut short prolonged drug treatment, costly follow up and avoid the need for radio-isotope facilities for 1311 ablation. Aim of the present study was to assess the result of subtotal thyroidectomy in 32 cases of Grave's Disease referred for surgery by the endocrinologist in a teaching hospital. Patients were prepared for surgery with Lugol's iodine and propranalol. Subtotal thyroidectomy was performed by a standard technique, which included dissection and exposure of recurrent laryngeal nerves and parathyroid glands. Actual estimation of weight of the remnant gland was not part of the study. Duration of follow up ranged from 6 months to 4 years. 13 of 32 cases were males. Age ranged from 20 to 57 years. There was 1 death in the immediate post-operative period. There were no cases of permanent hypoparathyroidism or recurrent laryngeal nerve palsy. 1 patient developed temporary hypoparathyroidism. 1 patient developed recurrence of hyperthyroidism and 3 cases developed hypothyroidism all within 2 years of surgery. The study has demonstrated the safety and effectiveness of surgery for Grave's Disease in comparison to the reported high incidence of hypothyroidism following radio-iodine therapy and high recurrence rate after anti thyroid drug therapy.

  7. Prevention of Graves' ophthalmopathy.

    Science.gov (United States)

    Bartalena, Luigi

    2012-06-01

    Smoking is the most important risk factor for the occurrence/progression of Graves' ophthalmopathy (GO), as well as for its lower/slower response to immunosuppression. Accordingly, refrain from smoking should be urged, both as primary prevention (removal of risk factors in Graves' patients without GO), secondary prevention (early detection and treatment of asymptomatic/very mild GO) and tertiary prevention (reduction of complications/disability of overt GO). A 6-month course of 200 μg/day sodium selenite can prevent progression of mild GO to more severe GO and is, therefore, a form of secondary prevention and, probably, primary prevention. Correction of thyroid dysfunction and stable maintenance of euthyroidism are important preventive measures. The optimal treatment for hyperthyroidism in patients with GO is uncertain, because evidence demonstrating the superiority of antithyroid drugs over thyroid ablation (radioiodine, thyroidectomy, or both) is lacking. If radioiodine is used, low-dose steroid prophylaxis is recommended, particularly in smokers, to prevent radioiodine-associated GO progression. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Radioiodine therapy of Graves' disease - a dosimetric comparison of different strategies concerning antithyroid drugs; Radioiodtherapie des Morbus Basedow - dosimetrischer Vergleich verschiedener Therapieregime bezueglich der Thyreostatikabgabe

    Energy Technology Data Exchange (ETDEWEB)

    Urbannek, V.; Voth, E.; Moka, D.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Medizinische Einrichtungen der Univ. zu Koeln (Germany)

    2001-08-01

    Aim: Premedication with antithyroid drugs (ATD) compared to patients not pretreated with ATD causes a higher failure rate of radioiodine therapy (RITh) or demands higher therapeutical dosage of radioiodine (RI). For clinical reasons and because of accelerated iodine metabolism in hyperthyreosis a compensated thyroid metabolism is desirable. Aim of this study was to investigate the influence of ATD on the biokinetics of RI in case of Graves' disease in order to improve RITh of patients pre-treated with ATD. Methods: 385 consecutive patients who underwent RITh because of Graves' disease for the first time were included: Group A (n = 74): RITh under continuous medication with ATD; Group B (n = 111): Application of RI under continuous medication with ATD, in case of insufficient RI-uptake or shortened effective RI-half-life ATD were stopped 1-5 days after RITh; Group C (n = 200): ATD were stopped 2 days prior to RITh in all patients. We examined the influence of ATD on RI-uptake and effective RI-half-life as well as the absorbed dose achieved on the thyroid in dependence of thyroid volume and applied RI-dosage [TEQ - therapy efficiency quotient, (2)]. Results: In the RI-pretest (all patients under ATD) the RI-uptake was comparable in all three groups. During RITh-RI-uptake, effective RI-half-life and therefore the TEQ were significantly higher in Group C as compared to Groups A and B (p<0,001, respectively). In Group B the medication with ATD was stopped in 61 of 111 cases 1-5 days after RITh. In this subgroup the effective RI-half-life increased from 4,4 {+-} 1,7 d to 5,1 {+-} 1,6 d after stopping of ATD (p = 0,001). Conclusion: Stopping of ATD 2 days prior to RITh leads to an increased efficiency of about 50% compared to RITh carried out under ATD and therefore to a clear reduction of radiation exposure to the rest of the body with equal absorbed doses of the thyroid. Stopping of ATD shortly after RITh increases efficiency in case of short effective RI

  9. Growth hormone and insulin-like growth factor 1 affect the severity of Graves' disease.

    Science.gov (United States)

    Di Cerbo, Alfredo; Pezzuto, Federica; Di Cerbo, Alessandro

    2017-01-01

    Graves' disease, the most common form of hyperthyroidism in iodine-replete countries, is associated with the presence of immunoglobulins G (IgGs) that are responsible for thyroid growth and hyperfunction. In this article, we report the unusual case of a patient with acromegaly and a severe form of Graves' disease. Here, we address the issue concerning the role of growth hormone (GH) and insulin-like growth factor 1 (IGF1) in influencing thyroid function. Severity of Graves' disease is exacerbated by coexistent acromegaly and both activity indexes and symptoms and signs of Graves' disease improve after the surgical remission of acromegaly. We also discuss by which signaling pathways GH and IGF1 may play an integrating role in regulating the function of the immune system in Graves' disease and synergize the stimulatory activity of Graves' IgGs. Clinical observations have demonstrated an increased prevalence of euthyroid and hyperthyroid goiters in patients with acromegaly.The coexistence of acromegaly and Graves' disease is a very unusual event, the prevalence being Graves' disease associated with acromegaly and show that surgical remission of acromegaly leads to a better control of symptoms of Graves' disease.

  10. Total thyroidectomy: is morbidity higher for Graves' disease than nontoxic goiter?

    Science.gov (United States)

    Welch, Kellen C; McHenry, Christopher R

    2011-09-01

    Total thyroidectomy for treatment of Graves' disease is controversial and much of the debate centers on the concern for complications. The purpose of this study was to evaluate the morbidity of total thyroidectomy for Graves' disease and determine if it is different than for patients with nontoxic nodular goiter. The rates of life threatening neck hematoma, recurrent laryngeal nerve (RLN) injury, transient hypocalcemia, and hypoparathyroidism were determined for consecutive patients with Graves' disease treated with total thyroidectomy from 1996 to 2010. Results were compared with patients who underwent total thyroidectomy for nontoxic nodular goiter during the same period, matched for the weight of the excised thyroid gland. Total thyroidectomy was performed in 111 patients with Graves' disease (group I) and 283 patients with nontoxic nodular goiter (group II). Parathyroid autotransplantation was performed in 31(28%) patients in group I and 98 (35%) patients in group II (P = NS). Comparative analysis of morbidity revealed no significant difference in neck hematoma, 0(0%) (I) versus 3(1%) (II); permanent RLN injury, 0(0%) (I) versus 2(1%) (II); and permanent hypoparathyroidism in 1(1%) (I) versus 1 (0.4%) (II) (P = NS). Transient hypocalcemia was more common in patients with Graves' disease, 80(72%) (I) versus 170 (60%) (II) (P Graves' disease; only transient hypocalcemia occurred more often than in patients with nodular goiter. Total thyroidectomy should be presented as a therapeutic option for all patients with Graves' disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Simultaneous induction of Graves' hyperthyroidism and Graves' ophthalmopathy by TSHR genetic immunization in BALB/c mice.

    Directory of Open Access Journals (Sweden)

    Nan Xia

    Full Text Available Graves' disease is the most common form of autoimmune thyroid disorder, characterized by hyperthyroidism due to circulating autoantibodies. To address the pathological features and establish a therapeutic approach of this disease, an animal model carrying the phenotype of Graves' disease (GD in concert with Graves' Ophthalmopathy (GO will be very important. However, there are no ideal animal models that are currently available. The aim of the present study is to establish an animal model of GD and GO disease, and its pathological features were further characterized.A recombinant plasmid pcDNA3.1- T289 was constructed by inserting the TSHR A-subunit gene into the expression vector pcDNA3.1, and genetic immunization was successfully performed by intramuscular injection of the plasmid pcDNA3.1-T289 on female 8-week-old BALB/c mice. Each injection was immediately followed by in vivo electroporation using ECM830 square wave electroporator. Morphological changes of the eyes were examined using 7.0T MRI scanner. Levels of serum T4 and TSHR antibodies (TRAb were assessed by ELISA. The pathological changes of the thyroid and orbital tissues were examined by histological staining such as H&E staining and Alcian blue staining.More than 90% of the immunized mice spontaneously developed goiter, and about 80% of the immunized mice manifested increased serum T4 and TRAb levels, combined with hypertrophy and hyperplasia of thyroid follicles. A significantly increased synthesis of hyaluronic acid was detected in in the immunized mice compared with the control groups.We have successfully established an animal model manifesting Graves' hyperthyroidism and ophthalmopathy, which provides a useful tool for future study of the pathological features and the development of novel therapies of the diseases.

  12. La prise en charge des suicides par précipitation en traumatologie

    Directory of Open Access Journals (Sweden)

    Abdelmajid Elmrini

    2010-09-01

    Full Text Available OBJECTIFS: A travers ce travail, l’épidémiologie et la psychopathologie du suicide par précipitation seront rappelées, le rôle du chirurgien traumatologue dans la restauration physique et psychique sera démontré. METHODES: Nous rapportons une étude rétrospective de 15 suicidants par précipitation admis pour des traumatismes complexes de l’appareil locomoteur entre 2004 et 2007. RESULTATS: Il s’agissait de primosuicidants, comprenant 10 femmes et 5 hommes. L’âge moyen des hommes est de 26,5 ans (24-34 ans et celui des femmes de 40,7 ans (17-45 ans. Le bilan lésionnel des suicidants a retrouvé 14 fractures des membres inférieurs, 4 traumatisme du rachis avec compression médullaire dans 1 cas, une fracture du bassin; deux traumatismes du membre supérieur. Aucun de ces patients n’a présenté de lésions viscérales ni de traumatismes crâniofacial. 80% (n = 12 des patients souffraient d’une affection psychiatrique avant leur passage à l’acte suicidaire : 8 pour une pathologie dépressive et 4 pour une schizophrénie. Chaque suicidant a subi au moins un acte chirurgical. Tous les patients avaient poursuivi la prise en charge psychiatrique en ambulatoire. Nos résultats fonctionnels étaient satisfaisants sans complications. Aucun des patients n’a récidivé. La pathologie suicidaire représente un problème de santé publique. Le suicide par précipitation représente 5 % de l’ensemble des modalités suicidaires. Les traumatismes occasionnés par ce mode suicidaire sont complexes et graves. Leur prise en charge nécessite une collaboration multidisciplinaire. CONCLUSION: La réparation chirurgicale permet à la fois le rétablissement de la fonction et l’amélioration psychique du sujet prévenant contre une rechute dépressive ou une récidive suicidaire.

  13. Graves, Ancestors and Cement in Land disputes in Acholi and Ikland, Uganda

    DEFF Research Database (Denmark)

    Meinert, Lotte; Willerslev, Rane; Seebach, Sophie Hooge

    2017-01-01

    graves are made concrete and increasingly cemented indices of belonging in wrangles over land. Belonging is often justified through the presence of ancestor graves on land. The cementing of graves turns them into more concrete and durable proofs of ownership, and the reburial of relatives to disputed......The paper explores the roles of graves, ancestors and concrete pillars in disputes over land across different land-systems, -conflicts, and territory making in northern Uganda by comparing extended cases between Acholi in Gulu district and Ik in Kaabong district . In the post-conflict Acholi region...

  14. Pretibial myxedema without ophthalmopathy: an initial presentation of Graves' disease.

    Science.gov (United States)

    Lohiya, Sheela; Lohiya, Vipin; Stahl, Elizabeth J

    2013-07-01

    To report a rare case of Graves' disease without ophthalmopathy presenting with pretibial myxedema (PM) as an initial presentation. We present the clinical history, physical findings, laboratory studies and biopsy data of a 62-year-old man with a history of uncontrolled type 2 diabetes (DM2) presenting with arm and leg skin lesions in the absence of other physical findings. Histopathology confirmed PM. Graves' disease and its association with PM without Graves' ophthalmopathy and the pertinent literature are reviewed. A 60-year-old man with a history of uncontrolled DM2 presented for glycemic management. He described symptoms of anxiety, insomnia and fatigue for the last 5 to 6 months. He described diffuse chest pain, occasionally associated with palpitations, and a 50-pound weight loss. He also complained of severe itching and burning of his arms and legs for the past several months. Subsequent thyroid studies revealed hyperthyroidism suggestive of Graves' disease. In the interim, he was hospitalized for atrial flutter and was cardioverted. After being started on methimazole, his symptoms abated. His skin lesions were biopsied, and the leg biopsy was consistent with PM. He however had no lid lag or proptosis characteristic of Graves' disease. He subsequently underwent radioiodine ablation. His hyperglycemia was better control led after treatment of his hyperthyroidism. PM is an autoimmune manifestation of Graves' disease. Almost all cases of thyroid dermopathy are associated with relatively severe ophthalmopathy. Usually ophthalmopathy appears first and dermopathy much later. However, this case represents a rare initial presentation of Graves' disease with PM without ophthalmologic symptoms or findings. Hyperthyroidism is typically associated with worsening glycemic control and increased insulin requirements. In patients with diabetes having hyperthyroidism, deterioration in glycemic control should be anticipated and treatment should be adjusted accordingly

  15. Pancytopenia in a Patient with Grave's Disease.

    Science.gov (United States)

    Loh, Huai Heng; Tan, Florence

    2013-08-01

    Pancytopenia can rarely complicate Grave's disease. It can be due to uncontrolled thyrotoxicosis or as a result of rare side effect of antithyroid medication. Pernicious anemia leading to Vitamin B12 deficiency is another rare associated cause. We report a case of a patient with Grave's disease and undiagnosed pernicious anemia whom was assumed to have antithyroid drug induced pancytopenia. Failure to recognize this rare association of pernicious anemia as a cause of pancytopenia had resulted in delay in treatment and neurological complication in our patient.

  16. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    Energy Technology Data Exchange (ETDEWEB)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))

    1994-09-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

  17. Genetic susceptibility to Grave's disease.

    Science.gov (United States)

    Li, Hong; Chen, Qiuying

    2013-06-01

    The variety of clinical presentations of eye changes in patients with Graves' disease (GD) suggests that complex interactions between genetic, environmental, endogenous and local factors influence the severity of Graves' ophthalmopathy (GO). It is thought that the development of GO might be influenced by genetic factors and environmental factors, such as cigarette smoking. At present, however, the role of genetic factors in the development of GO is not known. On the basis of studies with candidate genes and other genetic approaches, several susceptibility loci in GO have been proposed, including immunological genes, human leukocyte antigen (HLA), cytotoxic T-lymphocyte antigen-4 (CTLA-4), regulatory T-cell genes and thyroid-specific genes. This review gives a brief overview of the current range of major susceptibility genes found for GD.

  18. Safety precautions in atomic pile control (1962); Securite dans le controle des piles atomiques (1962)

    Energy Technology Data Exchange (ETDEWEB)

    Furet, J [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1962-07-01

    We have been led to study the problem of safety in atomic pile control as a result of our participation on the one hand in the planning of C.E.A. atomic piles, and on the other hand in the pile safety sub omission considering atomic pile safety of operational or planned C.E.A. piles. We have thus had to consider the wishes occurring in piles during their operation and also their behaviour in the dynamic state The present work deals mainly with the importance of intrinsic safety devices, with the influence of reactivity variations on the power fluctuations during accidental operation, and with the development of robust and reliable safety appliances. The starting p accident has been especially studied both for low-flux piles where a compromise is necessary between the response time of the safety appliances and the statistical fluctuations and for high lux piles where xenon poisoning has an effect on the lower limit of the velocity of reactivity liberation. The desirability has been stressed of automation as a safety factor in atomic pile control. The details required for an understanding of the diagrams of the apparatus are given. (author) [French] Nous avons aborde le probleme de la securite dans le controle des piles atomiques a la suite de notre participation d'une part aux avant rojets de piles atomiques du CE.A. et d'autre part a l'examen au sein de la sous ommission de surete des piles, de la securite des piles du CE.A. en fonctionnement ou en projet. Nous avons ete amenes a nous interesser alors aux risques encourus par les piles pendant leur fonctionnement et par la meme a leur comportement en regime dynamique. Ce travail traite principalement de l'importance des securites intrinseques, de l'influence des variations de reactivite sur les evolutions de puissance en regime d'accident et du developpement d'appareillages de securite robustes et de fonctionnement tres sur. L'accident de demarrage a ete particulierement developpe aussi bien pour les piles a bas

  19. Safety precautions in atomic pile control (1962); Securite dans le controle des piles atomiques (1962)

    Energy Technology Data Exchange (ETDEWEB)

    Furet, J. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1962-07-01

    We have been led to study the problem of safety in atomic pile control as a result of our participation on the one hand in the planning of C.E.A. atomic piles, and on the other hand in the pile safety sub omission considering atomic pile safety of operational or planned C.E.A. piles. We have thus had to consider the wishes occurring in piles during their operation and also their behaviour in the dynamic state The present work deals mainly with the importance of intrinsic safety devices, with the influence of reactivity variations on the power fluctuations during accidental operation, and with the development of robust and reliable safety appliances. The starting p accident has been especially studied both for low-flux piles where a compromise is necessary between the response time of the safety appliances and the statistical fluctuations and for high lux piles where xenon poisoning has an effect on the lower limit of the velocity of reactivity liberation. The desirability has been stressed of automation as a safety factor in atomic pile control. The details required for an understanding of the diagrams of the apparatus are given. (author) [French] Nous avons aborde le probleme de la securite dans le controle des piles atomiques a la suite de notre participation d'une part aux avant rojets de piles atomiques du CE.A. et d'autre part a l'examen au sein de la sous ommission de surete des piles, de la securite des piles du CE.A. en fonctionnement ou en projet. Nous avons ete amenes a nous interesser alors aux risques encourus par les piles pendant leur fonctionnement et par la meme a leur comportement en regime dynamique. Ce travail traite principalement de l'importance des securites intrinseques, de l'influence des variations de reactivite sur les evolutions de puissance en regime d'accident et du developpement d'appareillages de securite robustes et de fonctionnement tres sur. L'accident de demarrage a ete particulierement

  20. Aspects anatomocliniques et thérapeutiques des accidents de la ...

    African Journals Online (AJOL)

    46,7%), méatoplastie (13,3%), pansement humide + antibiothérapie ( 6,7%), urétroplastie par lambeau de muqueuse buccale (6,7%), désenlisement de verge (6,7%), vésicostomie ( 6,7%) et hémostase de l'artère du frein (6,7%). Les accidents ...

  1. Development of Graves' disease following radiation therapy in Hodgkin's disease

    International Nuclear Information System (INIS)

    Loeffler, J.S.; Tarbell, N.J.; Garber, J.R.; Mauch, P.

    1988-01-01

    Radiation-related thyroid dysfunction is a common occurrence in patients with Hodgkin's disease treated with mantle field radiation. Although chemical and clinical hypothyroidism are most commonly seen, Graves' disease has also been described. We have examined the records of 437 surgically staged patients who received mantle field irradiation between April 1969 and December 1980 to ascertain the frequency of manifestations of Graves' disease. Within this group, seven patients developed hyperthyroidism accompanied by ophthalmic findings typical of those seen in Graves' disease. The actuarial risk of developing Graves' disease at 10 years following mantle irradiation for Hodgkin's disease was 3.3% in female patients and 1% in male patients in this study. The observed/expected ratios were 5.9 and 5.1 for female and male patients, respectively. This observed risk significantly exceeded that seen in the general population

  2. Persistent hyperthyroidism and de novo Graves' ophthalmopathy after total thyroidectomy.

    Science.gov (United States)

    Tay, Wei Lin; Loh, Wann Jia; Lee, Lianne Ai Ling; Chng, Chiaw Ling

    2017-01-01

    We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion. It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy.TSH receptor antibody may persist after total thyroidectomy and may potentially contribute to the development of de novo Graves' ophthalmopathy.

  3. Risk analysis related to dangerous materials transport and storage in urban areas; L'integration du risque lie au transport et au stockage des produits chimiques dans la planification urbaine: l'apport des outils d'analyse decisionnelle

    Energy Technology Data Exchange (ETDEWEB)

    Lombard, J; Hubert, P; Pages, P

    1989-12-01

    Risk management in an urban areas not always an easy task and the selection of appropriate prevention measure is often difficult. Consequences of an accident can be multiple (mortality, destruction, pollution, interruption of supplies, economic losses, traffic difficulties), and preventive measures are difficult to compare. The objective of this report is to present different methods applicable for decision making emphasising the criteria for their intercomparison and their limitations. In any case a more sophisticated analysis is needed for risk management in urban areas. Principals of methods needed for decision making are presented. These methods are based on a single criteria (regular constraint), on a few criteria that can be measured (cost-benefit), or a number of criteria at choice. These rather general methods should be adaptable to be applied for specific domain. For risk management the following adaptation are presented: identifying the limit of maximum individual risk (generalisation of regular constraint); adoption of different values of human life as a function of nature of consequences (generalisation of cost-benefit method), application of risk avoidance factors. These different developments predict versions of tools for decision making which can be applicable to risk management in urban areas. [French] La gestion des risques en milieu urbain n'est pas toujours une tache aisee et la selection du moyen de prevention approprie sera souvent difficile. En effet, les consequences d'un accident peuvent etre multiples (mortalite, morbidite, destruction, pollution, interruption de reseaux, pertes economiques, difficultes de circulation...) et les moyens de prevention envisageables pour limiter l'occurrence d'un accident et/ou les consequences associees seront alors difficiles a comparer. Le recours a une methode d'evaluation permettant de quantifier puis de comparer les merites respectifs de ces differents moyens devient aujourd'hui necessaire afin de

  4. Applied anatomy of thyroid arteries for interventional embolization of Graves' disease

    International Nuclear Information System (INIS)

    Ding Zhongxiang; Zhao Wei; Hou Jialin; Xiang Shutian; Li Liyuan; Zou Zhirong; Li Xingguo; Song Dianping; Yuan Jianhua

    2007-01-01

    Objective: To explore the anatomy and imaging manifestations of thyroid arteries for improving the efficiency and lowering the complication in interventional embolization of Graves' disease. Methods: Thyroid arteries were investigated, including 16 adult cadavers (Cadaver group), 8 non-thyropathic patients (Normal group)and 17 Graves patients (Graves group). The inner diameters of the trunk and supplying branches of thyroid artery, the angles between the origination of branches and the beginning of the trunk, and the angles between the trunk of thyroid artery and carotid or subclavian artery were measured. In addition, data of the three groups were statistically analyzed. Results: Many non-thyroid arterial branches arose from thyroid artery, with no statistical difference in their indexes between Cadaver group and Normal group. The thyroid arteries showed much longer, obviously wider in diameter, and larger angles between the trunk of thyroid artery and carotid artery in Graves group than those of Cadaver group and Normal group; outcoming with significant statistical differences; and furthermore, with increase of interglandular branches and dangerous internal and external anastomoses. Conclusions: The specific thyroid arterial changes of Graves' disease are helpful for the interventional embolization. Non-thyroid branches and dangerous anastomoses should not be embolized as far as possible, for decreasing the complications of the interventional procedure for Graves' disease. (authors)

  5. Serum immunoglobulin G4 levels and Graves' disease phenotype.

    Science.gov (United States)

    Martin, Carmen Sorina; Sirbu, Anca Elena; Betivoiu, Minodora Andreea; Florea, Suzana; Barbu, Carmen Gabriela; Fica, Simona Vasilica

    2017-02-01

    We investigated, at diagnosis, the relationship between serum immunoglobulin G4 levels and the main characteristics of Graves' disease: hyperthyroidism severity, goiter size, presence of active Graves' ophthalmopathy, antithyroid antibodies status, and titer. This prospective study included 80 newly diagnosed Graves' disease patients. The main parameters measured at diagnosis: thyroid-stimulating hormone, free thyroxine, free triiodothyronine, total triiodothyronine, thyroglobulin, antithyroid peroxidase antibodies, anti-thyroglobulin antibodies, thyroid-stimulating hormone receptor antibodies, immunoglobulin G4. In Graves' disease patients, serum immunoglobulin G4 levels were higher than in general population (p = 0.028) and higher in men compared to women (p = 0.002). Only one female patient with intense hypoechoic goiter, high anti-thyroglobulin antibody, and antithyroid peroxidase antibody titers had an elevated serum immunoglobulin G4 level at diagnosis. Patients with immunoglobulin G4 levels above the 75th percentile (>237.52 mg/dl, N = 20) were younger at Graves' ophthalmopathy onset (p 286.28 mg/dl, N = 8) had lower total triiodothyronine values (p = 0.001) than patients with IgG below the 90th percentile. No significant correlations were found between smoking status (p = 0.58), goiter size (p = 0.50), the presence of ophthalmopathy (p = 0.42) or thyroid-stimulating hormone receptor antibody titers (p = 0.45) and the mean value of immunoglobulin G4 levels at diagnosis. Our data suggest that Graves' disease patients with elevated immunoglobulin G4 levels at diagnosis have a phenotype characterized by higher anti-thyroglobulin antibody and antithyroid peroxidase antibody titers, less severe T3 hyperthyroidism, younger age at ophthalmopathy onset and require a shorter duration of the first methimazole treatment cycle.

  6. Clinical significance of determination of serum TRAb levels in patients with relapsing graves' disease

    International Nuclear Information System (INIS)

    Guo Chunlei; Zhou Jiaqiang; Li Wenpeng

    2004-01-01

    Objective: To explore the clinical significance of changes of serum TRAb levels in patients with relapsing Graves' disease. Methods: Serum TRAb (with RRA) and several other thyroid-related hormones (TT 4 , TT 3 , TSH, FT 3 , with CLIA) were determined in the following subjects: 1. 25 cases of relapsing Graves' disease after previous successful treatment; 2. 18 cases of recently diagnosed Graves' disease; 3. 31 cases of successfully treated Graves' disease; 4. 15 cases of simple goiter; 5. 10 cases of nodular goiter; 6. 18 cases of hypothyroidism due to Hashimoto disease. Results: Positive rate of TRAb was 76.00% in patients with relapsing Graves' disease and 77.78% in recently diagnosed Graves' disease cases, both being significantly higher than that in all the other sets of patients studied (P<0.01). Conclusion: Determination of serum TRAb levels was helpful for the diagnosis of relapse in Graves' disease

  7. Stress corrosion cracking of Inconel in high temperature water; Corrosion fissurante sous contrainte de l'Inconel dans l'eau a haute temperature

    Energy Technology Data Exchange (ETDEWEB)

    Coriou,; Grall,; Gall, Le; Vettier, [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

    1960-07-01

    Some Inconel samples were subjected to hot water corrosion testing (350 deg. C), under stress slightly above the elastic limit. It has been observed that different types of alloys - with or without titanium - could suffer serious intergranular damage, including a complete rupture, within a three months period. In one case, we observed an unusual intergranular phenomenon which appeared quite different from common intergranular corrosion. (author) [French] Des essais de corrosion d'Inconel sont realises dans l'eau a 350 deg. C, et sous contrainte legerement superieure a la limite elastique. On constate que differentes varietes d'alliage avec ou sans titane donnent lieu a des accidents intergranulaires graves allant jusqu'a rupture complete en 3 mois. Dans un cas, on observe un phenomene intergranulaire particulier tres different de la corrosion intergranulaire classique. (auteur)

  8. Pourquoi la Commission de la santé et de la sécurité du travail du Québec n’est pas le premier recours des enseignantes et des préposées à l’aide domestique ayant des lésions professionnelles

    Directory of Open Access Journals (Sweden)

    Nancy Guberman

    2005-05-01

    Full Text Available Cet article examine les motifs de deux groupes de travailleuses pour s’adresser ou pas à la Commission de la santé et de la sécurité du travail du Québec (CSST pour des lésions perçues comme étant liées au travail. Il est basé sur des entrevues qualitatives auprès de 16 enseignantes et de 16 préposées à l’aide domestique. Pour les deux groupes, les motifs de non-recours incluent la croyance que la CSST existe essentiellement pour les accidents et les retraits préventifs des femmes enceintes, l’image de la CSST comme un organisme qui accorde difficilement des indemnisations ainsi que la difficulté perçue de prouver le lien entre le travail et le problème de santé. Pour les préposées, le manque à gagner entre les prestations et le revenu d’emploi est aussi un facteur tandis que pour les enseignantes l’accès relativement facile à une assurance salaire joue contre le recours à la CSST. De plus, pour bien comprendre les choix des répondantes, il faut tenir compte de leur rapport à leur emploi et à leur santé et de la culture de leur milieu de travail.This article examines the motives behind the decisions of two groups of workers on whether or not to submit claims to the Workers’ Compensation Board (CSST for perceived work-related accidents or illnesses. It is based on qualitative interviews with 16 teachers and 16 cleaners. For both groups, motives for not making claims include the belief that the CSST is essentially for accidents and preventive work withdrawal for pregnant women, the view that compensation is difficult to obtain from the CSST, as well as a perceived difficulty of proving a relationship between their work and their health problem. For the cleaners, the difference between the compensation and employment income is also a factor, while for teachers, the fact that they have relatively easy access to wage-replacement insurance is one reason they do not submit claims to the CSST. To better

  9. Postoperative Outcomes in Graves' Disease Patients: Results from the Nationwide Inpatient Sample Database.

    Science.gov (United States)

    Rubio, Gustavo A; Koru-Sengul, Tulay; Vaghaiwalla, Tanaz M; Parikh, Punam P; Farra, Josefina C; Lew, John I

    2017-06-01

    Current surgical indications for Graves' disease include intractability to medical and/or radioablative therapy, compressive symptoms, and worsening ophthalmopathy. Total thyroidectomy for Graves' disease may be technically challenging and lead to untoward perioperative outcomes. This study examines outcomes in patients with Graves' disease who underwent total thyroidectomy and assesses its safety for this patient population. A retrospective cross-sectional analysis was performed using the Nationwide Inpatient Sample database from 2006 to 2011. Total thyroidectomy performed in patients with Graves' disease, benign multinodular goiter (MNG), and thyroid cancer was identified. Demographic factors, comorbidities, and postoperative complications were evaluated. Chi-square, one-way analysis of variance, and risk-adjusted multivariable logistic regression were performed. Of 215,068 patients who underwent total thyroidectomy during the study period, 11,205 (5.2%) had Graves' disease, 110,124 (51.2%) MNG, and 93,739 (43.6%) thyroid malignancy. Patients with Graves' disease were younger than MNG and thyroid cancer patients (M age  = 42.8 years vs. 55.5 and 51.0 years; p Graves' disease group included a higher proportion of women (p Graves' disease was independently associated with a higher risk of vocal-cord paralysis (odds ratio [OR] = 1.36 [confidence interval (CI) 1.08-1.69]), tracheostomy (OR = 1.35 [CI 1.1-1.67]), postoperative hypocalcemia (OR = 1.65 [CI 1.54-1.77]), and hematoma requiring reoperation (OR = 2.79 [CI 2.16-3.62]) compared to MNG patients. High-volume centers for total thyroidectomy were independently associated with lower risk of postoperative complications, including in patients with Graves' disease. Despite low overall morbidity following total thyroidectomy, Graves' disease patients are at increased risk of postoperative complications, including bleeding, vocal-cord paralysis, tracheostomy, and hypocalcemia. These risks appear

  10. Characteristics of patients with graves disease and intrathyroid hypovascularity compared to painless thyroiditis.

    Science.gov (United States)

    Uchida, Toyoyoshi; Shigihara, Nayumi; Takeno, Kageumi; Komiya, Koji; Goto, Hiromasa; Abe, Hiroko; Sato, Junko; Honda, Akira; Fujitani, Yoshio; Watada, Hirotaka

    2014-10-01

    The purpose of this study was to assess the frequency and sonographic and laboratory characteristics of Graves disease with intrathyroid hypovascularity in Japanese patients and to compare these characteristics in patients with painless thyroiditis. A total of 194 consecutive patients with Graves disease and 21 patients with painless thyroiditis were enrolled. The patients underwent thyroid volume measurement, mean superior thyroid artery peak systolic velocity (PSV) measurement, power Doppler sonography, and proper blood testing to discriminate between Graves disease and painless thyroiditis. Based on the power Doppler sonographic findings, they were divided into 4 groups: from pattern 0 (most hypovascular thyroid) to pattern III (most hypervascular thyroid). Comparisons of multiple thyroid parameters were made among the groups. The prevalence of Graves disease with pattern 0 (n = 27) was 13.9% among the patients with Graves disease. The sonographic and laboratory data for patients with Graves disease and pattern 0 were compared to those of the 21 patients with painless thyroiditis, which typically shows intrathyroid hypovascularity. Free triiodothyronine and thyroxine levels and the superior thyroid artery PSV were significantly lower in patients with Graves disease and pattern 0 than those with patterns I, II, and III (P thyroid volume and thyrotropin receptor antibody level were significantly lower in patients with Graves disease and pattern 0 than those with pattern III. In the comparison between patients with Graves disease and pattern 0 and those with painless thyroiditis and pattern 0, apart from thyrotropin receptor antibody, only the superior thyroid artery PSV was different. Although the clinical features of patients with Graves disease and intrathyroid hypovascularity were similar to those patients with painless thyroiditis, the superior thyroid artery PSV showed a moderate ability to discriminate these patients. © 2014 by the American Institute of

  11. Radiation retinopathy after orbital irradiation for Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Kalina, R.E.; Brower, S.A.; Mills, R.P.; Johnson, R.H.

    1984-01-01

    Recent reports indicate that orbital irradiation for Graves' ophthalmopathy is sometimes beneficial, particularly for dysthyroid optic neuropathy, and is not associated with serious complications. We are aware, however, of four patients who were found to have radiation retinopathy after orbital irradiation for Grave's ophthalmopathy. All four patients have decreased central acuity, and three of the four are legally blind in one or both eyes. Computer reconstruction of the dosimetry, based on computed tomography and beam profiles, shows that errors in dosage calculations and radiotherapy technique probably account for the radiation retinopathy in three of the four patients. Radiotherapy for Graves' ophthalmopathy should be administered only by competent radiotherapists who are experienced in the treatment of this disease. Similar errors in dosage calculations and treatment techniques may account for other reports of radiation retinopathy after reportedly safe dosages

  12. Thyrotoxic Graves' disease with normal thyroidal technetium-99m pertechnetate uptake

    Energy Technology Data Exchange (ETDEWEB)

    Ikekubo, Katsuji; Hino, Megumu; Ito, Hidetomi; Koh, Toshikiyo; Ishihara, Takashi; Kurahachi, Hiroyuki (Kobe City General Hospital (Japan)); Kasagi, Kanji; Hidaka, Akinari; Mori, Toru

    1990-07-01

    We saw 24 thyrotoxic Graves' patients with normal thyroidal uptake of technetium-99m pertechnetate ({sup 99m}Tc) out of 201 untreated thyrotoxic Graves' patients seen over 4 years. The clinical and laboratory findings for these patients were studied and analyzed. Thyroid uptake and scintigraphic examinations by means of {sup 99m}Tc, TBII and TSab activity measurement clearly distinguished these patients from other thyrotoxic disorders (destruction-induced thyrotoxicosis and autonomously functioning thyroid lesions). Different from other disorders, these patients had not lower but normal thyroid uptake and also showed diffuse and discrete trapping into the enlarged glands. These patients had significantly smaller goiters, a lower serum thyroid hormone level, and lower TBII and TSab activity, when compared with other high {sup 99m}Tc uptake groups with Graves' disease, and their condition could be easily controlled with small amounts of antithyroid drugs. Our study indicates that thyrotoxic Graves' disease with normal {sup 99m}Tc uptake exists and {sup 99m}Tc uptake study and TBII activity measurement is very useful for the diagnosis. The normal {sup 99m}Tc uptake thyrotoxic Graves' patient might be early stage patients with general Graves' disease and their early discrimination from general Graves' patients is very advantageous for treatment and prognosis. (author).

  13. The observation on plasma endothelin levels in patients with graves' disease

    International Nuclear Information System (INIS)

    Hao Xiaojun; Liu Changshan; Yang Lianrong; Zhang Qiliang; Wang Honggang; Liu Xudong

    2002-01-01

    Observing the plasma endothelin levels in patients with Graves' disease to probe its clinical significance, plasma endothelin levels were measured in 55 cases of Graves' disease before and after treatment respectively, and these were compared with that of 23 health subjects. Results: plasma endothelin levels in patients with Graves' disease significantly increase, compared with heath subjects (150.4 +- 29.31 ng/L vs 42.80 +- 7.58 ng/L, P < 0.01); post-treatment endothelin levels apparently decrease (97.61 +- 15.99 ng/L vs 150.4 +- 29.31 ng/L, P < 0.01). Plasma endothelin levels in patients with Graves' disease significantly increase, and after treatment the endothelin levels decrease following decreasing of thyroid hormone level and high hemodynamics

  14. Thyroid Ultrasonography in Differentiation between Graves' Disease and Hashimoto's Thyroiditis.

    Science.gov (United States)

    Pishdad, P; Pishdad, G R; Tavanaa, S; Pishdad, R; Jalli, R

    2017-03-01

    Graves' disease and Hashimoto's thyroiditis are the most common causes of hyper and hypothyroidism, respectively. Differentiation of these 2 diseases, if the patient is euthyroid, may sometimes be extremely difficult on the basis of clinical and laboratory findings. The purpose of this study was to determine the sensitivity and specificity of gray scale sonography in differentiation of Graves' disease from Hashimoto's thyroiditis. This study included 149 patients divided into three groups, patients with Graves' disease (34 patients, mean age = 36.8 ± 10.17 years), Patients with Hashimoto's thyroiditis (62 patients, mean age = 33.4 ± 12.16 years) and control group (53 healthy people, mean age = 34.74 ± 16.87 years). Members of all groups were referred to a single radiologist for thyroid sonography for evaluation of thyroid echogenicity pattern. A total of 117 women and 32 men were examined by sonography. The most common sonographic pattern in Hashimoto and Graves' was homogenous hypo-echogenicity which was observed in 45.2% and 47.1% of cases, respectively. Peripheral hypo-echogenicity pattern was seen in 40.3% of Hashimoto's group with 100% specificity and 40.3% sensitivity. Central-hypoechogenic pattern was observed in 17.6% of Graves' group with 100% and 17.6% specificity and sensitivity, respectively. Our findings indicate that sonography has high specificity but low sensitivity in the diagnosis of either Graves' disease or Hashimoto's thyroiditis. It is therefore not possible to differentiate between these two diseases using sonography alone. Confirmation by laboratory data is also needed.

  15. Radioprotection problems resulting from the presence of experimental devices around an atomic reactor; Problemes de radioprotection poses par l'implantation de dispositifs experimentaux aupres d'une pile atomique

    Energy Technology Data Exchange (ETDEWEB)

    Fitoussi, L; Lebouleux, Ph; Bricard, Ph; Moreau, A [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1965-07-01

    The setting up of experimental devices around a reactor produces dangers of irradiation and radioactive contamination which can become very great in the case of an accident, especially if the in-pile portion contains fissile matter. This may result in irradiation of personnel, prohibition of access to the experimental zones until the sources of irradiation and contamination have been eliminated, and a prolonged stoppage of the reactor. The plans for an in-pile experiment should take into account radioprotection factors; the aim of these is to reduce to a minimum the radioactive risks normally encountered during the experiment and to eliminate any risks of bad accidents and their consequences. In this report are classified the various types of experiments requiring installations outside the pile itself; for each of these experiments the particular radioprotection factors are given. In order to make possible a study of the radioactive dangers likely to arise during a projected experiment, the authors summarize the physical and technical data required by radioprotection specialists and give the rules and general advice concerning radioprotection which should be useful during the planning of an in-pile experiment and the setting-up of the equipment. (authors) [French] L'implantation de dispositifs experimentaux aupres des reacteurs cree des risques d'irradiation et de contamination radioactive qui peuvent devenir importants en cas d'accident, surtout si la partie en pile comprend des matieres fissiles. Il peut en resulter des irradiations de personne, l'interdiction des aires experimentales jusqu'a elimination des sources d'irradiation et de contamination, un arret prolonge de la pile. L'etude d'un projet d'experience en pile doit donc tenir compte des considerations de radioprotection dont le souci est de reduire aux niveaux tolerables les risques radioactifs inherents au fonctionnement normal de l'experience et d'eliminer les risques d'accidents graves et leurs

  16. Hypocalcaemia after total thyroidectomy for Graves' disease and for benign atoxic multinodular goitre.

    Science.gov (United States)

    Hallgrimsson, Páll; Nordenström, E; Bergenfelz, A; Almquist, M

    2012-10-01

    Postoperative hypocalcaemia has been reported to be more common after total thyroidectomy (TT) for Graves' disease than after TT for benign atoxic multinodular goitre (MNG). The reasons for this potential association are not clear. In the present study, the frequency and risk factors of hypocalcaemia after TT for Graves' vs MNG were compared. Between January 1999 and October 2009, patients with first-time surgery for Graves' disease or MNG treated with a TT were included in the study. Postoperative hypocalcaemia was defined by symptoms, calcium levels and treatment with calcium and/or vitamin D analogues during postoperative hospital stay, at discharge, and at the 6-week and 6-month follow-ups. Outcomes were compared with Mann-Whitney, chi(2) and Fishers' exact test where appropriate and by multivariable logistic regression analysis. There were 128 patients with Graves' disease and 81 patients with MNG. Patients with Graves' disease were younger than patients with MNG (median age, 35 vs 51 years, p Graves' disease (p Graves' disease, there was no difference in the overall frequency of biochemical hypocalcaemia, low levels of PTH and/or treatment with calcium and vitamin D.

  17. Magnetic Ghosts: Mineral Magnetic Measurements On Roman and Anglo-saxon Graves

    Science.gov (United States)

    Linford, N.

    The location of inhumations, in the absence of ferrous grave goods, often presents a considerable challenge to archaeological geophysics given the small physical size of the features and the slight contrast between the fill of the grave and the surround- ing subsoil. Even during excavation, the identification of graves may be complicated where site conditions do not favour the preservation of human skeletal remains and often only a subtle soil stain is likely to survive. A recent initiative in the United King- dom has seen the formation of the Buried Organic Matter Decomposition Integrated with Elemental Status (BODIES) research group, to examine the decomposition of organic artefacts in ancient graves with respect to localised changes in pH, redox po- tential and nutrient status. This paper presents initial results from a limited mineral magnetic study of two grave sites in an attempt to ascertain whether the decomposi- tion of organic remains may lead to a detectable magnetic signature within the soil. Results from a series of isothermal, hysteresis and magneto-thermal experiments will be presented together with surface magnetometer and topsoil susceptibility surveys.

  18. Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

  19. Grave's disease associated with immunoglobulin A nephropathy: A rare association.

    Science.gov (United States)

    Khan, I; Bhat, R A; Khan, I; Hameed, I

    2015-01-01

    Immunoglobulin A (Ig A) nephropathy is the most common form of primary glomerulonephritis. The association of Ig A nephropathy with Grave's disease has not been reported so far. We report a case of 20-year-old female with Grave's disease who presented with edema, facial puffiness, and decreased urine output. She was found to be hypertensive with renal failure and nephrotic range proteinuria. Renal biopsy revealed features of Ig A nephropathy. The patient was treated with oral corticosteroids (1 mg/kg/day). To our knowledge, this is the first case showing association of Grave's disease with Ig A nephropathy.

  20. Resultados do tratamento da pancreatite aguda grave

    Directory of Open Access Journals (Sweden)

    Franz Robert Apodaca-Torrez

    Full Text Available OBJETIVO: Avaliar os resultados do Protocolo de Atendimento de pacientes com diagnóstico de pancreatite aguda grave. MÉTODOS: Foram analisados, consecutivamente, a partir de janeiro de 2002, idade, sexo, etiologia, tempo de internação, tipo de tratamento e mortalidade de 37 pacientes portadores de pancreatite aguda grave. RESULTADOS: A idade dos pacientes variou de 20 a 88 anos (média de 50 anos; 27% foram do sexo feminino e 73% do masculino. O tempo médio global de internação foi 47 dias. Treze pacientes foram tratados cirurgicamente; a média de operações realizadas foi duas por paciente. Ocorreram seis óbitos dentre os pacientes submetidos ao tratamento cirúrgico (46% e dois óbitos no grupo submetido somente ao tratamento clínico (8,3%. A mortalidade global foi 21% CONCLUSÃO: Após a modificação na forma de abordagem dos pacientes com pancreatite aguda grave, houve diminuição da mortalidade e uma tendência para a conduta expectante.

  1. Grave Tending: With Mom at the Cemetery

    Directory of Open Access Journals (Sweden)

    Carolyn Ellis

    2003-05-01

    Full Text Available This autoethnographic story shows the process of tending the graves of family members. In the past, the author reluctantly accompanied her mother on her visits to the family cemetery. Once there, she took on the role of distant observer as her mother took care of the family cemetery plots. When her mother becomes disabled, the author begins to arrange the flowers on the graves. Doing so leads her to examine the meaning of visiting the cemetery, feel and connect with her losses, and consider the customs she wants to be part of her own death. When her mother dies, the next generation of women in the family—the author, her sister, and sister-in-law—take on the role of tending the graves, connected in their love and respect for their mother and their feelings of family and family responsibility. This story examines the meanings of family rituals around death and how they are passed from generation to generation. URN: urn:nbn:de:0114-fqs0302285

  2. Thyroid Follicular Carcinoma in a Fourteen-year-old Girl with Graves' Disease.

    Science.gov (United States)

    Kojima-Ishii, Kanako; Ihara, Kenji; Ohkubo, Kazuhiro; Matsuo, Terumichi; Toda, Naoko; Yamashita, Hiroyuki; Kono, Shinji; Hara, Toshiro

    2014-04-01

    Here we present the case of a 14-yr-old girl who developed thyroid follicular carcinoma accompanied by Graves' disease. She was diagnosed with Graves' disease at 10 yr of age and soon achieved a euthyroid state after starting treatment. When she was 13 yr of age, her hyperthyroidism and goiter worsened despite medical therapy. Multiple nodules were found in her enlarged thyroid gland by ultrasonography. Her serum Tg level seemed within the normal range. She underwent near-total thyroidectomy for control of thyroid function. Histopathological study demonstrated that multiple oxyphilic follicular neoplasms were surrounded by the thyroid tissue compatible with Graves' disease. Capsular invasion was identified in one of the nodules, and thus the histological diagnosis was minimally invasive follicular carcinoma. She did not have signs suggesting metastasis, and has had no relapse for 18 mo after the operation. Although some previous studies showed a high prevalence of thyroid cancer with an aggressive nature in adult patients with Graves' disease, few reports about thyroid cancer accompanied by Graves' disease are available in children. The present case, however, suggests that careful investigation is needed when we detect thyroid nodules or progressive thyroid enlargement, especially in children with Graves' disease.

  3. Significance of changes of serum TPOAb and TRAb levels in patients with Graves' disease (GD)

    International Nuclear Information System (INIS)

    Zhang Zhongshu Xu Ruiji; Wang Guohong

    2006-01-01

    Objective: To investigate the significance of changes of serum TPOAb and TRAb levels in patients with Graves' dis- ease (GD). Methods: Serum TPOAb (with RIA) and TRAb (with RRA) levels were determined in 27 patients with Graves' disease, before treatment 10 patients with Graves' disease clinically cured and 35 controls. Results: The serum levels and positive rates of TPOAb and TRAb in patients with Graves' disease before treatment were significantly higher than those in the patients with Graves' disease clinically cured and controls (P<0.01). Conclusion: TPOAb and TRAb were involved in the pathogenesis of Graves' dis- ease and could be used as diagnostic and treatment indicators. (authors)

  4. Biologiske behandlingsmuligheder ved Graves' oftalmopati

    DEFF Research Database (Denmark)

    El Fassi, Daniel; Nielsen, Claus Henrik; Hegedüs, Laszlo

    2008-01-01

    The current medical treatment options for Graves' ophthalmopathy (GO) are unsatisfactory. Recent treatment of GO patients with the B-lymphocyte depleting monoclonal antibody rituximab or with the anti-tumor necrosis factor-alpha agents etanercept and infliximab has shown promising results. We...

  5. Study progress on free radicals and graves disease

    International Nuclear Information System (INIS)

    Zhang Ruiguo; Jin Jianhua

    2009-01-01

    Free radical-mediated oxidative injury has been closely implicated in the occurrence and development of many diseases. Graves disease was also accompanied by changes of the free radicals, especially for reactive oxygen species and reactive nitrogen, et al, and the oxidative stress can cause a certain degree of injury on the thyroid and other human important organs. Antithyroid drug and 131 I treatment of Graves disease, the oxidative and antioxidative parameters can also be changed. (authors)

  6. Transient hypothyroidism after 131I treatment of Graves disease

    International Nuclear Information System (INIS)

    Liu Jianfeng; Fang Yi; Zhang Xiuli; Ye Genyao; Xing Jialiu; Zhang Youren

    2003-01-01

    Objective: To evaluate the results of the transient hypothyroidism after 131 I treatment of Graves disease. Methods: A total of 32 transient hypothyroidism patients treated with 131 I for Graves disease were studied and followed up. Results: Transient hypothyroidism occurred within 2-6 months after 131 I treatment and 19 patients were symptomatic. At diagnosis of transient hypothyroidism, T 3 and T 4 levels were decreased had normal, TSH levels were increased, normal or low. Follow-up examination found that 20 patients were normal and 12 patients had relapse of hyperthyroidism. Conclusions: Therapy of Graves disease with low doses of 131 I causes a high incidence of transient hypothyroidism. After recovery of transient hypothyroidism, some patients have relapse of hyperthyroidism

  7. 131I-therapy of graves' disease and non-immunogenic thyrotoxicosis

    International Nuclear Information System (INIS)

    Hoeschel, M.; Heinze, H.G.

    1984-01-01

    From 1977 to 1982, 315 patients suffering from thyrotoxicosis with diffuse and/or nodular goitre or Graves' disease were treated with 131 I. In 246 patients, the results of treatment after 7 months to 5 1/2 years could be evaluated. After a single treatment with 131 I, 72% of the patients with hyperthyroid nodular goitre and 61% of those with diffuse goitre, but only 36% of the patients with Graves' disease showed normal thyroid function. By repeated 131 I treatments - as many as 5 for those with Graves' disease - normal thyroid function could be achieved in nearly all patients examined. Patients with immune thyrotoxicosis, type Graves' disease, showed a high resistance to therapy. A dependence was found between the results of these treatments and previous antithyroidal drug therapy or surgery. The rate of hypothyroidism varied between 4 and 15%. The highest rate of hypothyroidism was observed in operated patients with persistent or recurring thyrotoxicosis. (orig.) [de

  8. Graves hyperthyroidism and pregnancy: a clinical update.

    Science.gov (United States)

    Patil-Sisodia, Komal; Mestman, Jorge H

    2010-01-01

    To provide a clinical update on Graves' hyperthyroidism and pregnancy with a focus on treatment with antithyroid drugs. We searched the English-language literature for studies published between 1929 and 2009 related to management of hyperthyroidism in pregnancy. In this review, we discuss differential diagnosis of hyperthyroidism, management, importance of early diagnosis, and importance of achieving proper control to avoid maternal and fetal complications. Diagnosing hyperthyroidism during pregnancy can be challenging because many of the signs and symptoms are similar to normal physiologic changes that occur in pregnancy. Patients with Graves disease require prompt treatment with antithyroid drugs and should undergo frequent monitoring for signs of fetal and maternal hyperthyroidism and hypothyroidism. Rates of maternal and perinatal complications are directly related to control of hyperthyroidism in the mother. Thyroid receptor antibodies should be assessed in all women with hyperthyroidism to help predict and reduce the risk of fetal or neonatal hyperthyroidism or hypothyroidism. The maternal thyroxine level should be kept in the upper third of the reference range or just above normal, using the lowest possible antithyroid drug dosage. Hyperthyroidism may recur in the postpartum period as Graves disease or postpartum thyroiditis; thus, it is prudent to evaluate thyroid function 6 weeks after delivery. Preconception counseling, a multidisciplinary approach to care, and patient education regarding potential maternal and fetal complications that can occur with different types of treatment are important. Preconception counseling and a multifaceted approach to care by the endocrinologist and the obstetric team are imperative for a successful pregnancy in women with Graves hyperthyroidism.

  9. PREGO (presentation of Graves' orbitopathy) study: changes in referral patterns to European Group On Graves' Orbitopathy (EUGOGO) centres over the period from 2000 to 2012

    NARCIS (Netherlands)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio; Ayvaz, Göksun; Baldeschi, Lelio; Bartalena, Luigi; Boschi, Antonella; Bournaud, Claire; Brix, Thomas Heiberg; Covelli, Danila; Ćirić, Slavica; Daumerie, Chantal; Eckstein, Anja; Fichter, Nicole; Führer, Dagmar; Hegedüs, Laszlo; Kahaly, George J.; Konuk, Onur; Lareida, Jürg; Lazarus, John; Leo, Marenza; Mathiopoulou, Lemonia; Menconi, Francesca; Morris, Daniel; Okosieme, Onyebuchi; Orgiazzi, Jaques; Pitz, Susanne; Salvi, Mario; Vardanian-Vartin, Cristina; Wiersinga, Wilmar; Bernard, Martine; Clarke, Lucy; Currò, Nicola; Dayan, Colin; Dickinson, Jane; Knežević, Miroslav; Lane, Carol; Marcocci, Claudio; Marinò, Michele; Möller, Lars; Nardi, Marco; Neoh, Christopher; Pearce, Simon; von Arx, George; Törüner, Fosun Baloş

    2015-01-01

    The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres. All new referrals with a

  10. Stratégie transfusionnelle des hémorragies graves du post-partum: étude rétrospective à propos de 47 cas

    Science.gov (United States)

    Khouadja, Hosni; Rouissi, Wissem; Mahjoub, Mohamed; Sakhri, Jaballah; Beletaifa, Dhafer; Jazia, Khaled Ben

    2016-01-01

    Introduction L’hémorragie du post-partum est la principale cause de morbi-mortalité maternelle dans le monde. La prise en charge est multidisciplinaire. La stratégie transfusionnelle est capitale jouant un rôle majeur dans le pronostic maternel. L’objectif de ce travail a été de déterminer le rapport PFC/CGR lors de la prise en charge des hémorragies graves du post-partum. Méthodes Une étude Etude rétrospective sur une période de 4 ans (2009-2012) a été réalisée dans un centre de maternité de référence de niveau III du centre-Est tunisien. Elle a inclut les parturientes admises pour une hémorragie sévère du post-partum définit par la nécessité d’une transfusion de plus de 04 CGR durant les 3 premières heures ou de plus de 10 CGR durant les 24 premières heures de prise en charge. Résultats Notre étude a inclut 47 parturientes. Le diagnostic de l’HPP a été fait devant un saignement vaginal dans 28 cas et suite à une césarienne dans 19 cas. En préopératoire le taux d’Hb a été de 6.3 g/dl. Le rapport transfusionnel (PFC/CGR) a été de 1/0.7. Conclusion Au cours de notre prise en charge, le rapport transfusionnel a été plus élevé que les recommandations récentes de la littérature stipulant une administration précoce et massive de PFC avec un ratio PFC/CGR compris entre 1/2 et 1/1. L’administration du fibrinogène (Fbg) et de l’acide tranexamique doit être précoce. L’emploi du facteur VII activé recombinant (rFVIIa) doit rester une solution ultime de prise en charge. PMID:28292131

  11. 77 FR 39406 - Safety Zone; Tom Graves Memorial Fireworks, Port Bay, Wolcott, NY

    Science.gov (United States)

    2012-07-03

    ...-AA00 Safety Zone; Tom Graves Memorial Fireworks, Port Bay, Wolcott, NY AGENCY: Coast Guard, DHS. ACTION..., NY. This safety zone is intended to restrict vessels from a portion of Port Bay during the Tom Graves... necessary to ensure the safety of spectators and vessels during the Tom Graves Memorial Fireworks. This zone...

  12. Personalised immunomodulating treatments for Graves' disease: fact or fiction?

    Science.gov (United States)

    Struja, Tristan Mirko; Kutz, Alexander; Fischli, Stefan; Meier, Christian; Müller, Beat; Schütz, Philipp

    2017-08-14

    Although Graves' disease has been recognised for more than 100 years, its physiopathological mechanisms are incompletely understood. Treatment strategies today mainly focus on suppression of thyroid hormone production by use of antithyroid drugs or radio-iodine, but neglect the underlying immunological mechanisms. Although Graves' disease is often seen as a prototype for an autoimmune mechanism, it is more likely to be a heterogeneous syndrome showing characteristics of both autoimmunity and immunodeficiency. The interplay of these two mechanisms may well characterise the physiopathology of this disease and its complications. Immunodeficiency may be either genetically determined or secondarily acquired. Various triggering events lead to autoimmunity with stimulation of the thyroid gland resulting in the clinical syndrome of hyperthyroidism. Also, relapse risk differs from patient to patient and can be estimated from clinical parameters incorporated into the Graves' Recurrent Events After Therapy (GREAT) score. Accurate risk stratification may help to distinguish high-risk patients for whom a more definitive treatment approach should be used from others where there is a high probability that the disease will recover with medical treatment alone. Several smaller trials having found positive effects of immunosuppressive drugs on recurrence risk in Graves' disease; therefoore, there is great potential in the use of novel immunomodulating drugs in addition to the currently used antithyroid drugs for the successful treatment of this condition. Further in-depth exploration of susceptibility, triggering factors and immunological mechanisms has the potential to improve treatment of Graves' disease, with more personalised, risk-adapted treatment strategies based on the different physiopathological concepts of this heterogeneous condition.

  13. EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

    Science.gov (United States)

    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

    2012-01-01

    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  14. Accidents - Chernobyl accident; Accidents - accident de Tchernobyl

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This file is devoted to the Chernobyl accident. It is divided in four parts. The first part concerns the accident itself and its technical management. The second part is relative to the radiation doses and the different contaminations. The third part reports the sanitary effects, the determinists ones and the stochastic ones. The fourth and last part relates the consequences for the other European countries with the case of France. Through the different parts a point is tackled with the measures taken after the accident by the other countries to manage an accident, the cooperation between the different countries and the groups of research and studies about the reactors safety, and also with the international medical cooperation, specially for the children, everything in relation with the Chernobyl accident. (N.C.)

  15. Clinical experience of radiation therapy for Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo [Gunma Univ., Maebashi (Japan). School of Medicine

    1996-11-01

    The effect of radiation therapy for Graves` ophthalmopathy was evaluated. Ten patients with Graves` ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves` ophthalmopathy. (author)

  16. Clinical experience of radiation therapy for Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo

    1996-01-01

    The effect of radiation therapy for Graves' ophthalmopathy was evaluated. Ten patients with Graves' ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves' ophthalmopathy. (author)

  17. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

    Directory of Open Access Journals (Sweden)

    Antonio L. dos Santos Werneck

    1993-11-01

    Full Text Available Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada. O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia grave constituem associação pouco frequente. A presença de esclerodermia e miastenia grave é rara. Não encontramos na literatura a coincidência destas três doenças.

  18. Radioiodine treatment of Graves' disease. An assessment of its potential risks

    International Nuclear Information System (INIS)

    Graham, G.D.; Burman, K.D.

    1986-01-01

    Concern about the side effects of radiation exposure has deterred physicians from using radioiodine treatment for Graves' disease, although the efficacy and safety of this treatment have been established in the 35 years since its introduction. In that time, no significant side effects have been discovered. We believe iodine-131 should be considered the treatment of choice in most patients with Graves' disease. This article reviews the current understanding of the risks in radioiodine treatment of Graves' disease, including the risks for teratogenicity, genetic damage, carcinogenesis, and cellular dysfunction

  19. Medical management of Graves' ophthalmopathy

    NARCIS (Netherlands)

    Prummel, M. F.; Wiersinga, W. M.

    1995-01-01

    In most patients with Graves' hyperthyroidism the eye signs are self-limiting and mostly subclinical. However, about one-third of the patients have clinically relevant ophthalmopathy, which can be disabling and disfiguring. The mechanical causes of the symptoms and signs of the eye disease are

  20. Clinical significance of determination of serum BGP levels in patients with Graves' disease

    International Nuclear Information System (INIS)

    Tu Liping; Zhang Chunyan; Wang Linglong; Yu Yuefang; Zhu Weijie; Cai Ao

    2006-01-01

    Objective: To study the clinical significance of changes of serum BGP levels in patients with Graves' disease. Methods: Serum BOP levels as well as T 3 , T 4 , FT 3 , FT 4 , TSH, TGA, TMA levels were determined with RIA in 158 patients with Graves' disease and 145 controls. Results: The serum BGP levels in patients with Graves' disease were significantly higher than those in controls (P 3 , T 4 , FT 3 , FT 4 levels, but not with TSH, TGA, TMA. Conclusion: Serum BGP levels is a useful marker for monitoring bone metabolism in patients with Graves' disease. (authors)

  1. Lambeaux autofermants pour le traitement des brulures electriques du scalp par haut voltage

    Science.gov (United States)

    Hafidi, J.; El Mazouz, S.; El Mejatti, H.; Fejjal, N.; Gharib, N.E.; Abbassi, A.; Belmahi, A.M.

    2011-01-01

    Summary Les brûlures électriques par haut voltage sont responsables de gros dégâts tissulaires en immédiat et dans les jours suivant l’accident du fait de la chaleur importante dégagée par effet joule et de la thrombose microvasculaire évolutive. Les pertes de substances du scalp secondaires à ces brûlures nécessitent une couverture par lambeaux vu la destruction du périoste et du calvarium en regard. De juin 1997 à juin 2008, 15 patients ont été traités pour des pertes de substance du scalp secondaires à des brûlures électriques par haut voltage de diamètre allant de 8 à 11 cm et siégeant dans la région tonsurale. Ces patients ont été opérés dans la première semaine suivant l’accident. Les pertes de substance du scalp de taille moyenne secondaires à ces brûlures peuvent être couvertes per primam de façon fiable par des lambeaux locaux axialisés et multiples. Nous relatons l’expérience du Service de Chirurgie Plastique du Centre Hospitalier Universitaire Ibn-Sina, Rabat, Maroc, dans la gestion et la prise en charge de ces brûlures. PMID:22262963

  2. Epidemiology, management and outcomes of Graves' disease-real life data.

    Science.gov (United States)

    Hussain, Y S; Hookham, J C; Allahabadia, A; Balasubramanian, S P

    2017-06-01

    Treatment options in Graves' disease are clearly defined, but management practices and the perceptions of success are varied. The outcomes of treatment in large consecutive cohorts of Graves' disease have not been well characterised. The study describes the epidemiology, management strategies and medium term outcomes following anti-thyroid drug treatment, radio-iodine ablation and surgery in Graves' disease. All patients (n = 659) who received treatment for a new diagnosis of Graves' disease in secondary care over a 5 year period were included with a median (interquartile range) follow-up of 42.9 (29-57.5) months. The age adjusted incidence of adult onset Graves' disease in Sheffield, UK was 24.8 per 100,000 per year. Excluding 35 patients lost to follow-up, 93.1% (n = 581) were controlled on anti-thyroid drug treatment. Of these, 73.6% went into remission following withdrawal of anti-thyroid drugs; 5.2% were still undergoing initial therapy; 13.3% lost control whilst on anti-thyroid drugs; and 7.9% went on to have either surgery or radio-iodine ablation whilst controlled on anti-thyroid drugs. Of the 428 patients who achieved remission, 36.7% relapsed. Of 144 patients who had radio-iodine ablation treatment, 5.6% relapsed and needed further treatment. Of 119 patients having surgery, 5.2% had long-term hypoparathyroidism and none had documented long-term recurrent laryngeal nerve palsy. In the follow-up, 39.9% of patients underwent surgery or radio-iodine ablation with little morbidity. Up to two-thirds of patients who achieved remission did not relapse. Data on effectiveness and risks of treatments for Graves' disease presented in this study will help clinicians and patients in decision making.

  3. Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre

    DEFF Research Database (Denmark)

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus

    2014-01-01

    BACKGROUND AND OBJECTIVE: Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves......' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease.METHODS: 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre......'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression.RESULTS: In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves...

  4. F-18-FDG PET of the thyroid in Graves' disease

    International Nuclear Information System (INIS)

    Boerner, A.R.; Voth, E.; Schicha, H.; Wienhard, K.; Wagner, R.

    1998-01-01

    This study evaluates F-18-FDG PET of the thyroid in Graves' disease. Methods: Thirty patients were investigated the day before radioiodine therapy, 15 patients 3-10 days after radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG uptake was higher in Graves' disease patients than in controls. Negative correlations of F-18-FDG uptake with half-life of radioiodine and absorbed radiation dose due to radioiodine therapy were found along with a positive correlation to autoantibody levels. Conclusion: Thus F-18-FDG PET is likely to give information on the biological activity of Graves' disease as well as on early radiation effects. (orig.) [de

  5. Important considerations in the management of Graves' disease in pregnant women.

    Science.gov (United States)

    Okosieme, Onyebuchi E; Lazarus, John H

    2015-01-01

    Graves' disease is an autoimmune disorder in which autoantibodies to the thyroid-stimulating hormone receptor cause hyperthyroidism through unregulated stimulation of the thyroid-stimulating hormone receptor. Effective management of Graves' disease in pregnancy must address the competing fetal and maternal priorities of controlling hyperthyroidism in the mother on the one hand, and on the other, minimizing the impact of maternal disease and antithyroid drugs on the well-being of the fetus. Optimal strategies for achieving this intricate balance are currently a source of continued debate among thyroid experts and studies in recent decades are now providing greater clarity into the risk posed to the unborn baby by the combination of biochemical, immunological and pharmacological hazards arising from Graves' disease and its therapy. This review summarizes the current best practice and highlights important considerations and areas of uncertainty in the management of Graves' disease in pregnant women.

  6. 131I therapy of Graves' disease using lithium

    International Nuclear Information System (INIS)

    Sato, Kenshi

    1983-01-01

    Lithium is known to cause goiter and hypothyroidism. In the mechanism of goitrogenesis, there is general agreement that lithium inhibits the release of the thyroid hormones from the thyroid gland without significantly impairing other thyroid functions. The present study was undertaken, therefore, to investigate the usefulness of lithium in the radioiodine treatment of Graves' disease. Nine patients with Graves' disease who were all, except one, previously treated with antithyroid drugs were studied. 600 mg of lithium carbonate were administered daily to investigate the effects on thyroidal 131 I uptake, disappearance rate of 131 I from the prelabeled thyroid and the serum concentrations of thyroid hormones. Lithium showed no significant effect on the thyroidal 131 I uptake when the 24 hour thyroidal 131 I uptakes were determined both before and during lithium treatment in the five cases. On the other hand, lithium clearly prolonged the mean value of effective half-lives of 131 I to approximately 8 days vs. 5.1 days before lithium treatment (p 4 and T 3 levels significantly decreased during lithium treatment, from 21.3 to 12.4μg/dl (n=9, p 131 I for the Graves' disease can be reduced by using lithium, the radiation exposure to the total body is decreased. Moreover, it is possible to perform the 131 I therapy while improving the thyrotoxicosis with lithium. Finally, it is concluded that lithium is a very useful drug to be combined with the 131 I therapy of Graves' disease. (author)

  7. A mild Grave's ophthalmopathy during pregnancy.

    Science.gov (United States)

    Abbouda, Alessandro; Trimboli, Pierpaolo; Bruscolini, Alice

    2014-01-01

    Thyroid ophthalmopathy is a complication most commonly associated with Grave's disease. The disease course ranges from mild to severe, with severe cases resulting in major visual impairment. A complete ophthalmic examination in a 35-year-old secundigravida to 14 weeks of gestation presented to the hospital for a routine ophthalmological examination with eyelid retraction in the right eye was made. We studied the course of ocular disease through the gestation with orbit ecography and a 3T MRI. A diagnosis of Grave's Ophthalmopathy was made. This case presents an unusual course of the GD during pregnancy and a normal post-partum relapse, according to the Th1/Th2 balance. The frequent follow-up and the use of MRI allowed a prompt identification and complete control of the disease.

  8. Simulation of power excursions - Osiris reactor; Simulation des excursions de puissance - pile Osiris

    Energy Technology Data Exchange (ETDEWEB)

    Pascouet, A [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1964-07-01

    Following the experimental work accomplished in the U.S.A. on Borax 1 and SPERT 1 and the accident of SL 1, the 'Commissariat a l'Energie Atomique' started a research program about the safety of its own swimming Pool reactors, with regard to power excursions. The first research work led to the design of programmed explosive charges, adapted to the simulation of a power excursion. This report describes the application of these methods to the investigation of Osiris safety. (author) [French] A la suite des essais effectues aux U.S.A. sur BORAX 1 et SPERT 1 et de l'accident survenu a SL 1, le Commissariat a l'Energie Atomique a lance un programme d'etudes sur la surete de ses reacteurs piscines vis-a-vis des excursions de puissance. Les premieres etudes ont abouti A la mise au point de charges programmees capables de simuler une excursion de puissance. On trouvera dans le present rapport l'application de ces methodes a l'etude de la surete d'OSIRIS. (auteur)

  9. Comparative Assessment Of Natural Gas Accident Risks

    International Nuclear Information System (INIS)

    Burgherr, P.; Hirschberg, S.

    2005-01-01

    The study utilizes a hierarchical approach including (1) comparative analyses of different energy chains, (2) specific evaluations for the natural gas chain, and (3) a detailed overview of the German situation, based on an extensive data set provided by Deutsche Vereinigung des Gas- und Wasserfaches (DVGW). According to SVGW-expertise DVGW-data can be regarded as fully representative for Swiss conditions due to very similar technologies, management, regulations and safety culture, but has a substantially stronger statistical basis because the German gas grid is about 30 times larger compared to Switzerland. Specifically, the following tasks were carried out by PSI to accomplish the objectives of this project: (1) Consolidation of existing ENSAD data, (2) identification and evaluation of additional sources, (3) comparative assessment of accident risks, and (4) detailed evaluations of specific issues and technical aspects for severe and smaller accidents in the natural gas chain that are relevant under Swiss conditions. (author)

  10. Examination of vegetation around a nuclear plant emitting gaseous fluorides in order to detect fluorine pollution; Utilisation des vegetaux pour detecter la pollution fluoree autour d'une usine susceptible d'emettre des effluents gazeux fluores

    Energy Technology Data Exchange (ETDEWEB)

    Teulon, Francoise; Bonnaventure, J. P. [Commissariat a l' energie atomique et aux energies alternatives - CEA, Centre de Pierrelatte, Section de Protection contre les Radiations (France)

    1971-08-15

    Fluorine pollution (chronic or occasional) around a plant rejecting gaseous fluoride effluents can be detected from vegetation samples by chemical analysis. Systematic monitoring allows the effects and gravity of the pollution to be estimated. The analytical method used consists of a double distillation (in phosphoric acid and perchloric acid) followed by a spectro-colorimetric analysis (alizarine-complexon-lanthane). This method of control allows both the efficiency of the trapping installations and also the appearance of effluents at unexpected places to be checked, In the event of an accident it is possible to determine the advisability of prohibiting the consumption of locally grown produce by humans or fodder by cattle. Research conducted in order to determine the relation between visible, damage to certain vegetables (tomatoes, haricot beans and sorghum) and their fluorine contents demonstrated that such a relation appears above all at the level of the leaves; chemical analysis may thus be used to confirm or reject information obtained on the basis of visual evidence [French] La detection d'une pollution fluoree (chronique ou accidentelle) autour d'une usine susceptible d'emettre des effluents gazeux fluores peut etre avantageusement realisee par un reseau de prelevements vegetaux suivis de dosages chimiques. Une surveillance systematique permet une evaluation des consequences et du degre de gravite de la pollution. La methode d'analyse consiste en une double distillation (dans l'acide phosphorique et l'acide perchlorique) suivie d'une spectrocolorimetrie (alizarine-complexon-lanthane). Ce mode de controle permet non seulement de verifier si les installations de piegeage sont efficaces mais egalement de localiser des points d'emission imprevus. En cas d'accident, on peut egalement juger de l'opportunite d'interdire la consommation des legumes par les habitants ou du fourrage par le betail des environs. Enfin, des etudes experimentales ont ete realisees pour

  11. Airway complication occurring during radioiodine treatment for Graves' disease

    International Nuclear Information System (INIS)

    Kinuya, Seigo; Yoneyama, Tatsuya; Michigishi, Takatoshi

    2007-01-01

    Airway complications rarely occur in 131 I radioiodine therapy for Graves' disease. This study presents two cases in which 131 I therapy caused this acute complication. The patients complained of the symptom 6 h and 33 h after administration of 131 I. A histamine H1 receptor antagonist and hydrocortisone rapidly resolved symptoms in both cases. These two cases remind physicians that 131 I therapy for Graves' disease may cause potentially life-threatening complications. (author)

  12. Comparative Study on the Long-Acting Thyroid Stimulator in Graves' Disease

    International Nuclear Information System (INIS)

    Kim, Dong Sup; Koh, Chang Soon; Lee, Mun Ho

    1973-01-01

    In order to study the role of LATS in the pathogenesis of the Graves' disease, the serum activity of the LATS was determined by the bioassay of the modified McKenzie method. The subjects examined in the study consisted of 76 individuals including 12 cases of normal control, 54 cases with typical Graves' disease and 10 cases of chronic thyroiditis. The data observed in the patients with the Graves' disease were analyzed in comparison with the clinical features, laboratory findings, and responsiveness to the treatment. The results obtained are as follows: 1) None of the subjects which did not have the Graves' disease showed a positive LATS activity, except one case with the chronic thyroiditis. 2) Twenty-two oui of the 54 cases with the Graves' disease showed positive results for LATS (40.7%). The positivity was significantly higher in the patients who had been treated with antithyroid regimen but still showed hyperthyroidism than in the patients who had not been treated. 3) The activity of LATS was gradually decreased or even became absent as the hyperthyroidism was corrected after the treatment. 4) No significant difference was noticed in age and-sex between the positive and negative groups of LATS. 5) There was no evidence of significant correlation between the LATS activity and clinical features.

  13. Proposed classification scale for radiological incidents and accidents; Elaboration d'une echelle de classement des incidents et accidents radiologiques

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-04-15

    The scale proposed in this report is intended to facilitate communication concerning the severity of incidents and accidents involving the exposure of human beings to ionising radiations. Like the INES, it comprises eight levels of severity and uses the same terms (accident, incident, anomaly, serious and major) for keeping the public and the media informed. In a radiological protection context, the severity of an event is considered as being directly proportional to the risk run by an individual (the probability of developing fatal or non-fatal health effects) following exposure to ionising radiation in an incident or accident situation. However for society, other factors have to be taken into account to determine severity. The severity scale proposed is therefore based on assessment of the individual radiological risk. A severity level corresponding to exposure of a member of the public in an incident or accident situation is determined on the basis of risk assessment concepts and methods derived from international consensus on dose/effect relationships for both stochastic and deterministic effects. The severity of all the possible exposure situations - worker exposure, collective exposure, potential exposure - is determined using a system of weighting in relation to situations involving members of the public. In the case of this scale, to indicate the severity of an event, it is proposed to make use of the most penalizing level of severity, comparing: - the severity associated with the probability of occurrence of deterministic effects and the severity associated with the probability of occurrence of stochastic effects, when the event gives rise to both types of risk; - the severity for members of the public and the severity for exposed workers, when both categories of individuals are involved; - the severity on the proposed radiological protection scale and that obtained using the INES, when radiological protection and nuclear safety aspects are associated with

  14. Hypocalcaemia following thyroidectomy for treatment of Graves' disease: implications for patient management and cost-effectiveness.

    Science.gov (United States)

    Hughes, O R; Scott-Coombes, D M

    2011-08-01

    No consensus exists on optimal treatment for Graves' disease once anti-thyroid medication fails to induce remission. Total thyroidectomy is a more cost-effective treatment than radioactive iodine or life-long anti-thyroid medication, but hypocalcaemia is an important complication, leading to longer hospital admissions and increased prescription costs. This study aimed to compare the relative risk of hypocalcaemia requiring medical treatment for patients with Graves' disease. Prospective cohort study of patients undergoing total thyroidectomy for Graves' disease and for multinodular goitre, calculating serum calcium levels 24-hours post-operatively and prescription rates. Mean corrected calcium concentrations 24 hours post-operatively were 2.05 mmol/l for Graves' disease patients and 2.14 mmol/l for multinodular goitre patients (p = 0.003). Biochemical hypocalcaemia developed in 92 per cent (n = 34) of Graves' disease patients and 71 per cent (n = 43) of multinodular goitre patients (p = 0.012). Graves' disease patients were more likely to be prescribed calcium supplementation pre-discharge (p = 0.037). Total thyroidectomy for Graves' disease carries an increased risk of hypocalcaemia at 24 hours, and of calcium supplementation pre-discharge. Graves' disease patients should be informed of the increased risk of hypocalcaemia associated with total thyroidectomy, and this risk must be factored into future cost-effectiveness analysis.

  15. The choice of sites considered with respect to problems of radioactive waste disposal; Le choix des sites considere dans ses rapports avec les problemes de rejets d'effluents radioactifs

    Energy Technology Data Exchange (ETDEWEB)

    Duhamel, F [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

    1960-07-01

    The author of this article shows clearly that a knowledge of the behaviour of wastes together with an analysis of the risks of accidents makes it possible to define the general characteristics of a site as a function of, on the one hand the geological and meteorological factors, and on the other, the proposed installations. Consideration of the biological environment makes it possible to clarify the sitological study and to make a choice between the several sites possible. The author shows the real necessity for radio-protection specialists to share their knowledge, to establish regulations, and to cooperate with the authors responsible for the installations, from the moment of the choice of the site and of the planning of the apparatus up to the final reject of the waste. (author) [French] L'auteur de ce rapport montre clairement que la connaissance du comportement des effluents jointe a l'analyse des risques d'accident permettent de degager les caracteristiques generales d'un site en fonction d'une part, des donnees geologiques et meteorologiques, d'autre part des installations projetees. La consideration du milieu biologique permet de preciser l'etude sitologique et d'effectuer un choix entre plusieurs sites donnes. L'auteur met en evidence la necessite absolue pour les specialistes de la radioprotection d'echanger leurs connaissances, d'etablir des reglements et de cooperer avec les autorites responsables des installations depuis le choix des sites et le projet des appareillages jusqu'au rejet ultime des residus. (auteur)

  16. Grave pit modifications and wooden structures in the Great Moravian graves and their information potential for cognition of the social structure of the Great Moravian society

    Czech Academy of Sciences Publication Activity Database

    Mazuch, Marian; Hladík, Marek

    2013-01-01

    Roč. 54, č. 2 (2013), s. 45-55 ISSN 1211-7250 R&D Projects: GA ČR GP13-20936P Keywords : Early Middle Ages * Great Moravia * Mikulčice * burial sites * graves * grave pits * burial pits * wooden structures * funeral rite * social structure * GIS * statistics Subject RIV: AC - Archeology, Anthropology, Ethnology

  17. Graves' disease and toxic nodular goiter - radioiodine therapy

    International Nuclear Information System (INIS)

    Schicha, H.; Dietlein, M.

    2002-01-01

    At the 15th conference on the human thyroid in Heidelberg in 2001 the following aspects of the radioiodine therapy of benign thyroid disorders were presented: General strategies for therapy of benign thyroid diseases, criterions for conservative or definitive treatment of hyperthyroidism as first line therapy and finally preparation, procedural details, results, side effects, costs and follow-up care of radioiodine therapy as well as legal guidelines for hospitalization in Germany. The diagnosis Graves' hyperthyroidism needs the decision, if rather a conservative treatment or if primary radioiodine therapy is the best therapeutic approach. In the USA 70-90% of these patients are treated with radioiodine as first line therapy, whereas in Germany the conservative therapy for 1-1.5 years is recommended for 90%. This review describes subgroups of patients with Graves' disease showing a higher probability to relapse after conservative treatment. Comparing benefits, adverse effects, costs, and conveniences of both treatment strategies the authors conclude that radioiodine therapy should be preferred as first line therapy in 60-70% of the patients with Graves' hyperthyroidism. (orig.) [de

  18. Regression of the carotid intima media thickness by propylthiouracil therapy in Graves' hyperthyroidism.

    Science.gov (United States)

    Bilir, Cemil; Gökosmanoglu, Feyzi; Caliskan, Mustafa; Cinemre, Hakan; Akdemir, Ramazan

    2012-04-01

    One of the cardiovascular effects of hyperthyroidism is increased carotid intima media thickness (CIMT). The aim of this study is to investigate the CIMT in patients with Graves' hyperthyroidism and the effect of propylthiouracil (PTU) therapy on CIMT. Twenty-six patients with Graves' hyperthyroidism and 33 healthy controls were included in the study. CIMT was measured at the right and left external carotid arteries in every patient in both groups. CIMT was measured before and after the PTU therapy in patients with Graves' hyperthyroidism. There was a significant difference in CIMT between the group of Graves' hyperthyroid patients and the control group (0.72 versus 0.55 mm, P treatment, CIMT decreased significantly compared with the baseline values [0.84 (0.54-1.3) to 0.72 (0.50-1.2), change 0.12 mm, P hyperthyroidism is associated with atherosclerosis as assessed by CIMT. Treatment of Graves' hyperthyroidism with PTU decreases the CIMT.

  19. CD28/CTLA-4/ICOS haplotypes confers susceptibility to Graves' disease and modulates clinical phenotype of disease.

    Science.gov (United States)

    Pawlak-Adamska, Edyta; Frydecka, Irena; Bolanowski, Marek; Tomkiewicz, Anna; Jonkisz, Anna; Karabon, Lidia; Partyka, Anna; Nowak, Oskar; Szalinski, Marek; Daroszewski, Jacek

    2017-01-01

    Graves' disease, an autoimmune disease with heterogeneous symptoms including Graves' orbitopathy, has a combined genetic/environmental background, where variations within CD28/CTLA-4/ICOS genes are considered as disease markers.Association of CD28c.17+3T>C(rs3116496), CTLA-4g.319C>T(rs5742909), CTLA-4c.49A>G(rs231775), CTLA-4g.*642AT(8_33), CT60(rs3087243), Jo31(rs11571302), ICOSc.1554+4GT(8_15) polymorphisms with susceptibility to Graves' disease and clinical outcome was investigated. The study group comprised of 561 Polish Caucasians, including 172 unrelated Graves' disease patients. CTLA-4c.49A>G, CTLA-4g.319C>T, and CT60 were genotyped by PCR-RFLP; Jo31 and CD28c.17+3C>T by minisequencing; CTLA-4g.*642AT(8_33) and ICOSc.1554+4GT(8_15)-PCR and fluorescence-based technique. CD28c.17+3T>C(rs3116496)T/CTLA-4g.319C>T(rs5742909)C/CTLA-4c.49A>G(rs231775)G/CTLA-4g.*642AT(8_33)(AT 16-21 )/CT60(rs3087243)G/Jo31(rs11571302)G/ICOSc.1554+4GT(8_15)(m) and TCA(AT Graves' disease, especially in males, as well as overall Graves' orbitopathy development with severe outcome. TCG(AT 16-21 )GG(l) haplotype increased risk of Graves' disease and reduced the chance of successful medical treatment. Although this haplotype was mainly observed in patients without signs of Graves' orbitopathy, if Graves' orbitopathy developed it favored a Graves' orbitopathy outcome. Haplotype TCA(AT >21 )GT(m) increased Graves' disease risk in women and, in all patients, was linked to Graves' disease without Graves' orbitopathy. TCG(AT Graves' disease risk factor, whereas CT60 was an independent factor for disease progression. Sporadic Graves' disease was related to presence of CTLA-4c.49A>G[A] and the rare CTLA-4g.319C>T[T] allele variant. Familial background of the disease was exclusively associated with CTLA-4g.*642AT(8_33)[AT >21 ]/[AT >21 ] genotype. CD28/CTLA-4/ICOS loci may confer inherited susceptibility to Graves' disease or may be involved in susceptibility to Graves' disease and play a

  20. Hyperthyroidism: diagnosis and management of Graves' disease.

    Science.gov (United States)

    Schilling, J S

    1997-06-01

    Hyperthyroidism, or thyrotoxicosis, results when the body's tissues are exposed to excessive levels of thyroid hormone. Hyperthyroidism affects 2% of women but only one-tenth as many men. Graves' disease is the most common form of hyperthyroidism, often occurring in young adults. It is an autoimmune disorder with an important genetic component. Hyperthyroidism's hallmarks include goiter and myriad signs and symptoms related to increased metabolic activity in virtually all body tissues. Increased sensitivity to circulating catecholamines adds to the clinical picture. Diagnosed by patient history, physical examination, and laboratory tests, Graves' disease is treated with antithyroid drugs, radioactive iodine, and/or surgery, plus supportive therapy. A good treatment outcome can be expected; long-term follow-up is indicated.

  1. An update on the medical treatment of Graves' hyperthyroidism.

    Science.gov (United States)

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo

    2014-11-01

    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  2. Follow-up of newborns of mothers with Graves' disease.

    Science.gov (United States)

    Levy-Shraga, Yael; Tamir-Hostovsky, Liran; Boyko, Valentina; Lerner-Geva, Liat; Pinhas-Hamiel, Orit

    2014-06-01

    Overt neonatal Graves' disease is rare, but may be severe, even life threatening, with deleterious effects on neural development. The main objective of this study was to describe the course of thyrotropin (TSH) and free thyroxin (fT4) levels, as well as postnatal weight gain in relation to fT4 levels, in neonates born to women with Graves' disease without overt neonatal thyrotoxicosis. Such information is important to deduce the optimal schedule for evaluation. We conducted a retrospective chart review of neonates born to mothers with Graves' disease between January 2007 and December 2012. The records were reviewed for sex, gestational age, birth weight, maternal treatment during pregnancy, and maternal thyroid stimulating immunoglobulin (TSI) level. For each visit in the clinic, the data included growth parameters, presence of symptoms suspected for hyperthyroidism, blood test results (levels of TSH, fT4, and TSI), and treatment. Ninety-six neonates were included in the study (49 males), with a total of 320 measurements of thyroid function tests (TSH and fT4). Four neonates (4%) had overt neonatal Graves' disease; one of them along with nine others were born preterm. In 77 (92.9%) of the remaining 83 neonates (the subclinical group), fT4 levels were above the 95th percentile on day 5. All had normal fT4 on day 15. A negative association was found between fT4 and weight gain during the first two weeks. In this cohort, most neonates born to mothers with Graves' disease had a subclinical course with abnormal fT4 levels that peaked at day 5. After day 14, all measurements of fT4 returned to the normal range, although measurements of TSH remained suppressed for up to three months. Elevated fT4 was associated with poor weight gain.

  3. [Grave's disease in 2009].

    Science.gov (United States)

    Philippe, Jacques

    2009-04-08

    Grave's disease is an autoimmune disease of the thyroid gland characterized by hyperthyroidism, a homogenous goiter and occasionally an ophtalmopathy. It occurs in less than 1% of the population with a large predominance in women (10/1). Treatment is directed to inhibit thyroid hormone synthesis with carbimazole during 12-18 months. Recurrence rates after stopping treatment is about 50%; in these patients, radioactive iodine is the preferred treatment.

  4. Quality control of 131I treatment of graves' disease

    International Nuclear Information System (INIS)

    Liu Zeng; Liu Guoqiang

    2009-01-01

    To make a preliminary quality control (QC) criteria and apply on the various stages of clinic 131 I treatment of Graves' disease in order to decrease the early happening of hypothyroidism and enhance the onetime 131 I cure rate of Graves' disease, the quality control criteria in the stochastic outpatient with 131 I treatment, such as plan of the indication, contraindication, method of treatment, matters needing attention, follow-up observation and curative effect appraisal, patient selection, RAIU, thyroid gland weight measurement and 131 I dose criteria for the various steps of 131 I medication were determined. The 131 I treatment effects of Graves' disease including the once-cure rate, the improving rate, duplicate cure rate and the early happening rate of hypothyroidism were analyzed in patients with applying QC and without QC ccriteria. The results showed that the oncecure rate in patients with applying QC criteria was increased from 76.6% to 90.9% (P≤0.01); the improving rate was decreased from 12.2% to 7.0% (P≤0.01); the duplicate cure rate was increased from 90.1% to 93.0% (P>0.05); the early happening rate of hypothyroidism was decreased from 11.0% to 2.1% (P≤0.01). The 131 I treatment of Graves' disease applying with QC criteria had tremendously improved the oncecure rate and decreased the early happening of hypothyroidism rate. (authors)

  5. ¿Hay diferencias entre la violencia grave y la violencia menos grave contra la pareja?: un análisis comparativo

    Directory of Open Access Journals (Sweden)

    Enrique Echeburúa

    2008-01-01

    Full Text Available En este estudio ex post facto se lleva a cabo una descripción de las características presentadas por 1.081 casos denunciados por violencia contra la mujer en las comisarías de la Ertzaintza del País Vasco. En primer lugar, se presentan las variables psicológicas y sociodemográficas del agresor y de la víctima, así como de la relación de pareja. Y en segundo lugar, se determinan las diferencias más significativas entre la violencia grave y la violencia menos grave en relación con esas mismas variables. Los resultados ponen de manifiesto que tanto los agresores como las víctimas tienden a ser jóvenes, con una sobrerrepresentación de agresores y víctimas extranjeros inmigrantes. En el caso de los maltratadores graves, tienden a ser celosos o posesivos, a sentirse humillados por la ruptura de la pareja, lo que redunda directamente en un descenso de su autoestima y a consumir abusivamente alcohol o drogas. Por lo que se refiere a las víctimas de la violencia grave, se suelen sentir con frecuencia en peligro de muerte y están más fácilmente en circunstancias de vulnerabilidad, como una edad muy joven, una personalidad muy dependiente, una situación de enfermedad crónica o de dependencia económica, un consumo de drogas o un entorno de soledad. Se comentan las implicaciones de este estudio para la investigación y para la práctica clínica.

  6. A report of three cases of untreated Graves' disease associated with pancytopenia in Malaysia.

    Science.gov (United States)

    Rafhati, Abdullah Noor; See, Chee Keong; Hoo, Fan Kee; Badrulnizam, Long Bidin Mohamed

    2014-01-01

    Generally, clinical presentations of Graves' disease range from asymptomatic disease to overt symptomatic hyperthyroidism with heat intolerance, tremor, palpitation, weight loss, and increased appetite. However, atypical presentation of Graves' disease with hematological system involvement, notably pancytopenia, is distinctly uncommon. Hereby, we present and discuss a series of three untreated cases of Graves' disease clinically presented with pancytopenia and the hematological abnormalities that responded well to anti-thyroid treatment. With resolution of the thyrotoxic state, the hematological parameters improved simultaneously. Thus, it is crucial that anti-thyroid treatment be considered in patients with Graves' disease and pancytopenia after a thorough hematological evaluation.

  7. Graves' ophthalmopathy evaluated by infrared eye-movement recordings

    International Nuclear Information System (INIS)

    Feldon, S.E.; Unsoeld, R.

    1982-01-01

    Thirteen patients with varying degrees of Graves' ophthalmopathy were examined using high-resolution infrared oculography to determine peak velocities for horizontal eye movements between 3 degrees and 30 degrees. As severity of the orbital disease increased, peak velocities became substantially lower. Vertical-muscle surgery failed to have any effect on peak velocity of horizontal eye movements. In contrast, orbital decompression caused notable improvement in peak velocity of eye movements. Eye-movement recordings, which provide a measure of extraocular muscle function rather than structure, may provide a safe, sensitive, and accurate method for classifying and following up patients with Graves' ophthalmopathy

  8. Populations protection and territories management in nuclear emergency and post-accident situation; Protection des populations et gestion des territoires en situation d'urgence nucleaire et post-accidentelle

    Energy Technology Data Exchange (ETDEWEB)

    Bourrel, M.; Calmon, Ph.; Calvez, M.; Chambrette, V.; Champion, D.; Devin, P.; Godino, O.; Lombard, J.; Rzepka, J.P.; Schneider, Th.; Verhaeghe, B.; Cogez, E.; Kayser, O.; Guenon, C.; Jourdain, J.R.; Bouchot, E.; Murith, Ch.; Lochard, J.; Cluchier, A.; Vandecasteele, Ch.; Pectorin, X.; Dubiau, Ph.; Gerphagnon, O.; Roche, H.; Cessac, B.; Cochard, A.; Machenaud, G.; Jourdain, J.R.; Pirard, Ph.; Leger, M.; Bouchot, E.; Demet, M.; Charre, J.P.; Poumadere, M.; Cogez, E.

    2010-07-01

    This document gathers the slides of the available presentations given during these conference days. Twenty seven presentations out of 29 are assembled in the document and deal with: 1 - radiological and dosimetric consequences in nuclear accident situation: impact on the safety approach and protection stakes (E. Cogez); 2 - organisation of public authorities in case of emergency and in post-event situation (in case of nuclear accident or radiological terror attack in France and abroad), (O. Kayser); 3 - ORSEC plan and 'nuclear' particular intervention plan (PPI), (C. Guenon); 4 - thyroid protection by stable iodine ingestion: European perspective (J.R. Jourdain); 5 - preventive distribution of stable iodine: presentation of the 2009/2010 public information campaign (E. Bouchot); 6 - 2009/2010 iodine campaign: presentation and status (O. Godino); 7 - populations protection in emergency and post-accident situation in Switzerland (C. Murith); 8 - CIPR's recommendations on the management of emergency and post-accident situations (J. Lochard); 9 - nuclear exercises in France - status and perspectives (B. Verhaeghe); 10 - the accidental rejection of uranium at the Socatri plant: lessons learnt from crisis management (D. Champion); 11 - IRE's radiological accident of August 22, 2008 (C. Vandecasteele); 12 - presentation of the CEA's crisis national organisation: coordination centre in case of crisis, technical teams, intervention means (X. Pectorin); 13 - coordination and realisation of environmental radioactivity measurement programs, exploitation and presentation of results: status of IRSN's actions and perspectives (P. Dubiau); 14 - M2IRAGE - measurements management in the framework of geographically-assisted radiological interventions in the environment (O. Gerphagnon and H. Roche); 15 - post-accident management of a nuclear accident - the CODIRPA works (I. Mehl-Auget); 16 - nuclear post-accident: new challenges of crisis expertise (D

  9. Clinical significance and changes of TRAb and TSI assay in patients with Graves' disease

    International Nuclear Information System (INIS)

    Hu Xiaolin; Zhang Haiyan

    2006-01-01

    Objective: To explore the changes and clinical significance of TRAb and TSI detection in patients with Graves' disease. Methods: Serum TRAb and TSI levels were detected by enzyme-linked immunosorbent assay, and thyroid hormone levels were detected by microparticle enzyme immunoassay, including normal controls, Graves' disease in period of onset, catabsis group and hashimotos thyroiditis group. Results: The positive rate of TRAb and TSI in Graves' in period of onset group is 86.67% and 95.0%, TGA and TMA in hashimotos thyroiditis group is 85.29% and 91.18%, respectively. More importantly these results were significant difference than normal controls. Conclusions: It's very important for Graves' disease patients to detect TRAb, TSI, TGA, TMA and thyroid hormone simulta-neously, especially to the curative effect and prognosis criterin in patients with Graves' disease and antidi-astole in patients with hashimotos thyroiditis. (authors)

  10. ¿Hay diferencias entre la violencia grave y la violencia menos grave contra la pareja?: un análisis comparativo

    OpenAIRE

    Enrique Echeburúa; Javier Fernández-Montalvo; Paz de Corral

    2008-01-01

    En este estudio ex post facto se lleva a cabo una descripción de las características presentadas por 1.081 casos denunciados por violencia contra la mujer en las comisarías de la Ertzaintza del País Vasco. En primer lugar, se presentan las variables psicológicas y sociodemográficas del agresor y de la víctima, así como de la relación de pareja. Y en segundo lugar, se determinan las diferencias más significativas entre la violencia grave y la violencia menos grave en relación con esas mismas v...

  11. An evaluation of supervoltage orbital irradiation for Graves' opthalmopathy

    International Nuclear Information System (INIS)

    Teng, C.S.; Crombie, A.L.; Hall, R.; Ross, W.M.

    1980-01-01

    Twenty patients with moderately severe ophthalmopathy due to Graves' disease or ophtalmic Graves' disease were treated by supervoltage orbital radiotherapy generated by a linear accelerator. Seven patients (35%) showed some response within 3 weeks of the treatment, four patients (20%) improved minimally while nine patients (45%) were unchanged. Improvement was noted mainly in soft tissue changes while proptosis decreased in only four patients. With one exception, ophthalmoplegia did not improve after the radiotherapy. The benefit obtained with the treatment was not impressive. (author)

  12. Remission of Grave's disease after oral anti-thyroid drug treatment.

    Science.gov (United States)

    Ishtiaq, Osama; Waseem, Sabiha; Haque, M Naeemul; Islam, Najmul; Jabbar, Abdul

    2009-11-01

    To evaluate remission rate of anti-thyroid drug treatment in patients with Grave's disease, and to study the factors associated with remission. A cross sectional study. The Endocrine Department of the Aga Khan University Hospital, Karachi from 1999 to 2000. Seventy four patients of Grave's disease were recruited who were prescribed medical treatment. Grave's disease was diagnosed in the presence of clinical and biochemical hyperthyroidism along with anti-microsomal (AMA) and anti-thyroglobulin antibodies (ATA) and thyroid scan. These patients were prescribed oral anti-thyroid drugs using titration regime and followed at 3, 6, 12 and 18 months. Patients were categorized into two groups: "remission group" and "treatment failure group" and results were compared using a chi-square test, t-test and logistic regression model with significance at p disease on initial presentation.

  13. A case of severe autoimmune hepatitis associated with Graves' disease

    Directory of Open Access Journals (Sweden)

    Samia Abdulla Bokhari

    2016-01-01

    Full Text Available Graves' disease is a common condition and is known to have a wide range of effects on a variety of organs. Hepatic dysfunction ranging from mild to severe due to direct effect of high circulating thyroid hormones as well as a deleterious effect of antithyroid medications (methimazole and propylthiouracil has been well - documented in literature. However, severe autoimmune hepatitis (AIH associated with Graves' disease is rare and limited to few case reports only. A 38-year-old woman presented with abdominal pain and yellowish discolouration of conjunctivae. On investigation, she was found to have Graves' disease and AIH. The liver histopathology showed typical features of AIH. She responded excellently to glucocorticoid therapy with normalisation of thyroid function and liver histology. The case is discussed with relevant literature review.

  14. Secrets of a Mass Grave

    Science.gov (United States)

    Ament, Caitlin Marie; Graham, Theodore J.

    2017-01-01

    This article presents a unit of study in which students examine skeletons and draw conclusions from the evidence they find in a simulated mass grave. The activity involves the foundation of forensic anthropology--interpreting the structure of skeletal remains to determine sex, age, height, and possible cause of death. Working through a series of…

  15. Les accidents, fléaux méconnus en agriculture. De la solidarité facultative à la solidarité obligatoire : pour une histoire sociale du monde agricole

    OpenAIRE

    Michard, Claire-Élise

    2008-01-01

    À la fin du 19e siècle, un grand pas s’accomplit en matière d’accidents du travail. Toutefois, la loi du 9 avril 1898 protège les travailleurs de l’industrie, mais non pas ceux de l’agriculture. Cette situation résulte de causes diverses. L’agriculture est alors un secteur protégé par des hommes politiques qui ont besoin du vote et du soutien rural pour appuyer la République naissante. Les agriculteurs et leurs familles peuvent s’assurer contre les conséquences des accidents auprès de la Mutu...

  16. Predictive factors for intraoperative excessive bleeding in Graves' disease.

    Science.gov (United States)

    Yamanouchi, Kosho; Minami, Shigeki; Hayashida, Naomi; Sakimura, Chika; Kuroki, Tamotsu; Eguchi, Susumu

    2015-01-01

    In Graves' disease, because a thyroid tends to have extreme vascularity, the amount of intraoperative blood loss (AIOBL) becomes significant in some cases. We sought to elucidate the predictive factors of the AIOBL. A total of 197 patients underwent thyroidectomy for Graves' disease between 2002 and 2012. We evaluated clinical factors that would be potentially related to AIOBL retrospectively. The median period between disease onset and surgery was 16 months (range: 1-480 months). Conventional surgery was performed in 125 patients, whereas video-assisted surgery was performed in 72 patients. Subtotal and near-total/total thyroidectomies were performed in 137 patients and 60 patients, respectively. The median weight of the thyroid was 45 g (range: 7.3-480.0 g). Univariate analysis revealed that the strongest correlation of AIOBL was noted with the weight of thyroid (p Graves' disease, and preparation for blood transfusion should be considered in cases where thyroids weigh more than 200 g. Copyright © 2014. Published by Elsevier Taiwan.

  17. BP « Deepwater Horizon » du Golfe du Mexique à l’Afrique : un tournant pour l’industrie pétrolière ? BP “Deepwater Horizon” from the Gulf of Mexico to Africa : a turning point for the Oil Industry ?

    Directory of Open Access Journals (Sweden)

    Géraud Magrin

    2010-09-01

    Full Text Available L’explosion de la plateforme BP Deepwater Horizon du 20 avril 2010 constitue une des plus graves pollutions pétrolières de l’histoire. Sa localisation dans les eaux du premier consommateur mondial, et l’implication d’une des compagnies les plus avancées en matière de responsabilité sociale d’entreprise, sont révélatrices des enjeux actuels de la gestion environnementale des risques pétroliers. Alors que les gisements les plus accessibles sont exploités par des sociétés nationales, les compagnies internationales satisfont l’inextinguible demande en pétrole du système mondial en explorant des situations extrêmes, comme les eaux très profondes. Cela s’accompagne de risques croissants. La catastrophe de BP nous montre le danger de considérer un risque infime comme une absence de risque : l’exemption de planification d’urgence explique la longue durée et l’ampleur de la fuite. Elle rappelle aussi que les impacts du pétrole ne sont bien connus qu’à la surface et le long des côtes : or, cette fuite en eaux profondes causera des dommages écologiques graves dans les zones pélagiques. Cet événement changera les règles du jeu de la régulation environnementale pétrolière dans les zones sensibles. Nous donnons un aperçu des évolutions qu’il pourrait favoriser en Afrique, notamment en Mauritanie. Il reste à savoir si l’augmentation des coûts qui en résultera contribuera à accélérer la transition énergétique mondiale hors de la dépendance des hydrocarbures.On Thursday the 20th april 2010, the blowout of the Deepwater Horizon drilling platform operated by BP in the Gulf of Mexico starts what can be considered one of the major oil spills in the world history. Taking place in the national waters of the world’s first oil consumer and affecting one of the more advanced oil major in Corporate Social Responsibility, this accident may turn out to be a land mark for environmental management in the

  18. Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre.

    Science.gov (United States)

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus; Hegedüs, Laszlo; Bjoerner, Jakob Bue; Groenvold, Mogens; Bonnema, Steen Joop; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla

    2014-09-01

    Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease. 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre completed the Hospital Anxiety and Depression Scale (HADS). The differences in the mean HADS scores between the groups were analysed using multiple linear regression, controlling for socio-demographic variables. HADS scores were also analysed dichotomized: a score >10 indicating probable 'anxiety'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression. In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were associated with anxiety and depression symptoms. Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity.

  19. Evaluation of the patients with Grave's ophthalmopathy after the corticosteroids treatment.

    Science.gov (United States)

    Petrović, Mirjana Janićijević; Sarenac, Tatjana; Srećković, Suncica; Petrović, Marko; Vulović, Dejan; Janićijević, Katarina

    2012-03-01

    Graves' ophthalmopthy is one of the most common causes of exophthalmos as well as the most common manifestation of Graves' disease. The treatment of Graves' ophthalmopathy includes ophthalmological and endocrinological therapy. The aim of this study was to clinically evaluate the patients with Graves' ophthalmopathy treated with corticosteroids. Evaluation of 21 patients was performed in the Ophthalmology Clinic and Endocrinology Clinic, Clinical Centre Kragujevac, in the period from 2009 to 2010. They were treated with pulse doses of intravenous corticosteroids. They were referred to ophthalmologist by endocrinologist in euthyroid condition in the active phase of Graves' ophthalmopathy (ultrasonography of orbit findings and positive findings of antithyroid stimulating hormone receptor antibody--anti-TSH R Ab). The clinical activity score (CAS) and NO SPECS classification for evaluation of disease severity were used. Ophthalmological examination includes: best corrected visual acuity, slit-lamp exam, Hertels' test, direct ophthalmoscopy and ultrasonography of the orbit. According to our results 76.19% of the patients were female; mean age of the patients was 35.2 +/- 5.6 years. According to CAS classification after 6 months of the treatment recovery was shown in 23.81% of the patients, partial amelioration in 47.62% and no clinical amelioration in 28.57% of the patients. We achieved better results with male, young patients with high clinical activity score. Good results were observed after the first dose of corticosteroids, much better CAS after the third dose, which maintained until 6 months after the first treatment. Our results signify that intravenous pulse dose of corticosteroids treatment of the patients with Graves' ophthalmopthy is safe, comfortable, clinically justified and accessible for the clinicians and patients. Positive results are achieved after the first dose with increasing trend up to the third dose, which was maintained for the next three months.

  20. The work of the South Manchester Accident Rescue Team (SMART).

    Science.gov (United States)

    Redmond, A D

    1990-01-01

    Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment. Skill in anaesthesia, monitoring and operating, if tested only in these circumstances may be found to be gravely inadequate when exposed to the fluctuant and hostile environment at the site. Doctors who wish to do this sort of work or are designated to do it, must undergo regular and frequent training, especially if they are not trained in accident and emergency departments. This has long been recognised by the British Association for Immediate Care. In combination with the Royal College of Surgeons of Edinburgh they have now established a diploma in Immediate Medical Care. In urban areas the need for a doctor to attend at the scene of an accident is usually limited to entrapment. These occasions are likely to be infrequent and this can result in a lack of preparedness for such events. Interhospital transfer, primarily from peripheral hospitals to the specialist services of a teaching hospital, often involves critically ill and injured patients. The management of these cases by the mobile team provides regular, frequent exposure to working in a 'hostile' environment. Relationships with the rescue services are developed and staff become familiar with equipment and call-out procedures. The care of transported patients is improved. None of our patients have died in transit or within 6 h of arrival at base.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Tratamiento de la enfermedad de Graves Basedow

    Directory of Open Access Journals (Sweden)

    Hernando Vargas-Uricoechea

    2014-05-01

    Full Text Available Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroidismo como el de problemas especiales con el que puede estar asociado. La fisiopatología y el diagnóstico de la Enfermedad de Graves-Basedow son motivo de otra publicación.

  2. Documentation of Urn Graves of Knovíz Culture by RPAS

    Directory of Open Access Journals (Sweden)

    Jaroslav Šedina

    2016-12-01

    Full Text Available This paper deals with the documentation, positional determination of urn graves of the Knovíz culture (1200 - 1000 BC, and geometric and positional determination of tumulus at the archaeological site located near the village Ctiněves, in the Usti region in the Czech Republic. Several hundred urn graves are located in the archaeological site and it is one of the biggest burial sites of Knovíz culture in the Czech Republic. RPAS (Remotely Piloted Aircraft System was used for the documentation and positional determination of urn graves and tumulus. RPAS was equipped by visible spectral range, two near-infrared range, multispectral and thermal camera (one camera for a single flight. The result is a unique data set documenting this archaeological site. Thanks to the suitable winter and spring conditions in 2016 urn graves and tumulus could be detected on the basis of vegetation symptoms. The paper is also focused on how to process the data and creation of a differential digital surface model.

  3. A 3-year-old girl with Graves' disease with literature review

    Directory of Open Access Journals (Sweden)

    Yo Han Ho

    2014-09-01

    Full Text Available Graves' disease, the main cause of hyperthyroidism in the pediatric age group, is very rare in children younger than 4 years old but can seriously interfere with growth and development if not recognized and treated. Here we report a case of a 3-year-old girl with Graves' disease who presented with goiter, exophthalmos, heat intolerance, and hyperactivity. At her first visit, her serum concentrations of triiodothyronine (T3 and free thyroxine (free T4 were normal, whereas that of thyroid-stimulating hormone (TSH was decreased. Antimicrosomal antibody was 7,053.94 IU/mL, and TSH-binding inhibitory immunoglobulin was 31.62%. A thyroid scan showed diffuse enlargement with markedly increased uptake of both thyroid glands. Although T3 and free T4 levels were initially normal, she developed hyperthyroidism 3 months later. She was finally diagnosed with Graves' disease and treated with methimazole for 6 months. This is the first report of Graves' disease in children younger than 4 years old in Korea.

  4. Modified lateral orbital wall decompression in Graves' orbitopathy using computer-assisted planning.

    Science.gov (United States)

    Spalthoff, S; Jehn, P; Zimmerer, R; Rana, M; Gellrich, N-C; Dittmann, J

    2018-02-01

    Graves' orbitopathy, a condition seen in the autoimmune syndrome Graves' disease, affects the fatty tissue and muscles inside the orbit. Graves' orbitopathy is associated with increasing exophthalmos and sometimes leads to compressive dysthyroid optic neuropathy, resulting in progressive vision loss. Dysthyroid compressive optic neuropathy, functional problems, and cosmetic problems are the main indications for surgical decompression of the orbit, especially if conservative treatment has not led to a reduction in symptoms. Many surgical techniques are described in the literature. This article presents a modification of the lateral orbital wall osteotomy, involving the rotation and reduction of the osteotomized bone segment using preoperative planning, intraoperative computed navigation, and piezoelectric surgery. This new method combines the advantages of different techniques and appears to be a valid approach to the treatment of severe cases of Graves' orbitopathy. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Radioiodine therapy of autonomously functioning thyroid nodules and of Graves' disease

    International Nuclear Information System (INIS)

    Guhlmann, C.A.; Rendl, J.; Boerner, W.

    1995-01-01

    We studied the effects of radioiodine therapy (RIT) for autonomously functioning thyroid nodules (AFTNs) and Graves' disease on thyroid function and size up to one year after RIT. In 230 patients with AFTNs, a dose of 300 Gy was effective in about 90% of the cases 6 months after RIT. Out of 65 patients suffering from Graves' disease, 5 patients (8%) had persisting hyperthyroidism 6 months after RIT with a dose of 150 Gy. This group consisted exclusively of patients with manifest hyperthyroidism at the time of RIT. As determined by ultrasonography 6 months after RIT, a reduction of thyroid size by about 40% and 60% was observed in patients with AFTNs and Graves' disease, respectively. (orig.) [de

  6. CT volumetric measurements of the orbits in Graves' disease

    International Nuclear Information System (INIS)

    Krahe, T.; Schlolaut, K.H.; Poss, T.; Trier, H.G.; Lackner, K.; Bonn Univ.; Bonn Univ.

    1989-01-01

    The volumes of the four recti muscles and the orbital fat was measured by CT in 40 normal persons and in 60 patients with clinically confirmed Graves' disease. Compared with normal persons, 42 patients (70%) showed an increase in muscle volume and 28 patients (46.7%) an increase in the amount of fat. In nine patients (15%) muscle volume was normal, but the fat was increased. By using volumetric measurements, the amount of fat in the orbits in patients with Graves' disease could be determined. (orig.) [de

  7. La dynamique des régimes de régulation de la sûreté nucléaire française à la lumière de ses instruments

    OpenAIRE

    Chanton , Olivier; Mangeon , Michael; Pallez , Frédérique; Rolina , Grégory

    2016-01-01

    International audience; L’accident de Fukushima a provoqué une prise de conscience sans précédent concernant l’importance des risques naturels à l’échelle internationale. En mettant en cause plusieurs aspects institutionnels, et notamment les liens de dépendance entre l’autorité de sûreté nucléaire et le ministère de l’industrie japonais, les analyses de l’accident posent également la question de la gouvernance et de la régulation des risques nucléaires avec une acuité nouvelle (Delamotte 201...

  8. Radioiodine therapy versus antithyroid medications for Graves' disease.

    Science.gov (United States)

    Ma, Chao; Xie, Jiawei; Wang, Hui; Li, Jinsong; Chen, Suyun

    2016-02-18

    Graves' disease is the most common cause of hyperthyroidism. Both antithyroid medications and radioiodine are commonly used treatments but their frequency of use varies between regions and countries. Despite the commonness of the diagnosis, any possible differences between the two treatments with respect to long-term outcomes remain unknown. To assess the effects of radioiodine therapy versus antithyroid medications for Graves' disease. We performed a systematic literature search in the Cochrane Library, MEDLINE and EMBASE and the trials registers ICTRP Search Portal and ClinicalTrials.gov. The date of the last search was September 2015 for all databases. Randomised controlled trials (RCTs) comparing the effects of radioiodine therapy versus antithyroid medications for Graves' disease with at least two years follow-up. Two authors independently screened titles and abstracts for relevance. One author carried out screening for inclusion, data extraction and 'Risk of bias' assessment and a second author checked this. We presented data not suitable for meta-analysis as descriptive data. We analysed the overall quality of evidence utilising the GRADE instrument. We included two RCTs involving 425 adult participants with Graves' disease in this review. Altogether 204 participants were randomised to radioiodine therapy and 221 to methimazole therapy. A single dose of radioiodine was administered. The duration of methimazole medication was 18 months. The period of follow-up was at least two years, depending on the outcome measured. For most outcome measures risk of bias was low; for the outcomes health-related quality of life as well as development and worsening of Graves' ophthalmopathy risks of performance bias and detection bias were high in at least one of the two RCTs.Health-related quality of life appeared to be similar in the radioiodine and methimazole treatment groups, however no quantitative data were reported (425 participants; 2 trials; low quality evidence

  9. Treatment choice, satisfaction and quality of life in patients with Graves' disease.

    Science.gov (United States)

    Conaglen, Helen M; Tamatea, Jade A U; Conaglen, John V; Elston, Marianne S

    2018-04-06

    Thyrotoxicosis, most often caused by Graves' disease (GD), when treated inadequately may result in premature mortality. There is little consensus as to which of the 3 treatment options available - antithyroid drugs (ATD), radioactive iodine (RAI) and surgery, is better. (i) To assess factors involved in treatment choice and treatment satisfaction in patients treated for Graves' disease; (ii) To assess quality of life (QoL) following treatment of Graves' disease. Participants were selected from a prospective study cohort assessing thyrotoxicosis incidence and severity. Of the 172 eligible patients with Graves' disease, 123 treated patients participated (64% had received ATD only, 11% RAI and 25% total thyroidectomy, the latter 2 usually after a period of ATD), along with 18 untreated patients with newly diagnosed Graves' disease (overall participation rate, 73%). Consented patients completed a questionnaire detailing factors involved in treatment choice, QoL and satisfaction with treatment. Participants reported that the most important factors in choosing a treatment were the following: the effects on activities of daily living, concern about use of radioiodine, possibility of depression or anxiety, and doctor's recommendations. Satisfaction levels were high across all 3 treatment types. QoL 1-year following treatment was higher than in untreated patients, and comparable with other international studies. Patient satisfaction with therapy and QoL does not differ by treatment type. Therefore, clinical and social factors, in combination with patient choice and resource availability, should determine which treatment modality patients with Graves' disease should receive. © 2018 John Wiley & Sons Ltd.

  10. Measurements of Actual Effective Half - Life in 131I Therapy for Graves' Hyperthyroidism

    International Nuclear Information System (INIS)

    So, Yong Seon; Kim, Myung Seon; Kwon, Ki Hyun; Kim, Seok Whan; Kim, Tae Hyung; Han, Sang Woong; Kim, Eun Sil; Kim, Chong Soon

    1996-01-01

    Radioiodine[131I] has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and read minister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective 131I half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean administered activity and the mean values of absorbed doses wet: 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51 MBq and marked differences of 131I thyroidal uptake between tracer and therapy occurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal 131I uptake measurements after tracer and therapy dose, provides sufficient data about the effective treatment in Graves' hyperthyroidism.

  11. La prise en charge des troubles de santé mentale par les omnipraticiens du Québec

    Science.gov (United States)

    Fleury, Marie-Josée; Farand, Lambert; Aubé, Denise; Imboua, Armelle

    2012-01-01

    Résumé Objectif Cette recherche vise à documenter la prise en charge des troubles mentaux (TM) par les omnipraticiens. Type d’étude Il s’agit d’une étude mixte intégrant un questionnaire auto-administré et des entrevues qualitatives. La banque de données administratives des actes médicaux de la Régie de l’assurance maladie du Québec a aussi été analysée. Contexte La province de Québec. Participants Un total de 1415 omnipraticiens de différents lieux de pratiques ont été sollicités pour le questionnaire; 970 ont été rejoints. Un sous-groupe de 60 omnipraticiens a été rejoint pour les entrevues. Principaux paramètres à l'étude La prévalence annuelle des consultations reliées à des TM courants (TMC) ou graves (TMG), les pratiques cliniques, les pratiques de collaboration, les facteurs facilitant ou entravant la prise en charge des TM, ainsi que les recommandations pour l’amélioration du système de soins. Résultats Le taux de réponse a été de 41% (n = 398 omnipraticiens) pour le questionnaire et de 63% (n = 60) pour les entrevues. Environ 25 % des visites chez les omnipraticiens sont associées à des TM. Presque tous les omnipraticiens prennent en charge des TMC et se sentent compétents pour le faire, à l’inverse de la situation retrouvée pour les TMG. Près de 20 % des TMC sont référés (principalement à des intervenants psychosociaux), alors que près de 75 % des TMG sont référés (surtout en psychiatrie et à l’urgence). Plus de 50 % des omnipraticiens affirment n’entretenir aucun contact avec l’une ou l’autre des ressources de santé mentale. Plusieurs facteurs influencent la prise en charge des TM: les profils des patients (complexité des TM, troubles concomitants); les caractéristiques des omnipraticiens (réseau informel, formation); la culture professionnelle (travail en silo, mécanismes cliniques formalisés); le milieu institutionnel (multidisciplinarité, salariat); l’organisation des

  12. Chylothorax Associated with Substernal Goiter in Graves' Disease Treated with Radioactive Iodine.

    Science.gov (United States)

    Young Oh, Seo; Hyun Kim, Bo; Young Kim, Do; Min Lee, Kyu; Jin Lee, Min; Su Kim, Sung; Ho Kim, Jong; Kyung Jeon, Yun; Soo Kim, Sang; Ki Kim, Yong; Joo Kim, In

    2017-04-01

    We present a rare case of chylothorax associated with an intrathoracic goiter in Graves' disease that was treated with radioactive iodine. A 23-year-old woman with Graves' disease was referred to our clinic with a pleural effusion, dyspnea, characteristic bilateral proptosis, and a diffuse goiter. The pleural fluid biochemistry was consistent with chylothorax. However, the chylothorax did not decrease with conservative therapy. Therefore, RAI was administered. Subsequently, the chylothorax and goiter improved more quickly than expected. This case illustrates that chylothorax associated with a substernal goiter in Graves' disease can be treated successfully with radioactive iodine instead of surgery.

  13. Activation of latent Graves' disease in children. Review of possible psychosomatic mechanisms.

    Science.gov (United States)

    Morillo, E; Gardner, L I

    1980-03-01

    In some children, psychological events have appeared to be important in the triggering of Graves' disease. This report examines the case histories of three children in whom the appearance of symptomatology of Graves' disease was associated with depression following the death of a loved one. An analysis of neuroendocrine and immunologie pathways suggests that depression, set off by bereavement, causes low levels of norepinephrine in the brain. The latter in turn may mediate an increase in ACTH and cortisol, leading to reductions in immune surveillance and resultant production of thyroid-stimulating immunoglobulins, hence the development of Graves' disease.

  14. Efeito da hipertermia na pancreatite aguda grave experimental

    Directory of Open Access Journals (Sweden)

    Maurício Gustavo Ieri Yamanari

    Full Text Available OBJETIVO: O objetivo deste estudo é avaliar os efeitos da hipertermia na pancreatite aguda (PA grave experimental induzida por ácido taurocólico. MÉTODO: A PA grave foi induzida pela injeção retrógrada de ácido taurocólico a 2,5% ou 5% no ducto pancreático principal. Após a indução, os animais foram colocados numa gaiola contendo duas lâmpadas de 100 W. A temperatura corporal foi aumentada para 39,5ºC e mantida neste nível por 45 minutos. Foram estudados taxa de mortalidade em 72 horas, permeabilidade vascular no pâncreas, porcentagem de água no tecido pancreático, amilase sérica, histologia (edema, necrose acinar e infiltrado inflamatório e níveis séricos de IL-6 e IL-10. RESULTADOS: Não houve alteração em nenhum dos parâmetros avaliados. CONCLUSÃO: Não há benefício da hipertermia na PA grave experimental induzida por ácido taurocólico.

  15. Hyperparathyroidism after radioactive iodine therapy for Graves' disease

    International Nuclear Information System (INIS)

    Kawamura, Juichi; Tobisu, Kenichi; Sanada, Shingo

    1983-01-01

    Herein we report a 36-year-old man with hyperparathyroidism and a past history of internal irradiation to the thyroid. Twelve years previously at age 24 years he had received 8 mCi of radioactive iodine for Graves' disease. An additional dose of 4 mCi was required 3 years later. A right lower parathyroid adenoma (28 x 23 x 20 mm, 5.7 g) was found at neck exploration. Although the association of external ionizing radiation to the head and neck and the subsequent development of hyperfunctioning parathyroid glands has been described in recent years, there are only 4 cases in the literature of parathyroid surgery for hyperparathyroidism secondary to earlier treatment with radioactive iodine for Graves' disease. In a long-term follow-up of 180 patients treated with radioactive iodine for Graves' disease, neither hypercalcemia nor hypophosphatemia was found. Whether internal radiation therapy can be a causative factor in the development of hyperparathyroidism should be elucidated in future. However, it seems reasonable to suggest that patients whose hyper-thyroidism has been treated with radioactive iodine should have their scrum calcium levels examined at 5-year intervals. (author)

  16. SCPRI Emergency Kit for Use in the Event of a Nuclear Accident; Le Dispositif d'Intervention Rapide du SCPRI en Cas d'Accident Nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Ervet, P.; Moroni, J. P.; Pellerin, P. [Service Central de Protection Contre les Rayonnements Ionisants, Ministere des Affaires Sociales, Le Vesinet (France)

    1969-10-15

    In the event of a nuclear accident necessitating implementation of the ORSEC radiation protection plan, the Service central de protection contre les rayonnements ionisants (Central Service for Protection against Ionizing Radiations), in conjunction with the Service national de la protection civile (National Civil Defence Service), has adopted the necessary measures for rapid evaluation of possible contamination as promptly as possible. With this aim in mind the Service has prepared emergency kits, which are permanently stored at airfields in the Paris region; these can be carried by aircraft together with two engineers from the Service, thereby enabling them to reach the site of the incident with the specialized equipment in a few hours at most. This paper describes the monitoring and sampling equipment as well as the conditions under which the kit is carried and used (it operates independently by having a built-in generating unit). It is basically designed to permit an initial assessment of the situation, to furnish local authorities with data on which to base decisions for the safety of the population, and to determine any additional measures that need to be adopted. (author) [French] Dans le cas d'un accident nucleaire impliquant la mise en application du plan ORSEC radiologique, en liaison avec le Service national de la protection civile, le Service central de protection contre les rayonnements ionisants a pris les dispositions necessaires pour faire une evaluation rapide, aussi preooce que possible, des contaminations eventuelles. Dans ce but, il a realise des cantines d'intervention qui sont deposees en permanence sur les aerodromes de la region parisienne, et peuvent etre embarquees par avion avec deux ingenieurs du service qui peuvent etre ainsi sur les lieux de l'incident, avec un materiel specialise, dans un delai qui n'excede pas quelques heures. Le memoire decrit le materiel de mesure et de prelevement, ainsi que les conditions de transport et d

  17. The curative effect analysis of 131I-therapy on patients with Graves' disease

    International Nuclear Information System (INIS)

    Cui Qin; Lu Shujun; Lu Tianhe

    2002-01-01

    To investigate the curative effect of 131 I-therapy on Graves' disease, the authors analyse conditions of patients who have received 131 I-therapy (n -674). These results showed that the incidence of fully recover, improve, Graves' disease and invalid is 80.11%, 7.28%, 11.87% and 0.74% respectively. Therefore, 131 I-therapy on Graves' disease is convenient. It has little side effect, low cost and better curative effect, it is one of the best therapeutic methods to treat hyperthyroidism

  18. Sociological aspects of 3.11 Fukushima Daiichi Accident aftermath and the Genshiryoku-mura (nuclear village, or pro-nuclear concession sector)

    Energy Technology Data Exchange (ETDEWEB)

    Sawada, T., E-mail: tetsuo@nr.titech.ac.jp [Tokyo Inst. of Technology, Research Laboratory for Nuclear Reactors, Meguro-ku, Tokyo (Japan)

    2014-07-01

    In the 3.11 Fukushima Daiichi Accident aftermath, information contamination induced societal confusion that led to unnecessarily grave fear among the public. The origins and development of the information contamination, and the labeling of Goyo-gakusha and Genshiryoku-mura were phenomenologically analyzed. The historical background to, and reasons for emergence of Goyo-gakusha's were examined by using an axiological approach. The analyses and examination have clarified a typical case of the origins to formation of Genshiryoku-mura. (author)

  19. Graves' orbitopathy: Management of difficult cases

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.

    2012-01-01

    Management of Graves' ophthalmopathy (GO) is based on three pillars: to stop smoking, to restore and maintain euthyroidism, and to treat the eye changes according to severity and activity of GO. Difficulties are frequently encountered in each of these three management issues. The advice to

  20. Graves' disease associated with infectious mononucleosis due to primary Epstein-Barr virus infection: report of 3 cases.

    Science.gov (United States)

    Akahori, Hiroshi; Takeshita, Yumie; Saito, Reina; Kaneko, Shuichi; Takamura, Toshinari

    2010-01-01

    Although the etiology of Graves' disease is still not clear, it is generally suggested that environmental factors such as infections contribute to the development of Graves' disease. We report here three cases of Graves' disease which presented simultaneously with infectious mononucleosis due to primary EBV infection. Acute EBV infection might play an important role in the onset of Graves' disease. These three women complained of a sore throat or neck pain, resembling subacute thyroiditis. In the case of thyrotoxicosis accompanied by sore throat or neck pain, Graves' disease must be distinguished from subacute thyroiditis.

  1. Pathogenesis of Graves` disease and therapeutic implications; Pathogenese des Morbus Basedow und therapeutische Implikationen

    Energy Technology Data Exchange (ETDEWEB)

    Seif, F.J. [Tuebingen Univ. (Germany). Medizinische Klinik und Poliklinik

    1997-12-01

    Graves` disease presents itself clinically mainly as hyperthyroidism and infiltrative ophthalmopathy and to a minimal extent also as dermopathy and acropachy. Autoimmune processes are the basic pathogenesis. Stimulating antibodies against the TSH receptor cause hyperthyroidism. Autoantibodies and autoreactive T lymphocytes against primarily thyroidal antigens cross-react with similar antigens of the eye muscles and orbital connective tissue, thus spreading the disease from the thyroid to the eyes. The therapeutic goal comprises not only the treatment of hyperthyroidism, but also the induction of a steady immuntolerance in order to minimize the irreversible damage to the eye. The therapeutic armamentarium is formed by antithyroid drugs, glucocorticoids, retrobulbar radition and thyroid ablation, either by nearly total thyroidectomy or by radioiodine. The different indications for both ablative procedures are discussed. (orig.) [Deutsch] Der Morbus Basedow manifestiert sich klinisch hauptsaechlich als Hyperthyreose und infiltrative Orbitopathie, waehrend Demopathie und Akropathie selten sind. Der Krankheit liegt ein Autoimmunprozess zugrunde, wobei stimuliernde Autoantikoerper gegen den TSH-Rezeptor die Hyperthyreose hervorrufen. Autoantikoerper und T-Lymphozyten gegen primaer thyreoidale Antigene verursachen durch Kreuzreaktion mit aehnlichen Antigenen an den Augenmuskeln und orbitalem Bindegewebe die Orbitopathie. Das therapeutsiche Ziel besteht nicht nur in der Behandlung der Hyperthyreose, sondern vor allem in der Induktion einer immuntoleranten Remission, um die irreversiblen Schaeden am Auge zu minimieren. Die Therapie umfasst Thyreostatika, Glukokortikoide und Orbitaspitzenbestrahlung sowie eine Schilddruesenablation entweder durch fast totale Schilddruesenresektion oder durch Radiojodtherapie. Die Differentialindikationen fuer die beiden ablativen Massnahmen werden eroertert. (orig.)

  2. p27kip1 expression distinguishes papillary hyperplasia in Graves' disease from papillary thyroid carcinoma.

    Science.gov (United States)

    Erickson, L A; Yousef, O M; Jin, L; Lohse, C M; Pankratz, V S; Lloyd, R V

    2000-09-01

    In most cases, the histopathologic and cytologic distinction between Graves' disease and papillary thyroid carcinoma is relatively easy, but on occasion Graves' disease may simulate a thyroid papillary carcinoma. For example, papillary fronds with fibrovascular cores may be present in both Graves' disease and papillary carcinoma. p27kip1 (p27) is a cyclin-dependent kinase inhibitory protein that has been shown to be an independent prognostic factor in a variety of human tumors. Our previous studies of p27 expression in hyperplastic and neoplastic endocrine lesions showed that the level of p27 was quite different in these two conditions. To determine if this distinction could also be made between Graves' disease and papillary carcinoma, we analyzed expression of p27 and other cell cycle proteins in a series of cases of Graves' disease with papillary hyperplasia and a series of papillary thyroid carcinomas. Formalin-fixed paraffin-embedded tissues from 61 randomly selected patients with thyroid disease, including 29 cases of Graves' disease with papillary architectural features and 32 cases of papillary carcinoma, were analyzed for expression of p27, Ki-67, and DNA topoisomerase II alpha (topo II alpha) by immunostaining. The distribution of immunoreactivity was analyzed by quantifying the percentage of positive nuclei that was expressed as the labeling index (LI) plus or minus the standard error of the mean. The papillary hyperplasia of Graves' disease had a p27 LI of 68.2 +/- 3.1 (range, 24 to 88), whereas papillary carcinomas had a LI of 25.6 +/- 2.5 (range, 12 to 70) (P hyperplasia in Graves' disease and papillary carcinoma. These results indicate that p27 protein expression is significantly higher in papillary hyperplasia of Graves' disease compared to papillary carcinoma, which may be diagnostically useful in difficult cases.

  3. Change in Practice over Four Decades in the Management of Graves' Disease in Scotland.

    Science.gov (United States)

    Smith, D M; Dutta, S; Ahmed, F; Thaha, M A

    2016-01-01

    There is continuing debate on the optimal treatment for Grave's thyrotoxicosis with a resultant variation in clinical practice. The present study aimed to ascertain changes in practice in the treatment of Grave's thyrotoxicosis in Tayside, Scotland, over the past four decades. Methods. The "Scottish automated follow-up register" (SAFUR) was queried to identify all patients treated for Grave's thyrotoxicosis from 1968 to 2007 inclusive. Patients were divided into 4 groups (Groups A to D) according to the decades. Demographic profile, treatment modalities, radioactive iodine (RAI) dose, and recurrence rates were studied and outcomes were compared by χ (2) test and ANOVA using SPSS v15.0. A p value of Grave's thyrotoxicosis over the 4 decades. Use of RAI has increased from 43.1% in Group A to 68% in Group D (p Grave's thyrotoxicosis suggests increasing use of RAI as the preferred first line of treatment. Furthermore, using a single higher dose of RAI and adoption of total thyroidectomy have decreased recurrence rates.

  4. Treating the thyroid in the presence of Graves' ophthalmopathy

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo; Bonnema, Steen J; Smith, Terry J

    2012-01-01

    The etiology of Graves' orbitopathy (GO) remains enigmatic. Optimal therapeutic choices for the hyperthyroidism associated with Graves' disease (GD) in the presence of GO remain controversial. Whether antithyroid drugs (ATDs), radioiodine (RAI), or thyroidectomy should be favored in such patients...... - independent of extent - do not influence the natural course of GO. RAI can cause de novo development or progression of GO, which is largely preventable with oral steroid prophylaxis. In patients with mild GO, the thyroid treatment is largely independent of GO. Moderate to severe GO should be treated promptly...

  5. Dissociative disorder due to Graves' hyperthyroidism: a case report.

    Science.gov (United States)

    Mizutani, Kaoru; Nishimura, Katsuji; Ichihara, Atsuhiro; Ishigooka, Jun

    2014-01-01

    We report the case of a 20-year-old Japanese woman with no psychiatric history with apparent dissociative symptoms. These consisted of amnesia for episodes of shoplifting behaviors and a suicide attempt, developing together with an exacerbation of Graves' hyperthyroidism. Patients with Graves' disease frequently manifest various psychiatric disorders; however, very few reports have described dissociative disorder due to this disease. Along with other possible causes, for example, encephalopathy associated with autoimmune thyroid disease, clinicians should be aware of this possibility. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. La enfermedad de Graves, signos y síntomas

    OpenAIRE

    Young, P.; Finn, B. C.; Bruetman, J. E.

    2007-01-01

    La enfermedad de Graves es la causa más común de hipertiroidismo, es de patogenia autoinmune. Se distingue clínicamente de otras formas de hipertiroidismo por la presencia de bocio difuso, oftalmopatía y ocasionalmente mixedema pretibial. En este artículo describimos la vida y obra de Robert Graves, realizando posteriormente una revisión de los signos y síntomas de la enfermedad. En el mundo de la medicina actual, en donde la tecnología juega un rol preponderante, queremos recordar la importa...

  7. Infección odontogénica grave: Posibles factores predictores

    Directory of Open Access Journals (Sweden)

    Oscar García-Roco Pérez

    2003-04-01

    Full Text Available Se analizaron factores que pudieran predisponer a una infección odontogénica grave que requiera cuidados intensivos. Se realizó un estudio observacional descriptivo a 100 pacientes ingresados consecutivamente con infección odontogénica severa en el Hospital "Manuel Ascunce Domenech" de Camagüey desde 1999 al 2001. A partir de las historias clínicas se estudiaron diferentes variables que incluyeron parámetros médicos, sociales y procedimientos dentales previos. Se prestó particular atención al resultado de los cultivos bacterianos. La edad media de los 59 pacientes masculinos y 41 femeninos fue de 41 ± 15,8 años; 18 pacientes requirieron cuidados intensivos. El 41 % de los pacientes era de bajo nivel de escolaridad; 11 pacientes graves (61,1 % y 42 no graves (51,2 % eran fumadores. Dos pacientes (11,1 % de los graves y 8 (9,8 % de los no graves referían consumo excesivo de bebidas alcohólicas. La prevalencia de enfermedades crónicas fue mayor entre los no graves (31,7 %. La afección subyacente más común fue la osteítis periapical (70 % de los episodios infecciosos, seguido por la extracción dental en el 27,5 % de los graves y 10,9 % de los no graves. Ninguno de estos factores predijo la necesidad de cuidados intensivos. No existieron diferencias significativas en cuanto a síntomas, demora en solicitar atención médica, procedimientos dentales previos o terapéutica antimicrobiana. Predominaron los estreptococos aerobios (grupo S. milleri asociados con bacterias anaerobias variadas. No se encontraron variables sociales o clínicas predictoras de un curso grave en infecciones odontogénicas. Todos los pacientes deben ser cuidadosamente monitoreados para evitar complicaciones severas.Those factors that may predispose to a severe odontogenic infection requiring intensive care were analyzed. An observational descriptive study was conducted among 100 patients that were consecutively admitted with severe odontogenic infection at

  8. Grave's Eye disease developing following radioiodine treatment for toxic nodular goitre.

    Science.gov (United States)

    Tahrani, A A; Rangan, S; Moulik, P

    2007-07-01

    The development of Grave's ophthalmopathy (GO) following radioiodine (RI) treatment for Grave's thyrotoxicosis, though controversial, is well described. The development of ophthalmopathy following RI treatment for toxic nodular goitre is much less recognised. We report a 49 year-old female patient who developed thyrotoxicosis and GO after receiving RI treatment for toxic nodular goitre and we also review the relevant literature.

  9. Efficacité des néonicotinoïdes et des pyréthrinoïdes utilisés contre le ...

    African Journals Online (AJOL)

    Efficacité des néonicotinoïdes et des pyréthrinoïdes utilisés contre le foreur des tiges du cacaoyer ( Eulophonotus myrmeleon Felder : Lepidoptera, Cossidae). Implications dans la stratégie de protection de la cacaoculture en Côte d'Ivoire.

  10. Pooled genome wide association detects association upstream of FCRL3 with Graves' disease.

    Science.gov (United States)

    Khong, Jwu Jin; Burdon, Kathryn P; Lu, Yi; Laurie, Kate; Leonardos, Lefta; Baird, Paul N; Sahebjada, Srujana; Walsh, John P; Gajdatsy, Adam; Ebeling, Peter R; Hamblin, Peter Shane; Wong, Rosemary; Forehan, Simon P; Fourlanos, Spiros; Roberts, Anthony P; Doogue, Matthew; Selva, Dinesh; Montgomery, Grant W; Macgregor, Stuart; Craig, Jamie E

    2016-11-18

    Graves' disease is an autoimmune thyroid disease of complex inheritance. Multiple genetic susceptibility loci are thought to be involved in Graves' disease and it is therefore likely that these can be identified by genome wide association studies. This study aimed to determine if a genome wide association study, using a pooling methodology, could detect genomic loci associated with Graves' disease. Nineteen of the top ranking single nucleotide polymorphisms including HLA-DQA1 and C6orf10, were clustered within the Major Histo-compatibility Complex region on chromosome 6p21, with rs1613056 reaching genome wide significance (p = 5 × 10 -8 ). Technical validation of top ranking non-Major Histo-compatablity complex single nucleotide polymorphisms with individual genotyping in the discovery cohort revealed four single nucleotide polymorphisms with p ≤ 10 -4 . Rs17676303 on chromosome 1q23.1, located upstream of FCRL3, showed evidence of association with Graves' disease across the discovery, replication and combined cohorts. A second single nucleotide polymorphism rs9644119 downstream of DPYSL2 showed some evidence of association supported by finding in the replication cohort that warrants further study. Pooled genome wide association study identified a genetic variant upstream of FCRL3 as a susceptibility locus for Graves' disease in addition to those identified in the Major Histo-compatibility Complex. A second locus downstream of DPYSL2 is potentially a novel genetic variant in Graves' disease that requires further confirmation.

  11. Histological Changes in Autoimmune Hepatitis with Graves' Disease: A Child Case Report.

    Science.gov (United States)

    Yamada, Mamiko; Shibata, Hironori; Masugi, Yohei; Ishi, Tomohiro; Kameyama, Kaori; Ebinuma, Hirotoshi; Hasegawa, Tomonobu

    2017-08-15

    We herein report a child case of autoimmune hepatitis (AIH) accompanied with Graves' disease. Elevated aminotransferase levels were found in a 12-year-old Japanese girl with Graves' disease. In her first liver biopsy, necrosis and inflammation was limited to the centrilobular area, while the second biopsy showed different findings. Namely, portal injury newly appeared, including interface hepatitis, which represents the histological characteristics of AIH. As the histological findings at the onset of AIH do not always show typical findings, a re-biopsy is considered to be important in individuals suspected to have AIH. AIH should be included in the differential diagnosis of liver dysfunction in Graves' disease, even in children.

  12. Comparison of Bilateral Axillo-Breast Approach Robotic Thyroidectomy with Open Thyroidectomy for Graves' Disease.

    Science.gov (United States)

    Kwon, Hyungju; Yi, Jin Wook; Song, Ra-Yeong; Chai, Young Jun; Kim, Su-jin; Choi, June Young; Lee, Kyu Eun

    2016-03-01

    There is an ongoing debate about whether robotic thyroidectomy (RT) is appropriate for Graves' disease. The aim of this study was to compare the safety of bilateral axillo-breast approach (BABA) RT with that of open thyroidectomy (OT) in patients with Graves' disease. From January 2008 to June 2014, 189 (44 BABA RT and 145 OT) patients underwent total thyroidectomy for Graves' disease. Recurrence of Graves' disease, intraoperative blood loss, hospital stay, and complication rates including recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism were analyzed between BABA RT and OT groups, after propensity score matching according to age, gender, body mass index, surgical indication, the extent of operation, excised thyroid weight, and follow-up period. No patient experienced recurrence of Graves' disease after median follow-up of 35.0 months. Intraoperative blood loss (151.8 ± 165.4 mL vs. 134.5 ± 75.4 mL; p = 0.534) and hospital stay (3.4 ± 0.7 day vs. 3.3 ± 0.7 day; p = 0.564) were not different between BABA RT and OT groups. Complication rates including transient RLN palsy (11.4 vs. 11.4%; p = 1.000), transient hypoparathyroidism (18.2 vs. 20.5%; p = 0.787), permanent RLN palsy (0 vs. 2.3%; p = 0.315), and permanent hypoparathyroidism (2.3 vs. 2.3%; p = 1.000) were also comparable between groups. BABA RT for Graves' disease showed comparable surgical completeness and complications to conventional OT. BABA RT can be recommended as an alternative surgical option for patients with Graves' disease who are concerned about cosmesis.

  13. Accidents - Chernobyl accident

    International Nuclear Information System (INIS)

    2004-01-01

    This file is devoted to the Chernobyl accident. It is divided in four parts. The first part concerns the accident itself and its technical management. The second part is relative to the radiation doses and the different contaminations. The third part reports the sanitary effects, the determinists ones and the stochastic ones. The fourth and last part relates the consequences for the other European countries with the case of France. Through the different parts a point is tackled with the measures taken after the accident by the other countries to manage an accident, the cooperation between the different countries and the groups of research and studies about the reactors safety, and also with the international medical cooperation, specially for the children, everything in relation with the Chernobyl accident. (N.C.)

  14. The clinical experience of interventional embolization in treatment of graves disease

    International Nuclear Information System (INIS)

    Di Zhenhai; Wang Xiaochuan; Liu Longtu; Wang Xiuhua; Wang Zubin

    2002-01-01

    Objective: To evaluate the method and result of thyroid artery embolization as a new therapy for Graves disease. Methods: Ten patients with Graves disease underwent selective thyroid artery embolization. Totally 25 thyroid arteries were embolized with PVA microspheres. The indications to this therapy were as following: Graves disease with recurrent clinical symptoms or with leucopenia during the period of treating with administration of antithyroid drugs or recurrence after subtotal thyroidectomy. Results: Serum level of thyroid hormones dropped significantly [median FT 3 from 20.90 pmol/L (13.36-50.92 pmol/L) to 7.81 pmol/L (3.67-35.3 pmol/L), median FT 4 from 57.9 pmol/L (30.96-57.9 pmol/L) to 28.13 pmol/L (20.44-39.60 pmol/L), (P < 0.005)] and then followed-up for 5-8 months. The symptoms of hyperthyroidism were controlled in 7 patients and the remaining 3 cases were treated with lower dosage of antithyroid drug therapy. None serious complications were found. Conclusions: thyroid artery embolization represents a promising new method for treating Graves disease with safety and good clinical results. Further investigation would be required to assess its long-term effect

  15. Graves' orbitopathy as a rare disease in Europe: a European Group on Graves' Orbitopathy (EUGOGO) position statement

    NARCIS (Netherlands)

    Perros, P.; Hegedüs, L.; Bartalena, L.; Marcocci, C.; Kahaly, G. J.; Baldeschi, L.; Salvi, M.; Lazarus, J. H.; Eckstein, A.; Pitz, S.; Boboridis, K.; Anagnostis, P.; Ayvaz, G.; Boschi, A.; Brix, T. H.; Currò, N.; Konuk, O.; Marinò, M.; Mitchell, A. L.; Stankovic, B.; Törüner, F. B.; von Arx, G.; Zarković, M.; Wiersinga, W. M.

    2017-01-01

    Graves' orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence of GO in Europe may be declining, however data on the prevalence of this disease are sparse.

  16. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  17. Santé des adolescents et des jeunes au Burkina Faso : état des ...

    African Journals Online (AJOL)

    Il s'est agi d'une étude évaluative ayant utilisé une revue documentaire associée à une interview des acteurs clés et un atelier de validation et d'identification des interventions pertinentes pour un plan stratégique national. La situation de la santé des adolescents et des jeunes est caractérisée par des grossesses précoces ...

  18. Fatal and non-fatal adverse events of glucocorticoid therapy for Graves' orbitopathy

    DEFF Research Database (Denmark)

    Marcocci, Claudio; Watt, Torquil; Altea, Maria Antonietta

    2012-01-01

    The objective of this study was to investigate the side effects of glucocorticoid (GC) therapy observed by European thyroidologists during the treatment of Graves' orbitopathy (GO).......The objective of this study was to investigate the side effects of glucocorticoid (GC) therapy observed by European thyroidologists during the treatment of Graves' orbitopathy (GO)....

  19. Results and tasks of the implementation of federal target programs aimed at overcoming the consequences of radiation accidents and catastrophes in the Russian Federation

    International Nuclear Information System (INIS)

    Gerasimova, N.V.

    2002-01-01

    Major results are presented on the implementation of federal target programs on overcoming the consequences of the accident at the Chernobyl nuclear power plant, radiation accidents and incidents at the 'Mayak' Industrial Association, nuclear tests at the Semipalatinsk test site in the period of 1992-2000. The status of the standards and legislation regulating the activities aimed at population protection and rehabilitation of territories is analyzed. The current state of the problem is evaluated. The proposals are laid down for major directions of the state policy of the Russian Federation in overcoming the consequences of radiation accidents for the period until 2010, and the outlook for the efforts in the above domain and the above period is given. About 130 thousand square kilometers of the territories of 20 Russian Federation subjects with a population of around 4 million people were affected by accidents at nuclear fuel cycle sites/facilities, and nuclear and hydrogen weapons tests. The accidents entailed a host of grave radioecological, medical, demographic, and socio-economic consequences, exerted a significant unfavorable impact upon the socio-economic development of the affected territories. (author)

  20. La fabrique des sciences des institutions aux pratiques

    CERN Document Server

    Benninghoff, Martin; Crettaz von Roten, Fabienne; Merz, Martina

    2006-01-01

    Aujourd'hui, les façons de produire, d'organiser, d'évaluer et d'utiliser les savoirs sont en profond débat. De plus en plus, l'Etat, la société civile et l'économie tentent d'influencer les activités des universités et des laboratoires de recherche. Ces développements mettent à l'épreuve tout à la fois les fondements des systèmes d'enseignement supérieur et de recherche, l'autonomie des institutions scientifiques, la définition des frontières des savoirs et l'acceptation des sciences. Dans des contextes suisses et européens, cet ouvrage s'intéresse aux manières dont les sciences et les technologies sont fabriquées, en analysant leurs institutions et les pratiques. A partir d'une approche relationnelle, les sciences et les technologies sont conçues comme des phénomènes profondément sociaux, culturels et politiques. Une telle démarche déstabilise les visions parfois idéalisées et stéréotypées de la construction des savoirs. Des études de cas détaillées décrivent des phénomè...

  1. [Echo-tracking technology for evaluating femoral artery endothelial function in patients with Grave's disease].

    Science.gov (United States)

    Wei, Wei; Wang, Jingyuan; Zhao, Qiaoling; Yang, Jinru

    2012-10-01

    To assess the value of echo-tracking technology in evaluating endothelial function of the femoral artery in patients with Grave's disease. Thirty-four patients with Grave's disease patients and 30 normal adults as controls were recruited in this study. The intima-media thickness (IMT), arterial stiffness (β), pressure strain elastic modulus (Ep), arterial compliance (AC), pulse wave conducting velocity (PWVβ) and augmentation index (AI) parameters were examined using echo-tracking technology for evaluating the right femoral arterial elasticity. Compared with the control subjects, the patients with Grave's disease showed significantly increased β, Ep, and PWVβ and significantly decreased AC (P0.05). In patients with Grave's disease, β and Ep were positively correlated with FT3, FT4, TT3, TT4, and PWVβ was positively correlated with FT3 and FT4. Echo-tracking technology can provide more accurate quantitative evidences for early diagnosis of femoral artery endothelial dysfunction in patients with Grave's disease, but the influence of procedural factors on the measurement accuracy should be considered in the evaluation.

  2. Ecocardiograma e fatores de risco cardiovascular em obesos graves

    OpenAIRE

    Elaine Gonçalves Moreira Rocha, Isaura

    2003-01-01

    Introducão: Alterações em parâmetros hemodinâmicos e na função cardíaca ocorrem na obesidade grave, em associação a outros fatores de risco cardiovascular, como dislipidemia, hipertensão arterial e diabete melito. Material e métodos: Foi descrito o perfil clínico, metabólico, ecocardiográfico e o risco de doença cardiovascular, avaliado através do escore de Framingham, em 32 obesos graves candidatos à gastroplastia, no Hospital das Clínicas da Universidade Federal de Pernambuco, entre jane...

  3. Organizations putting in place in case of accident in a french nuclear power plant

    International Nuclear Information System (INIS)

    Noc, B.; Queniart, D.

    1987-01-01

    In case of accident entraining radiological consequences on or near the site of nuclear power reactor, organizations are putting in place. These organizations include as well as side of operating authority (generally Electricite de France) or public organizations including safety organizations (Service Central de Surete des Installations Nucleaires, Institut de Protection et de Surete Nucleaire), one local organization and one centralized national organization. Informations exchange and coordination necessary between these organizations are governed by protocols. These protocols include particularly, the problems of mobilizing experts and of dealing with the saturation of normal telecommunications channels. The lessons acquired during accident simulation exercises carried out in recent years are progressively put in place in these protocols [fr

  4. Radiation protection in the Marcilio Dias Naval Hospital during the arrived of the victims of the accident in Goiania

    International Nuclear Information System (INIS)

    Fajardo, P.W.

    1988-05-01

    The procedure carried out for Nuclear Medicine Sector of the Marcilio Dias Hospital in the arrived of the victims more graves of the accident in Goiania are presented. The datas obtained with the services of monitoring realized with the detector DSM-3 of the Nardeaux and the radiometric raising of the patients and of their bedroom, making with a ionization chamber 'baby-line' are shown. The services of radiation protection in the ward and the decontamination of the patients are described. The procedures to the necropsy of the contamineted bodies are presented. (V.R.B.)

  5. Thyrotropin-producing pituitary adenoma simultaneously existing with Graves' disease: a case report.

    Science.gov (United States)

    Arai, Nobuhiko; Inaba, Makoto; Ichijyo, Takamasa; Kagami, Hiroshi; Mine, Yutaka

    2017-01-06

    Thyrotropin-producing pituitary tumor is relatively rare. In particular, concurrent cases associated with Graves' disease are extremely rare and only nine cases have been reported so far. We describe a case of a thyrotropin-producing pituitary adenoma concomitant with Graves' disease, which was successfully treated. A 40-year-old Japanese woman presented with mild signs of hyperthyroidism. She had positive anti-thyroid-stimulating hormone receptor antibody, anti-thyroglobulin antibody, and anti-thyroid peroxidase antibody. Her levels of serum thyroid-stimulating hormone, which ranged from low to normal in the presence of high levels of serum free thyroid hormones, were considered to be close to a state of syndrome of inappropriate secretion of thyroid-stimulating hormone. Magnetic resonance imaging showed a macropituitary tumor. The coexistence of thyrotropin-producing pituitary adenoma and Graves' disease was suspected. Initial therapy included anti-thyroid medication, which was immediately discontinued due to worsening symptoms. Subsequently, surgical therapy for the pituitary tumor was conducted, and her levels of free thyroid hormones, including the thyroid-stimulating hormone, became normal. On postoperative examination, her anti-thyroid-stimulating hormone receptor antibody levels decreased, and the anti-thyroglobulin antibody became negative. The coexistence of thyrotropin-producing pituitary adenoma and Graves' disease is rarely reported. The diagnosis of this condition is complicated, and the appropriate treatment strategy has not been clearly established. This case suggests that physicians should consider the coexistence of thyrotropin-producing pituitary adenoma with Graves' disease in cases in which thyroid-stimulating hormone values range from low to normal in the presence of thyrotoxicosis, and the surgical treatment of thyrotropin-producing pituitary adenoma could be the first-line therapy in patients with both thyrotropin-producing pituitary adenoma

  6. Fréquence et caractéristiques des AVC impliquant les artères perforantes dans le Service de Neurologie de l’Hopital Bafelatanana, Antananarivo

    Science.gov (United States)

    Rasaholiarison, Nomena Finiavana; Randrianasolo, Rahamefy Odilon; Rajaonarison, Lala Andriamasinavalona; Rakotomanana, Jenny Larissa; Razafimahefa, Julien; Tehindrazanarivelo, Alain Djacoba

    2017-01-01

    Introduction Les accidents vasculaires cérébraux des artères perforantes sont surtout des artériolopathies. Ils évoluent vers la démence et la récurrence. Pour mieux prévenir ces complications notre étude avait pour but d'évaluer la fréquence et les caractéristiques de ces AVC. Méthodes c'est une étude descriptive rétrospective du 01 Mars au 25 Septembre 2015 au service de Neurologie CHU-JRB. Ont été inclus les patients présentant un déficit neurologique brutal et un scanner cérébral avec atteinte du territoire profonde. Les caractéristiques des AVC des artères perforantes ont été recueillies. Les données étaient traitées par le logiciel SPSS 20. Résultats Quatre-vingt-trois (48,25%) patients avaient des AVC des artères perforantes sur 172 AVC. Pour les AVC des artères perforantes la population était jeune avec 65,06% moins de 65 ans et à prédominance masculine avec 61,44%. Les formes hémorragiques étaient à 67,46%. Trente et un patients (37,34%) ont connu des récurrences et parmi eux presque le quart avait 2 récurrences avec 38,70% en moins de un an. Tous les patients avec récurrence avaient un trouble dysexécutif (p AVC pendant l'hospitalisation. Conclusion Un suivi spécifique en neurologie est nécessaire dès le premier accident vasculaire cérébral d'artère perforante pour dépister un début de démence et prévenir les récurrences. PMID:29255546

  7. Clinical value of serum TRAb levels determination in diagnosis of Graves's disease

    International Nuclear Information System (INIS)

    Huang Zhaosui; Huang Chunhong; Liu Kaiyuan; Huang Shengli

    2005-01-01

    Objective: To investigate the clinical diagnostic value of serum TRAb levels determination in patients with Graves' disease. Methods: Serum TRAb (with RRA), FT 3 , FT 4 , TSH (with CLIA) levels were measured in 223 patients with Graves' disease both before and 6, 12, 36 months after treatment with antithyroid drugs (ATD) as well as in 50 controls. Results: Positive rate of serum TRAb was 93.3% in patients with Graves' disease before treatment. Six months after ATD therapy the positive rate dropped to 41.3%, being still significantly higher than that in controls (P<0.05). The TRAb positive rate dropped steadily with 12 (18.3% ), 24 (8.9% ) and 36 months (4.9%) of ATD treatment. In the 21 patients who had hyperthyroidism recurred after the course of treatment, TRAb remained positive in 18 of them (80.7%). Conclusion: Persistent positive TRAb despite euthyroid status in patients with Graves' disease after seemingly successful ATD treatment donates persistent immunodysfunction and possible recurrence. It is mandatory to continue ATD treatment until TRAb negative. (authors)

  8. Les brulures electriques chez les voleurs de cuivre

    Science.gov (United States)

    Belmir, R.; Fejjal, N.; Achbouk, H.; El Mazouz, S.; Gharib, N.; Abassi, A.; Belmahi, A.

    2011-01-01

    Summary Les vols de biens fabriqués avec le cuivre semblent en hausse depuis un certain temps du fait de son prix élevé de revente, ce qui est à l’origine d’une augmentation du nombre d’accidents électriques par haut voltage (AEHV) qui sont graves du fait des brûlures profondes qu’elles provoquent le long des axes vasculo-nerveux. Les Auteurs rapportent une série de neuf cas d’AEHV traités au service de chirurgie plastique et de brûlés de l’Hôpital Ibn Sina de Rabat, Maroc, à travers laquelle ils étudient les caractéristiques épidémiologiques, cliniques et thérapeutiques. La population intéressée était jeune et active. Les brûlures étaient secondaires à un contact avec des câbles à haute tension lors de tentatives de vol par arrachement de conducteurs en cuivre dans les transformateurs dans 67% des cas, et lors de tentatives de coupure de caténaires alimentant les trains électriques sur le réseau ferroviaire dans 33% des cas. Le traitement des lésions électrothermiques a nécessité des interventions itératives avec amputation et désarticulation des segments de membres nécrosés dans 66% des cas, dont les suites étaient marquées par des séquelles fonctionnelles invalidantes. La prévention de ce type d’AEHV reste fondamentale. PMID:22262961

  9. Clinical studies on thyroid CT number in Graves' disease and destructive thyrotoxicosis

    International Nuclear Information System (INIS)

    Kamijo, Keiichi

    1994-01-01

    The purpose of the present study was to investigate CT Hounsfield unit (H.U.) of the thyroid in hyperthyroid and euthyroid Graves' disease and destructive thyrotoxicosis. The mean thyroid CT number in 95 controls was 122±18 H.U.(±SD) and did not change significatly with advancing age. The mean thyroid CT number (±SD) of 85±22 H.U. in 60 patients with hyperthyroid Graves' disease was significantly lower than either in normal controls or 116±22 H.U. in 11 patients with euthyroid Graves' disease. Comparison of thyroid hormones and TSH receptor Ab values of untreated patients with a normal and an abnormally low thyroid CT number showed that serum total and free T 3 were significantly higher in the latter group than the former group. With respect to the effect of methimazol (MMI) on the thyroid CT number, in the untreated 10 patients with a low thyroid CT number, the initial mean CT number was 65±11 H.U. and increased significantly to 76±14 H.U. after treatment with MMI. In contrast, in 6 patients with a normal thyroid CT number prior to therapy, the initial mean thyroid CT number was 102±11 H.U. and fell significantly to 84±16 H.U. after treatment with MMI. The thyroid CT number in destructive thyrotoxicosis is markedly decreased to less than 70 H.U. and the mean values of 57±7 H.U. in 6 patients with silent thyroiditis and of 61±5 H.U. in 7 with subacute thyroiditis differ significantly from Graves' disease. In conclusion, the thyroid CT number is significantly reduced in hyperthyroid Graves' disease, normal in euthyroid Graves' disease and markedly decreased in destructive thyrotoxicosis. The high T-3 value seemed to play an important role in the pathogenesis of a decline in the thyroid CT number in Graves' disease. An antithyroid drug therapy caused two different changes in the thyroid CT number, depending on whether the thyroid CT number prior to therapy was normal or low. (author)

  10. A 27-year-old woman diagnosed as polycystic ovary syndrome associated with Graves' disease.

    Science.gov (United States)

    Jung, Jung Hwa; Hahm, Jong Ryeal; Jung, Tae Sik; Kim, Hee Jin; Kim, Ho Soo; Kim, Sungsu; Kim, Soo Kyoung; Lee, Sang Min; Kim, Deok Ryong; Choi, Won Jun; Seo, Yeong Mi; Chung, Soon Il

    2011-01-01

    Polycystic ovary syndrome (PCOS) and Graves' disease are the common causes of menstrual irregularity leading to infertility in women of child-bearing age. A 21-year-old female patient visited us with complaints of oligomenorrhea and hand tremor. She was diagnosed as having PCOS and hyperthyroid Graves' disease, simultaneously. She had low body weight (BMI: 16.4 kg/m(2)), mild hirsutism, and thyrotoxicosis. The patient was treated with anti-thyroid drug and beta-blocker for about two years, and then recovered to normal thyroid function. Although some studies have suggested a connection between PCOS and autoimmune thyroiditis, no study indicated that PCOS is associated with Graves' disease until now. Here, we describe the first case report of a lean woman with normal insulin sensitivity presenting PCOS and Graves' disease simultaneously.

  11. Doença de Graves associada à artrite idiopática juvenil Graves' disease associated with juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Vanessa de Matos Santos Mendonça Marques

    2011-04-01

    Full Text Available Os autores relatam o caso de uma menina de 10 anos de idade com diagnóstico de doença de Graves (DG, em tratamento com propiltiouracil, que desenvolveu uveíte e artrite poliarticular e cuja mãe também tem DG e lúpus discoide. São discutidos os diagnósticos diferenciais de artrite inflamatória que surge em uma criança com doença tireoidiana autoimune medicada com drogas antitireóideas.The authors report the case of a 10-year-old girl with Graves' disease (GD, treated with propylthiouracil, who developed uveitis and polyarticular arthritis, and whose mother also had GD and discoid lupus. The differential diagnosis of inflammatory arthritis that appears in a child with autoimmune thyroid disease managed with antithyroid drugs is discussed.

  12. Raman spectroscopy of gemstones on the necklaces from ancient graves at the Castle of Devin

    International Nuclear Information System (INIS)

    Gregor, M.; Vanco, L.; Kadlecikova, M.; Breza, J.

    2013-01-01

    The subjects of Raman and X-ray analyses were the beads from two necklaces found in ancient graves from the 11'"t"h and 12"t"h centuries at the Castle of Devin. One of the necklaces, consisting of 23 beads, was found in tomb 12/1980. Inside the grave, an incomplete skeleton of a woman was found, oriented in the west - east direction. The skull, shoulder blades and lower limbs were preserved in good condition. The grave contained a rich inventory: a silver ear-ring at the left side of the skull, a necklace between the shoulder blades and a ring on the right side at the height of the right hand. The other necklace, consisting of six stones, was found in grave 145/1985 in which, similarly like in the first grave, a woman's skeleton was discovered. The stones were found below the mandible. All beads are drilled through axially. (authors)

  13. A Survey of Serious Aircraft Accidents Involving Fatigue Fracture. Volume 2. Rotary-Wing Aircraft (Etude sur des Accidents Importants d’Avions du aux Effets des Fractures de Fatigue. Volume 2. Effets sur des Helicopteres).

    Science.gov (United States)

    1983-04-01

    Convention on International Civil Aviation, Second Edition , March 1966. 5. WORLD AIRLINE ACCIDENT SUMMARY. Civil Aviation Authority, (Great Britain...people who either provided information, or who suggested other sources of information for the current edition of this survey. E.M.R. Alexander Civil...Waverley, New Zealand. F-28C Tail rotor drive shaft. Fatigue strength reduc- ed by softened condition & surface decarbur- isation. AISA 4130 steel. Ref: NZ

  14. Caractérisation de formations Miocène de la région de Taza pour des valorisations et exploitations industrielles Industrial value of the Miocene calcarenites in the region of Taza

    Directory of Open Access Journals (Sweden)

    Lahrach A.

    2012-09-01

    Full Text Available La valorisation de la formation Miocène dans la région de Taza, représentée par les calcarénites, a été menée selon deux axes ; tout d’abord une étude géologique, couplée à des études de terrain nous a permis d’évaluer l’épaisseur de la formation, une carte d’épaisseur a été dressée à cet effet. L’étude géotechnique de ces matériaux révèle que ces calcarénites ont des qualités intéressantes pour des utilisations industrielles. En effet, en se basant sur les différents tests de dureté (Los Angeles et Micro Duval, la résistance à la rupture et la porosité de nos quatre échantillons, une valeur ajoutée industrielle peut leur être attribuée dans beaucoup de domaines, comme: -Graves non traités pour couches de fondations pour les chaussées ou grave bitumeux de fondation; -Ajouts dans les bétons; -Roche marbrière et pierre de façade. En fin, sur la base de ces études géologiques et géotechniques, on peut considérer que les calcarénites de la région de Taza répondent à l’ensemble des critères d’une exploitation industrielle. The valuation of the Miocene formation in the Taza region, represented by calcarenites, was conducted according two axes; first geological survey, coupled with field studies allowed us to evaluate the thickness of the formation, a thickness map was derived from this purpose. The geotechnical study of these materials reveals that these calcarenites have interesting qualities for industrial uses. Indeed, based on the different hardness tests (Los Angeles and Micro Duval, the tensile strength and porosity of our four samples, an industrial added value can be attributed to them in many areas, such as: - Untreated Graves for layers of foundations for pavements or bituminous serious foundation; - Additions in concrete; - Roche marble and stone facade. Finally, on the basis of geological and geotechnical studies, we can consider that the calcarenites of the Taza region meet

  15. Blast pulmonaire primaire chez le brûlé. a propos d’un cas et revue de la littérature

    Science.gov (United States)

    Siah, S.; Emane, A.; Bertin-Maghit, M.

    2016-01-01

    Summary Le blast est à l’origine de lésions spécifiques pour lesquelles une prise en charge spécialisée est nécessaire. Après une explosion on peut observer des lésions de blast primaire, liées à l’onde de choc, secondaire par polycriblage et tertiaire par projection du patient. Les blasts secondaire et tertiaire sont plus fréquents que le blast primaire et peuvent entraîner un polytraumatisme. Dans 5% des cas, on retrouve des brûlures pouvant faire partie du blast quaternaire, qui regroupe toutes les lésions d’autres mécanismes que ceux précités. La prise en charge des lésions secondaires et tertiaires de blast est comparable à celle des traumatisés graves. Le blast pulmonaire primaire aggrave le pronostic des blessés les plus graves mais impose rarement une prise en charge spécifique. La connaissance des particularités physiopathologiques et lésionnelles permet de mieux traiter les blastés et brûlés graves survivants. Nous rapportons une observation de blast pulmonaire primaire chez un brûlé. PMID:28149247

  16. Generalised pruritus as a presentation of Grave's disease.

    Science.gov (United States)

    Tan, Ce; Loh, Ky

    2013-01-01

    Pruritus is a lesser known symptom of hyperthyroidism, particularly in autoimmune thyroid disorders. This is a case report of a 27-year-old woman who presented with generalised pruritus at a primary care clinic. Incidental findings of tachycardia and a goiter led to the investigations of her thyroid status. The thyroid function test revealed elevated serum free T4 and suppressed thyroid stimulating hormone levels. The anti-thyroid antibodies were positive. She was diagnosed with Graves' disease and treated with carbimazole until her symptoms subsided. Graves' disease should be considered as an underlying cause for patients presenting with pruritus. A thorough history and complete physical examination are crucial in making an accurate diagnosis. Underlying causes must be determined before treating the symptoms.

  17. Clinical studies on thyroid CT number in Graves' disease and destructive thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Kamijo, Keiichi (Kamijo Thyroid and Pituitary Clinic, Sapporo (Japan))

    1994-02-01

    The purpose of the present study was to investigate CT Hounsfield unit (H.U.) of the thyroid in hyperthyroid and euthyroid Graves' disease and destructive thyrotoxicosis. The mean thyroid CT number in 95 controls was 122[+-]18 H.U.([+-]SD) and did not change significatly with advancing age. The mean thyroid CT number ([+-]SD) of 85[+-]22 H.U. in 60 patients with hyperthyroid Graves' disease was significantly lower than either in normal controls or 116[+-]22 H.U. in 11 patients with euthyroid Graves' disease. Comparison of thyroid hormones and TSH receptor Ab values of untreated patients with a normal and an abnormally low thyroid CT number showed that serum total and free T[sub 3] were significantly higher in the latter group than the former group. With respect to the effect of methimazol (MMI) on the thyroid CT number, in the untreated 10 patients with a low thyroid CT number, the initial mean CT number was 65[+-]11 H.U. and increased significantly to 76[+-]14 H.U. after treatment with MMI. In contrast, in 6 patients with a normal thyroid CT number prior to therapy, the initial mean thyroid CT number was 102[+-]11 H.U. and fell significantly to 84[+-]16 H.U. after treatment with MMI. The thyroid CT number in destructive thyrotoxicosis is markedly decreased to less than 70 H.U. and the mean values of 57[+-]7 H.U. in 6 patients with silent thyroiditis and of 61[+-]5 H.U. in 7 with subacute thyroiditis differ significantly from Graves' disease. In conclusion, the thyroid CT number is significantly reduced in hyperthyroid Graves' disease, normal in euthyroid Graves' disease and markedly decreased in destructive thyrotoxicosis. The high T-3 value seemed to play an important role in the pathogenesis of a decline in the thyroid CT number in Graves' disease. An antithyroid drug therapy caused two different changes in the thyroid CT number, depending on whether the thyroid CT number prior to therapy was normal or low. (author).

  18. A controlled monitoring study of simulated clandestine graves using 3D ground penetrating radar

    CSIR Research Space (South Africa)

    van Schoor, Michael

    2017-06-01

    Full Text Available A controlled three-dimensional ground penetrating radar monitoring study over simulated clandestine graves was conducted near Pretoria, South Africa, in which the detectability of graves as a function of post-burial interval was assessed...

  19. Graves' disease presenting as right heart failure with severe pulmonary hypertension

    OpenAIRE

    Furqan Mohd Akram Khan; Anannya Mukherji; Shekhar T. Nabar; Ashwini G

    2016-01-01

    We report a patient who presented to our institution with clinical features of right sided heart failure and hyperthyroidism. Diagnosis of grave's disease induced reversible severe pulmonary hypertension leading to severe tricuspid regurgitation and right sided heart failure was made after all the common causes were ruled out using the biochemical and radiological investigations and review of literature. Graves disease is a common cause hyperthyroidism, is an immune system disorder that resul...

  20. Diagnosis and differential diagnosis of Graves' orbitopathy in MRI; Diagnose und Differenzialdiagnose der endokrinen Orbitopathie in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Daubner, D.; Spieth, S.; Engellandt, K.; Kummer, R. von [Universitaetsklinikum Carl Gustav Carus, Technische Universitaet Dresden, Abteilung Neuroradiologie, Institut und Poliklinik fuer Radiologische Diagnostik, Dresden (Germany)

    2012-06-15

    Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.) [German] Die Bildgebung der endokrinen Orbitopathie (EO) umfasst radiologische und nuklearmedizinische Verfahren, die je nach Methode Aussagen zur Verteilung und Aktivitaet der Erkrankung liefern. Die Magnetresonanztomographie (MRT) ist nicht nur zur Diagnosestellung hilfreich, sondern auch in der Lage, die aktive von der inaktiven Form anhand des intramuskulaeren Oedems zu unterscheiden. Das Verfahren eignet sich deshalb auch zur Aktivitaetsbeurteilung und zur Bewertung einer Therapie im Verlauf. Die Erkrankung fuehrt zu einer typischen Verdickung des Muskelbauchs der extraokulaeren Augenmuskeln, wobei die Mm. rectus inferior, rectus medialis und levator palpebrae am haeufigsten betroffen sind. Signalveraenderungen des intra- und extrakonalen Fettgewebes sind moeglich, und eine bilaterale Manifestation ist haeufig. Die Differenzialdiagnose umfasst neben anderen

  1. First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

    Science.gov (United States)

    Chen, Louis C; Green, Jennifer B

    2011-06-01

    Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range disease was the most likely diagnosis. As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

  2. The microclimate within a Neolithic passage grave

    DEFF Research Database (Denmark)

    Klenz Larsen, Poul; Aasbjerg Jensen, Lars; Ryhl-Svendsen, Morten

    2017-01-01

    Microclimate measurements in a Neolithic passage grave in Denmark have shown that natural ventilation through the open entrance destabilizes the relative humidity (RH), whereas a sealed entrance gives a much more stable RH, above 90%. Episodes of condensation occur on the stone surfaces in summer...... with too much ventilation and in winter with too little ventilation. Soil moisture measurements above, below, and beside the grave mound indicate that rainfall on the mound is not a significant source of moisture to the chamber, whereas the ground below the sealed chamber is constantly moist. The chamber...... can be kept dry all year by putting a moisture barrier membrane over the floor. Apart from the more variable climate within the open chamber, there is also a significant penetration of ozone, which is absent in the sealed chamber. The ozone may have deteriorated the folds of birch bark put between...

  3. Graves' disease presenting as pseudotumor cerebri: a case report

    Directory of Open Access Journals (Sweden)

    Freitas Cláudia

    2011-02-01

    Full Text Available Abstract Introduction Pseudotumor cerebri is an entity characterized by elevated intracranial pressure with normal cerebrospinal fluid and no structural abnormalities detected on brain MRI scans. Common secondary causes include endocrine pathologies. Hyperthyroidism is very rarely associated and only three case reports have been published so far. Case presentation We report the case of a 31-year-old Luso-African woman with clinical symptoms and laboratory confirmation of Graves' disease that presented as pseudotumor cerebri. Conclusion This is a rare form of presentation of Graves' disease and a rare cause of pseudotumor cerebri. It should be remembered that hyperthyroidism is a potential cause of pseudotumor cerebri.

  4. Severe aplastic anaemia and Grave's disease in a paediatric patient.

    Science.gov (United States)

    Kumar, Manjusha; Goldman, Jeffrey

    2002-07-01

    Severe aplastic anaemia (SAA) is considered to be an autoimmune disorder affecting the haematopoietic cells and most often is idiopathic. An association between SAA and other autoimmune diseases is rare and has been described in adults for eosinophilic fasciitis, thymomas, systemic lupus erythematosus and thyroid disorders. We describe the first paediatric patient with chronic relapsing SAA and Grave's disease. We discuss the difficulty in diagnosis of Grave's disease, the possibility of its manifestation due to withdrawal of immunosuppressants, and issues to consider in the treatment of this disease in the setting of bone marrow failure.

  5. Tombes et cimetières éthiopiens : des rois, des saints, des anonymes1

    OpenAIRE

    Derat, Marie-Laure

    2009-01-01

    L’histoire des tombes et cimetières éthiopiens, dans la longue durée, en est encore à ses balbutiements. Si les tombes des saints et des rois nous sont un peu mieux connus grâce à des textes témoignant à la fois des enjeux entourant les sépultures de ces personnages hors du commun et des soins apportés à leur inhumation, en revanche, les cimetières ordinaires échappent encore largement à l’enquête, en grande partie parce que le commun des mortels est inhumé dans l’anonymat et dans un grand dé...

  6. Évaluation des pratiques agricoles des légumes feuilles : le cas des ...

    African Journals Online (AJOL)

    Face à ce constat, le défi de la recherche serait la détermination du niveau actuel de contamination des légumes feuilles et des eaux du barrage et celui de l'État serait l'initiation de programmes de sensibilisation des producteurs par rapport à une gestion plus rigoureuse des pesticides. Mots-clés : pratiques paysannes, ...

  7. A Survey of Serious Aircraft Accidents Involving Fatigue Fracture. Volume 1. Fixed-Wing Aircraft (Etude sur des Accidents Importants d’Avions du aux Effets des Fractures de Fatigue. Volume 1. Effets sur des Avions).

    Science.gov (United States)

    1983-04-01

    17 Jan 68 0 S Dell Rapidis, S.Dak. USA. Bonanza Propeller cylinder attach screws. Propeller in service approx. 170 hr . F85 Beech K35 5 Sep 69 4 D Provo...Ice land Iraq Ireland Jamaica (1966 -1981) Japan (1973 - Feb. 81) Kenya Lethoso Malaysia Ma law i Mal ta Mexico Netherlands New Zealand Norway...Laboratories, Australia. E. Keller Federal Aircraft Accident Investigation Bureau, Switzerland. Quek Seng Kiew Civil Aviation Dept., Malaysia . Tor B

  8. Paramètres d’évaluation des programmes de prévention des blessures chez les jeunes travailleurs occupant des professions à haut risque : examen de la portée de la littérature

    Directory of Open Access Journals (Sweden)

    Jennifer Smith

    2018-01-01

    Full Text Available Introduction. Malgré la protection juridique dont les jeunes travailleurs au Canada font l’objet, les jeunes de 15 à 24 ans sont exposés à un risque élevé de blessures traumatiques au travail. Étant donné que de nombreuses initiatives de prévention des blessures ciblant les jeunes travailleurs existent, les défenseurs des droits des jeunes et les employeurs doivent relever le défi de choisir quels aspects de la prévention vont être les plus efficaces afin d’y consacrer leurs efforts. Une analyse de la littérature universitaire et de la littérature grise a été entreprise afin de compiler les paramètres (indicateurs évalués et méthodes de mesure couramment utilisés pour évaluer les programmes de prévention des blessures auprès des jeunes travailleurs. Les paramètres constituent des références de mesure permettant d’évaluer l’efficacité, le rendement, le progrès ou la qualité d’un projet, d’un procédé ou d’un produit. Méthodologie. Nous avons utilisé le modèle PICO pour définir les termes de recherche. Des recherches ont été effectuées dans Medline, PubMed, OVID, EMBASE, CCOHS, PsychINFO, CINAHL, NIOSHTIC, Google Scholar et dans la littérature grise afin de trouver des articles en anglais publiés entre 1975 et 2015. Deux lecteurs critiques indépendants ont examiné la liste des articles et ont classé les paramètres en trois catégories de prévention des blessures : l’éducation, l’environnement et l’application de règlements. Résultats. Sur les 174 articles ayant répondu aux critères d’inclusion, 21 décrivaient et évaluaient une intervention. Parmi ceux-ci, la moitié (n=11 étaient à caractère éducatif. Les paramètres couramment évalués étaient : les connaissances, les perceptions, les comportements ou les intentions autodéclarées, l’exposition aux dangers, les demandes d’indemnisation pour blessures et le taux d’accidents de travail. Une étude pr

  9. Genotypes in relation to phenotypic appearance and exposure to environmental factors in Graves' hyperthyroidism

    NARCIS (Netherlands)

    Vos, Xander G.; Endert, Erik; Tijssen, Jan G. P.; Wiersinga, Wilmar M.

    2012-01-01

    Background: Genetic polymorphisms and environmental factors are both involved in the pathogenesis of Graves' disease, but their interaction and effect on Graves' phenotypes have scarcely been investigated. Objective: To test the hypothesis that subjects with susceptibility genotypes develop more

  10. La convergence des rôles respectifs des relationnistes et des journalistes influence-t-elle la perception qu'ils ont les uns des autres?

    DEFF Research Database (Denmark)

    Valentini, Chiara

    2017-01-01

    la convergence des rôles respectifs des praticiens des relations publiques et des journalistes a un effet favorable sur la perception qu’ils ont les uns des autres. L’effet est plus marqué chez les praticiens des relations publiques, car leur vision de la profession en journalisme correspond à celle...

  11. Mécanique des sols et des roches

    CERN Document Server

    Vullier, Laurent; Zhao, Jian

    2016-01-01

    La mécanique des sols et la mécanique des roches sont des disciplines généralement traitées séparément dans la littérature. Pour la première fois, un traité réunit ces deux spécialités, en intégrant également les connaissances en lien avec les écoulements souterrains et les transferts thermiques. A la fois théorique et pratique, cet ouvrage propose tout d'abord une description détaillée de la nature et de la composition des sols et des roches, puis s'attache à la modélisation de problèmes aux conditions limites et présente les essais permettant de caractériser les sols et les roches, tant d'un point de vue mécanique qu'hydraulique et thermique. La problématique des sols non saturés et des écoulements multiphasiques est également abordée. Une attention particulière est portée aux lois de comportement mécanique et à la détermination de leurs paramètres par des essais in situ et en laboratoire, et l'ouvrage offre également une présentation détaillée des systèmes de classi...

  12. The Why and How of Nuclear Accident Dosimetry; Dosimetrie en cas d'Accident Nucleaire: Raison d'Etre et Modalites; 041e 0411 041e 0421 041d 041e 0412 0414 ; Dosimetria en Casos de Accidente Nuclear: Justificacion y Modalidades

    Energy Technology Data Exchange (ETDEWEB)

    Vallario, E. J.; Wasson, H. R. [United States Atomic Energy Commission, Washington, DC (United States)

    1965-06-15

    The objective of an effective nuclear accident dosimetry programme is to ensure that a means is provided for estimating the gamma neutron dose from a nuclear accident. In this connection, the limitation of the film badge is discussed, in addition to certain accident experiences which demonstrate the need for an effective accident dosimetry programme at facilities having a potential for nuclear accidents. Certain basic parameters should be considered in the development of an effective nuclear accident dosimetry programme. These are (a) a method for screening personnel involved in nuclear accidents, (b) a fixed system (primary unit) capable of determining first collision dose within some established degree of accuracy at its point of location, (c) the need for ''secondary units'', and (d) the need for a device worn by personnel which would afford spectrum and flux information to assist in dose extrapolation from the fixed unit to the location of man. The neutron component of the system should permit flux and spectral information in order to arrive at appropriate quality factors in the dose estimation. Accuracies should be established based upon the current state of the art. The gamma -ray component of the system should permit measuring gamma radiation within the biological area of interest, i. e. from 10 to 10{sup 3}r. Consideration for the number, placement and ease of recovery of accident units are indeed an integral part of an effective system of accident dosimetry. These considerations should enable reasonable data collection across the entire fission spectrum. (author) [French] L'objet d'un programme efficace de dosimetrie en cas d'accident nucleaire est d'evaluer la dose de rayons gamma et de neutrons emise lors d'un acccident nucleaire. Le memoire examine les limitations des dosimetres a film et expose les circonstances accompagnant certains accidents, lesquelles demontrent la necessite de prevoir un programme efficace de dosimetrie dans les installations ou

  13. Multiple Fractures in Patient with Graves' Disease Accompanied by Isolated Hypogonadotropic Hypogonadism.

    Science.gov (United States)

    Yi, Hyon-Seung; Kim, Ji Min; Ju, Sang Hyeon; Lee, Younghak; Kim, Hyun Jin; Kim, Koon Soon

    2016-02-01

    Isolated hypogonadotropic hypogonadism (IHH) is known to decrease bone mineral density due to deficiency of sex steroid hormone. Graves' disease is also an important cause of secondary osteoporosis. However, IHH does not preclude the development of primary hyperthyroidism caused by Graves' disease, leading to more severe osteoporosis rapidly. Here, we describe the first case of 35-year-old Asian female patient with IHH accompanied by Graves' disease and osteoporosis-induced multiple fractures. Endocrine laboratory findings revealed preserved anterior pituitary functions except for secretion of gonadotropins and showed primary hyperthyroidism with positive autoantibodies. Sella magnetic resonance imaging showed slightly small sized pituitary gland without mass lesion. Dual energy X-ray absorptiometry revealed severe osteoporosis in lumbar spine and femur neck of the patient. Plain film radiography of the pelvis and shoulder revealed a displaced and nondisplaced fracture, respectively. After surgical fixation with screws for the femoral fracture, the patient was treated with antithyroid medication, calcium, and vitamin D until now and has been recovering fairly well. We report a patient of IHH with Graves' disease and multiple fractures that is a first case in Korea.

  14. B-cell depletion with rituximab in the treatment of autoimmune diseases. Graves' ophthalmopathy the latest addition to an expanding family

    DEFF Research Database (Denmark)

    Nielsen, Claus H; El Fassi, Daniel; Hasselbalch, Hans K

    2007-01-01

    In this review, the authors summarise the clinical results obtained after therapy with rituximab in autoimmune diseases, including Graves' disease and Graves' ophthalmopathy. On the basis of qualitative and quantitative analyses of B- and T-cell subsets, and autoantibody levels obtained in other...... diseases before and after rituximab therapy, the authors interpret the results of the only two clinical investigations of the efficacy of rituximab in the treatment of Graves' disease and Graves' opthalmopathy reported so far. No significant effect on autoantibody levels was observed. Nonetheless, 4 out...... of 10 Graves' disease patients remained in remission 400 days after rituximab treatment versus none in the control group, and remarkable improvements in the eye symptoms of patients with Graves' ophthalmopathy were observed. This supports a role for B cells in the pathogenesis of Graves' ophthalmopathy...

  15. Outcomes analysis of radioactive iodine and total thyroidectomy for pediatric Graves' disease.

    Science.gov (United States)

    Cohen, Reuven Zev; Felner, Eric I; Heiss, Kurt F; Wyly, J Bradley; Muir, Andrew B

    2016-03-01

    The majority of pediatric patients with Graves' disease will ultimately require definitive therapy in the form of radioactive iodine (RAI) ablation or thyroidectomy. There are few studies that directly compare the efficacy and complication rates between RAI and thyroidectomy. We compared the relapse rate as well as the acute and long-term complications of RAI and total thyroidectomy among children and adolescents with Graves' disease treated at our center. Medical records from 81 children and adolescents with a diagnosis of Graves' disease who received definitive therapy over a 12-year period were reviewed. Fifty one patients received RAI and 30 patients underwent thyroidectomy. The relapse rate was not significantly different between RAI and thyroidectomy (12.1% vs. 0.0%, p=0.28). There were no acute or long-term complications in the RAI group, but there were eight cases of hypoparathyroidism (two transient and six permanent) in the thyroidectomy group. None of the patients developed a recurrent laryngeal nerve injury. RAI is a safe and effective option for treatment of children and adolescents with Graves' disease. In light of the rate of permanent hypoparathyroidism seen at our center with thyroidectomy and previously published long-term safety of RAI, we recommend RAI as the first line treatment for children and adolescents with Graves' disease. For those centers performing thyroidectomies, we recommend that each center select 1-2 high-volume pediatric surgeons to perform all thyroid procedures, allowing individuals to increases case volume and potentially decrease long-term complications of thyroidectomy.

  16. Le Pseudomonas: Experience du Centre des Brules D’Annaba et Revue de la Litterature

    Science.gov (United States)

    Chaibdraa, A.; Medjellekh, M.S.; Saouli, A.; Bentakouk, M.C.

    2008-01-01

    Summary Le Pseudomonasest un agent pathogène à l'origine d'infections nosocomiales graves dans les centres des brûlés. Son opportunisme et sa virulence en font une préoccupation majeure. Ce travail se propose d'évaluer la place de cette bactérie dans l'écologie bactérienne locale et d'en apprécier la sensibilité aux antibiotiques. Cette étude rétrospective préliminaire porte sur la période de juin 2003 à décembre 2005. Elle intéresse l'ensemble des prélèvements bactériologiques ayant pu être réalisés au centre des brûlés d'Annaba. L'effectif est de 633 micro-organismes isolés dont 128 Pseudomonas (20,2%): 127 aeruginosa (99,2%), 1 fluorescens (0,8%); distribution selon le site de prélèvement: écouvillon (87,5%), prélèvement trachéobronchique (4,6%), hémoculture (3,1%), cathéters (1,6%), urine (1,6%) et sonde urinaire (1,6%). Le pyocyanique se situe après le staphylocoque pour les prélèvements précoces et repasse en tête après un séjour supérieur à une semaine, où 89% des pyocyaniques sont identifiés. Il est en première position dans les pneumopathies sous ventilation assistée invasive. Il se classe troisième dans les hémocultures et les cultures de cathéters. Dans les infections urinaires il est devancé par Candida et la flore périnéale. Les 128 antibiogrammes regroupent 314 réponses sensibles. La sensibilité à plus de deux antibiotiques est de 68%, à deux antibiotiques 24% et à un antibiotique 8%. Seules quatre molécules restent actives: ciprofloxacine > péfloxacine > pipéracilline > ceftazidime. Une résistance absolue est retrouvée pour trois Pseudomonas (2,4%). Le pronostic sévère des infections nosocomiales à pyocyanique et les risques d'options thérapeutiques très limitées font toute leur gravité, d'où l'intérêt de respecter des règles strictes de prescription des antibiotiques et des mesures de prévention. PMID:21991140

  17. Prenatal diagnosis and management of fetal goiter caused by maternal Grave's disease.

    Science.gov (United States)

    Hadi, H A; Strickland, D

    1995-07-01

    We present a case of maternal Grave's disease associated with fetal goitrous hyperthyroidism. Fetal goiter was diagnosed by ultrasound and diagnosis of fetal hyperthyroidism was established by umbilical blood sampling. Fetus was successfully treated by increasing maternal propylthiouracil dosage. Fetal thyroid status was normal at birth. Role of sonography and umbilical blood sampling in management of fetal goiter complicated with maternal Grave's disease is discussed.

  18. Evaluation of sanitary consequences of Chernobylsk accident in France. Epidemiological surveillance plan, state of knowledge, risks evaluation and perspectives; Evaluation des consequences sanitaires de l'accident de Tchernobyl en France. Dispositif de surveillance epidemiologique, etat des connaissances, evaluation des risques et perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Verger, P.; Cherie-Challine, L

    2000-12-15

    This report jointly written by IPSN and InVS, reviews the sanitary consequences in France of the Chernobyl accident, which occurred in 1986. The first point is dedicated to a short presentation of the knowledge relative to the sanitary consequences of the Chernobyl accident in the high contaminated countries and to the risk factors of the thyroid cancer. Secondly, this report describes the main systems of epidemiological surveillance of health implemented in France in 1986 and in 1999, as well as the data of the incidence and mortality of thyroid cancer observed in France since 1975. In addition, this report presents an analysis of the risk of thyroid cancer related to radioactive contamination in France, for young people of less than 15 years of age who where living in 1986 in the highest contaminated areas of France (Eastern territories). For this purpose, the theoretical number of thyroid cancers in excess is evaluated for this population, on the basis of different available risk model. Finally starting from the results of risk assessment, there is a discussion about the relevance and the feasibility of different epidemiological methods in view of answering the questions related to the sanitary consequences of the Chernobyl accident. In conclusion, this report recommends to reinforce the surveillance of thyroid cancer in France. (author)

  19. The role of radiation therapy in Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Chowdhury, A.D.; Moriaty, M.J. [Saint Luke`s Hospital, Dublin (Ireland)

    1996-11-01

    Graves` ophthalmopathy can occur in 25-30% of patients with hyperthyroidism. This condition can result in serious visual disturbance and disfigurement. The treatment options for symptomatic disease are oral corticosteroids or orbital irradiation. Ten patients with Graves` ophthalmopathy were treated with external beam radiotherapy at Saint Lukes Hospital from March 1991 to February 1994. Eight of these patients had excellent response with minimal morbidity. A dose of 2000 cGy in 10 fractions over 2 weeks is considered to be sufficient to alleviate symptoms in most patients. It is concluded that orbital radiotherapy is effective and well tolerated, and should replace corticosteroid therapy as the initial treatment modality in these patients. A minimum follo-up of 6 months is considered adequate for detecting radiation-induced complications. 7 refs., 1 fig.

  20. [Orbital decompression in Grave's disease: comparison of techniques].

    Science.gov (United States)

    Sellari-Franceschini, S; Berrettini, S; Forli, F; Bartalena, L; Marcocci, C; Tanda, M L; Nardi, M; Lepri, A; Pinchera, A

    1999-12-01

    Grave's ophthalmopathy is an inflammatory, autoimmune disorder often associated with Grave's disease. The inflammatory infiltration involves the retrobulbar fatty tissue and the extrinsic eye muscles, causing proptosis, extraocular muscle dysfunction and often diplopia. Orbital decompression is an effective treatment in such cases, particularly when resistant to drugs and external radiation therapy. This work compares the results of orbital decompression performed by removing: a) the medial and lateral walls (Mourits technique) in 10 patients (19 orbits) and b) the medial and lower walls (Walsh-Ogura technique) in 17 patients (31 orbits). The results show that removing the floor of the orbit enables better reduction of proptosis but more easily leads to post-operative diplopia. Thus it proves necessary to combine the two techniques, modifying the surgical approach on a case-by-case basis.

  1. Influence des déformations tectoniques sur les caractéristiques pétrophysiques matricielles des réservoirs calcaires Influence of Tectonic Deformation on the Petrophysical Matrix Properties of Limestone Reservoirs

    Directory of Open Access Journals (Sweden)

    Trémolières P.

    2006-11-01

    Full Text Available Cet article présente les principaux résultats d'une étude menée en commun par l'Institut Français du Pétrole (IFP et la Société Nationale Elf Aquitaine (Production (SNEA (P, étude qui avait pour but de rechercher l'influence des contraintes tectoniques sur les propriétés pétrophysiques matricielles des réservoirs calcaires. Ces travaux, ayant porté principalement surle Burdigalien des Alpilles (Provence et accessoirement sur le Turonien de Mareuil (Aquitaine et la « Scaglia bianca » du Monte Conero (Ancàne-Itatie, ont permis de mettre en évidence - des variations importantes de la porosité et de la perméabilité en fonction de la position structurale du matériau et, à plus petite échelle, de la courbure des couches; - un double processus de la réduction des porosité et perméabilité : soit par tassement mécanique, soit par cristallisation dans les pores d'une calcite provenant probablement d'une dissolution le long de joints stylolithiques d'origine tectonique. On montre enfin qu'en certaines zones particulières (dans les périclinaux ou à l'aplomb d'accidents profonds jouant en faille inverse les effets des contraintes tectoniques sur les qualités matricielles peuvent être très importants et survenir avant la structuration des couches par plissement. This article describes the main results of a joint Institut Français du Pétrole (IFP-Société Nationale Elf Aquitaine (Production (SNEA (P research project on the influence of tectonic stresses on thé petrophysical matrix properties of limestone reservoirs. Research mainly concentrated on the Burdigalien from the Alpilles mountains in ihe Provence région and accessorily on the Turonian from Mareuil in the Aquitaine region and Scaglia Bianca from Monte Conero in Anconia, Italy. The following findings were made: - considerable variations in porosity and permeability can be found, depending on the structural position of the material and, on a smaller scale, on the

  2. Case report of recurrent atrial fibrillation induced by thyrotropin-secreting pituitary adenoma with Graves' disease.

    Science.gov (United States)

    Li, Jiaqi; Tan, Huiwen; Huang, Juan; Luo, Dan; Tang, Ying; Yu, Ruichao; Huang, Hui

    2018-06-01

    Thyrotropin-secreting adenoma (TSHoma) is rare. Even though the thyrotoxicosis is mild in patients with TSHoma, it is still a rare cause of arrhythmia, ignore of mild disfunction of thyroid function of TSHoma can lead to the delayed diagnosis of pituitary tumor or leading to recurring of complications. Graves' disease is an auto-immue endocrinological disorder. Association of TSHoma and Graves's disease is extremely rare. Coexistence of these two diseases made the diagnosis and treatment complicated. This patient was a 55-year-old man who had been referred to the department of endocrinology and metabolism of the West China Hospital due to recurrent atrial fibrillation (AF) and thyroxicosis. Examinations revealed pituitary thyrotropin-secreting macroadenoma with Graves' disease. We conducted transsphenoidal surgery. Thyrozol was used to treat the recurrence of Graves' disease after pituitary surgery. The TSHoma was successfully cured, and recurrent Graves' disease was controlled very well. The association of TSHoma and Graves' disease is extremely rare. Even though the clinical features of thyrotoxicosis are milder in patients with TSHoma, thyroid function tests are still important clinical assessment of patients with AF, which is an arrhythmia associated with hyperthyroidism. TSHoma is a rare cause of thyrotoxicosis; however, ignoring of the mild disfunction caused by TSHoma can lead to the delayed diagnosis of pituitary tumors or to recurring of complications of TSHoma.

  3. The role of diffusion weighted MR imaging for differentiation between Graves' disease and Hashimoto thyroiditis.

    Science.gov (United States)

    Ozturk, T; Bozgeyik, Z; Ozturk, F; Burakgazi, G; Akyol, M; Coskun, S; Ozkan, Y; Ogur, E

    2015-08-01

    The aim of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWMRI) for differentation between Graves' disease and Hashimoto's thyroiditis. Fifty patients (27 Graves diseases and 23 Hashimoto thyroiditis) and twenty healthy volunteers were examined using T1, T2 and DWMRI. The patients were diagnosed on the basis of physical findings and the results of thyroid function tests and serological tests. Circular ROIs were positioned on the bilateral thyroid lobes and isthmus. All measurements were repeated three different b values including 100, 600 and 1000 s/mm2 in all cases. ADC (Apparent diffusion coefficient) maps were calculated automatically with the MR system. Mean ADC values were 2.93 × 10-3, 1.97 × 10-3 and 1.62 × 10-3 mm2/s in the healthy volunteers; 3.47 × 10-3, 2.25 × 10-3 and 1.64 × 10-3 mm2/s in Graves' disease; 2.53 × 10-3, 1.76 × 10-3, 1.28 × 10-3 mm2/s in Hashimoto thyroiditis for b100, b600 and b1000, respectively. The ADC values of the Graves diseases were higher than healty volunteers and Hashimoto thyroiditis. ADC values were statistically significant for differentation between Hashimoto thyroiditis and Graves' disease all b values (p Hashimoto thyroiditis and Graves' disease.

  4. Measurements of Actual Effective Half - Life in {sup 131}I Therapy for Graves' Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    So, Yong Seon; Kim, Myung Seon; Kwon, Ki Hyun; Kim, Seok Whan; Kim, Tae Hyung; Han, Sang Woong; Kim, Eun Sil; Kim, Chong Soon [Hanil General Hospital, Seoul (Korea, Republic of)

    1996-03-15

    Radioiodine[131I] has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and read minister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective 131I half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean administered activity and the mean values of absorbed doses wet: 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51 MBq and marked differences of 131I thyroidal uptake between tracer and therapy occurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal 131I uptake measurements after tracer and therapy dose, provides sufficient data about the effective treatment in Graves' hyperthyroidism.

  5. The international cooperation using the example of the reactor accident in Chernobyl; Die internationale Zusammenarbeit am Beispiel des Tschernobylunfalls

    Energy Technology Data Exchange (ETDEWEB)

    Molitor, Norbert [PLEJADES GmbH - Independent Experts, Griesheim (Germany)

    2017-10-01

    The explosion of the reactor unit 4 of the NPP Chernobyl and the subsequent fire was up to now the most severe accident in the civil nuclear industry. The consequences of the accident far outside the Ukraine and the former Soviet Union demonstrated that nuclear safety is a trans-border challenge. The mitigation of the accident consequences and the recovery of safety for the public, the workers and the environment required outstanding efforts and the international cooperation was of significant importance. The contribution discusses experiences and practical aspects of the international cooperation and implications for future cooperation options for the long-term removal of accident consequences.

  6. Évaluation des pratiques agricoles des légumes feuilles : le cas des ...

    African Journals Online (AJOL)

    SARAH

    30 sept. 2017 ... ... de Biochimie et Immunologie Appliquée, Centre de Recherche en Sciences Biologiques, Alimentaires et .... l'intoxication des agriculteurs et des consommateurs, ... source d'alimentation en eau et au pouvoir d'achat des.

  7. Treatment of Graves' disease and the course of ophthalmopathy

    International Nuclear Information System (INIS)

    Sridama, V.; DeGroot, L.J.

    1989-01-01

    Contradictory results have been obtained with regards to the effect of various treatment modes on the exacerbation of Graves' ophthalmopathy, probably because the number of patients in each study was small and some studies were analyzed only in relation to one type of treatment. To circument these problems, we studied the course of Graves' ophthalmopathy after various modes of therapy for thyrotoxicosis among 537 patients with Graves' disease. A total of 537 patients with Graves' disease were prospectively studied over an 11-year period. Thirty-one patients were lost to follow-up during the first six months after treatment and were excluded from the study. Of those remaining, 426 received one form of treatment, 79 received two kinds of therapy, and one received three kinds of therapy. Thus, surgical treatments numbered 164, radioactive iodine-131 ( 13 1I) treatments numbered 241, and medical treatments numbered 182. Ocular signs were considered improved or exacerbated by the following criteria: decrement or increment of the exophthalmos of 2 mm or more, improvement or deterioration of visual acuity, and regression or progression of extraocular muscle involvement causing diplopia. Among patients who did not have infiltrative ophthalmopathy before treatment, there was no difference in the occurrence of posttreatment exophthalmos in the surgically, medically, and 131I-treated patients (7.1%, 6.7%, and 4.9%, respectively). The incidence and the degree of progression of ophthalmopathy in patients who already had exophthalmos before treatment were similar in the medically, surgically, and 131I-treated groups (19.2%, 19.8%, and 22.7%, respectively). Most of the progression occurred in the posttreatment euthyroid stage. The incidence of improvement of ophthalmopathy was also similar 14.1%, 12.6%, and 12.3% in the medically, surgically, and 131I-treated patients

  8. Radioiodine therapy in patients with Graves' disease and the effects of prior carbimazole therapy.

    Science.gov (United States)

    Karyampudi, Arun; Hamide, Abdoul; Halanaik, Dhanapathi; Sahoo, Jaya Prakash; Kamalanathan, Sadishkumar

    2014-09-01

    The use of radioiodine as the first line of treatment in Graves' disease is restricted in India because of its limited availability and an unrealistic risk perception associated with it. Additionally, the effectiveness of radioiodine ablation in Graves' disease is influenced by many factors. Prior medical antithyroid therapy is one such important factor. To analyze the efficacy of low dose radioiodine therapy (5 mCi) in treatment of naive patients of Graves' disease in comparison to that in which it was already primed with an antithyroid drug, carbimazole. A non-randomized, interventional study conducted in the Department of Medicine and Endocrinology of a tertiary care institute in South India. The study had two groups; Group A (36 treatment naive, uncomplicated Graves' disease patients) and B (34 Graves' disease patients on carbimazole prior to radioiodine therapy). Both groups had baseline clinical, biochemical evaluation and were reassessed at 3 and 6 months for evaluating the clinical status for possible documentation of cure. The cure rate was 61.1% in drug naive group and 58.8% in pretreated group at 6 months following radioiodine (P = 0.845). Higher baseline 999m technicium (99m Tc) uptake, male gender, BMI and higher baseline free thyroxine (fT4) level predicted treatment failure following radioiodine therapy. Administration of carbimazole prior to low dose radioiodine therapy does not alter the efficacy of radioiodine. Low fixed dose (5 mCi) of radioactive iodine may be a safe and effective primary therapeutic option in Graves' disease patients pretreated with antithyroid drugs.

  9. Accident management for severe accidents

    International Nuclear Information System (INIS)

    Bari, R.A.; Pratt, W.T.; Lehner, J.; Leonard, M.; Disalvo, R.; Sheron, B.

    1988-01-01

    The management of severe accidents in light water reactors is receiving much attention in several countries. The reduction of risk by measures and/or actions that would affect the behavior of a severe accident is discussed. The research program that is being conducted by the US Nuclear Regulatory Commission focuses on both in-vessel accident management and containment and release accident management. The key issues and approaches taken in this program are summarized. 6 refs

  10. Long-term sequential monitoring of controlled graves representing common burial scenarios with ground penetrating radar: Years 2 and 3

    Science.gov (United States)

    Schultz, John J.; Walter, Brittany S.; Healy, Carrie

    2016-09-01

    Geophysical techniques such as ground-penetrating radar (GPR) have been successfully used for forensic searches to locate clandestine graves and physical evidence. However, additional controlled research is needed to fully understand the applicability of this technology when searching for clandestine graves in various environments, soil types, and for longer periods of time post-burial. The purpose of this study was to determine the applicability of GPR for detecting controlled graves in a Spodosol representing multiple burial scenarios for Years 2 and 3 of a three-year monitoring period. Objectives included determining how different burial scenarios are factors in producing a distinctive anomalous response; determining how different GPR imagery options (2D reflection profiles and horizontal time slices) can provide increased visibility of the burials; and comparing GPR imagery between 500 MHz and 250 MHz dominant frequency antennae. The research site contained a grid with eight graves representing common forensic burial scenarios in a Spodosol, a common soil type of Florida, with six graves containing a pig carcass (Sus scrofa). Burial scenarios with grave items (a deep grave with a layer of rocks over the carcass and a carcass wrapped in a tarpaulin) produced a more distinctive response with clearer target reflections over the duration of the monitoring period compared to naked carcasses. Months with increased precipitation were also found to produce clearer target reflections than drier months, particularly during Year 3 when many grave scenarios that were not previously visible became visible after increased seasonal rainfall. Overall, the 250 MHz dominant frequency antenna imagery was more favorable than the 500 MHz. While detection of a simulated grave may be difficult to detect over time, long term detection of a grave in a Spodosol may be possible if the disturbed spodic horizon is detected. Furthermore, while grave visibility increased with the 2D

  11. Modelisation des effets physico-techniques pour la conception des ...

    African Journals Online (AJOL)

    automatisation dans les installations industrielles a besoin d'une régulation automatique des commandes des processus technologiques pour lesquelles certaines contraintes sont à relever compte tenu des exigences des innovations scientifiques de ...

  12. Graves' disease in children: long-term outcomes of medical therapy.

    Science.gov (United States)

    Rabon, Shona; Burton, Amy M; White, Perrin C

    2016-10-01

    Management options are limited for the treatment of Graves' disease, and there is controversy regarding optimal treatment. We describe the demographic and biochemical characteristics of children with Graves' disease and the outcomes of its management. This is a retrospective study reviewing medical records from 2001 to 2011 at a tertiary-care paediatric hospital. Diagnostic criteria included elevated free T4 and total T3, suppressed TSH, and either positive thyroid-stimulating immunoglobulin or thyroid receptor antibodies or clinical signs suggestive of Graves' disease, for example exophthalmos. Patients were treated with antithyroid drugs (ATD), radioactive iodine, or thyroidectomy. The main outcome measures were remission after medical therapy for at least 6 months and subsequent relapse. A total of 291 children met diagnostic criteria. A total of 62 were male (21%); 117 (40%) were Hispanic, 90 (31%) Caucasian, and 59 (20%) African American. Mean age (±standard deviation) at diagnosis was 12·3 ± 3·8 (range 3-18·5) years. At diagnosis, 268 patients were started on an antithyroid drug and 23 underwent thyroid ablation or thyroidectomy. Fifty-seven (21%) children achieved remission and 16 (28%) of these patients relapsed, almost all within 16 months. Gender and ethnicity did not affect rates of remission or relapse. Of 251 patients treated with methimazole, 53 (21%) had an adverse reaction, including rash, arthralgias, elevated transaminases, or neutropenia. Most children with Graves' disease treated with ATD do not experience remission, but most remissions do not end in relapse. Adverse reactions to methimazole are common but generally mild. © 2016 John Wiley & Sons Ltd.

  13. Rectus extraocular muscle paths and decompression surgery for Graves orbitopathy: mechanism of motility disturbances

    NARCIS (Netherlands)

    Abràmoff, Michael D.; Kalmann, Rachel; de Graaf, Mieke E. L.; Stilma, Jan S.; Mourits, Maarten P.

    2002-01-01

    PURPOSE: To study possible causes of motility disturbances that may result from orbital decompression surgery in patients with Graves orbitopathy and especially the role of rectus extraocular muscle paths. METHODS: Sixteen patients with Graves orbitopathy were studied before and 3 to 6 months after

  14. Remission of aplastic anemia induced by treatment for Graves disease in a pediatric patient.

    Science.gov (United States)

    Das, Prabodh Kumar; Wherrett, Diane; Dror, Yigal

    2007-08-01

    Aplastic anemia (AA) is mediated by T-cell autoimmunity in the majority of cases; it is rare and mostly idiopathic in children. We describe a child, who developed AA following Graves' disease which could not be attributed to antithyroid drugs. We hypothesized that both diseases were caused by similar autoimmune process. We monitored the blood counts and did not administer any conventional treatment for AA assuming that the existing anti- hematopoietic stem cell humoral and cellular immunity might subside with induction of remission of Grave's disease. The child went into complete remission with the treatment of the Graves' disease.

  15. Vecteurs Singuliers des Theories des Champs Conformes Minimales

    Science.gov (United States)

    Benoit, Louis

    En 1984 Belavin, Polyakov et Zamolodchikov revolutionnent la theorie des champs en explicitant une nouvelle gamme de theories, les theories quantiques des champs bidimensionnelles invariantes sous les transformations conformes. L'algebre des transformations conformes de l'espace-temps presente une caracteristique remarquable: en deux dimensions elle possede un nombre infini de generateurs. Cette propriete impose de telles conditions aux fonctions de correlations qu'il est possible de les evaluer sans aucune approximation. Les champs des theories conformes appartiennent a des representations de plus haut poids de l'algebre de Virasoro, une extension centrale de l'algebre conforme du plan. Ces representations sont etiquetees par h, le poids conforme de leur vecteur de plus haut poids, et par la charge centrale c, le facteur de l'extension centrale, commune a toutes les representations d'une meme theorie. Les theories conformes minimales sont constituees d'un nombre fini de representations. Parmi celles-ci se trouvent des theories unitaires dont les representation forment la serie discrete de l'algebre de Virasoro; leur poids h a la forme h_{p,q}(m)=[ (p(m+1) -qm)^2-1] (4m(m+1)), ou p,q et m sont des entiers positifs et p+q= 2. Ces representations possedent un sous-espace invariant engendre par deux sous-representations avec h_1=h_{p,q} + pq et h_2=h_{p,q} + (m-p)(m+1-q) dont chacun des vecteurs de plus haut poids portent le nom de vecteur singulier et sont notes respectivement |Psi _{p,q}> et |Psi_{m-p,m+1-q}>. . Les theories super-conformes sont une version super-symetrique des theories conformes. Leurs champs appartiennent a des representation de plus haut poids de l'algebre de Neveu-Schwarz, une des deux extensions super -symetriques de l'algebre de Virasoro. Les theories super -conformes minimales possedent la meme structure que les theories conformes minimales. Les representations sont elements de la serie h_{p,q}= [ (p(m+2)-qm)^2-4] /(8m(m+2)) ou p,q et m sont

  16. Effects of radioiodine on thyrotrophin binding inhibiting immunoglobulins in Graves' disease

    International Nuclear Information System (INIS)

    McGregor, A.M.; Petersen, M.M.; Capiferri, R.; Evered, D.C.; Rees Smith, B.; Hall, R.

    1979-01-01

    The effects of 131 I therapy on thyrotrophin binding inhibiting immunoglobulins (TBII) were studied in fifty-five patients with Graves' disease and five patients with toxic multinodular goitre (MNG). A group of forty patients with Graves' disease and four patients with toxic MNG were treated with drugs and acted as controls. In 78% of patients treated with 131 I there was a dramatic increase in serum TBII activity during the 3 months following therapy, whereas drug-treated patients showed a decrease (77%) or no change in TBII activity over the same period. TBII activity was not detectable in patients with toxic MNG before or after drug or 131 I therapy. Consideration of the mechanisms involved in the changes in serum TBII activity after 131 I treatment or during drug treatment provide insight into the basic defects responsible for the development of Graves' disease and suggest that both the thyroid and immune system are involved. (author)

  17. Thyroxine, shape, and weight: interaction of Graves' disease and bulimia nervosa.

    Science.gov (United States)

    Teufel, Martin; Giel, Katrin Elisabeth; Lehr, Jule; Becker, Sandra; Muthig, Michaela; Zipfel, Stephan; Kuprion, Jürgen

    2013-03-01

    A case of a 25-year-old woman with bulimia nervosa and Graves' disease is presented. Graves' disease is the cause of 50-80 % of hyperthyroidism. The disease is characterized by increases of thyroid hormone production, activation of the metabolism, and successive weight loss. Bulimia nervosa is characterized by purging behavior after binge eating episodes. We report a patient suffering from both entities. A pronounced non-compliance to the intake of antithyroid drugs (Carbimazole) correlated with eating disorder symptoms like negative evaluation of the body and fear of weight gain. Thus, elevated hyperthyroidism due to Graves' disease served as a purging method. During 8 weeks of inpatient psychotherapy, the patient adapted to a structured eating behavior. Self-esteem was less influenced by body shape and body weight, and compliance to endocrinological recommendations improved. Non-compliance to antithyroid drugs may be a symptom of an eating disorder. A careful and primarily non-confronting interdisciplinary diagnostic and treatment approach is required.

  18. Tratamento cirúrgico da laringomalácia grave: estudo retrospectivo de 11 casos

    Directory of Open Access Journals (Sweden)

    José Antonio Pinto

    2013-10-01

    Full Text Available A laringomalácia é a anomalia congênita da laringe mais frequente, sendo responsável por cerca de 60% a 75% dos casos de estridor congênito. Apesar de seu curso benigno e autolimitado, 10% dos casos necessitam de intervenção. Atualmente, as supraglotoplastias são consideradas o tratamento padrão da laringomalácia grave. OBJETIVO: Descrever a experiência adquirida pelos autores no tratamento cirúrgico dos pacientes com laringomalácia grave. Metodologia: Estudo retrospectivo. MÉTODO: Os prontuários de 11 casos consecutivos de laringomalácia grave, submetidos ao tratamento cirúrgico entre 2003 e 2012, foram analisados quanto à idade, gênero, sintomas, doenças associadas, técnica cirúrgica adotada, tempo de extubação, complicações cirúrgicas, tempo de internação e evolução clínica. RESULTADOS: Dos 11 casos de laringomalácia grave, seis pacientes (54,5% foram operados com o uso do laser de CO2 e em cinco pacientes (45,5% foram realizadas a técnica a frio. Apenas um paciente (9,1% necessitou reabordagem cirúrgica. Não foram observados casos de complicações cirúrgicas. Todos os pacientes apresentaram melhora clínica importante. CONCLUSÃO: A supraglotoplastia mostrou-se um procedimento eficaz e seguro no tratamento da laringomalácia grave.

  19. Treatment of Grave's hyperthyroidism-prognostic factors for outcome

    International Nuclear Information System (INIS)

    Alfadda, A.; Malabu, Usman H.; El-Desouki, Mahmoud I.; Al-Rubeaan, Khalid A.; Al-Ruhaily, Atallah D.; Fouda, Mona A.; Al-Maatouq, Mohamed A.; Sulimani, Riad A.

    2007-01-01

    To determine clinical and biochemical features of Grave's disease at presentation predict response to medical and radioiodine treatment. We carried out a retrospective 10-year study of 194 consecutive Saudi subjects with Grave's disease who was treated with antithyroid drugs, radioiodine therapy, or both, between January 1995 and December 2004 at King Khalid University Hospital, Riyadh, Saudi Arabia. At diagnosis, the mean age was 32+-0.9 years. Only 26% of patients had successful outcome after a course of antithyroid medication. None of the clinical or biochemical factors were associated with a favorable outcome of antithyroid treatment. One dose of radioiodine [13-15 mCi (481-555 MBq)] cured hyperthyroidism in 83% of patients. Presence of ophthamopathy at presentation was shown to be a significant contributing factor to failure to respond to a single dose of radioiodine (odds ratio, 6.4; 95%CI, 1.51-24.4; p<0.01). Failure of radioiodine treatment was also associated with higher serum free T3 concentration at presentation (p=0.003). In patients with Grave's hyperthyroidism, radioiodine treatment is associated with higher success rate than antithyroid drugs. A dose of 13-15 mCi (481-555 MBq) seems to practical and effective, and should be considered as first line therapy. Patients with high free T3 concentration and, those with ophthalmopathy at presentation were more likely to fail radioiodine treatment. A higher dose of radioiodine may be advisable in such patients. (author)

  20. CASE REPORT : GRAVE'S DISEASE PRESENTING AS PARANOID SCHIZOPHRENIA

    OpenAIRE

    Singh, S.K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I.

    1989-01-01

    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms.

  1. Utilisation sans risque des eaux usées, des excréta et des eaux ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Les responsables de ce projet piloteront l'application et l'adaptation des principes directeurs relatifs à l'utilisation sans risque des eaux usées, des excreta et des eaux grises en agriculture et en aquaculture (Guidelines for the Safe Use of Wastewater, Excreta and Greywater in Agriculture and Aquaculture), que ...

  2. Preeclampsia grave: características y consecuencias

    Directory of Open Access Journals (Sweden)

    Arturo Pérez de Villa Amil Álvarez

    2015-07-01

    Full Text Available Fundamento: la preeclampsia es un trastorno hipertensivo del embarazo y es una de las principales causas de morbimortalidad perinatal y materna. Objetivo: identificar los factores maternos, terapéuticos, y daños asociados a la preeclampsia grave en gestantes. Método: estudio de serie de casos, que incluyó 69 pacientes diagnosticadas con preeclampsia grave en el período del 1ro de enero de 2012 al 31 de diciembre de 2013, atendidas en el Hospital General Universitario Dr. Gustavo Aldereguía Lima. Se clasificaron en dos grupos correspondiendo ambos a los criterios de preeclampsia grave con y sin asociación de factores agravantes. Se evaluaron variables relacionadas a: características maternas, características de atención médica, características neonatales y fetales. Se aplicó un formulario confeccionado según los datos obtenidos de las historias clínicas, acorde a la Clasificación Internacional de Enfermedades Décima Revisión. Las comparaciones entre grupos se efectuaron por el estadístico X2 aceptándose como significativo una p<0,05. Resultados: la frecuencia de preeclampsia grave fue de 0,8x100 partos. La mayor frecuencia correspondió al rango de edad de 31-35 años. La eclampsia se observó en 0,91x1000 partos. El daño materno ascendió a 30,4 %. El sulfato de magnesio se utilizó como profilaxis en el 89 % de los casos. La frecuencia de eclampsia en las que no se usó fue del 50 %, mientras que en las que se usó fue de solo 6,4 %. La cesárea se realizó en el 85,5 % de las pacientes. El daño neonatal se asoció al 52,3 %. La mortalidad fetal tardía fue de 4,6x100 nacimientos. En las diferencias intergrupos se observaron divergencias significativas respecto al daño neonatal. Conclusión: es evidente la alta asociación de restricción del crecimiento intrauterino con la prematuridad inducida, alto índice de cesárea primitiva y el elevado daño materno, neonatal y fetal. El uso del sulfato de magnesio impresiona con

  3. Mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease.

    Science.gov (United States)

    Bunevicius, Robertas; Velickiene, Dzilda; Prange, Arthur J

    2005-01-01

    To evaluate the prevalence of mood and anxiety disorders in women with treated hyperthyroidism caused by Graves' disease and to compare them with the prevalence of such findings in women without past or present thyroid disease. Thirty inpatient women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease and 45 women hospitalized for treatment of gynecologic disorders such as abnormal vaginal bleeding, benign tumors or infertility were evaluated for the prevalence of mood and anxiety diagnoses using a standard Mini-International Neuropsychiatric Interview and for mood and anxiety ratings using the Profile of Mood States (POMS). At the time of assessment, it was discovered that 14 of 30 women with treated hyperthyroidism caused by Graves' disease were still hyperthyroid, while 16 women were euthyroid. Significantly greater prevalence of social anxiety disorder, generalized anxiety disorder, major depression and total mood and anxiety disorders, as well as higher symptom scores on the POMS, was found in hyperthyroid women with Graves' disease in comparison with the control group. A prevalence of total anxiety disorder, as well as history of mania or hypomania and lifetime bipolar disorder, but not lifetime unipolar depression, was more frequent in both the euthyroid and the hyperthyroid subgroups of study women in comparison with the control group. These results confirm a high prevalence of mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease. Hyperthyroidism plays a major role in psychiatric morbidity in Graves' disease.

  4. ANALYSE DES PERCEPTIONS LOCALES ET DES FACTEURS ...

    African Journals Online (AJOL)

    AISA

    1Faculté des Sciences Agronomiques (FSA), Université d'Abomey-Calavi (UAC), 01 BP 526 Cotonou Bénin. Email : cgbemavo@yahoo.fr. 2Institut National des Recherches Agricoles du Bénin, Centre de Recherches Agricoles d'Agonkanmey (CRA-A),. Laboratoire des Sciences du Sol, Eau et Environnement (LSSEE).

  5. Analysis of adverse reactions and complications of Graves' disease after thyroid arteries embolization

    International Nuclear Information System (INIS)

    Zhuang Wenquan; Chen Wei; Yang Jianyong; Xiao Haipeng; Huang Yonghui; Li Jiaping; Guo Wenbo

    2003-01-01

    Objective: To retrospectively analyse the adverse reactions and complications of Graves' disease after thyroid arteries embolization. Methods: 41 patients of Graves' disease underwent interventional embolization have been analysed with its adverse reactions and complications. Polyvinyl alcohol or bletilla microspheres and micro-coils were used in these patients. Results: Laryngopharyngeal and neck pain occurred in all patients. T 3 and T 4 increased in 3 days to one week after the procedure. Thirty of them showed fever. Dystopia embolism happened in two cases with one of transitory hypoparathyroidism. No hypothyroidism or hypoparathyroidism or hoarseness occur during long term follow up. Conclusions: The adverse reactions and complications of Graves disease after thyroid arteries embolization may occur. Some of them are preventable and curable

  6. Secondary Pulmonary Hypertension and Right-Sided Heart Failure at Presentation in Grave's Disease.

    Science.gov (United States)

    Ganeshpure, Swapnil Panjabrao; Vaidya, Gaurang Nandkishor; Gattani, Vipul

    2012-01-01

    A young female presented with evidence of right-sided heart failure and was subsequently found to have significant pulmonary artery hypertension (PAH). Because of her normal left ventricular function and pulmonary capillary wedge pressure, the most probable site of etiology seemed to be the pulmonary vasculature. All the common possible secondary causes of PAH were ruled out, but during the investigations, she was found to have elevated thyroid function tests compatible with the diagnosis of Grave's disease. The treatment of Grave's disease, initially by medications and subsequently by radioiodine therapy, was associated with a significant reduction in the pulmonary artery systolic pressure. The purpose of this case report is to highlight one of the unusual and underdiagnosed presentations of Grave's disease.

  7. The mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization

    International Nuclear Information System (INIS)

    Li Weiduo; Yang Jianyong; Zhuang Wenquan; Chen Wei; Li Heping

    2002-01-01

    Objective: To explore the mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization. Methods: Twenty-five patients of Graves' disease treated with interventional embolization were followed up for 24-57 months. T 3 and T 4 were monitored at pre-operation, six months, 12 months, 2, 3 and 4 years after operation, respectively. Other references included pulse, thyroid size, and vessel's murmur. Results: Twenty-two patients completely relieved from the hyperthyroidism during the follow-up. Only one patient suffered from recurrence. Other two patients were still on maintaining dosage of antithyroid drug therapy. No hypothyroidism or hypoparathyroidism was found during this term. Conclusion: Mid-to-long term follow-up showed satisfactory efficacy of interventional therapy, offering another alternative for treatment of refractory Graves' disease

  8. Differential diagnosis of back pain; Differenzialdiagnose des Rueckenschmerzes

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W.; Nabhan, A.; Kelm, J.; Naumann, N.; Ahlhelm, F. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2006-06-15

    Back pain is one of the most frequent clinical pictures encountered in a physician's practice. It can pose a great burden on the individual and in addition have a multifactorial origin. It can be caused by intervertebral discs, vertebral joints, nerve roots, ligaments, sacroiliac joints, or a combination of the above. Back pain, as a symptom of a systemic disease, can also be a warning signal of grave disorders such as malignancies or in the event of aortic aneurysm. The well-considered choice of appropriate diagnostic procedures and suitable treatment requires a thorough knowledge of this multifactorial clinical picture. (orig.) [German] Rueckenschmerzen gehoeren zu den haeufigsten Krankheitsbildern in der aerztlichen Praxis. Sie koennen individuell sehr belastend und darueber hinaus multifaktoriell bedingt und durch die Bandscheibe, Wirbelgelenke, Nervenwurzeln, Ligamente, Sakroiliakalgelenke oder eine Kombination der genannten bedingt sein. Der Rueckenschmerz, als Symptom einer systemischen Erkrankung, kann auch ein Warnsignal bei schwerwiegenden Erkrankungen wie malignen Erkrankungen oder im Falle eines Aortenaneurysmas sein. Die reflektierte Wahl des adaequaten Diagnostikums und eine angemessene Therapie setzen ein gruendliches Wissen ueber dieses multifaktorielle Krankheitsbild voraus. (orig.)

  9. variabilite des productions et des revenus des exploitations

    African Journals Online (AJOL)

    3Centre de coopération internationale en recherche agronomique pour le développement (CIRAD), UMR Innovation,. Montpellier, France. Doubangolo COULIBALY, Email kone_b@yahoo.fr. RESUME. La durabilité des systèmes de production à base de coton dans un contexte de variabilité des prix aux producteurs et de ...

  10. Le statut vitaminique des individus et des populations…

    Directory of Open Access Journals (Sweden)

    Icart Jean-Claude

    2000-05-01

    Full Text Available Comme le souligne un récent rapport du Haut comité de santé publique, le statut vitaminique des individus et des populations demeure une question d’actualité. Si les études ne révèlent plus de signes évocateurs de carence, au plus des problèmes de déficiences pour certains groupes à risque, des interrogations, demeurent malgré le contexte d’abondance, concernant la couverture des besoins, laquelle pourrait s’avérer inférieure aux valeurs considérées comme satisfaisantes.

  11. Application des TIC à l'atténuation des effets des catastrophes dans ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    L'Amérique centrale est souvent aux prises avec des inondations et des ... (SIG) et de traitement des images, afin de cartographier les dangers et de modéliser les ... de l'Institut d'étude du développement international de l'Université McGill.

  12. CASE REPORT : GRAVE'S DISEASE PRESENTING AS PARANOID SCHIZOPHRENIA

    Science.gov (United States)

    Singh, S.K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I.

    1989-01-01

    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms. PMID:21927380

  13. L'évolution des combustibles pour moteurs thermiques Evolution of Fuels for Thermal Engines

    Directory of Open Access Journals (Sweden)

    Balaceanu J. C.

    2006-11-01

    Full Text Available Depuis la crise pétrolière, l'accroissement des prix et les craintes de pénurie ont conduit à adapter les moteurs aux combustibles disponibles. Si la situation apparaît comme moins tendue, l'industrie des machines thermiques, qui pendant longtemps a eu comme partenaire une industrie du pétrole très sûre, se trouve cependant confrontée à un marché des combustibles incertain dans son ravitaillement et surtout dans ses prix. Les progrès des moteurs diesel et des turbines à gaz, dûs à une meilleure adaptation à leur usage et aussi à l'évolution de la technologie, supposent que les combustibles n'apporteront aucune contrainte majeure en quantité ou en qualité. La modification des usages dévolus désormais au pétrole entraînera une réduction de la coupe lourde et un raffinage plus profond des bruts avec en particulier un développement du craquage catalytique et de la viscoréduction. Or, ces différentes opérations de conversion peuvent conduire à une détérioration de la qualité des combustibles moins grave pour le gazole que pour le fuel lourd. Dans les différents domaines impliqués, les parades technologiques sont en cours de développement. L'industrie des machines thermiques, qui poursuit l'amélioration des engins, et l'industrie du pétrole, qui recherche une réduction des prix des combustibles, sont donc conduites à un compromis optimal auquel elles ne peuvent accéder efficacement qu'en définissant les règles du jeu c'est-à-dire des spécifications internationales rigoureuses des combustibles. Since the oil crisis, the increase in prices and fears of a shortage have led to the adapting of engines to what fuels are available. Whereas the situation now seems somewhat less tense, the thermal machinery industry, which for a long time had a very reliable petroleum industry as its partner, nonetheless finds itself confronted with an uncertain fuel market with regard to supplies and especially to prices. Progress

  14. Advice about the safety of graphite storage silos of Saint Laurent des Eaux facility; Avis sur la surete des silos de stockage de graphite de Saint Laurent des Eaux

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This document is the safety analysis made by the national association of the local commissions of information about nuclear activities (ANCLI), about the safety of graphite storage silos of Saint Laurent des Eaux nuclear facility. The analysis covers: the operation safety and the accident hypothesis, the monitoring of indoor and outdoor contamination in routine situation, the geotechnical characteristics of the site environment, the isotopic inventory and the estimation of radioactivity in routine and accidental situation, the estimation of doses received by the population in accidental situation and the internal emergency plan. After examination of these different points, the scientific committee of the ANCLI considers that a new global evaluation of risks, which integrates more recent exposure data, has to be carried out. (J.S.)

  15. La gestion des résultats des entreprises innovantes

    OpenAIRE

    Dumas, Guillaume

    2014-01-01

    Cette thèse s’intéresse à la gestion des résultats dans le cadre des entreprises innovantes. Elle est constituée de trois articles. Dans le premier, il s’agit d’examiner si les résultats des entreprises innovantes sont gérés et si le stade de développement des innovations influence cette gestion des résultats. Il apparaît que les résultats des entreprises innovantes sont gérés à la hausse. Cette gestion ne semble intervenir qu’au cours de l’activité d’innovation (c’est-à-dire lorsque les entr...

  16. Facts and fallacies about radioactive iodine therapy for Graves' disease

    International Nuclear Information System (INIS)

    Miller, J.L.

    1982-01-01

    The therapeutic options available in the hyerthyroidism of Graves' disease are two basic treatments. Firstly antithyroid drugs and secondly one can 'ablate' the thyroid gland by means of thyroidectomy or radioactive iodine ( 131 I). At present 131 I is the current treatment of chioce for Graves' disease. In a follow-up study of 21 714 patients who were treated with 131 I and observed for a period of 8 years, there was no increase in the incidence of thyriod carcinoma. A possible explanation for this is that the dose of 131 I used destroys the ability of the thyroid cells to replicate and thus transmit genetically damaged material

  17. Etude des erreurs d'estimation des populations par la méthode des captures successives (DeLURY, 2 captures et des captures-recaptures (PETERSEN

    Directory of Open Access Journals (Sweden)

    LAURENT M.

    1978-01-01

    Full Text Available L'estimation des populations naturelles par capture-recapture et par captures successives est souvent entachée d'erreur car, dans de nombreux cas, l'hypothèse fondamentale d'égalité des probabilités de captures pour tous les individus dans le temps et dans l'espace n'est pas respectée. Dans le cas des populations de poissons envisagés ici, les captures ont lieu par la pêche électrique. On a pu chiffrer l'ordre de grandeur des erreurs systématiques faites sur l'estimation des peuplements, en fonction des conditions particulières, biotiques et abiotiques, des différents milieux inventoriés.

  18. Circulating microRNA-1a is a biomarker of Graves' disease patients with atrial fibrillation.

    Science.gov (United States)

    Wang, Fang; Zhang, Sheng-Jie; Yao, Xuan; Tian, Dong-Mei; Zhang, Ke-Qin; She, Dun-Min; Guo, Fei-Fan; Zhai, Qi-Wei; Ying, Hao; Xue, Ying

    2017-07-01

    It has been increasingly suggested that specific microRNAs expression profiles in the circulation and atrial tissue are associated with the susceptibility to atrial fibrillation. Nonetheless, the role of circulating microRNAs in Graves' disease patients with atrial fibrillation has not yet been well described. The objective of the study was to identify the role of circulating microRNAs as specific biomarkers for the diagnosis of Graves' disease with atrial fibrillation. The expression profiles of eight serum microRNAs, which are found to be critical in the pathogenesis of atrial fibrillation, were determined in patients with Graves' disease with or without atrial fibrillation. MicroRNA expression analysis was performed by real-time PCR in normal control subjects (NC; n = 17), patients with Graves' disease without atrial fibrillation (GD; n = 29), patients with Graves' disease with atrial fibrillation (GD + AF; n = 14), and euthyroid patients with atrial fibrillation (AF; n = 22). Three of the eight serum microRNAs,i.e., miR-1a, miR-26a, and miR-133, had significantly different expression profiles among the four groups. Spearman's correlation analysis showed that the relative expression level of miR-1a was positively correlated with free triiodothyronine (FT3) and free thyroxine (FT4), and negatively related to thyroid stimulating hormone. Spearman's correlations analysis also revealed that the level of miR-1a was negatively correlated with a critical echocardiographic parameter (left atrial diameter), which was dramatically increased in GD + AF group compared to GD group. Furthermore, the receiver-operating characteristic curve analysis indicated that, among the eight microRNAs, miR-1a had the largest area under the receiver-operating characteristic curves not only for discriminating between individuals with and without Graves' disease, but also for predicting the presence of atrial fibrillation in patients with Graves' disease. Our findings

  19. The Challenge of Reconstructing "Failed" States Le défi de la reconstruction des États «faillis» : Quelles leçons tirer des erreurs commises en Afghanistan ? El desafío de la reconstrucción de estados fracasados

    Directory of Open Access Journals (Sweden)

    Serge Michailof

    2000-12-01

    -driven administration that can only weaken State institutions. While State building requires founding modern institutions, this issue is paradoxically, neglected by the international aid community, even though this is feasible in difficult contexts as demonstrated by a number of successful achievements in Afghanistan. He then criticizes the superficial formal type of democracy systematically imposed by the international community in such contexts and stresses the need for grassroots democracy. Drawing from this extremely in-depth analysis, he finally makes a series of general recommendations intended for both official development aid institutions and non-government organizations (NGOs that are currently facing and will continue to face similar challenges in other areas of the world.Alors que l’aide internationale accroît ses appuis à la reconstruction des pays sortant de crises graves ou de guerres civiles, pays fragiles et pays « faillis », on se rend aujourd’hui compte que le désastre en Afghanistan est pour une bonne part lié aux erreurs commises par la coalition occidentale et en particulier à la grave désorganisation de son effort d’aide au développement dans ce pays. Dans cet article sans complaisance, Serge Michailof procède à une analyse méthodique des erreurs commises par les donateurs internationaux en Afghanistan de 2002 à 2010, pour en tirer des enseignements de portée plus générale et éviter que les mêmes erreurs ne soient répétées dans d’autres contextes.Après avoir rappelé que les performances de l’aide internationale dans les pays sortant de crise sont globalement décevantes et que pour reconstruire ces pays il faut d’importantes ressources financières et pas seulement des promesses et des effets d’annonce, Serge Michailof  procède ensuite à une analyse sévère de l’absence de stratégie cohérente de l’aide internationale en Afghanistan et du flou des objectifs qui ont déterminé son action. Il rappelle qu’assurer la s

  20. Radiotherapy for Graves' orbitopathy : randomised placebo-controlled study

    NARCIS (Netherlands)

    Mourits, MP; van Kempen-Harteveld, ML; Garcia, MBG; Koppeschaar, HPF; Tick, L; Terwee, CB

    2000-01-01

    Background The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. Methods In a double-blind randomised clinical trial, 30 patients with

  1. Preoperative management in patients with Graves' disease.

    Science.gov (United States)

    Piantanida, Eliana

    2017-10-01

    Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. If serum thyrotropin (TSH) is low, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations should be measured to distinguish between subclinical (with normal circulating thyroid hormones) and overt hyperthyroidism (with increased circulating thyroid hormones). Graves' disease is treated with any of three effective and relatively safe initial treatment options: antithyroid drugs (ATDs), radioactive iodine ablation (RAIU), and surgery. Total thyroidectomy is favored in several clinical situations, such as intolerance, ineffectiveness or recurrence after ATD treatment, radioiodine therapy contraindicated, documented or suspected thyroid malignancy, one or more large thyroid nodules, coexisting moderate-to-severe active Graves' orbitopathy, women planning a pregnancy within 6 months. Whenever surgery is selected as treatment, selection of an expert high-volume thyroid surgeons is fundamental and careful preoperative management is essential to optimize surgical outcomes. Pretreatment with ATDs in order to promptly achieve the euthyroid state is recommended to avoid the risk of precipitating thyroid storm during surgery. For the majority of patients, euthyroidism is achieved after few weeks of ATD treatment. Beta-blockers, such as propranolol, are often added effectively to control hyperthyroid symptoms. Saturated solution of potassium iodide (SSKI) or potassium iodine (Lugol's solution), given for a short period prior to surgery, in order to reduce both thyroid hormone release and thyroid gland

  2. Reacciones adversas graves y mortales a los antimicrobianos. Sistema Cubano de Farmacovigilancia, 2003-2012

    Directory of Open Access Journals (Sweden)

    Ismary Alfonso Orta

    Full Text Available Introducción: las reacciones adversas a los antimicrobianos ocasionan más de 142 000 visitas a las salas de urgencias hospitalarias por año en los Estados Unidos. En Cuba han ocupado el primer lugar en el reporte, por ejemplo, en el año 2008 representaron el 31,4 % del total de las reacciones adversas graves y el 25 % de las reacciones adversas mortales. Objetivo: caracterizar las reacciones adversas graves y mortales a los antimicrobianos notificadas a la Unidad Nacional Coordinadora de Farmacovigilancia, durante el periodo 2003-2012. Métodos: se realizó un estudio de farmacovigilancia, observacional, descriptivo y transversal, utilizando la base de datos nacional de farmacovigilancia durante el periodo 2003-2012. Se trabajó con el total de reportes de reacciones adversas graves y mortales a los antimicrobianos. Las reacciones adversas se clasificaron según tipo de reacción, sistema de órgano afectado, imputabilidad y frecuencia. Se identificaron los principales antimicrobianos sospechosos y se estudiaron los pacientes que presentaron reacciones adversas según sexo y edad. Resultados: se detectaron 631 sospechas de reacciones adversas graves y mortales a los antimicrobianos, de ellas fueron 550 graves y 81 mortales. Predominaron el sexo femenino con 60,1 % y 405 adultos. Las reacciones adversas comprometieron los sistemas: general (30,4 %, respiratorio (25,2 % y cardiovascular (14,9 %. El shock anafiláctico fue la reacción más reportada y la penicilina el fármaco más relacionado con esta. El 73,5 % fueron probables y el 58,9 % ocasionales. Conclusiones: las reacciones adversas graves y mortales predominaron en el sexo femenino y en los adultos. La penicilina fue el fármaco más relacionado. Las reacciones adversas probables y ocasionales fueron la mayoría en el estudio.

  3. Injectabilite des coulis de ciment dans des milieux fissures

    Science.gov (United States)

    Mnif, Thameur

    Le travail presente ici est un bilan du travaux de recherche effectues sur l'injectabilite des coulis de ciment dans lu milieux fissures. Un certain nombre de coulis a base de ciment Portland et microfin ont ete selectionnes afin de caracteriser leur capacite a penetrer des milieux fissures. Une partie des essais a ete menee en laboratoire. L'etude rheologique des differents melanges a permis de tester l'influence de l'ajout de superplastifiant et/ou de fumee de silice sur la distribution granulometrique des coulis et par consequent sur leur capacite a injecter des colonnes de sable simulant un milieu fissure donne. La classe granulometrique d'un coulis, sa stabilite et sa fluidite sont apparus comme les trois facteurs principaux pour la reussite d'une injection. Un facteur de finesse a ete defini au cours de cette etude: base sur la classe granulometrique du ciment et sa stabilite, il peut entrer dans la formulation theorique du debit d'injection avant application sur chantier. La deuxieme et derniere partie de l'etude presente les resultats de deux projets de recherche sur l'injection realises sur chantier. L'injection de dalles de beton fissurees a permis le suivi de l'evolution des pressions avec la distance au point d'injection. L'injection de murs de maconnerie a caractere historique a montre l'importance de la definition de criteres de performance des coulis a utiliser pour traiter un milieu donne et pour un objectif donne. Plusieurs melanges peuvent ainsi etre predefinis et mis a disposition sur le chantier. La complementarite des ciments traditionnels et des ciments microfins devient alors un atout important. Le choix d'utilisation de ces melanges est fonction du terrain rencontre. En conclusion, cette recherche etablit une methodologie pour la selection des coulis a base de ciment et des pressions d'injection en fonction de l'ouverture des fissures ou joints de construction.

  4. Effectiveness and Mechanism of Preoperative Lugol Solution for Reducing Thyroid Blood Flow in Patients with Euthyroid Graves' Disease.

    Science.gov (United States)

    Huang, Shih-Ming; Liao, Wei-Ting; Lin, Chiou-Feng; Sun, H Sunny; Chow, Nan-Haw

    2016-03-01

    To reduce intraoperative and postoperative complications, using Lugol solution to preoperatively prepare patients with Graves' disease has (1) rapidly reduced the severity of thyrotoxicosis and (2) reduced the vascularity of the thyroid gland. The vascularity reduction normally accompanies reducing the severity of thyrotoxicosis. However, the effects and mechanism of Lugol solution for reducing blood flow have not been well investigated in the patients with euthyroid (normally functioning thyroid) Graves' disease. Twenty-five patients with euthyroid Graves' disease being preoperatively treated with Lugol solution for 10 days were measured, at baseline and on the operative day, for (1) superior thyroid artery blood flow; (2) systemic angiogenic factor (VEGF); and (3) systemic inflammatory factor [interleukin (IL)-16]. All three parameters were significantly (p Graves' disease. We recommend routine preoperative Lugol solution treatment for all patients with Graves' disease.

  5. Mortality in Graves' orbitopathy is increased and influenced by gender, age and pre-existing morbidity

    DEFF Research Database (Denmark)

    Schwensen, Charlotte F; Hjelm Brandt Kristensen, Frans; Hegedüs, Laszlo

    2017-01-01

    INTRODUCTION: It is unclear whether the excess mortality associated with Graves' disease differs between individuals with Graves' orbitopathy (GO) or without (GD). SUBJECTS AND METHODS: A nationwide, register-based cohort study in which all adult Danes diagnosed with GD (n = 28 461) and GO (n......-existing morbidity using the Charlson score. RESULTS: Adjusted mortality in Graves' disease overall (GD + GO) was significantly increased compared to that in the background population (HR = 1.18 (95% confidence interval: 1.15-1.21)). In GD and GO separately, adjusted mortality was also significantly higher than...

  6. Aesthetic refinements in the treatment of graves ophthalmopathy.

    Science.gov (United States)

    Doumit, Gaby; Abouhassan, William; Yaremchuk, Michael J

    2014-09-01

    Graves ophthalmopathy is a chronic, multisystem, autoimmune disorder characterized by increased volume of intraorbital fat and hypertrophic extraocular muscles. Proptosis, impaired ocular motility, diplopia, lid retraction, and impaired visual acuity are treated with orbit decompression and fat reduction. The authors present the addition of skeletal augmentation to further improve periorbital aesthetics. Through a transconjunctival with lateral canthotomy incision, a balanced orbital decompression was executed, removing medial and lateral walls and medial floor. Intraorbital fat was excised. All patients underwent placement of porous polyethylene infraorbital rim implants and midface soft-tissue elevation, increasing inferior orbital rim projection and improving the globe-cheek relationship. From 2009 to 2012, 13 patients (11 female and two male; 26 eyes) with Graves ophthalmopathy underwent surgery at two institutions. Outcomes were evaluated for improvements of proptosis, diplopia, dry eye symptoms, and cosmetic satisfaction. Postoperative follow-up ranged from 0.5 to 3 years (median, 1.5 years). The mean improvement on Hertel exophthalmometry was 5.4 mm. Diplopia resolved in three patients (23 percent). No patients had worsening diplopia, and 12 (92 percent) discontinued use of eye lubricants. All patients had cosmetic satisfaction. One patient suffered temporary inferior orbital nerve paresthesia. There were no infections, hematomas, or ocular complications. Skeletal augmentation is a useful adjunct to orbital decompression and fat excision for treating Graves ophthalmopathy. Balanced orbital decompression with infraorbital rim implants is reliable, effective, and safe, with good, lasting results. Resolution of ocular symptoms is improved, as are the patient's personal well-being and social life, with a high-benefit-to-low-risk. Therapeutic, IV.

  7. La gouvernance des risques naturels et la problematique des ...

    African Journals Online (AJOL)

    Depuis quelques années, la gouvernance des risques naturels dus aux inondations remet en cause les processus de mise en oeuvre des politiques urbaines et la qualité de la structure des aménagements dans les grandes villes du Golfe de Guinée. La perception de la gouvernance et l'application des politiques de ...

  8. Avaliação e tratamento da hiperglicemia em pacientes graves

    Directory of Open Access Journals (Sweden)

    Marina Verçoza Viana

    2014-03-01

    Full Text Available A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse. Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento da hiperglicemia no paciente graves. Na prática clínica, devem ser levados em consideração diversos aspectos para o controle desses pacientes, inclusive os alvos de glicemia, o histórico de diabetes mellitus, a via de nutrição (enteral ou parenteral e o equipamento de monitoramento disponível, o que aumenta substancialmente a carga de trabalho dos profissionais envolvidos nesse tratamento. Esta revisão descreveu a epidemiologia, a fisiopatologia, o tratamento e o monitoramento da hiperglicemia no paciente adulto grave.

  9. Graves' orbitopathy as a rare disease in Europe

    DEFF Research Database (Denmark)

    Perros, Petros; Hegedüs, L; Bartalena, L.

    2017-01-01

    BACKGROUND: Graves' orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence of GO in Europe may be declining, however data on the prevalence of this dise...

  10. Sjiele sacrifices, Odin treasures and Saami graves?

    Directory of Open Access Journals (Sweden)

    Inger Zachrisson

    1987-01-01

    Full Text Available This paper presents archaeological findings described as Saami metal deposits. These well-known "Finds from Lapp Places of Sacrifice", objects from the Viking Age and Early Middle Ages, were mostly found in northern Sweden. The author also presents a research project dealing with prehistoric and medieval Saami graves from the south Saami area.

  11. The observation of the therapeutic effectiveness of 131I on 260 youngster with Grave's hyperthyroidism

    International Nuclear Information System (INIS)

    Liu Binwen; Gao Xiusheng; Zhang Yahua; Pu Dongli

    2003-01-01

    Objective: To study the therapeutic effect and find new ways on treatment of Grave's hyperthyroidism in youngsters. Methods: 260 Grave's hyperthyroidism patients (age under 21 years) treated with 131 I were followed up 1-16 years later. Results: 118 of all patients were cured and 55 cases improved, failed treatment 2 cases, subclinical hypothyroidism 9 cases, clinical hypothyroidism 6 cases. 35 cases were treated with 131 I two or three times. All the patients with subclinical hypothyroidism and clinical hypothyroidism caused by 131 I were cured with medicine. 131 I treatment had no effect on growth and mentality and didn't cause leukemia nor thyroid cancer. Conclusions: The therapy of youngsters with Grave's hyperthyroidism with 131 I has the same effectiveness as adult. To the youngster Grave's patients who failed medical treatment, therapy with 131 I is safe and effective. It leads to temporary hypothyroidism which can be cured with medicine, no delayed hypothyroidism has been found

  12. Paradoxical euthyroid hormone profile in a case of Graves' disease with cardiac failure

    Directory of Open Access Journals (Sweden)

    Kapoor Aditya

    2011-07-01

    Full Text Available Abstract Cardiac failure is an uncommon complication of juvenile hyperthyroidism. We describe an adolescent boy with Graves' disease who developed manifestations of heart failure while on antithyroid medications. There was no evidence of any underlying cardiac disease. He had paradoxical euthyroid hormone profile which rose to hyperthyroid range when the manifestations of the cardiac failure subsided. The case highlights several unusual features of Graves' disease.

  13. Hyperthyroidism in Patients with Graves' Ophthalmopathy, and Thyroidal, Skeletal and Eye Muscle Specific Type 2 Deiodinase Enzyme Activities.

    Science.gov (United States)

    Molnár, Ildikó; Szentmiklósi, József A; Somogyiné-Vári, Éva

    2017-09-01

    Graves' ophthalmopathy is characterized by hyperthyroidism, which is associated with higher serum T 3 levels than T 4 due to deiodinase enzymes.The effect of Graves' patient's sera (n=52) with elevated thyroid hormone and TSH receptor or thyroid peroxidase antibody (anti-TPO) levels was investigated on thyroidal, skeletal and eye muscle type 2 deiodinase enzyme (DII) activities. DII activities were measured with 125 I-T 4 substrate, while thyroid hormone and antibody levels with immunoassays.In Graves' ophthalmopathy, sera with elevated FT 4 or FT 3 levels reduced DII activites remarkably in all tissue fractions. Thyroidal DII activities were lower than those using eye muscle fraction (0.6±0.22 vs 1.14±0.43 pmol/mg/min, PEffect of sera with increased FT 3 levels demonstrated also reduced DII activities in patients with Graves' ophthalmopathy after methimazole therapy compared to those who had no ophthalmopathy (2.88±2 vs 20.42±11.82 pmol/mg/min, PHyperthyroid sera with TSH receptor antibodies resulted in increased DII activities, while sera with anti-TPO antibodies were connected to lower DII activities in Graves' ophthalmopathy.In summary, the actions of hyperthyroid sera derived from patients with Graves' disease were tested on tissue-specific DII activities. Elevated FT 4 level-induced DII inactivation is present in Graves' ophthalmopathy, which seems to be also present at the beginning of methimazole therapy. Stimulating TSH receptor antibiodies increased DII activities via their nongenomic effects using sera of hyperthyroid Graves' ophthalmopathy, but anti-TPO antibodies could influence DII activities via altering FT 4 levels. © Georg Thieme Verlag KG Stuttgart · New York.

  14. A study of the effect of seasonal climatic factors on the electrical resistivity response of three experimental graves

    Science.gov (United States)

    Jervis, John R.; Pringle, Jamie K.

    2014-09-01

    Electrical resistivity surveys have proven useful for locating clandestine graves in a number of forensic searches. However, some aspects of grave detection with resistivity surveys remain imperfectly understood. One such aspect is the effect of seasonal changes in climate on the resistivity response of graves. In this study, resistivity survey data collected over three years over three simulated graves were analysed in order to assess how the graves' resistivity anomalies varied seasonally and when they could most easily be detected. Thresholds were used to identify anomalies, and the ‘residual volume' of grave-related anomalies was calculated as the area bounded by the relevant thresholds multiplied by the anomaly's average value above the threshold. The residual volume of a resistivity anomaly associated with a buried pig cadaver showed evidence of repeating annual patterns and was moderately correlated with the soil moisture budget. This anomaly was easiest to detect between January and April each year, after prolonged periods of high net gain in soil moisture. The resistivity response of a wrapped cadaver was more complex, although it also showed evidence of seasonal variation during the third year after burial. We suggest that the observed variation in the graves' resistivity anomalies was caused by seasonal change in survey data noise levels, which was in turn influenced by the soil moisture budget. It is possible that similar variations occur elsewhere for sites with seasonal climate variations and this could affect successful detection of other subsurface features. Further research to investigate how different climates and soil types affect seasonal variation in grave-related resistivity anomalies would be useful.

  15. Postulated accidents

    International Nuclear Information System (INIS)

    Ullrich, W.

    1980-01-01

    This lecture on 'Postulated Accidents' is the first of a series of lectures on the dynamic and transient behaviour of nuclear power plants, especially pressurized water reactors. The main points covered will be: Reactivity Accidents, Transients (Intact Loop) and Loss of Cooland Accidents (LOCA) including small leak. This lecture will discuss the accident analysis in general, the definition of the various operational phases, the accident classification, and, as an example, an accident sequence analysis on the basis of 'Postulated Accidents'. (orig./RW)

  16. Comparison of curative effect of 131I and antithyroid drugs in Graves' disease: a meta analysis.

    Science.gov (United States)

    Yuan, Ju; Lu, Xiuqing; Yue, Yan

    2017-03-01

    Radioactive 131I is currently reported to be a potential effective intervention for Graves' Disease treatment in China. Whether 131I treatment was associated with effective outcome or reduced risk of side effects, reccurence rate remained unknown. Eligible studies were selected from Chinese VIP, Wangfang, CNKI databases using the keywords "Iodine" and "Graves Disease". Finally, 13 clinical trials met the inclusion criterion and were included this meta-analysis. Our meta-analysis included 1355 patients diagnosed of Graves' Disease with regular anti-thyroid drugs oral administration and 1320 patients with 131I therapy. The results showed that there was significant symptom improvement with radioactive iodine intervention (Odd Ratio (OR)=4.50, 95% CI [3.55, 5.71], PGraves' Disease. Treatment with 131I was associated with better clinical outcome; it reduced side effects and reccurence rate but increased hypothyroidism in Graves' Disease.

  17. Atresia biliar: una enfermedad grave

    OpenAIRE

    Ramonet, Margarita; Ciocca, Mirta; Alvarez, Fernando

    2014-01-01

    La atresia biliar es una grave enfermedad que se manifiesta en los recién nacidos, y se desconoce su causa. La inflamación y destrucciónprogresiva de los conductos biliares conducen a la aparición de ictericia, coluria y acolia entre la segunda y sexta semana de vida. Como existen múltiples causas de colestasis neonatal en esta etapa de la vida, es necesario realizar un diagnóstico y derivación precoz para ofrecer un tratamiento quirúrgico, con el fin de restablecer el flujo biliar. Alrededor...

  18. Classification of the eye changes of Graves' disease

    NARCIS (Netherlands)

    Wiersinga, W. M.; Prummel, M. F.; Mourits, M. P.; Koornneef, L.; Buller, H. R.

    1991-01-01

    Classification of the eye changes of Graves' disease may have clinical use in the description of the present eye state, in the assessment of treatment results, and in the choice of therapy. Requirements for any classification system should include simplicity, clinical nature (i.e., easily carried

  19. Profil épidémiologique des hémoglobinopathies: étude transversale descriptive autour du cas index

    Science.gov (United States)

    Dahmani, Fatima; Benkirane, Souad; Kouzih, Jaafar; Woumki, Aziz; Mamad, Hassan; Masrar, Azlarab

    2017-01-01

    Les hémoglobinopathies sont des affections constitutionnelles conséquentes à des anomalies des hémoglobines. Elles sont souvent graves dans leurs formes majeures, leur prise en charge est lourde avec un grand impact psycho-social sur les patients et leur famille. Classées parmi les maladies rares, elles sont encore insuffisamment connues des professionnels de santé. Cette méconnaissance est à l'origine d'une errance diagnostique, d'un retard dans leur prise en charge et par conséquent une morbidité et une mortalité élevée chez ces patients. L'Organisation Mondiale de la Santé (OMS) a publié en 2008 des données concernant l'épidémiologie des hémoglobinopathies: plus de 330000 cas naissent chaque année avec une hémoglobinopathie (83% des cas de drépanocytose, 17% des cas de thalassémie). Les troubles de l'hémoglobine sont responsables d'environ 3,4% des décès chez les moins de 5 ans. A l'échelle mondiale, 7% environ des femmes enceintes seraient porteuses d'une forme de la thalassémie et 1% des couples sont à risque. Toutefois, elles sont relativement fréquentes dans certaines régions du globe où les mariages consanguins sont communs. Afin de décrire les caractéristiques épidémiologiques des familles à risque d'hémoglobinopathies (étude autour du cas) dont les cas index sont suivis au service de pédiatrie à l'Hôpital Provincial El Idrisi de Kenitra au Maroc, une étude transversale descriptive a été réalisée durant deux enquêtes la première en mai 2015 et la deuxième en juin de la même année lors des journées de vaccination des cas index contre le pneumocoque. Après avoir recueilli les données épidémiologiques de nos patients, nous avons réalisé une étude biologique comportant: l'hémogramme avec étude morphologique des globules rouges en coloration MGG et numération automatique des réticulocytes; les électrophorèses de l'hémoglobine à pH alcalin (8.8) et secondairement à pH acide (5.4) sur gel d

  20. Relationship between the management of Graves' disease and the course of Graves' ophthalmopathy: a systematic review

    International Nuclear Information System (INIS)

    Li Suping; Kuang Anren

    2008-01-01

    Objective: To perform literature search and review on the controversial relationship between therapies of hyperthyroidism due to Graves' disease (GD) and the course of Graves' ophthalmopathy (GO). Methods: We searched the database of MEDLINE (1966-2006.3), EMBASE (1984-2005), Cochrane Library(2006 No. 1), CBMdisc (1978.1-2006.4) and CNKI (1994-2006). The methodological quality of the studies selected for review was assessed according to the quality assessment criteria suggested by the Cochrane systematic review guideline. Meta-analysis was performed by RevMan 4.2 software. Results: Eight studies were included in the systematic review. Meta-analysis showed that there was statistically significant difference between mi and other forms of therapy [surgery or antithyroid drugs (ATD)] (test value: 2.31, 5.97, 3.70, 5.55; all P 0.05). There were not yet any studies on the impact between early prevention of hypothyroidism after mi therapy and GO. Conclusions: Based on meta-analysis on literature data, if early measures are not performed to prevent hypothyroidism after mi therapy, it may induce or aggravate GO more frequently than ATD or surgical treatment. Symptomatic relief of GO after 131 I therapy is also less effective than the other 2 forms of therapy. Therefore, 131 I therapy should be delivered carefully in those patients with GO. (authors)

  1. La mise en œuvre de la Convention des Nations Unies sur la lutte contre la désertification au Burkina Faso

    Directory of Open Access Journals (Sweden)

    Lynda Hubert Ta

    2017-09-01

    Full Text Available Parmi les instruments internationaux issus de la Conférence des Nations Unies sur l’environnement et le développement ou Sommet de la Terre, qui s’est tenue en 1992 à Rio de Janeiro (Brésil, la Convention des Nations Unies sur la lutte contre la désertification a été adoptée à Paris le 17 juin 1994. 193 États l’ont ratifiée. En effet, reconnaissant la désertification comme un problème environnemental, social et économique grave et persistant, malgré les efforts de la communauté internationale pour en venir à bout, les États présents à Rio ont exprimé leurs préoccupations face à ce problème et ont pris la résolution de préparer un accord dédié à la lutte contre la désertification. Cet accord est devenu l’une des pierres angulaires du droit international de l’environnement. Juridiquement contraignant pour les Parties qui doivent en appliquer les dispositions, les échos du discours global qu’il véhicule sont appelés à être intégrés aux politiques nationales des Parties, particulièrement les pays les plus affectés par le phénomène de désertification comme le Burkina Faso. Le présent article a pour objectif de questionner la mise en œuvre de la Convention des Nations Unies sur la lutte contre la désertification dans ce pays, plus d’une vingtaine d’années après son adoption, afin de porter un regard critique sur le chemin parcouru et celui qu’il reste à parcourir pour en vue des objectifs de la Convention.

  2. EFFET DES TRAITEMENTS THERMIQUES SUR LA REACTION ENTRE DES COUCHES MINCES DE TITANE ET DES SUBSTRATS EN ACIER

    Directory of Open Access Journals (Sweden)

    D Slimani

    2015-06-01

    Full Text Available Des couches minces du titane pur ont été déposées avec la méthode de pulvérisation cathodique sur des substrats en acier, type FF80 K-1 contenants ~1% mass. en carbone. La réaction entre les deux parties du système substrat-couche mince est activée avec des traitements thermiques sous vide dans l’intervalle de températures de 400 à900°Cpendant 30 minutes. Les Spectres de diffraction de rayons x confirment l’inter- diffusion des éléments  chimiques du système résultants la formation et la croissance des nouvelles phases en particulier le carbure binaire TiC ayant des caractéristiques thermomécaniques importantes. L’analyse morphologique des échantillons traités  avec le microscope électronique à balayage (MEB montre l’augmentation du flux de diffusion atomique avec la température de recuit, notamment la diffusion du manganèse et du fer vers la surface libre des échantillons aux températures élevées provoquant la dégradation des propriétés mécaniques des revêtements contrairement au premiers stades d’interaction où on a obtenu des bonnes valeurs de la microdureté.

  3. Formalisation des bases méthodologiques et conceptuelles d'une analyse spatiale des accidents de la route

    Directory of Open Access Journals (Sweden)

    Florence Huguenin Richard

    1999-06-01

    Full Text Available Cet article pose les bases méthodologiques et conceptuelles d’une analyse spatiale du risque routier. L’étude de ce phénomène requiert une masse importante de données qui décrivent différentes dimensions de l’accident et qui peuvent être gérées dans un système d’information géographique. Elle demande aussi une réflexion méthodologique sur la cartographie du risque, les échelles d’observation, l’agrégation de données qualitatives et quantitatives, l’utilisation de méthodes statistiques adaptées au risque routier et l'intégration de l’espace comme facteur d’insécurité.

  4. The experience of gasless endoscopic-assisted thyroidectomy via the anterior chest approach for Graves' disease.

    Science.gov (United States)

    Hong, Yun; Yu, Shi-Tong; Cai, Qian; Liang, Fa-Ya; Han, Ping; Huang, Xiao-Ming

    2016-10-01

    The aim of this study was to evaluate the safety, feasibility, effectiveness, and cosmesis of a gasless endoscopic-assisted thyroidectomy via the anterior chest in patients with Graves' disease. We retrospectively reviewed 38 patients with Graves' disease treated with thyroidectomy from November 2007 to June 2015. We analyzed clinical characteristics of patients, type of operation, operative indications, operative duration, length of postoperative hospital stay, and postoperative complications. The thyroidectomies were classified as total thyroidectomy (n = 12) or near-total thyroidectomy with a remnant of Graves' disease is a safe, feasible, and effective and provides an excellent cosmetic outcome procedure. It is a valid option in appropriately selected patients.

  5. Hypothyroid Graves' disease complicated with elephantiasis nostras verrucosa (ENV): a case report and review of the literature.

    Science.gov (United States)

    Ukinç, Kubilay; Bayraktar, Miyase; Gedik, Arzu

    2009-08-01

    Thyroid dermopathy is not a frequent feature of hyperthyroid Graves' disease, being present in less than 5% of the patients. Graves' disease has been shown to exist in euthyroid or hypothyroid forms in untreated patients. Here, we describe a case of hypothyroid Graves' disease with elephantiasis nostras verrucosa (ENV), which is an extreme form of thyroid dermopathy (TD). A 58-year-old female patient was admitted to the emergency department with somnolence, hypothermia, and bradycardia. Her mental status gradually worsened, resulting in a deep coma. She was intubated and followed in the intensive care unit, as she needed mechanical ventilatory assistance due to respiratory failure. She also had bilateral non-pitting edema, a cobblestone-like appearance, and hyperkeratotic greenish-brown-colored lesions in the pretibial and dorsal regions of the feet that were compatible with ENV. Hypothyroid Graves' disease is a very rare condition among autoimmune thyroid disorders, and ENV is an extremely rare form of TD. Here, we present a patient with hypothyroid Graves' disease and ENV.

  6. Age and stress as determinants of the severity of hyperthyroidism caused by Graves' disease in newly diagnosed patients.

    Science.gov (United States)

    Vos, Xander G; Smit, Natalie; Endert, Erik; Brosschot, Jos F; Tijssen, Jan G P; Wiersinga, Wilmar M

    2009-02-01

    The evidence that stress may provoke Graves' hyperthyroidism in genetically susceptible subjects is substantial. Whether exposure to stress is related to the severity of thyrotoxicosis has not been studied. Advancing age is associated with not only less severe Graves' hyperthyroidism but also self-reported stress. We tested the hypothesis whether advancing age is associated with less exposure to stress, resulting in a lower immunological response, and less severe Graves' hyperthyroidism. Cross-sectional multicenter study. Two hundred and sixty-three consecutive untreated patients with a first episode of Graves' hyperthyroidism were included. The severity of Graves' hyperthyroidism was evaluated biochemically (freeT(4)-index and freeT(3)-index, thyrotropin-binding inhibitory immunoglobulin (TBII)) and clinically by the hyperthyroid symptom scale score (HSS score). Stress exposure was quantitated by three questionnaires. Advancing age was associated with less severe Graves' hyperthyroidism, both biochemically by lower serum freeT(3)-index and freeT(4)-index (Phyperthyroidism. Advancing age was associated with lower scores for stress exposure. Multivariate regression analysis showed that HSS score was independently related to the tendency to report negative feelings (Phyperthyroidism. Because no direct relationship exists between stress exposure and TBII or freeT(3)-index and freeT(4)-index, we reject our hypothesis that less stress is causally related to biochemically less severe Graves' hyperthyroidism in old age. HSS score is primarily determined by negative feelings and not by age.

  7. Accident management

    International Nuclear Information System (INIS)

    Lutz, R.J.; Monty, B.S.; Liparulo, N.J.; Desaedeleer, G.

    1989-01-01

    The foundation of the framework for a Severe Accident Management Program is the contained in the Probabilistic Safety Study (PSS) or the Individual Plant Evaluations (IPE) for a specific plant. The development of a Severe Accident Management Program at a plant is based on the use of the information, in conjunction with other applicable information. A Severe Accident Management Program must address both accident prevention and accident mitigation. The overall Severe Accident Management framework must address these two facets, as a living program in terms of gathering the evaluating information, the readiness to respond to an event. Significant international experience in the development of severe accident management programs exist which should provide some direction for the development of Severe Accident Management in the U.S. This paper reports that the two most important elements of a Severe Accident Management Program are the Emergency Consultation process and the standards for measuring the effectiveness of individual Severe Accident Management Programs at utilities

  8. [Grave's disease in children with 22q11 deletion. Report of three cases].

    Science.gov (United States)

    Gosselin, J; Lebon-Labich, B; Lucron, H; Marçon, F; Leheup, B

    2004-12-01

    Hypothyroidism is a well recognized complication of 22q11.2 deletion syndrome. Auto-immune hyperthyroidism is less common. We report three patients with a 22q11.2 deletion and Graves' disease diagnosed at age 17, 14 and 11 years, respectively. The clinical and biological presentation was typical for auto-immune hyperthyroidism. Graves' disease should be periodically sought during the follow-up program of patients with 22q11.2 deletion syndrome.

  9. Promouvoir l'entrepreneuriat inclusif des jeunes et des femmes ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le projet vise à analyser la contribution réelle et potentielle de l'entrepreneuriat inclusif au bien-être des jeunes et des femmes en Côte d'Ivoire, au Burkina Faso et au Kenya. Après un état des lieux de la pratique de l'entrepreneuriat inclusif dans chacun des pays ciblés, l'équipe de recherche étudiera son incidence sur ...

  10. B-cell depletion with rituximab in the treatment of autoimmune diseases. Graves' ophthalmopathy the latest addition to an expanding family

    DEFF Research Database (Denmark)

    Nielsen, Claus H; El Fassi, Daniel; Hasselbalch, Hans K

    2007-01-01

    of 10 Graves' disease patients remained in remission 400 days after rituximab treatment versus none in the control group, and remarkable improvements in the eye symptoms of patients with Graves' ophthalmopathy were observed. This supports a role for B cells in the pathogenesis of Graves' ophthalmopathy...

  11. Simulations numériques d'accidents réels véhicule/piéton et véhicule/cycliste

    OpenAIRE

    SERRE, T; PERRIN, C; CHALANDON, S; DEPRIESTER, JP; GINEYT, G; LLARI, M; DEON, J

    2006-01-01

    L'objectif de ce travail est de présenter et d'illustrer une méthode générale de reconstruction d'accidents réels impliquant une automobile et un piéton ou un cycliste. Le principe général s'appuie sur la complémentarité d'une double approche, d'une part accidentologique clinique, fondée sur des Études Détaillées d'Accidents, de l'autre biomécanique, fondée sur la simulation numérique multicorps du choc. Les données accidentologiques recueillies vont tout d'abord fournir, en amont de la simul...

  12. Characterization of radioiodine therapy failures in Graves' disease

    International Nuclear Information System (INIS)

    Sabri, O.; Zimny, M.; Schreckenberger, M.; Reinartz, P.; Nowak, B.; Ostwald, E.; Schaefer, W.; Block, S.; Setani, K.; Buell, U.

    2001-01-01

    Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves' disease without simultaneous carbimazole. Method: 226 patients with a confirmed diagnosis of Graves' disease received 686.8 ± 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), I-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 ± 76.6 Gy vs. 285.2 ± 82.1 Gy, p 0.2). Of the 14 failures, n = 8 reached an absorbed dose 250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p 0.2) or gender (p = 0.13). Two-tailed Fisher's exact test showed no significant influence of gender on success rates (failures/successes: male 1/36, female 13/176, p = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves' disease without simultaneous carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy. (orig.) [de

  13. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

    Directory of Open Access Journals (Sweden)

    Márcia Lait Morse

    2011-06-01

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary

  14. Analysis of the factors associated with Tc-99m pertechnetate uptake in thyrotoxicosis and Graves' disease

    International Nuclear Information System (INIS)

    Kidokoro-kunii, Yo; Emoto, Naoya; Cho, Keiichi; Oikawa, Shinichi

    2006-01-01

    To determine the factors associated with 20 minute Tc-99m pertechnetate thyroid uptake, we examined all patients in whom thyrotoxicosis was diagnosed at Chiba-Hokusoh Hospital, Nippon Medical School from 2001 April through 2003 March. Patients with thyrotoxicosis diagnosed during this period were 57 with Graves' disease (76%), 11 with transient hyperthyroxinemia (TH) (14.7%), and 7 with subacute thyroiditis (SAT) (9.3%). The uptake of Tc-99m ranged from 0.97% to 40.1% in Graves' disease and from 0.15% to 0.8% in TH. Although TH may include spontaneous resolution of Graves' disease as well as painless thyroiditis, no treatment was necessary for these patients. Uptake in all patients with SAT was less than 0.5%. There were significant correlations between the level of Tc-99m uptake and the levels of free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH)-binding inhibitory immunoglobulin (TBII), and thyroid stimulating antibody (TSAb) in patients with Graves' disease. Older patients with Graves' disease showed lower uptake than did younger patients. Both Tc-99m pertechnetate uptake and TBII levels, but not fT3, fT4 or TSAb levels, at the beginning of antithyroid drug treatment correlated significantly with the duration of treatment until the daily dose of methimazole reached 5 mg. These data suggest that Tc-99m pertechnetate uptake reflects the severity of Graves' disease and its response to the medical treatment and that antithyroid drug therapy is not necessary when the uptake is less than 0.9%. (author)

  15. Shipment of Gross Quantities of Radiostrontium; Transport de Grandes Quantites de Radiostrontium; 0422 0420 0410 041d 0421 041f 041e 0420 0422 0418 0420 041e 0412 041a 0410 0411 041e 041b 042c 0428 0418 0425 041a 041e 041b 0418 0427 0415 0421 0422 0412 0420 0410 0414 0418 041e 0418 0417 041e 0422 041e 041f 041e 0412 ; Transporte de Grandes Cantidades de Radioestroncio

    Energy Technology Data Exchange (ETDEWEB)

    Zahn, L. L.; Smith, C. W.; Junkins, R. L. [Hanford Laboratories General Electric Co., Richland, WA (United States)

    1963-02-15

    utilises pour les envois de Hanford, le critere de base etant d'assurer le confinement du contenu dans toutes les conditions normales de transport et en cas d'accident (impact avec une surface immobile a 50 km/h, suivi d'une interruption de 48 h de la dissipation de chaleur ou de l'exposition a un feu de 1570 Degree-Sign C pendant deux heures). A l'origine, les recipients etaient pourvus de dispositifs qui permettaient leur chargement et leur dechargement a la main et la commande a distance des ajustages et fermetures. Jusqu'a present, on transportait les produits de fission sous forme de tourteaux seches et stabilises dans le recipient ou sous forme de cations adsorbes par une substance inorganique echangeuse d'ions. Les auteurs decrivent les recipients construits a Hanford pour le transport de90Sr sous ces deux formes et comparent leurs specifications essentielles. Bien que ces recipients aient ete prevus pour supporter les accidents definis plus haut, on a reconnu qu'un accident grave pouvait provoquer la liberation d'une partie de leur contenu. L'evaluation des consequences possibles d'une telle liberation a montre que la dispersion dans l'atmosphere serait plus grave que la dispersion dans l'eau douce; c'est pourquoi les proprietes physiques et chimiques du moyen de transport ont une grande importance. Si ces radioelements a longue periode se dispersaient dans des zones d'habitation, il faudrait proceder a l'evacuation de la population et a une decontamination generale. Bien que la probabilite d'une liberation accidentelle soit tres faible, on a juge necessaire, en raison des consequences graves qu'elle pourrait avoir, d'imposer des controles administratifs visant a diminuer la possibilite d'un accident grave et a minimiser les dommages qui pouvaient etre ainsi causes. L'evaluation des dommages possibles a permis de definir les ameliorations a apporter pour parfaire les conditions de transport. On met au point a l'heure actuelle des recipients qui garderont longtemps

  16. Course of depression in Cushing's syndrome: response to treatment and comparison with Graves' disease.

    Science.gov (United States)

    Sonino, N; Fava, G A; Belluardo, P; Girelli, M E; Boscaro, M

    1993-01-01

    Depression in a common, life-threatening complication of Cushing's syndrome and may occur in several other endocrine disorders. It is not clear, however, whether distinct features pertain to hypercortisolism. We studied depression in Cushing's syndrome differentiating pituitary-dependent and pituitary-independent forms, its incidence compared to Graves' disease, and its appearance in the prodromal phase of both conditions. To 66 consecutive patients with Cushing's syndrome and 70 with Graves' disease, after treatment, a semistructured interview for depressive symptoms based on Paykel's clinical interview for depression was administered. In Cushing's syndrome, the response of depression to normalization of urinary cortisol levels was evaluated by Kellner's global rating method. There was a significant difference in the occurrence of depression (p Cushing's syndrome (62%) and Graves' disease (23%). Depression appeared in the prodromal phase in 27% of patients with Cushing's syndrome and in 14% of those with Graves' disease, but the difference was not significant. In Cushing's syndrome, there were no significant differences in depression between patients with pituitary-dependent (n = 41) and pituitary-independent (n = 20) forms, or in their response to treatment. About 70% of patients fully recovered from their depression, whereas there was no substantial change in the others and even worsening in 2. Our findings in Cushing's syndrome and Graves' disease are in agreement with previous investigations using specific diagnostic criteria for depression. We found a tendency for this symptom to manifest in the prodromal phase of both illnesses. An endocrine etiology should be, therefore, considered in depressed patients not responding to standard psychiatric treatment.

  17. Long-term results of radiotherapy for 104 patients with Graves' orbitopathy

    International Nuclear Information System (INIS)

    Qu Baolin; Yang Dong; Feng Linchun; Luo Zhiyuan

    2008-01-01

    Objective: To evaluate the long-term outcome and the sequelae of Graves' orbitopathy treated with radiotherapy, and to specify the prognostic factors. Methods: From 1979 to 1999, 104 patients with progressive Graves' orbitopathy were treated with conventional orbital radiotherapy. Post globe and pituitary irradiation of 25-35 Gy was given to 56 patients, which was followed by a boost of 15-20 Gy to the pituitary. Follow-up time was 7.5 - 25.0 years. The result of radiotherapy was analyzed. Results: Overall response rate was 71.1%. The response rate of patients with soft-tissue infiltration, corneal involvement, proptosis, sight loss and extraocular muscle dysfunction was 88.4%, 75.1%, 55.6%, 68.8% and 64.4%, respectively. Twelve patients (11.5%) developed cataracts 2.5-18.3 years (median 11.2 years) after irradiation. One patient developed left-eye retinopathy 3.2 years after irradiation. No patient developed secondary tumor within the irradiation field. Conclusions: Orbital radiotherapy for progressive Graves' orbitopathy, being effective and safe, can control the disease progression and improve the symptoms. The side effect of radiotherapy is fewer than other treatment modalities. (authors)

  18. Prise en charge des urgences au service d'accueil des urgences ...

    African Journals Online (AJOL)

    Introduction: La prise en charge des patients dans les services d'accueil des urgences est une des meilleures vitrines d'un système de santé. En Afrique subsaharienne, la gestion des urgences se heurte à des difficultés humaines et matérielles. Le but de ce travail était d'évaluer les difficultés de prise en charge au Service ...

  19. Lessons drawn from serious accidents in nuclear power stations

    International Nuclear Information System (INIS)

    Kosciusko-Morizet, F.; Tanguy, P.

    1981-01-01

    Taking a number of serious accidents considered to be particularly representative (Windscale, Enrico Fermi, Lucens, Browns Ferry, Three Mile Island and Saint-Laurent-des-Eaux), the paper analyses the conclusions reached in subsequent enquiries and the lessons drawn from them by the responsible authorities. While design problems sometimes come to light, it is much more generally operational safety - problems related to instructions, the training of operators, the man/machine relationship - which appears to be inadequate. The organization of relations between the different partners - builders, operators and safety bodies - likewise gives rise to some observations. Certain measures should be pursued on a broader scale in order to improve our ability to prevent serious accidents: (i) incidents important from the standpoint of safety must be identified; (ii) these incidents must be brought to the knowledge of all partners concerned, in all interested countries; (iii) the lessons drawn from them must be exchanged and compared; and (iv) the lessons must be made generally available in a directly usable form (i.e. as design modifications, changes in instructions and so on). Particular attention must be given to the problems of countries which are embarking on nuclear programmes and which, with a small number of installations, need direct and permanent access to all the lessons drawn from the operation of a large power station park, and must be able to call upon the assistance of teams from outside in the event of an accident. (author)

  20. Radioreceptor assay study of thyrotropin receptor antibody (TRAb) in Grave's diseases

    International Nuclear Information System (INIS)

    Lu Chao; Lin Xiangtong

    1989-01-01

    Here was reported the assay system using pig thyroid TSH receptor and 125 I-bTSH purified by receptor of thyroid cell membrane for the study of TRAb activity. The binding rate of ASH soluble receptor with 125 I-bTSH was 22.2 ∼ 37.4%, while as the control was only 1.0 ∼ 2.1%. TRAb was measured clinically in 48 cases of Grave's diseases and 25 normal persons. The TSH binding inhabitory index(TRII) was introduced for reflection of TRAb activity. The results showed that TBII was positure in 30 of 48 patients of Grave's diseases, the detctactibility was 79.2%

  1. Récit de guerre et éthique. Singularité, communauté et temporalité Adieu à tout cela de Robert Graves et La main coupée de Blaise Cendrars

    Directory of Open Access Journals (Sweden)

    Anne MOUNIC

    2011-06-01

    Full Text Available Après avoir évoqué brièvement quelques récits de la Grande Guerre selon certaines lignes de partage – idéalisme de la mort et choix de la vie, extase et goût de l’existence quotidienne, On et Nous, individualisme et singulier – de façon à mettre en évidence des pensées divergentes, je me propose de comparer deux récits majeurs, œuvre d’engagés volontaires dans le conflit, Adieu à tout cela (1929 de Robert Graves (1895-1985 et La main coupée (1946 de Blaise Cendrars (1887-1961. Outre des différences qui tiennent bien évidemment à la singularité de chacun, on peut repérer entre ces deux auteurs des attitudes et préoccupations semblables. Tous deux, blessés, et Cendrars, mutilé de sa main droite, celle de l’écrivain, ont éprouvé cette expérience de guerre comme épreuve initiatique menant à l’affirmation de leur singularité au sein du Nous de la communauté. Tous deux ont fait du souvenir de leurs camarades morts leur tâche poétique. Tous deux ont reconnu la réalité de ce que Graves, jusqu’à la fin de sa vie, nomma « meurtre » – et Cendras écrivit « J’ai tué ».L’expérience de guerre a suscité chez ces deux poètes un refus du dualisme idéaliste (« Il n’y a pas d’absolu, » écrit Cendrars. « Il n’y a donc pas de vérité, sinon la vie absurde qui remue ses oreilles d’âne. », un rejet de l’exaltation de la virilité, marque de la période de l’entre-deux guerres, comme l’a montré G.L. Mosse, et une volonté de ne pas succomber, dans leurs écrits, à une esthétique de la guerre (ce que font, chacun à leur manière, pour ne citer qu’eux, Jünger et Céline. Graves avoue, à la fin de son ouvrage : « J’ai tenté plusieurs fois durant ces années de me débarrasser du poison des souvenirs de guerre en finissant mon roman, mais pour l’abandonner, pris de honte d’avoir déformé mon matériau avec une intrigue, et manquant pourtant d’assurance pour

  2. The change of serum TRAb after 131I radiotherapy in patients of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    Cui Bangping; Jiang Changbin; Hu Wei; Yang Jianhua; Guo Zugao

    2007-01-01

    Objective: The clinical value of thyrotrophin receptor antibody (TRAb) in patients with Graves' hyperthyroidism was investigated during 131 I radiotherapy. Methods: A total of 130 patients with Graves' hyperthyroidism and 50 normal controls were included in the study. Serum concentration of TRAb was measured by radioreceptor assay (RRA) before and at 3, 6, 12 and 24 months after 131 I radiotherapy. Results: Abnormally higher TRAb level [(92.93±68.99)U/L] was noted in patients before treatment(P 131 I radiotherapy, the TRAb [(12.99±5.52) U/L] was back to normal with no difference to that of controls (P>0.05). Conclusion: Serum concentration of TRAb was of clinical significance in the diagnosis of Graves' hyperthyroidism and in the monitoring of 131 I radiotherapy. (authors)

  3. Clinical evaluation of the 2nd generation radio-receptor assay for anti-thyrotropin receptor antibodies (TRAb) in Graves' disease

    International Nuclear Information System (INIS)

    Giovanella, L.; Ceriani, L.; Garancini, S.

    2002-01-01

    Full text: Detection of autoantibodies to the TSH receptor by radioreceptorial assays (RRA) is largely requested in clinical practice for the diagnosis of Graves' disease and its differentiation from diffuse thyroid autonomy. Additionally, TRAb measurement during antithyroid drug treatment can be useful to evaluate the risk of disease's relapse alter therapy discontinuation. Nevertheless, some patients affected by Graves' disease are TRAb negative when 1st generation assay is used. Recently a new RRA method for TRAb assay was developed by using human recombinant TSH-receptor and solid-phase technique. Aim of our work was the comparison between 1st and 2nd generation TRAb assays in Graves' disease patients and, particularly, the evaluation of 2nd generation test in a sub-group of patients affected by Graves' disease but with negative 1st generation TRAb assay. We evaluated the diagnostic performance of a newly developed 2nd generation TRAb assay (DYNOtest(r) TRAK human, BRAHMS Diagnostica GmbH, Germany) in 46 patients affected by Graves' disease with negative 1st generation TRAb assay (TRAK Assay(r), BRAHMS Diagnostica GmbH, Germany) . A control groups of 50 Graves' disease patients with positive 1st generation TRAb assay, 50 patients affected by Hashimoto's thyroiditis and 50 patients affected by nodular goiter were also examined. 41 out of 46 patients affected by Graves' disease with negative 1st generation TRAb assay showed a positive 2nd generation test. The overall sensitivity of the 2nd generation test was significantly improved respect the 1st generation assay in Graves' disease patients (χ 2 = 22.5, p<0.0001). 1 and 3 out of 50 patients affected by Hashimoto's thyroiditis were positive by 1st and 2nd generation TRAB assay, respectively. All these patients showed primary hypothyroidism. No differences resulted in euthyroid Hashimoto's thyroiditis sub-group and in nodular goiter control group. The 2nd generation TRAB assay is clearly more sensitive than the 1

  4. Connaissances, attitudes et pratiques des prestataires de santé des ...

    African Journals Online (AJOL)

    ... des prestataires interrogés avaient respectivement une bonne connaissance des facteurs de risque et des moyens de dépistage. Les signes évocateurs et les examens complémentaires nécessaires au diagnostic du cancer du sein étaient connus par 15,3 % des prestataires. La définition du cancer du sein et les moyens ...

  5. Guide-line of the radio-iodine (131I) therapy in Graves' disease and thyroid cancer

    International Nuclear Information System (INIS)

    Mori, Yutaka; Ikekubo, Katsuji

    2005-01-01

    Radio-iodine ( 131 I) therapy has been using in Graves' disease and well differentiated thyroid cancer. The rules of control in the discharge from radio-isotope hospital were notified in 1999 in Japan. Guideline of the 131 I therapy in Graves' disease and thyroid cancer were prepared by sub-group of Japanese Society of Nuclear Medicine. (author)

  6. Composition en acide alphalinolénique des esters de cholestérol plasmatiques : un marqueur de consommation chez l’homme

    Directory of Open Access Journals (Sweden)

    Combe Nicole

    2002-07-01

    Full Text Available Le lien existant entre qualité et quantité des acides gras de l’alimentation, et santé est de plus en plus évident et défini, comme l’indique la revue des travaux plus spécifiquement consacrés aux implications dans le risque de maladies cardiovasculaires (MCV (cf. premier exposé de ce dossier. Néanmoins, si un grand nombre d’études épidémiologiques ou d’intervention ont permis d’aboutir à un consensus qui s’est traduit, en France, par la publication en 2001 des Apports Nutritionnels Conseillés [1], un débat perdure au sein de la communauté scientifique internationale sur les meilleurs apports en acides gras monoinsaturés versus poly-insaturés [2, 3]. Les études récentes de Rudel et al. [4-6] indiquent en effet que des singes nourris avec un régime très enrichi en acide oléique (18:1n-9 : 24% de l’apport énergétique développent une athérosclérose des artères coronaires qui pourrait être en relation avec l’accumulation subséquente d’oléate de cholestérol dans les LDL aux dépens du linoléate de cholestérol. Par ailleurs, eu égard aux effets bénéfiques reconnus à l’acide alphalinolénique (18:3n-3 vis-à-vis des risques d’infarctus du myocarde, de cardiopathie ischémique [7-9] et d’accident vasculaire cérébral [10, 11], le niveau de 18:3n-3 dans les esters de cholestérol (EC du plasma apparaît comme un bon indicateur de protection. En effet, l’étude conduite par Sandker et al. [12], sur deux groupes d’hommes âgés, issus des cohortes crétoises (Seven Countries Study et hollandaises (Zutphen Study, a permis de faire émerger l’intérêt de ce marqueur biologique. En moyenne, le pourcentage de 18:3n-3 mesuré dans les EC plasmatiques des Crétois était significativement plus élevé comparé à celui des Hollandais (0,9% vs 0,32% des acides gras, dont la cohorte présentait un taux de mortalité coronarienne 5 fois plus grand que celui de la cohorte crétoise. En outre, l

  7. Dosimetry-based treatment for Graves' disease.

    Science.gov (United States)

    Hyer, Steve L; Pratt, Brenda; Gray, Matthew; Chittenden, Sarah; Du, Yong; Harmer, Clive L; Flux, Glenn D

    2018-06-01

    The aim of this retrospective study was to assess the long-term outcome of a personalized dosimetry approach in Graves' disease aiming to render patients euthyroid from a planned thyroid absorbed dose of 60 Gy. A total of 284 patients with Graves' disease were followed prospectively following administration of radioiodine calculated to deliver an absorbed dose of 60 Gy. Patients with cardiac disease were excluded. Outcomes were analysed at yearly intervals for up to 10 years with a median follow-up of 37.5 months. A single radioiodine administration was sufficient to render a patient either euthyroid or hypothyroid in 175 (62%) patients, the remainder requiring further radioiodine. The median radioactivity required to deliver 60 Gy was 77 MBq. Less than 2% patients required 400-600 MBq, the standard activity administered in many centres. In the cohort receiving a single administration, 38, 32 and 26% were euthyroid on no specific thyroid medication at 3, 5 and 10 years, respectively. Larger thyroid volumes were associated with the need for further therapy. The presence of nodules on ultrasonography did not adversely affect treatment outcome. A personalized dosimetric approach delayed the long-term onset of hypothyroidism in 26% of patients. This was achieved using much lower administered activities than currently recommended. Future studies will aim to identify those patients who would benefit most from this approach.

  8. Orbital flourine-18-fluorodeoxyglucose positron emission tomography in patients with Graves' disease for evaluation of active inflammation.

    Science.gov (United States)

    Uslu-Beşli, Lebriz; Kabasakal, Levent; Sağer, Sait; Cicik, Erdoğan; Asa, Sertaç; Sönmezoğlu, Kerim

    2017-11-01

    Prediction and early diagnosis of orbitopathy is needed in patients with Graves' disease, especially when radioiodine therapy is planned. Positron emission tomography/computerized tomography (PET/CT) using flourine-18-fluorodeoxyglucose (FDG) is an effective imaging modality in detection of inflammation, however, its ability to detect orbital inflammation has not been well studied. The aim of our study is to determine the ability of FDG PET/CT to detect orbital inflammation related with Graves' disease, identify active orbitopathy, predict the radioiodine-triggered orbitopathy, and find out the effects of radioiodine on orbital inflammation. Total 31 Graves' disease patients and 17 controls were included. All Graves' disease patients underwent cranial FDG PET/CT imaging prior therapy. Radioiodine therapy and post-treatment PET/CT study was applied to 21 patients. PET/CT images of all examinees were evaluated, measuring extraocular muscle maximum standard uptake value (SUVmax) and muscle thickness. FDG uptake was increased in the majority of extraocular muscles in Graves' disease patients in comparison to controls and this increase was found to be irrelevant from muscle thickness. Extraocular muscle SUVmax values did not increase in Graves' orbitopathy patients who received radioiodine under corticosteroid prophylaxis. SUVmax level of all orbital rectus muscles were increased after radioiodine therapy in nonsmokers, whereas no increase was detected in smokers. FDG PET/CT may be helpful in detection of extraocular muscle inflammation and it may show ongoing orbitopathy in early stages of inflammation before anatomical changes occur.

  9. James George Frazer’s Anthropologic Heritage in the Work of Robert Graves

    Directory of Open Access Journals (Sweden)

    Tomislav M. Pavlović

    2016-02-01

    Full Text Available The works of Sir James George Frazer had an outstanding influence on the literature of modernism. Among those who benefited from Frazer’s ritualism were W. B. Yeats, T. S. Eliot. James Joyce, Ernest Hemingway, D. H. Lawrence, Ezra Pound, Mary Renault, Joseph Campbell, Robert Graves and many others. Robert Graves was known for his famous adaptation of Frazer’s concept of the sacred king who is sacrificed for the benefit of his subjects thus forming the narrative frame for the one of his most controversial novels. The dying king is also identified with the poet striving to attain the favour of the Triple Muse Goddess - who represents the embodiment of true poetic inspiration. The aforementioned concept is not the only thing that Graves inherited from his famous ancestor. In our analysis we laid stress on the customs, rituals, magic symbols and deities both authors dealt with. We also observed a striking resemblance of the style Greves and Frazer developed and their euchemeristic approach to myths as well.

  10. La prévalence des helminthoses bovines a-t-elle été modifiée par la canicule de l’été 2003 dans le sud-ouest de la France ?

    Directory of Open Access Journals (Sweden)

    Thomas C.

    2007-09-01

    Full Text Available La comparaison des résultats de 1 917 examens coproscopiques de bovins du midi toulousain montre qu’entre 2002 et 2003, la prévalence et le nombre moyen d’oeufs de grande douve, de paramphistomes, de petite douve et de strongles gastro-intestinaux ont significativement diminué. En revanche, dès l’année suivante, les niveaux parasitaires ont été restaurés. La discussion envisage les différents facteurs qui, à plus ou moins long terme, pourraient aboutir à une évolution durable de l’épidémiologie des helminthoses. Il s’agit d’une adaptation des souches de vers, d’une modification de l’écologie des hôtes intermédiaires et enfin d’un déplacement des hôtes ou des réservoirs. En bilan, un accident climatique comme celui de 2003 ne doit pas aboutir à un relâchement des mesures de lutte contre le parasitisme mais à leur adaptation en étudiant un nouveau calendrier des interventions.

  11. Multi-center study on the characteristics and treatment strategies of patients with Graves' orbitopathy: the first European Group on Graves' Orbitopathy experience

    NARCIS (Netherlands)

    Prummel, Mark F.; Bakker, Annemieke; Wiersinga, Wilmar M.; Baldeschi, Lelio; Mourits, Maarten P.; Kendall-Taylor, Pat; Perros, Petros; Neoh, Chris; Dickinson, A. Jane; Lazarus, John H.; Lane, Carol M.; Heufelder, Armin E.; Kahaly, George J.; Pitz, Suzanne; Orgiazzi, Jacques; Hullo, Alain; Pinchera, Aldo; Marcocci, Claudio; Sartini, Maria S.; Rocchi, Roberto; Nardi, Marco; Krassas, Gerry E.; Halkias, A.

    2003-01-01

    To improve management of patients with Graves' orbitopathy, a multi-center collaborative approach is necessary in order to have large enough sample sizes for meaningful randomized clinical trials. This is hampered by a lack of consensus on how to investigate the eye condition. The European Group on

  12. Usages des TIC et socialisation professionnelle des enseignants-chercheurs

    OpenAIRE

    Lavielle-Gutnik, Nathalie; Massou, Luc

    2013-01-01

    En prenant appui sur une nouvelle analyse des données recueillies dans l’enquête Tec-Meus (2008-2011, MSH Lorraine) sur la place accordée par des enseignants-chercheurs en sciences humaines et sociales aux technologies de l’information et de la communication (TIC) dans leur activité d’enseignement, nous souhaitons nous focaliser dans cet article sur la compréhension des processus de socialisation professionnelle en jeu dans leur usage déclaré des TIC. Par socialisation professionnelle, nous e...

  13. Earliest floral grave lining from 13,700-11,700-y-old Natufian burials at Raqefet Cave, Mt. Carmel, Israel.

    Science.gov (United States)

    Nadel, Dani; Danin, Avinoam; Power, Robert C; Rosen, Arlene M; Bocquentin, Fanny; Tsatskin, Alexander; Rosenberg, Danny; Yeshurun, Reuven; Weissbrod, Lior; Rebollo, Noemi R; Barzilai, Omry; Boaretto, Elisabetta

    2013-07-16

    Flowering plants possess mechanisms that stimulate positive emotional and social responses in humans. It is difficult to establish when people started to use flowers in public and ceremonial events because of the scarcity of relevant evidence in the archaeological record. We report on uniquely preserved 13,700-11,700-y-old grave linings made of flowers, suggesting that such use began much earlier than previously thought. The only potentially older instance is the questionable use of flowers in the Shanidar IV Neanderthal grave. The earliest cemeteries (ca. 15,000-11,500 y ago) in the Levant are known from Natufian sites in northern Israel, where dozens of burials reflect a wide range of inhumation practices. The newly discovered flower linings were found in four Natufian graves at the burial site of Raqefet Cave, Mt. Carmel, Israel. Large identified plant impressions in the graves include stems of sage and other Lamiaceae (Labiatae; mint family) or Scrophulariaceae (figwort family) species; accompanied by a plethora of phytoliths, they provide the earliest direct evidence now known for such preparation and decoration of graves. Some of the plant species attest to spring burials with a strong emphasis on colorful and aromatic flowers. Cave floor chiseling to accommodate the desired grave location and depth is also evident at the site. Thus, grave preparation was a sophisticated planned process, embedded with social and spiritual meanings reflecting a complex preagricultural society undergoing profound changes at the end of the Pleistocene.

  14. Mediastinal neoplasms in patients with Graves disease: a possible link between sustained hyperthyroidism and thymic neoplasia?

    Directory of Open Access Journals (Sweden)

    Boyd Jonathan D

    2012-07-01

    Full Text Available Abstract Background Anterior mediastinal masses are a rare but well documented finding in Graves disease. The vast majority of these lesions represents benign thymic hypertrophy and regress after treatment of the hyperthyroidism. A small percentage of these cases however represent neoplastic/malignant diseases which require further treatment. Cases 12 year old boy with one year history of refractory Graves disease was found to have an anterior mediastinal mass and underwent curative thyroidectomy for sustained hyperthyroidism. Cervical lymphadenopathy was detected during the procedure and biopsy was obtained. A 23 year old woman who presented with a one month history of hyperthyroid symptoms, was diagnosed with Graves disease and also was found to have an anterior mediastinal mass on imaging. Biopsy of the anterior mediastinal mass was obtained and subsequently the patient underwent robotic thymectomy. Histologic examination and immunophenotyping of the cervical lymph node in a 12 year old boy revealed neoplastic proliferation of T lymphoblasts diagnostic of T lymphoblastic leukemia/lymphoma. Examination of the anterior mediastinal mass biopsy in the 23 year old woman revealed type B1 thymoma which was confirmed after examination of the subsequent robotic thymectomy specimen. Conclusion This is the first reported case of T cell lymphoblastic lymphoma and the third reported case of thymoma associated with sustained hyperthyroidism due to Graves disease. These cases indicate that an anterior mediastinal mass in a patient with active Graves disease may be due to a neoplastic cause, which may require definitive treatment. Caution should be exercised when dismissing a mediastinal mass as benign thymic hyperplasia in patients with active Graves disease.

  15. Evaluer des études de gestion des entreprises : combiner des éléments principales avec des éléments pratiques

    NARCIS (Netherlands)

    Pennink, B.J.W.

    2002-01-01

    Evaluer la recherche de gestion demande une combinaison des critères classiques et des critères pratiques. Par cette combinaison il est possible de trouver une réponse cerrecte concernant la validité et l'effet de la recherche. Dans cet article nous allons décrire comment une combinaison des

  16. Accident management insights after the Fukushima Daiichi NPP accident

    International Nuclear Information System (INIS)

    Degueldre, Didier; Viktorov, Alexandre; Tuomainen, Minna; Ducamp, Francois; Chevalier, Sophie; Guigueno, Yves; Tasset, Daniel; Heinrich, Marcus; Schneider, Matthias; Funahashi, Toshihiro; Hotta, Akitoshi; Kajimoto, Mitsuhiro; Chung, Dae-Wook; Kuriene, Laima; Kozlova, Nadezhda; Zivko, Tomi; Aleza, Santiago; Jones, John; McHale, Jack; Nieh, Ho; Pascal, Ghislain; ); Nakoski, John; Neretin, Victor; Nezuka, Takayoshi; )

    2014-01-01

    The Fukushima Daiichi nuclear power plant (NPP) accident, that took place on 11 March 2011, initiated a significant number of activities at the national and international levels to reassess the safety of existing NPPs, evaluate the sufficiency of technical means and administrative measures available for emergency response, and develop recommendations for increasing the robustness of NPPs to withstand extreme external events and beyond design basis accidents. The OECD Nuclear Energy Agency (NEA) is working closely with its member and partner countries to examine the causes of the accident and to identify lessons learnt with a view to the appropriate follow-up actions to be taken by the nuclear safety community. Accident management is a priority area of work for the NEA to address lessons being learnt from the accident at the Fukushima Daiichi NPP following the recommendations of Committee on Nuclear Regulatory Activities (CNRA), Committee on the Safety of Nuclear Installations (CSNI), and Committee on Radiation Protection and Public Health (CRPPH). Considering the importance of these issues, the CNRA authorised the formation of a task group on accident management (TGAM) in June 2012 to review the regulatory framework for accident management following the Fukushima Daiichi NPP accident. The task group was requested to assess the NEA member countries needs and challenges in light of the accident from a regulatory point of view. The general objectives of the TGAM review were to consider: - enhancements of on-site accident management procedures and guidelines based on lessons learnt from the Fukushima Daiichi NPP accident; - decision-making and guiding principles in emergency situations; - guidance for instrumentation, equipment and supplies for addressing long-term aspects of accident management; - guidance and implementation when taking extreme measures for accident management. The report is built on the existing bases for capabilities to respond to design basis

  17. Aspects des Onychomycoses chez des patients camerounais de ...

    African Journals Online (AJOL)

    ... biologiques et évolutifs des onychomycoses chez des patients camerounais. Méthode : Il s'agit d'une étude rétrospective et descriptive menée de mars 2011 à mars 2014 dans l'unité de dermatologie de l'hôpital général de Douala (HGD), incluant des patients chez lesquels le diagnostic d'onychomycose avait été posé.

  18. Pregnancy after definitive treatment for Graves' disease--does treatment choice influence outcome?

    Science.gov (United States)

    Elston, Marianne S; Tu'akoi, Kelson; Meyer-Rochow, Goswin Y; Tamatea, Jade A U; Conaglen, John V

    2014-08-01

    Women requiring thyroid hormone replacement after definitive therapy (surgery or radioiodine) for Graves' disease who later conceive require an early increase in levothyroxine dose and monitoring of thyroid hormone levels throughout pregnancy. In addition, as TSH receptor antibodies (TRAb) can cross the placenta and affect the fetus, measurement of these antibodies during pregnancy is recommended. To review the management of pregnancies following definitive treatment for Graves' disease in order to assess the rates of maternal hypothyroidism and TRAb measurement. Retrospective chart review of women who had undergone definitive treatment for Graves' disease at a tertiary hospital and subsequently had one or more pregnancies. A total of 29 women were identified, each of whom had at least one pregnancy since receiving definitive treatment for Graves' disease: there were a total of 49 pregnancies (22 in the surgical group and 27 in the radioiodine group). Both groups had high rates of hypothyroidism documented during pregnancy (47 and 50%, respectively). The surgical group was more likely to be euthyroid around the time of conception. Less than half of the women were referred to an endocrinologist or had TRAb measured during pregnancy. Neonatal thyroid function was measured in one-third of live births. One case of neonatal thyrotoxicosis was identified. Adherence to the current American Thyroid Association guidelines is poor. Further education of both patients and clinicians is important to ensure that treatment of women during pregnancy after definitive treatment follows the currently available guidelines. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  19. A dosimetry based on artificial neural net theory in treatment of Graves disease

    International Nuclear Information System (INIS)

    Yang Ping; Luo Dongyun; Lin Yongxia; Zeng Shiquan

    2002-01-01

    Objective: To study the feasibility of radioactive treatment of Graves disease with dosimetry of 131 I in novel method by computer. Methods: The database comprised 206 selected Graves disease cases and according to this database the nonlinear functions could be inferred consequently, then 206 Graves disease patients were divided into two groups. The group one, 109 patients, was treated with back-propagation (BP) dosimetry method. The group two was treated with traditional method. The results were analyzed. Results: Group one had an effective rate of 93.5%, cure rate of 90.8%, recurrent rate of 3.6% and early stage of hypothyroidism rate of 3.6%. Group two had an effective rate of 90.7%, cure rate of 85.5%, recurrent rate of 5.1% and early stage of hypothyroidism rate of 5.1%. Conclusion: The BP method is efficient and the results reflect that this method might increase the accuracy of the dosimetry of 131 I and reduce recurrent rate and early stage of hypothyroidism occurrence

  20. Graves' hyperthyroidism and moderate alcohol consumption: evidence for disease prevention.

    Science.gov (United States)

    Carlé, Allan; Bülow Pedersen, Inge; Knudsen, Nils; Perrild, Hans; Ovesen, Lars; Rasmussen, Lone Banke; Jørgensen, Torben; Laurberg, Peter

    2013-07-01

    We recently demonstrated that moderate alcohol consumption is associated with a considerable reduction in the risk of autoimmune hypothyroidism, similar to findings in other autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. We aimed to study a possible association between alcohol intake and autoimmune Graves' hyperthyroidism. This is a population-based, case-control study. In a well-defined Danish population (2,027,208 person-years of observation), we prospectively identified patients with new overt thyroid dysfunction and studied 272 patients with Graves' hyperthyroidism. For each patient, we recruited four age-gender-region-matched controls with normal thyroid function (n = 1088). Participants gave detailed information on current and previous alcohol intake as well as other factors to be used for analyses. The association between alcohol intake and development of hyperthyroidism was analysed in conditional multivariate Cox regression models. Graves' patients had a lower reported alcohol consumption than controls (median units of alcohol (12 g) per week: 2 vs 4, P hyperthyroidism. Odds ratios (95% confidence interval) compared with the reference group with a recent (last year) consumption of 1-2 units of alcohol per week were as follows: 0 units/week 1·73 (1·17-2·56), 3-10 units/week 0·56 (0·39-0·79), 11-20 units/week 0·37 (0·21-0·65), ≥21 units/week 0·22 (0·08-0·60). Similar results were found for maximum previous alcohol consumption during a calendar year. No interaction was found with the type of alcohol consumed (wine vs beer), smoking habit, age, gender or region of inhabitancy. Moderate alcohol consumption is associated with a considerable reduction in the risk of Graves' disease with hyperthyroidism--irrespective of age and gender. Autoimmune thyroid disease seems to be much more dependent on environmental factors than hitherto anticipated. © 2012 John Wiley & Sons Ltd.

  1. Efficiency of radioiodine therapy in Graves disease and adenoma toxicum and incidence of hypothyroidism

    International Nuclear Information System (INIS)

    Petrovski, Z.P.

    2002-01-01

    The aim of the this study was to evaluate different states in hyperthyroid patients and incidence of hypothyroidism after I-131 therapy.We observed a total of 184 hyperthyroid pts, from which 108(58,7%)pts with Graves' disease,65(35,3%)pts with single toxicum nodule and 11(6%)pts with toxicum multinodular goitre,treated with radioiodine therapy during the period 1986-2001.Dose of I-131 orally administered ranged 150-1100MBq and was calculated according to the 'MBq/gram' method.The radioiodine-131 therapy was performed once in 69,5%(128/184)pts,twice in 21,2%(39/184)pts and in 9,3%(17/184)pts more than two doses. Completely cured of hyperthyroidism occurred in 61%(66/108)pts with Graves' disease,81,8%(9/11)pts with toxic multinodular goiter and 90,7%(59/65)pts with single toxic nodule. The patients in our study were evaluated 6 months to 15 years after received J-131 therapy. Incidence of early hypothyroidism within one year was 23,1%(25/108) in Graves' disease,9%(1/11) in toxic multinodular goiter and 4,6%(3/65) with single toxicum nodule.Overall incidence of hypothyroidism within one year was 17,6% and had cumulative increase of Graves' disease every following year approximately for 3%,while for adenoma toxicum there was no any significant changes. We concluded that radioiodine therapy is simple,comfortable radical method for medical treatment of hyperthyroidism and indicate higher incidence of hypothyroidism in patients treated with I-131 for Graves' disease than that of patients treated for toxicum multinodular goiters and single toxic nodule

  2. The negative correlation between thyrotropin receptor-stimulating antibodies and bone mineral density in postmenopausal patients with Graves' disease.

    Science.gov (United States)

    Amashukeli, Medea; Korinteli, Maka; Zerekidze, Tamar; Jikurauli, Nino; Shanava, Shorena; Tsagareli, Marina; Giorgadze, Elen

    2013-06-01

    Graves' disease is an autoimmune disorder with various clinical manifestations. Thyrotropin receptor antibodies (TRAbs), the circulating autoantibodies specific to Graves' disease, are the cause for hyperthyroidism, the most prevalent abnormality. Hyperthyroidism leads to increased bone turnover and a negative bone balance. The aims of the present study were to determine the relationship between TRAbs and bone mineral density (BMD), to assess the extent of BMD change in patients with Graves' disease, and to determine the impact of conservative and surgical therapy on BMD. Fifty female postmenopausal patients with Graves' disease were chosen for this study. Twenty women had a recent diagnosis of Graves' disease, 30 women presented with a compensated disease state after either conservative or surgical treatment, and 30 healthy postmenopausal women served as controls. Thyroid parameters were measured, and BMD values were obtained by dual energy x-ray absorptiometry scan.Femoral neck and lumbar spine BMD and T-scores were significantly lower in newly diagnosed patients compared with the control group, but a difference was not observed between the treated and control groups. Statistical analysis revealed a strong and significant negative correlation between femoral neck and lumbar spine BMD and TRAb values.Both surgical and conservative therapies are effective for restoring BMD in postmenopausal patients with Graves' disease, and the increased level of TRAb can be a useful marker of bone density impairment.

  3. A case of metastatic follicular thyroid carcinoma complicated with Graves' disease after total thyroidectomy.

    Science.gov (United States)

    Aoyama, Mariko; Takizawa, Hiromitsu; Tsuboi, Mitsuhiro; Nakagawa, Yasushi; Tangoku, Akira

    2017-12-28

    Thyroid cancer and Graves' disease may present simultaneously in one patient. The incidence of the development of hyperthyroidism from metastatic differentiated thyroid carcinoma is rare. We herein report a case of metastatic follicular carcinoma complicated with Graves' disease after total thyroidectomy. A 57-year-old woman underwent right hemithyroidectomy for follicular carcinoma. Metastatic lesions appeared in the lungs and skull two years after the first surgery, and remnant thyroidectomy was performed for radioactive iodine-131 (RAI) therapy, during which the TSH receptor antibody (TRAb) was found to be negative. The patient was treated with RAI therapy four times for four years and was receiving levothyroxine suppressive therapy. Although radioiodine uptake was observed in the lesions after the fourth course of RAI therapy, metastatic lesions had progressed. Four years after the second surgery, she had heart palpitations and tremors. Laboratory data revealed hyperthyroidism and positive TRAb. She was diagnosed with Graves' disease and received a fifth course of RAI therapy. 131I scintigraphy after RAI therapy showed strong radioiodine uptake in the metastatic lesions. As a result, the sizes and numbers of metastatic lesions decreased, and thyroid function improved. Metastatic lesions produced thyroid hormone and caused hyperthyroidism. RAI therapy was effective for Graves' disease and thyroid carcinoma.

  4. Graves hyperthyroidism 131I treatment the clinical curative effect of observation

    International Nuclear Information System (INIS)

    Duan Yongqiang; Wang Zuobing; Yu Hui; Wang Jing; Li Xiaoqin; Chen Yuanhao; Wu Jiquan

    2012-01-01

    Objective: to study the clinical treatment of 131 I Graves hyperthyroidism curative effect. Methods: the clinical data of Graves hyperthyroidism patients were retrospectively analyzed. Results: 258 cases of patients with hyperthyroidism Graves. 131 I treatment 1∼2 times after healed 200 cases, improvement of 38 patients, a low, 10 cases were invalid 10 cases failure; the total effective 96.12%. 1 year after treatment 131 I thyroid quality by before treatment 43.6 + 20.9 grams shrinks to 1.98 + 18.5 grams (p 131 I before treatment with prominent eyes 68 cases (26.4%) 131 I after treatment, the prominent eyes healed 24 cases (34.8%), improvement 30 patients (43.5%), invalid in 12 cases (17.4%), aggravating in 2 cases (2.9%), efficient for 79.7%. Concurrent hyperthyroidism 131 I before treatment in patients with 31 patients (heart), after the treatment of 131 I 12.0% in 25 patients recovered, 6 patients get better, efficient 100%. After the treatment of 131 I temporary armor low in 25 patients (9.7%) , permanent armour low 27 cases (10.5%). After the treatment of 131 I 15 cases have been reduced to a sex WBC (5.8%), 8 cases of liver function mild damage (3.1%), 13 cases itchy skin (1 case), cholesterol by 5.0% compared appear suspected hyperthyroidism crises (0.4%). 258 patients with thyroid type micronodular 41 cases, treatment cured after 131 I in 25 patients (61.0%), improvement in 16 (39.0%), laseris 100%, Diffuse 217 example, cure 175 cases (80.6%), improvement 22 patients (10%), a low 10 (4.6%), invalid 10 (4.6%), laseris 95.4 percent. Conclusion: 131 I treatment Graves hyperthyroidism is simple, safe, effective, and can be used as the preferred treatment method outperforms that of anti-thyroid drugs. (authors)

  5. Architecture, des normes et des systèmes d'information libres, phase ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Architecture, des normes et des systèmes d'information libres, phase II (OASIS II) - Renforcement des capacités dans l'ensemble de l'Afrique. Sur presque tout le continent africain, la prestation des services de santé est limitée en raison des maigres ressources disponibles et de la charge de morbidité de plus en plus ...

  6. Acidentes em postos e sistemas retalhistas de combustíveis: subsídios para a vigilância em saúde ambiental Environmental accidents in gas stations and retailling systems

    Directory of Open Access Journals (Sweden)

    Jorge Luiz Nobre Gouveia

    2007-09-01

    Full Text Available Os acidentes em postos e sistemas retalhistas resultam de forma imediata em danos graves à vida de pessoas, na contaminação do solo e da água. O objetivo deste trabalho foi discutir a importância da atuação conjunta dos órgãos ambientais e de saúde e subsidiar a estruturação do Sistema Nacional de Vigilância em Saúde Ambiental. A metodologia consistiu no estudo da literatura nacional e internacional; levantamento dos dados existentes em oito órgãos ambientais estaduais brasileiros sobre atendimentos emergenciais e análise de um caso ocorrido no município de Guarulhos, Estado de São Paulo, em janeiro de 2005. Os resultados revelaram que esses acidentes são importante causa de acidentes ambientais e há grande diferença na atuação dos diversos órgãos ambientais. Também demonstra que a estruturação da vigilância em saúde ambiental deve abordar a interface com outras instituições públicas envolvidas.The accidents in gas stations and retailing systems result in grave damages to the life of people and contamination of the soil and water. The objective is to discuss the importance of the joint action of environmental and health organs and to subsidize the structuring of the National System of Surveillance in Environmental Health. The methodology consisted of the studying of the national and international literature; to compile the existent data on eight environmental organs about accidents, and analysis of one case occurred in Guarulhos, State of São Paulo, in January, 2005. The results revealed that these accidents are an important cause of environmental accidents and that there is a great difference in the actions of the diverse environmental organs and demonstrates that the structure of surveillance in environmental health should consider the interface with other public institutions.

  7. Stressful life events and Graves' disease: Results of a case control study

    International Nuclear Information System (INIS)

    Pintor, A.B.; Barrenechea, E.A.; Laureta, E.G.; Ligon, R.A.

    2003-01-01

    Prolonged worry has generally been acknowledged as one of the main precipitating factors of the onset of Graves' disease. A review of literature reveals that emotional stresses of considerable severity precede the onset of hyperthyroidism in about 90% of cases. However, not everyone subscribes to the Stress/Graves' disease hypothesis. Attempts to resolve this issue have tended to focus on whether a correlation can be shown between the magnitude of antecedent life events and the disease. Hence the main objective of the present study was to identify the possible association between stressful life events and Graves' disease. This paper presents the results of a case-control study, involving patents and subjects from the Veterans Memorial Medical Centre of Manila. A total of 224 patients of Graves' disease, newly or previously diagnosed, representing the 'patient's' arm were interviewed. All patients were questioned regarding various stresses, which greatly affected their life style spanning over a 12-month period prior to the onset of the disease. Simultaneously, 224 control subjects were also interviewed, and their stresses spanning over a similar period preceding the dates of interviews were recorded in quantifiable terms. Different stresses were given different intensity scores based on a social readjustment scale taking into consideration the life situations, emotions and diseases. In cases of multiple stresses, intensity scores were added to obtain the total stress intensity. Results were expressed as mean, standard deviation, median, frequency and percent distribution. Scatter plot was also constructed for intensity of stressful life events. To determine association of different factors with Graves' disease, Students t-test and chi-square tests were applied to the data. Odds ratio (OR) was also computed to determine risk attributed to each factor. Since there was significant difference in gender distribution between the patients and controls, stratified Mantel

  8. Thyroidectomy for Graves' disease: is hypothyroidism inevitable?

    OpenAIRE

    Davenport, M.; Talbot, C. H.

    1989-01-01

    The outcome of 234 patients with Graves' disease treated by subtotal thyroidectomy over a 12-year period is analysed with specific reference to hypothyroidism. Of definite hypothyroid cases, 98% occurred within 2 years. Failure to develop hypothyroidism was statistically related to large remnant size and a large goitre preoperatively. Histological review showed that any degree of lymphocytic infiltration was associated with the development of hypothyroidism (50% vs 22%). Late onset hypothyroi...

  9. L'exode des cerveaux et le renforcement des capacités en Afrique ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1 févr. 2011 ... Ce phénomène ébranle les assises économiques et politiques de bien des pays africains. ... le défi consiste à recruter ces cerveaux. ... des missions africaines, des organisations non gouvernementales et des groupes de la diaspora réunis pour parler de l'exode des cerveaux en Afrique et des stratégies à ...

  10. Periodic Granulocyte Count Measuring Is Useful for Detecting Asymptomatic Agranulocytosis in Antithyroid Drug-Treated Patients with Graves' Disease.

    Science.gov (United States)

    Nakamura, Hirotoshi; Ide, Akane; Kudo, Takumi; Nishihara, Eijun; Ito, Mitsuru; Miyauchi, Akira

    2016-12-01

    Finding agranulocytosis (AG) at an early stage is important to improve outcome, but periodic granulocyte count monitoring is not generally recommended for patients with Graves' disease, because AG develops suddenly. At the Kuma Hospital, Graves' patients under antithyroid drug (ATD) treatment in an outpatient clinic have a granulocyte count examination during each visit, and if it is Graves' disease were 131 I-radioisotope therapy (19 patients), thyroidectomy (2 patients), inorganic iodine (1 patient), or another ATD (1 patient). Among the 33 GP patients, 31 (94%), including 20 asymptomatic cases, were discovered during periodic granulocyte count monitoring. Most of them stopped ATD, and other treatments for Graves' disease were selected. Periodic monitoring of granulocyte counts is useful for identifying AG and GP patients with no or minimum infection symptoms.

  11. Influence de l'occupation des terres sur la dynamique des ...

    African Journals Online (AJOL)

    L'objectif de la présente étude est d'évaluer l'impact de mise en culture, des pâturages, des jachères et l'influence des villages sur la dynamique des communautés végétales de la commune de ..... mais il n'y a que peu de recrutement. Au-delà de cinq ans, taille et phytovolume diminuent, témoignant du vieillissement de la ...

  12. Unavoidable Accident

    OpenAIRE

    Grady, Mark F.

    2009-01-01

    In negligence law, "unavoidable accident" is the risk that remains when an actor has used due care. The counterpart of unavoidable accident is "negligent harm." Negligence law makes parties immune for unavoidable accident even when they have used less than due care. Courts have developed a number of methods by which they "sort" accidents to unavoidable accident or to negligent harm, holding parties liable only for the latter. These sorting techniques are interesting in their own right and als...

  13. Diagnosis and treatment of Graves' disease with particular emphasis on appropriate techniques in nuclear medicine. General state of knowledge.

    Science.gov (United States)

    Prasek, Karolina; Płazińska, Maria Teresa; Królicki, Leszek

    2015-01-01

    Graves' disease is an autoimmune disease. It accounts for 50-80% of cases of hyperthyroidism. Antibodies against the TSH receptor (TRAb) are responsible for hyperthyroidism (TRAB). The key role in monitoring and diagnosis of Graves' disease plays the level of hormones of free thyroxine and triiodothyronine. Helpful is an ultrasound of the thyroid scintigraphy which due to its functional character is both a valuable addition to morphological studies as well as plays an important role in the diagnosis and therapy in patients with Graves' disease. There is no perfect treatment for Graves' disease. The reason for this is the lack of therapy directed against primary pathogenic mechanisms. Currently available treatments need to be thoroughly discussed during the first visit as the patient's understanding of the choice of a treatment constitutes a vital role in the success of therapy. Graves' disease treatment is based on three types of therapies that have been carried out for decades including: pharmacological treatment anti-thyroid drugs, I131 therapy and radical treatment - thyroidectomy. The purpose of the treatment is to control symptoms and patient to return to euthyreosis. Treatment of Graves' disease is of great importance because if left untreated, it can lead to long-term harmful effects on the heart, bone and mental well-being of patients.

  14. Changes and clinical significance of CD4+CD25+CD127- regulatory T cells in Graves disease

    International Nuclear Information System (INIS)

    Zou Jintao; Yu Peiling; Dong Jingwei; Liao Qihong; Liu Dongliang; Zeng Hongyi

    2012-01-01

    Objective: To investigate the mechanism of Graves disease by observing the changes of CD4 + CD25 + CD127 - regulatory T cells (Treg) population in the patients. Methods: Flow cytometry was used to detect the proportion of CD4 + CD25 + CD127 - Treg of CD4 + T cells in 90 Graves disease patients (Graves disease group) and 50 healthy adults (control group). Thyroid function and autoantibody levels were determined simultaneously. The t test was adopted for comparison between groups. The relationship between CD4 + CD25 + CD127 - Treg and thyroid function was analyzed by linear correlation analysis. Results: The percentages of CD4 + CD25 + CD127 - Treg in Graves disease group and control group were 1.39%±1.09% and 4.59%±1.14% separately. There was significant difference between the two groups (t=16.4, P<0.01). There were negative correlation between CD4 + CD25 + CD127 - Treg percentages and total triiodothyronine, total thyroxine,free triiodothyronine, free thyroxine and thyrotropin receptor antibody,thyroglobulin antibody, thyroid microsomal antibody (r=-0.62, -0.65, -0.56, -0.71, -0.50, -0.15, all P<0.01). Conclusions: The reduction of CD4 + CD25 + CD127 - Treg percentages in Graves disease group and close relations of CD4 + CD25 + CD127 - Treg with thyroid function and thyroid autoantibody levels suggest that CD4 + CD25 + CD127 - Treg decrease in the number may be associated with the onset of Graves disease. CD4 + CD25 + CD127 - may be the specific marker of Treg. (authors)

  15. Effect of Selenium Supplementation on Recurrent Hyperthyroidism Caused by Graves' Disease: A Prospective Pilot Study.

    Science.gov (United States)

    Wang, L; Wang, B; Chen, S R; Hou, X; Wang, X F; Zhao, S H; Song, J Q; Wang, Y G

    2016-09-01

    The effect of selenium supplementation on recurrent hyperthyroidism caused by Graves' disease is unclear. Our study aimed to assess the efficacy of selenium supplementation therapy on recurrent Graves' disease. Forty-one patients with recurrent Graves' disease were enrolled in this study. All patients received the routine treatment using methimazole (MMI), while patients allocated to the selenium group received additional selenium therapy for 6 months. The influence of selenium supplementation on the concentrations of thyroid stimulating hormone (TSH), anti-TSH-receptor antibodies (TRAb), free thyroxine (FT4), and free triiodothyronine (FT3) were assessed. The remission rate was also compared between 2 groups. There was no obvious difference in the demographic data and the levels of serum FT4, FT3, TSH, and TRAb between the 2 groups at baseline. Both FT4 and FT3 decreased more at 2 months in the selenium group than the controls, while the TSH level increased more in patients receiving selenium supplementation (pGraves' disease. Randomized trials with large number of participants are needed to validate the finding above. © Georg Thieme Verlag KG Stuttgart · New York.

  16. GENOMIQUE ET LIPIDES Génomique et métabolisme des lipides des plantes

    Directory of Open Access Journals (Sweden)

    Delseny Michel

    2002-03-01

    Full Text Available Il existe dans les bases de données publiques une énorme quantité de séquences d’ADN dérivées de plantes, et notamment la séquence complète du génome d’Arabidopsis thaliana, une plante modèle pour les oléagineux, proche parente du colza. Ces données constituent une ressource importante non seulement pour la compréhension de métabolisme lipidique et de sa régulation, mais aussi pour la sélection et le développement de variétés nouvelles d’oléagineux produisant davantage d’huiles ou des huiles de composition nouvelle. Cette abondance de séquences peut être exploitée, en utilisant les recherches d’homologies, pour identifier les gènes, pour obtenir des informations sur leur fonction, comme pour repérer des gènes candidats codant des fonctions nouvelles. L’analyse de ces bases de données a révélé que la majeure partie des gènes codant des enzymes impliquées dans le métabolisme lipidique appartient à des petites familles multigéniques, reflétant la diversification des fonctions des isoformes. Une analyse du catalogue des ADNc séquencés en aveugle reflète les niveaux d’expression des différents gènes et fournit un aperçu des régulations des flux au travers des voies métaboliques conduisant à la biosynthèse des lipides de réserve. La disponibilité de mutants et de lignées transgéniques d’Arabidopsis et le développement de puces à ADN qui permettent l’analyse simultanée de plusieurs milliers de gènes conduiront à une meilleure compréhension des facteurs qui régulent le métabolisme des huiles dans les graines. Une telle connaissance facilitera la manipulation de la composition des huiles et des quantités produites dans les graines.

  17. Occurrence of Type 1 Diabetes in Graves' Disease Patients Who Are Positive for Antiglutamic Acid Decarboxylase Antibodies: An 8-Year Followup Study

    Directory of Open Access Journals (Sweden)

    Matsuo Taniyama

    2011-01-01

    Full Text Available Glutamic acid decarboxylase antibodies (GADAs are one of the markers of islet cell autoimmunity and are sometimes present before the onset of type 1 diabetes (T1D. GADA can be present in Graves' patients without diabetes; however, the outcome of GADA-positive Graves' patients is not fully understood, and the predictive value of GADA for the development of T1D in Graves' patients remains to be clarified. We investigated the prevalence of GADA in 158 patients with Graves' disease and detected GADA in 10 patients. They were followed up to discover whether or not T1D developed. In the course of eight years, 2 patients with high titers of GADA developed T1D, both had long-standing antithyroid drug-resistant Graves' disease. Thus, Graves' disease with high GADA titer seems to be at high risk for T1D.

  18. Joint research project WASA-BOSS: Further development and application of severe accident codes. Assessment and optimization of accident management measures. Project B: Accident analyses for pressurized water reactors with the application of the ATHLET-CD code; Verbundprojekt WASA-BOSS: Weiterentwicklung und Anwendung von Severe Accident Codes. Bewertung und Optimierung von Stoerfallmassnahmen. Teilprojekt B: Druckwasserreaktor-Stoerfallanalysen unter Verwendung des Severe-Accident-Codes ATHLET-CD

    Energy Technology Data Exchange (ETDEWEB)

    Jobst, Matthias; Kliem, Soeren; Kozmenkov, Yaroslav; Wilhelm, Polina

    2017-02-15

    Within the framework of the project an ATHLET-CD input deck for a generic German PWR of type KONVOI has been created. This input deck was applied to the simulation of severe accidents from the accident categories station blackout (SBO) and small-break loss-of-coolant accidents (SBLOCA). The complete accident transient from initial event at full power until the damage of reactor pressure vessel (RPV) is covered and all relevant severe accident phenomena are modelled: start of core heat up, fission product release, melting of fuel and absorber material, oxidation and release of hydrogen, relocation of molten material inside the core, relocation to the lower plenum, damage and failure of the RPV. The model has been applied to the analysis of preventive and mitigative accident management measures for SBO and SBLOCA transients. Therefore, the measures primary side depressurization (PSD), injection to the primary circuit by mobile pumps and for SBLOCA the delayed injection by the cold leg hydro-accumulators have been investigated and the assumptions and start criteria of these measures have been varied. The time evolutions of the transients and time margins for the initiation of additional measures have been assessed. An uncertainty and sensitivity study has been performed for the early phase of one SBO scenario with PSD (until the start of core melt). In addition to that, a code -to-code comparison between ATHLET-CD and the severe accident code MELCOR has been carried out.

  19. An assessment of psychiatric disturbances in graves disease in a ...

    African Journals Online (AJOL)

    An assessment of psychiatric disturbances in graves disease in a medical college in eastern India. ... standard error of difference, the chi-square test, and paired Student's T-test. ... The common symptoms were insomnia, irritability, and anxiety.

  20. 78 FR 31570 - Prospective Grant of a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease...

    Science.gov (United States)

    2013-05-24

    ...-Up Exclusive Patent License Agreement: Treatment of Graves' Disease, Hyperthyroidism and Thyroid... Patent License Agreement may be worldwide and the field of use may be limited to: Treatment of Graves' Disease, hyperthyroidism and thyroid cancer. DATES: Only written comments or applications for a license...

  1. Des dispositions responsables à prendre pour la protection des ...

    African Journals Online (AJOL)

    En considérant l'effet néfaste des maladies, des parasites, du changement climatique et d'autres facteurs environnementaux (les OGM par exemple) sur la survie des abeilles, la baisse de leurs populations dans certaines parties du monde ne saurait être attribuée aux seules pesticides. En plus, l'impact de ces derniers sur ...

  2. Gestion des risques

    CERN Document Server

    Louisot, Jean-Paul

    2009-01-01

    Depuis le début du lie siècle, la gestion des risques connaît une véritable révolution culturelle. Jusqu'alors fonction technique, centrée autour de l'achat de couverture d'assurances, elle est devenue une discipline managériale et transversale : une valise d'instruments que chaque manager doit connaître et appliquer quels que soient son domaine de compétence et ses missions au sein de l'organisation. En effet, la gestion des risques est une culture qui doit être assimilée par chacun des acteurs. C'est précisément l'ambition des 101 questions rassemblées dans cet ouvrage : apporter à chaque manager d'entreprise, de collectivité, d'établissement de santé..., des réponses claires au " pourquoi " et au " comment " : Comment identifier les risques ? Comment analyser les risques ? Quels sont les objectifs de la gestion des risques ? Une carte des risques pour quoi faire ? Pourquoi faut-il financer les risques ? Les entreprises ont-elles des responsabilités pénales ? En quoi consiste la gestion...

  3. Comportement des polluants des eaux pluviales urbaines en ...

    African Journals Online (AJOL)

    développement et la croissance des organismes vivant dans l'eau et particulièrement les micro- organismes. Le suivi des températures enregistrées oscille entre 9 et 16°C dans les trois sites d'observation durant la période ... de la lumière du soleil. Le site C est bien aéré et .... Effets de différents modes de gestion des eaux ...

  4. Domino effect in chemical accidents: main features and accident sequences

    OpenAIRE

    Casal Fàbrega, Joaquim; Darbra Roman, Rosa Maria

    2010-01-01

    The main features of domino accidents in process/storage plants and in the transportation of hazardous materials were studied through an analysis of 225 accidents involving this effect. Data on these accidents, which occurred after 1961, were taken from several sources. Aspects analyzed included the accident scenario, the type of accident, the materials involved, the causes and consequences and the most common accident sequences. The analysis showed that the most frequent causes a...

  5. Hypofractionated radiotherapy for Graves' orbitopathy

    International Nuclear Information System (INIS)

    Heyd, R.; Herkstroeter, M.; Martin, T.; Zamboglou, N.; Strassmann, G.

    2001-01-01

    Background: Radiotherapy (RT) has been proven effective in the management of Graves' orbitopathy in numerous studies. Most commonly is the use of conventional fractionated RT and the value of hypofractionated irradiation has not been investigated. Materials and methods: The results in 33 euthyroid cases who underwent RT with a total dose of 21.0 Gy given in three weekly fractions of 3.0 Gy are retrospectively analyzed. The duration of symptoms ranged from 1-84 months and all of the cases had treatment failure after previous administration of corticosteroids. After a mean follow-up period of 33.6 months the overall results were assessed according to the criteria by Donaldson et al. and for evaluation of the clinical outcome a classification with the main criteria being eye-lid changes, exophthalmos, myopathy and eye nerve involvement was used. Results: At follow-up, the overall response to RT was 84.8% (28/33 cases). The analysis with the clinical classification demonstrated that in 19/33 (57.6%) cases occurred a decrease of eye lid changes and exophthalmos and 12/33 (36.4%) had a relief of myopathy. 2/33 cases (6.0%) developed an eye nerve compression causing the necessity of surgical decompression. 3/33 cases (9.0%) had a progression of at least of one of the single criteria of the score and therefore they were classified as non-responders. Conclusions: Hypofractionated RT has been proven effective for treatment of severe cases of Graves' orbitopathy in cases with a prolongated duration of symptoms. The comparison with literature data demonstrate that the results after hypofractionated RT are comparable to those obtained after conventional fractionated RT. (orig.)

  6. Caractérisation des plantes médicinales à flavonoïdes des marchés ...

    African Journals Online (AJOL)

    Les espèces guinéo-congolaises sont les plus abondantes et le mode de dissémination majoritaire des diaspores est la zoochorie. Les plantes à flavonoïdes les plus utilisées sont : Combretum micranthum, Aloe vera, Ageratum conyzoïdes et Cylicodiscus gabonensis. Elles rentrent dans le traitement de 73 maladies parmi ...

  7. Low-dose radioiodine given six-monthly in Graves' disease

    International Nuclear Information System (INIS)

    Hoskin, P.J.; McCready, V.R.; Harmer, C.L.; Spathis, G.S.; Cosgrove, D.O.

    1985-01-01

    Experience using low-dose radioiodine given six-monthly instead of yearly in hyperthyroid patients with Graves' disease is reported. One hundred and thirty-five patients have been treated over a three-year period with 74 MBq (2 mCi) doses of 131 I. |Thirty-eight|percent| were controlled with a single dose. Those patients requiring more than one dose were treated with a further 74 MBq (2 mCi) 131 I at six-monthly intervals until euthyroid. Using this approach, 46% were euthyroid one year after starting treatment, and 75% were euthyroid at two years. The incidence of hypothyroidism following treatment was 2.2% at one year, with a yearly incidence thereafter of 4-6%. Six-monthly scheduling of low-dose radioiodine in Graves' disease can reduce the time taken to become euthyroid, compared with conventional yearly low-dose treatments. Further follow up is required to confirm the present low incidence of hypothyroidism following treatment. (author)

  8. Hyperthyroidism and Graves' disease: Is an ultrasound examination needed?

    Directory of Open Access Journals (Sweden)

    Lakshminarayanan Varadhan

    2016-01-01

    Full Text Available Aim: The aim of our study was to assess the limitation of clinical examination in determining the morphology of thyroid gland in patients with hyperthyroidism and its implications. Methods: A retrospective analysis of consecutive patients with hyperthyroidism seen in a tertiary endocrine clinic were analyzed. Sub-analysis was performed on patients with proven Graves' disease. Results: Of the 133 patients included in this study with hyperthyroidism, 60 (45% patients had significant nodularity on ultrasound (US. However, only 67% of these were identified on clinical examination. In patients with confirmed Graves' disease (n = 73, the discordance between US and clinical examination was very similar (18 of 30 patients, 60%. Conclusion: US should form an essential part of the evaluation of hyperthyroidism as the morphology of thyroid gland could be variable and nodules in these glands would also need to be appropriately investigated. This would also significantly influence decision-making and appropriate immediate and follow-up management plan.

  9. Stress in accident and post-accident management at Chernobyl

    International Nuclear Information System (INIS)

    Girard, P.; Dubreuil, G.H.

    1996-01-01

    The effects of the Chernobyl nuclear accident on the psychology of the affected population have been much discussed. The psychological dimension has been advanced as a factor explaining the emergence, from 1990 onwards, of a post-accident crisis in the main CIS countries affected. This article presents the conclusions of a series of European studies, which focused on the consequences of the Chernobyl accident. These studies show that the psychological and social effects associated with the post-accident situation arise from the interdependency of a number of complex factors exerting a deleterious effect on the population. We shall first attempt to characterise the stress phenomena observed among the population affected by the accident. Secondly, we will be presenting an anlysis of the various factors that have contributed to the emerging psychological and social features of population reaction to the accident and in post-accident phases, while not neglecting the effects of the pre-accident situation on the target population. Thirdly, we shall devote some initial consideration to the conditions that might be conducive to better management of post-accident stress. In conclusion, we shall emphasise the need to restore confidence among the population generally. (Author)

  10. Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

    Science.gov (United States)

    Amrani, Salah

    La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues

  11. Graves' ophthalmopathy and 131I therapy

    International Nuclear Information System (INIS)

    Marcocci, C.; Bartalena, L.; Tanda, M.L.; Manetti, L.; Dell'Unto, E.; Mazzi, B.; Rocchi, R.; Barbesino, G.; Pinchera, A.

    1999-01-01

    Graves' ophthalmopathy is an autoimmune process initiated and maintained by antigen(s) shared by the thyroid and the orbit. A matter of argument concerns the choice of the method of treatment for Graves' hyperthyroidism when clinically evident ophthalmopathy is present. Restoration of euthyroidism appears to be beneficial for ophthalmopathy. On the other hand the continuing disease activity associated with the recurrence of hyperthyroidism appears to adversely affect the course of ophthalmopathy. For these reasons it is our opinion that in patients with Graves' hyperthyroidism and ophthalmopathy the permanent control of thyroid hyper function by ablation of thyroid tissue should be obtained by radioiodine therapy or thyroidectomy. The rationale for an ablative strategy is the following: i) permanent control of hyperthyroidism avoids exacerbations of eye disease associated with recurrence of hyperthyroidism; i i) hypothyroidism, which follows thyroid tissue ablation, should be regarded as a therapeutic end point rather than as an undesirable result; iii) ablation of thyroid tissue may result in the removal of both the thyroid-orbit cross-reacting antigen(s) and the major source of thyroid-auto reactive lymphocytes. The relationship between radioiodine therapy and the course of GO is a matter of controversy, and some authors have suggested that radioiodine administration ma be associated with a worsening of preexisting ophthalmopathy. This was not observed when radioiodine treatment was associated with a 3-month oral course of prednisone. The development or progression of GO after radioiodine therapy might be due to the release of thyroid antigens following radiation injury and to subsequent exacerbations of autoimmune reactions directed towards antigens shared by the thyroid and the orbit. The view that radioiodine therapy may be associated with a progression of ophthalmopathy is not shared by some authors who claim that the apparent link between progression of

  12. [Neonatal hyperthyroidism in a premature infant born to a mother with Grave's disease].

    Science.gov (United States)

    Nicaise, C; Gire, C; Brémond, V; Minodier, P; Soula, F; d'Ercole, C; Palix, C

    2000-05-01

    Neonatal thyrotoxicosis is most commonly due to transplacental transfer of maternal thyroid-stimulating hormone receptor antibodies (TRAb). Bioassay of thyrotropin receptor antibodies may help to determine the risk for neonatal hyperthyroidism. Thyrotoxicosis developed in a premature infant born to a mother with Graves' disease, with a low level of TRAb by bioassay. The infant was treated with carbimazole for two months, until TRAb had disappeared. Bioassay TRAb is not always reliable for predicting the development of neonatal hyperthyroidism in infants born to mothers with Graves' disease. Thyroid function should be measured in all these neonates.

  13. Evaluation of sanitary consequences of Chernobyl accident in France: epidemiological monitoring device, state of knowledge, evaluation of risks and perspectives; Evaluation des consequences sanitaires de l'accident de Tchernobyl en France: dispositif de surveillance epidemiologique, etat des connaissances, evaluation des risques et perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Verger, P.; Champion, D.; Gourmelon, P.; Hubert, Ph.; Joly, J.; Renaud, Ph.; Tirmarche, M.; Vidal, M. [CEA/Fontenay-aux-Roses, Inst. de Protection et de Surete Nucleaire, IPSN, 92 (France); Cherie-Challine, L.; Boutou, O.; Isnard, H.; Jouan, M.; Pirard, Ph. [Institut National de Veille Sanitaire, 94 - Saint-Maurice (France)

    2000-12-01

    The objectives of this document are firstly, to present the situation of knowledge both on the sanitary consequences of the Chernobyl accident and on the risk factors of thyroid cancers, these ones constituting one of the most principal consequences observed in Belarus, in Ukraine and Russia; secondly, the give the principal system contributing to the epidemiological surveillance of effects coming from a exposure to ionizing radiations, in France and to give the knowledge on incidence and mortality of thyroid cancer in France; thirdly, to discuss the pertinence and the feasibility of epidemiological approaches that could be considered to answer questions that the public and authorities ask relatively to the sanitary consequences of Chernobyl accident in France; fourthly to male a calculation of thyroid cancer risk in relation with Chernobyl fallout in France from works and studies made from 1986 on the consequences of this disaster in terms of radioecology and dosimetry at the national level. Besides, the improvement of thyroid cancer surveillance is also tackled. (N.C.)

  14. Heterotopic relation between media and materiality in children's online memorials and on children's graves

    DEFF Research Database (Denmark)

    Sandvik, Kjetil; Christensen, Dorthe Refslund

    place across media. We show how the death of an infant can lead to mediation, remediation and mediatization strategies which involves both the uses and arrangement of objects on memorial pages and on children’s graves as well as uses of new social technologies, that produce, negotiate and develop social......In this paper we analyze how bereaved parents make use of various media-strategies on online memorial sites and on children’s graves when performing processes of grief and commemoration for their stillborns and infants, and how these processes are not just linked to one particular media but take...... relations with the dead child and the (re)negotiating of parenthood. We understand media as a function of an object reflected in human practices and embedded and structured by the different materialities they are intertwined with. We argue that the use of media and materiality online and on the graves are...

  15. Image and Role of the Queen Mother of the West in Han Grave Art

    Directory of Open Access Journals (Sweden)

    Nataša VAMPELJ SUHADOLNIK

    2015-12-01

    Full Text Available The present article is a detailed study of the image of an ancient Chinese goddess, The Queen Mother of the West, called Xiwangmu 西王母 in Chinese. In the mythological tradition, Xiwangmu is a goddess who possesses the elixir of immortality and dwells in the western paradise, on the magic mountain Kunlun 崑崙. While her image can be found in mural paintings, and on lacquered objects and bronze mirrors, it appears primarily in the form of relief images on the stones and bricks of grave chambers and temples in the Han (206 BCE–220 CE grave complexes. The literary tradition reveals a multifunctional role of the mother, with her many attributes developing in accordance with the changing values of social and mythological concepts. The article concludes with a detailed discussion of her image and role within the wider cosmological context of Han grave art.

  16. Glucocorticoid administration for Graves' hyperthyroidism treated by radioiodine. A questionnaire survey among members of the European Thyroid Association

    NARCIS (Netherlands)

    Lazarus, J. H.; Bartalena, L.; Marcocci, C.; Kahaly, G. J.; Krassas, G.; Wiersinga, W. M.; Baldeschi, L.; Boboridis, K.; Boschi, A.; Currò, N.; Daumerie, C.; Dickinson, A. J.; Eckstein, A.; Kendall-Taylor, P.; Lane, C. M.; Ludgate, M. E.; Mann, K.; Marinò, M.; Mourits, M. P.; Nardi, M.; Neoh, C.; Orgiazzi, J.; Pearce, S.; Perros, P.; Pinchera, A.; Pitz, S.; Salvi, M.; Sivelli, P.; Stahl, M.; von Arx, G.

    2010-01-01

    Background: Glucocorticoid prophylaxis is required in some instances after radioiodine (RAI) treatment for Graves' hyperthyroidism to prevent progression of Graves' orbitopathy (GO). However, no randomized clinical trial has been performed to ascertain the optimum glucocorticoid therapy. Aim and

  17. Persistent Graves' hyperthyroidism despite rapid negative conversion of thyroid-stimulating hormone-binding inhibitory immunoglobulin assay results: a case report.

    Science.gov (United States)

    Ohara, Nobumasa; Kaneko, Masanori; Kitazawa, Masaru; Uemura, Yasuyuki; Minagawa, Shinichi; Miyakoshi, Masashi; Kaneko, Kenzo; Kamoi, Kyuzi

    2017-02-06

    Graves' disease is an autoimmune thyroid disorder characterized by hyperthyroidism, and patients exhibit thyroid-stimulating hormone receptor antibody. The major methods of measuring circulating thyroid-stimulating hormone receptor antibody include the thyroid-stimulating hormone-binding inhibitory immunoglobulin assays. Although the diagnostic accuracy of these assays has been improved, a minority of patients with Graves' disease test negative even on second-generation and third-generation thyroid-stimulating hormone-binding inhibitory immunoglobulins. We report a rare case of a thyroid-stimulating hormone-binding inhibitory immunoglobulin-positive patient with Graves' disease who showed rapid lowering of thyroid-stimulating hormone-binding inhibitory immunoglobulin levels following administration of the anti-thyroid drug thiamazole, but still experienced Graves' hyperthyroidism. A 45-year-old Japanese man presented with severe hyperthyroidism (serum free triiodothyronine >25.0 pg/mL; reference range 1.7 to 3.7 pg/mL) and tested weakly positive for thyroid-stimulating hormone-binding inhibitory immunoglobulins on second-generation tests (2.1 IU/L; reference range hyperthyroidism for more than 8 years, requiring 15 mg/day of thiamazole to correct. During that period, he tested negative on all first-generation, second-generation, and third-generation thyroid-stimulating hormone-binding inhibitory immunoglobulin assays, but thyroid scintigraphy revealed diffuse and increased uptake, and thyroid ultrasound and color flow Doppler imaging showed typical findings of Graves' hyperthyroidism. The possible explanations for serial changes in the thyroid-stimulating hormone-binding inhibitory immunoglobulin results in our patient include the presence of thyroid-stimulating hormone receptor antibody, which is bioactive but less reactive on thyroid-stimulating hormone-binding inhibitory immunoglobulin assays, or the effect of reduced levels of circulating thyroid

  18. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    showed a higher sensitivity to radioiodine, with more cases of early hypothyroidism, than non-operated patients. However, after 50 months of follow-up the outcome was identical. The results indicate that frequent assessment is necessary after radioiodine treatment of previously operated patients, since......Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  19. La cire cuticulaire des grains de raisin et des feuilles de la vigne

    Directory of Open Access Journals (Sweden)

    F. RADLER

    1968-06-01

    Full Text Available Je voudrais parler ici des recherches que j'ai effectuées dans le cadre d'un programme de recherches de l'Organisation australienne de recherches (C.S.I.R.O.. Ce sont des recherches sur la structure, la composition chimique et le rôle de la cire cuticulaire des grains de raisins et des feuilles. Ces recherches ont été effectuées principalement lors de l'étude des problèmes relatifs au séchage des raisins pour la production des raisins. Cependant, l'importance de la cire cuticulaire ne se limite pas seulement au séchage des raisins, car elle concerne aussi l'œnologie et les problèmes de la conservation des raisins de table. Je pense donc que mon exposé peut présenter pour vous un certain intérêt.

  20. Piezosurgery in Modified Pterional Orbital Decompression Surgery in Graves Disease.

    Science.gov (United States)

    Grauvogel, Juergen; Scheiwe, Christian; Masalha, Waseem; Jarc, Nadja; Grauvogel, Tanja; Beringer, Andreas

    2017-10-01

    Piezosurgery uses microvibrations to selectively cut bone, preserving the adjacent soft tissue. The present study evaluated the use of piezosurgery for bone removal in orbital decompression surgery in Graves disease via a modified pterional approach. A piezosurgical device (Piezosurgery medical) was used in 14 patients (20 orbits) with Graves disease who underwent orbital decompression surgery in additional to drills and rongeurs for bone removal of the lateral orbital wall and orbital roof. The practicability, benefits, and drawbacks of this technique in orbital decompression surgery were recorded. Piezosurgery was evaluated with respect to safety, preciseness of bone cutting, and preservation of the adjacent dura and periorbita. Preoperative and postoperative clinical outcome data were assessed. The orbital decompression surgery was successful in all 20 orbits, with good clinical outcomes and no postoperative complications. Piezosurgery proved to be a safe tool, allowing selective bone cutting with no damage to the surrounding soft tissue structures. However, there were disadvantages concerning the intraoperative handling in the narrow space and the efficiency of bone removal was limited in the orbital decompression surgery compared with drills. Piezosurgery proved to be a useful tool in bone removal for orbital decompression in Graves disease. It is safe and easy to perform, without any danger of damage to adjacent tissue because of its selective bone-cutting properties. Nonetheless, further development of the device is necessary to overcome the disadvantages in intraoperative handling and the reduced bone removal rate. Copyright © 2017 Elsevier Inc. All rights reserved.