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Sample records for le prolonged clinical

  1. Analysis of Relationship between Levofloxacin and Corrected QT Prolongation Using a Clinical Data Warehouse

    Science.gov (United States)

    Park, Man Young; Kim, Eun Yeob; Lee, Young Ho; Kim, Woojae; Kim, Ku Sang; Sheen, Seung Soo; Lim, Hong Seok

    2011-01-01

    Objective The aim of this study was to examine whether or not levofloxacin has any relationship with QT prolongation in a real clinical setting by analyzing a clinical data warehouse of data collected from different hospital information systems. Methods Electronic prescription data and medical charts from 3 different hospitals spanning the past 9 years were reviewed, and a clinical data warehouse was constructed. Patients who were both administrated levofloxacin and given electrocardiograms (ECG) were selected. The correlations between various patient characteristics, concomitant drugs, corrected QT (QTc) prolongation, and the interval difference in QTc before and after levofloxacin administration were analyzed. Results A total of 2,176 patients from 3 different hospitals were included in the study. QTc prolongation was found in 364 patients (16.7%). The study revealed that age (OR 1.026, p < 0.001), gender (OR 0.676, p = 0.007), body temperature (OR 1.267, p = 0.024), and cigarette smoking (OR 1.641, p = 0.022) were related with QTc prolongation. After adjusting for related factors, 12 drugs concomitant with levofloxacin were associated with QTc prolongation. For patients who took ECGs before and after administration of levofloxacin during their hospitalization (n = 112), there was no significant difference in QTc prolongation. Conclusions The age, gender, body temperature, cigarette smoking and various concomitant drugs might be related with QTc prolongation. However, there was no definite causal relationship or interaction between levofloxacin and QTc prolongation. Alternative surveillance methods utilizing the massive accumulation of electronic medical data seem to be essential to adverse drug reaction surveillance in future. PMID:21818458

  2. Analysis of Relationship between Levofloxacin and Corrected QT Prolongation Using a Clinical Data Warehouse.

    Science.gov (United States)

    Park, Man Young; Kim, Eun Yeob; Lee, Young Ho; Kim, Woojae; Kim, Ku Sang; Sheen, Seung Soo; Lim, Hong Seok; Park, Rae Woong

    2011-03-01

    The aim of this study was to examine whether or not levofloxacin has any relationship with QT prolongation in a real clinical setting by analyzing a clinical data warehouse of data collected from different hospital information systems. Electronic prescription data and medical charts from 3 different hospitals spanning the past 9 years were reviewed, and a clinical data warehouse was constructed. Patients who were both administrated levofloxacin and given electrocardiograms (ECG) were selected. The correlations between various patient characteristics, concomitant drugs, corrected QT (QTc) prolongation, and the interval difference in QTc before and after levofloxacin administration were analyzed. A total of 2,176 patients from 3 different hospitals were included in the study. QTc prolongation was found in 364 patients (16.7%). The study revealed that age (OR 1.026, p data seem to be essential to adverse drug reaction surveillance in future.

  3. Risk Factors for Prolonged Symptoms of Mild Traumatic Brain Injury: A Pediatric Sports Concussion Clinic Cohort.

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    Fehr, Shayne D; Nelson, Lindsay D; Scharer, Kyle R; Traudt, Elizabeth A; Veenstra, Joshua M; Tarima, Sergey S; Liu, Xue-Cheng; Walter, Kevin D

    2017-11-13

    To examine predictors of prolonged symptom duration from mild traumatic brain injury (mTBI) in a pediatric sports medicine specialty clinic cohort as these predictors may be distinct in this population. Retrospective chart review. Outpatient specialty clinic. Charts of 549 patients (age range: 10-18 years) with concussions were reviewed in an outpatient clinic that predominantly managed sports-related injuries (77.3%). Patients (n = 431) included in the final analysis met the criteria for mTBI and were symptomatic at their first visit. Patient history, injury, and recovery variables were evaluated. Predictors of prolonged time to reach self-reported symptom recovery were evaluated using Cox proportional hazards. Median time to symptom recovery of the 431 patients who presented to clinic with symptoms was 40 days (full clinic sample median = 34 days). Analyses identified 3 unique predictors of symptom recovery: loss of consciousness (LOC) [hazard ratio (HR) = 0.56, P < 0.0001], female sex (HR = 0.57, P < 0.0001), and concussion symptom score at first clinic visit (HR = 0.76, P < 0.0001). Prolonged duration of mTBI symptoms in patients who present to a pediatric sports-based concussion clinic is related to initial symptom severity, female sex, and LOC.

  4. Caput succedaneum thickness in prolonged second stage of labour: a clinical evaluation.

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    Gilboa, Yinon; Kivilevitch, Zvi; Kedem, Alon; Spira, Maya; Borkowski, Tamar; Moran, Orit; Katorza, Eldad; Achiron, Reuven

    2013-10-01

    Data are scarce regarding the association between the presence of caput succedaneum and the mode of delivery. To evaluate the presence and clinical significance of caput succedaneum thickness in prolonged second stage of labour. We conducted a prospective study of women, beyond 37 weeks of gestation, during prolonged second stage of labour. Transperineal ultrasound was performed to assess the caput succedaneum thickness. The relationships between caput succedaneum thickness, feto-maternal characteristics, delivery mode and immediate post-natal outcomes were analysed. Fifty-eight women, of whom 47 were nulliparas, in prolonged second stage of labour, were included in the study. The caput succedaneum thickness could be measured in all cases. Overall mean thickness was 21.9 (±4.9) mm (range 14-40 mm). No significant difference or correlation was found between caput succedaneum thickness, fetal head positions, modes of delivery, duration of second stage, head circumference or neonatal outcomes. Caput succedaneum is measurable in all cases at prolonged second stage using transperineal sonography. Its presence and dimensions presented in our pilot study seem to have no implication on delivery mode and neonatal outcome. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  5. Clinical and SEM characterization of prolonged retention of a primary tooth with pulpectomy.

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    Correa-Faria, Patricia; Alcantara, Carlos Eduardo Pinto; Mesquita, Ana Terezinha; Marques, Leandro Silva; Ramos-Jorge, Maria Leticia

    2013-01-01

    Root canal filling with zinc oxide-eugenol (ZOE) paste following primary tooth pulpectomy is a common practice in pediatric dentistry. This material offers high clinical and radiographic success rates. In some cases, however, it is not resorbed along with the root of the primary tooth. The aim of this study was to describe a case of prolonged retention of a primary maxillary incisor that was subjected to pulpectomy and filled with ZOE paste in order to characterize the aspects of root resorption using scanning electron microscopy.

  6. Prolonged PR interval predicts clinical recurrence of atrial fibrillation after catheter ablation.

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    Park, Junbeom; Kim, Tae-Hoon; Lee, Jihei Sara; Park, Jin Kyu; Uhm, Jae Sun; Joung, Boyoung; Lee, Moon Hyoung; Pak, Hui-Nam

    2014-10-07

    A prolonged PR interval is known to be a poor prognostic factor in cardiovascular disease. The aim of this study was to investigate the association between PR interval and clinical outcome in patients undergoing radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). We prospectively included 576 patients with AF (75.5% male, 57.8±11.6 years old, 68.8% paroxysmal AF) who underwent RFCA. We analyzed preprocedural sinus rhythm ECGs obtained in the absence of antiarrhythmic drug, and all enrolled patients were categorized into 4 groups based on the quartile values of the PR interval (166, 182, and 202 ms), and were analyzed according to the left atrium (LA) volume (CT; Computed tomography), LA voltage (NavX), and clinical outcome of AF ablation. Based on quartile value of PR interval, the highest quartile of PR interval (Q4; PR ≥202 ms) was oldest (PPR interval was a significant predictor of AF recurrence after RFCA of AF (HR=1.969, 95% CI 1.343 to 2.886, P=0.001). The PR interval was closely associated with advanced LA remodeling due to AF, and had a noninvasive significant predictive value of clinical recurrence of AF after RFCA. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  7. [Establishment of A Clinical Prediction Model of Prolonged Air Leak 
after Anatomic Lung Resection].

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    Wu, Xianning; Xu, Shibin; Ke, Li; Fan, Jun; Wang, Jun; Xie, Mingran; Jiang, Xianliang; Xu, Meiqing

    2017-12-20

    Prolonged air leak (PAL) after anatomic lung resection is a common and challenging complication in thoracic surgery. No available clinical prediction model of PAL has been established in China. The aim of this study was to construct a model to identify patients at increased risk of PAL by using preoperative factors exclusively. We retrospectively reviewed clinical data and PAL occurrence of patients after anatomic lung resection, in department of thoracic surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, from January 2016 to October 2016. 359 patients were in group A, clinical data including age, body mass index (BMI), gender, smoking history, surgical methods, pulmonary function index, pleural adhesion, pathologic diagnosis, side and site of resected lung were analyzed. By using univariate and multivariate analysis, we found the independent predictors of PAL after anatomic lung resection and subsequently established a clinical prediction model. Then, another 112 patients (group B), who underwent anatomic lung resection in different time by different team, were chosen to verify the accuracy of the prediction model. Receiver-operating characteristic (ROC) curve was constructed using the prediction model. Multivariate Logistic regression analysis was used to identify six clinical characteristics [BMI, gender, smoking history, forced expiratory volume in one second to forced vital capacity ratio (FEV1%), pleural adhesion, site of resection] as independent predictors of PAL after anatomic lung resection. The area under the ROC curve for our model was 0.886 (95%CI: 0.835-0.937). The best predictive P value was 0.299 with sensitivity of 78.5% and specificity of 93.2%. Our prediction model could accurately identify occurrence risk of PAL in patients after anatomic lung resection, which might allow for more effective use of intraoperative prophylactic strategies.
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  8. Attitudes of palliative care clinical staff toward prolonged grief disorder diagnosis and grief interventions.

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    Davis, Esther L; Deane, Frank P; Barclay, Gregory D; Bourne, Joan; Connolly, Vivienne

    2017-07-03

    The provision of psychological support to caregivers is an important part of the role of the clinical staff working in palliative care. Staff knowledge and attitudes may determine their openness to referring caregivers to a psychological intervention. We recently developed a self-help intervention for grief and psychological distress among caregivers and were interested in exploring the extent to which staff knowledge and attitudes might affect future implementation. The aims of our study were to: (1) examine the acceptability of self-help psychological intervention for caregivers among palliative care clinical staff; (2) examine potential attitudinal barriers toward prolonged grief disorder (PGD) as a diagnosis and interventions for grief; and (3) bolster staff confidence in skills and knowledge in identifying and managing caregiver psychological distress. An anonymous survey was distributed among clinical staff at two inpatient units and two community health services that assessed the acceptability of self-help interventions for caregivers, attitudes about PGD diagnosis and grief intervention, and staff confidence in skills and knowledge in assessing caregiver psychological distress. Overall, clinical staff were positively oriented toward self-help for caregivers and intervention for grief. They were also basically confident in their skills and knowledge. While it was positive PGD attitudes that were associated with acceptability of self-help for caregivers, it was both positive and negative PGD attitudes that were associated more specifically with a willingness to refer caregivers to such an intervention. Our findings are useful in highlighting the issues to be considered in the implementation of a self-help intervention within the healthcare service. Clinical staff seemed positively oriented toward engaging with a psychological intervention for caregivers and likely to act as key allies in implementation.

  9. Homework "Dose," Type, and Helpfulness as Predictors of Clinical Outcomes in Prolonged Exposure for PTSD.

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    Cooper, Andrew A; Kline, Alexander C; Graham, Belinda; Bedard-Gilligan, Michele; Mello, Patricia G; Feeny, Norah C; Zoellner, Lori A

    2017-03-01

    Homework is often viewed as central to prolonged exposure (PE) for posttraumatic stress disorder (PTSD), but its relationship with treatment outcome is not well understood. We evaluated homework type, dose, and patients' perceptions of helpfulness as predictors of symptom change and posttreatment outcomes in PE. Patients with chronic PTSD received PE in a randomized clinical trial. Independent evaluators assessed PTSD severity at pre- and posttreatment. Patients reported homework adherence and perceived helpfulness at the beginning of each session, separately for in vivo and imaginal exposure assignments. These variables were examined as predictors of change in PTSD symptoms, PTSD remission, and good end-state functioning (GESF; low PTSD, depression, and anxiety) at posttreatment. Higher imaginal homework adherence predicted greater symptom improvement between sessions and across treatment, as well as twice the odds of achieving remission and GESF. Patients who were at least moderately adherent to imaginal homework assignments (two or more times a week) reported more symptom gains than those who were least adherent but did not differ from those who were most adherent. In vivo adherence was not consistently associated with better outcome, perhaps due to heterogeneity in form and function of weekly assignments. Higher ratings of helpfulness of both types of homework predicted greater symptom improvement from pre- to posttreatment and between sessions. Overall, imaginal exposure homework may complement in-session exposures by enhancing key change processes, though perfect adherence is not necessary. Patients' perceptions of helpfulness may reflect buy-in or perceived match between homework completion and functional impairment. Clinically, in addition to targeting adherence to homework assignments, querying about perceived helpfulness and adjusting assignments appropriately may help augment clinical gains. Copyright © 2016. Published by Elsevier Ltd.

  10. The Power of Phase I Studies to Detect Clinical Relevant QTc Prolongation: A Resampling Simulation Study

    Directory of Open Access Journals (Sweden)

    Georg Ferber

    2015-01-01

    Full Text Available Concentration-effect (CE models applied to early clinical QT data from healthy subjects are described in the latest E14 Q&A document as promising analysis to characterise QTc prolongation. The challenges faced if one attempts to replace a TQT study by thorough ECG assessments in Phase I based on CE models are the assurance to obtain sufficient power and the establishment of a substitute for the positive control to show assay sensitivity providing protection against false negatives. To demonstrate that CE models in small studies can reliably predict the absence of an effect on QTc, we investigated the role of some key design features in the power of the analysis. Specifically, the form of the CE model, inclusion of subjects on placebo, and sparse sampling on the performance and power of this analysis were investigated. In this study, the simulations conducted by subsampling subjects from 3 different TQT studies showed that CE model with a treatment effect can be used to exclude small QTc effects. The number of placebo subjects was also shown to increase the power to detect an inactive drug preventing false positives while an effect can be underestimated if time points around tmax are missed.

  11. Adaptation to prolonged bedrest in man: A compendium of research. [bibliographies on clinical medicine and human pathology

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    Greenleaf, J. E.; Greenleaf, C. J.; Vanderveer, D.; Dorchak, K. J.

    1976-01-01

    A compilation of major studies that describe the clinical observations and elucidate the physiological mechanisms of the adaptive process of man undergoing prolonged bed rest is presented. Additional studies are included that provide background information in the form of reviews or summaries of the process. Wherever possible a detailed annotation is provided under the subheadings: (1) purpose, (2) procedure and methods, (3) results, and (4) conclusions. Additional references are provided in a selected bibliography.

  12. Clinically silent PML and prolonged immune reconstitution inflammatory syndrome in a patient with multiple sclerosis treated with natalizumab

    DEFF Research Database (Denmark)

    Blinkenberg, Morten; Sellebjerg, Finn; Leffers, Anne Mette

    2013-01-01

    We report the case of a woman with natalizumab-treated multiple sclerosis (MS) and clinically silent progressive multifocal leukoencephalopathy (PML) with an unusually long preclinical phase, followed by acute symptoms due to development of immune reconstitution inflammatory syndrome (IRIS......). Furthermore, the course of the IRIS was prolonged and continued to progress even five months after natalizumab treatment was ceased. This case shows that PML and IRIS can have a considerably variable course in natalizumab-treated MS patients and underlines the need for PML screening in JC virus antibody...

  13. Ciprofloxacin does not Prolong the QTc Interval : A Clinical Study in ICU Patients and Review of the Literature

    NARCIS (Netherlands)

    Heemskerk, Charlotte P.M.; Woldman, Evelien; Pereboom, Marieke; van der Hoeven, Ruud T M; Mantel-Teeuwisse, Aukje; Van Gemeren, Claudia; Becker, Matthijs Lambertus

    2017-01-01

    PURPOSE: Ciprofloxacin may prolong the QT interval and increase the risk of Torsade de Pointes (TdP). Intravenous administration of ciprofloxacin in patients with additional risks may elevate the risk of QTc interval prolongation. We prospectively assessed whether intravenous ciprofloxacin prolongs

  14. Prolonged-release melatonin versus placebo for benzodiazepine discontinuation in patients with schizophrenia: a randomized clinical trial - the SMART trial protocol

    DEFF Research Database (Denmark)

    Baandrup, Lone; Fagerlund, Birgitte; Jennum, Poul

    2011-01-01

    Treatment of schizophrenia frequently includes prolonged benzodiazepine administration despite a lack of evidence of its use. It is often difficult to discontinue benzodiazepines because of the development of dependence. We aim to assess if melatonin can facilitate the withdrawal of prolonged...... benzodiazepine administration in patients with schizophrenia. Furthermore, we aim to investigate the association of benzodiazepine dose reduction with the following clinically important variables: sleep, psychophysiology, cognition, social function, and quality of life....

  15. From the international space station to the clinic: how prolonged unloading may disrupt lumbar spine stability.

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    Bailey, Jeannie F; Miller, Stephanie L; Khieu, Kristine; O'Neill, Conor W; Healey, Robert M; Coughlin, Dezba G; Sayson, Jojo V; Chang, Douglas G; Hargens, Alan R; Lotz, Jeffrey C

    2018-01-01

    Prolonged microgravity exposure is associated with localized low back pain and an elevated risk of post-flight disc herniation. Although the mechanisms by which microgravity impairs the spine are unclear, they should be foundational for developing in-flight countermeasures for maintaining astronaut spine health. Because human spine anatomy has adapted to upright posture on Earth, observations of how spaceflight affects the spine should also provide new and potentially important information on spine biomechanics that benefit the general population. This study compares quantitative measures of lumbar spine anatomy, health, and biomechanics in astronauts before and after 6 months of microgravity exposure on board the International Space Station (ISS). This is a prospective longitudinal study. Six astronaut crewmember volunteers from the National Aeronautics and Space Administration (NASA) with 6-month missions aboard the ISS comprised our study sample. For multifidus and erector spinae at L3-L4, measures include cross-sectional area (CSA), functional cross-sectional area (FCSA), and FCSA/CSA. Other measures include supine lumbar lordosis (L1-S1), active (standing) and passive (lying) flexion-extension range of motion (FE ROM) for each lumbar disc segment, disc water content from T2-weighted intensity, Pfirrmann grade, vertebral end plate pathology, and subject-reported incidence of chronic low back pain or disc injuries at 1-year follow-up. 3T magnetic resonance imaging and dynamic fluoroscopy of the lumbar spine were collected for each subject at two time points: approximately 30 days before launch (pre-flight) and 1 day following 6 months spaceflight on the ISS (post-flight). Outcome measures were compared between time points using paired t tests and regression analyses. Supine lumbar lordosis decreased (flattened) by an average of 11% (p=.019). Active FE ROM decreased for the middle three lumbar discs (L2-L3: -22.1%, p=.049; L3-L4: -17.3%, p=.016; L4-L5: -30.3%, p

  16. Clinical Outcome with Oral Linezolid and Rifampin Following Recurrent Methicillin-Resistant Staphylococcus aureus Bacteremia Despite Prolonged Vancomycin Treatment

    Directory of Open Access Journals (Sweden)

    Jon-David Schwalm

    2004-01-01

    Full Text Available Drug-resistant Gram-positive bacteria, especially Staphylococcus aureus, are emerging as the predominant organisms involved in both nosocomial and community-acquired infections. Since the 1980s, vancomycin has been the first-line antibiotic used to treat methicillin-resistant S aureus. However, allergy and intolerance to vancomycin, the increasing number of vancomycin clinical failures and the existence of vancomycin intermediate-susceptible isolates of S aureus suggest that new antibiotics are needed. This paper reports the only known case of a successful clinical outcome with long term oral linezolid and rifampin therapy in the management of recurrent and persistent methicillin-resistant S aureus bacteremia with metastatic infections despite prolonged vancomycin use. More than two years since the initiation of linezolid and rifampin, the study patient has been clinically well with no evidence of adverse drug reactions including cytopenia and hepatic toxicities. Physicians must be aware of the novel developments in antibiotic therapy to treat drug-resistant bacterial infections.

  17. New approach for treatment of prolonged postoperative pain: APS Out-Patient Clinic.

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    Tiippana, Elina; Hamunen, Katri; Heiskanen, Tarja; Nieminen, Teija; Kalso, Eija; Kontinen, Vesa K

    2016-07-01

    Persistent postoperative pain (PPP) is a significant clinical problem. Several patient-related risk factors for PPP have been identified, including a previous chronic pain problem, young age, female gender and psychological vulnerability. Intra- and postoperative risk factors include surgical complications such as infections, haematoma, nerve damage and repeated surgery. As the length of hospital stay has been shortened, some patients may be discharged despite ongoing pain and insufficient analgesic medication. The challenge is to identify patients at high risk of developing PPP and to create a targeted care pathway to ensure effective and safe pain treatment especially in the subacute postoperative phase at home. This observational study describes the first two years of the Acute Pain Service Out-Patient Clinic (APS-OPC) at the Helsinki University Hospital. Patient characteristics, known risk factors, and details of treatment of PPP for the first 200 patients referred to our APS-OPC were retrospectively collected from the medical records. The APS-OPC clinic functions in close collaboration with the Multidisciplinary Pain Clinic (MPC), and the number of patients in need of physiotherapist, psychologist or psychiatrist counselling was recorded, as well as the number of patients referred to the MPC for further PPP management. Patients were referred to the APS-OPC from different surgical specialities, the two most common being thoracic and orthopaedic surgery. Seventy per cent of the patients (139/200) presented symptoms indicating neuropathic postsurgical pain. The patients had, on average, five risk factors for PPP. The median time from surgery to the first contact to the APS-OPC was two months, and the median duration of follow-up was 2.8 months (0-16 months). The median number of contacts with APS-OPC was 3 (range 1-14). Every fourth patient needed only one contact to the APS-OPC. Nineteen per cent of the patients had an appointment with the physiotherapist and 20

  18. Croissance prolongée de la diatomée marine Phaeodactylum tricornutum en milieu contaminé par le chlorure de tributylétain : conséquence sur le biotransfert du polluant

    Directory of Open Access Journals (Sweden)

    MARSOT P.

    1996-04-01

    Full Text Available Cette étude consiste à évaluer le biotransfert du tributylétain (TBT par le filtreur bivalve Mya arenaria, à partir d'une culture semi-continue de la diatomée Phaeodactylum tricornutum exposée à un niveau de contamination n'arrêtant pas sa croissance à long terme. La dose du contaminant employée (100 ng I-1 est de l'ordre de grandeur de celles décelées dans certaines régions contaminées, telles les marinas et les régions portuaires. Dans ces conditions, la culture de P tricornutum a maintenu son équilibre de croissance durant plus de 50 jours. Sa productivité était légèrement inférieure (de 4 % à celle de la culture témoin (sans contaminant. L'ingestion des diatomées contaminées, sur une période de 90 jours, a entraîné une bioaccumulation de TBT et DBT (dibutylétain dans la chair du mollusque, atteignant des concentrations respectives de 133 et 128 ng g-1 (poids humide. L'étude suggère que le biotransfert du TBT et du DBT associés à des micro-algues en croissance continue ou semi-continue pourrait constituer un facteur de bioamplification important du biocide en milieu naturel.

  19. Prolonged delay for controlling KPC-2-producing Klebsiella pneumoniae outbreak: the role of clinical management.

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    Delory, T; Seringe, E; Antoniotti, G; Novakova, I; Goulenok, C; Paysant, I; Boyer, S; Carbonne, A; Naas, T; Astagneau, P

    2015-10-01

    Carbapenemase-producing Enterobacteriaceae (CPE) are becoming of immediate concern for infection control policies. Prompt detection of CPE on health care setting admission is crucial to halt the spread of an outbreak. We report a cluster of 13 Klebsiella pneumoniae carbapenemase (KPC)-2-producing K pneumoniae cases in a tertiary care hospital.The objective of this study was to identify contributing factors originating the outbreak. An outbreak investigation was conducted using descriptive epidemiology, observation of health care practices, and interviews of management staff. A root cause analysis was performed to identify patent and latent failures of infection control measures using the association of litigation and risk management method. The main patent failure was the delay in identifying KPC-2-producing K pneumoniae carriers. Contributing factors were work and environmental factors: understaffing, lack of predefined protocols, staff members' characteristics, and underlying patients' characteristics. Latent failures were as follows: no promotion of the national guidelines for prevention of CPE transmission, no clear procedure for the management of patients hospitalized abroad, no clear initiative for promoting a culture of quality in the hospital, biologic activity recently outsourced to a private laboratory, and poor communication among hospital members. Clinical management should be better promoted to control hospital outbreaks and should include team work and safety culture. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. An imported case of severe falciparum malaria with prolonged hemolytic anemia clinically mimicking a coinfection with babesiosis.

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    Na, Young Ju; Chai, Jong-Yil; Jung, Bong-Kwang; Lee, Hyun Jung; Song, Ji Young; Je, Ji Hye; Seo, Ji Hye; Park, Sung Hun; Choi, Ji Seon; Kim, Min Ja

    2014-12-01

    While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.

  1. Aerobic Exercise for Adolescents With Prolonged Symptoms After Mild Traumatic Brain Injury: An Exploratory Randomized Clinical Trial.

    Science.gov (United States)

    Kurowski, Brad G; Hugentobler, Jason; Quatman-Yates, Catherine; Taylor, Jennifer; Gubanich, Paul J; Altaye, Mekibib; Wade, Shari L

    To describe the methodology and report primary outcomes of an exploratory randomized clinical trial (RCT) of aerobic training for management of prolonged symptoms after a mild traumatic brain injury (mTBI) in adolescents. Outpatient research setting. Thirty adolescents between the ages of 12 and 17 years who sustained a mTBI and had between 4 and 16 weeks of persistent symptoms. Partially blinded, pilot RCT of subsymptom exacerbation aerobic training compared with a full-body stretching program. The primary outcome was postinjury symptom improvement assessed by the adolescent's self-reported Post-Concussion Symptom Inventory (PCSI) repeated for at least 6 weeks of the intervention. Parent-reported PCSI and adherence are also described. Twenty-two percent of eligible participants enrolled in the trial. Repeated-measures analysis of variance via mixed-models analysis demonstrated a significant group × time interaction with self-reported PCSI ratings, indicating a greater rate of improvement in the subsymptom exacerbation aerobic training group than in the full-body stretching group (F = 4.11, P = .044). Adherence to the home exercise programs was lower in the subsymptom exacerbation aerobic training group compared with the full-body stretching group (mean [SD] times per week = 4.42 [1.95] vs 5.85 [1.37], P after an mTBI. These findings and other recent research support the potential benefit of active rehabilitation programs for adolescents with persistent symptoms after an mTBI. Larger replication studies are needed to verify findings and improve generalizability. Future work should focus on determining the optimal type, timing, and intensity of active rehabilitation programs and characteristics of individuals most likely to benefit.

  2. Late-onset epilepsy in children with acute febrile encephalopathy with prolonged convulsions: A clinical and encephalographic study.

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    Saito, Takashi; Saito, Yoshiaki; Sugai, Kenji; Nakagawa, Eiji; Komaki, Hirofumi; Okazaki, Tetsuya; Ishido, Yusaku; Kaneko, Yuu; Kaido, Takanobu; Takahashi, Akio; Ohtsuki, Taisuke; Sakuma, Hiroshi; Sasaki, Masayuki

    2013-06-01

    The aim of this study is to analyze the characteristics of epilepsies as the sequelae of acute febrile encephalopathy with prolonged convulsions during childhood. Sixteen patients (M:F=9:7) aged 2-13years (mean 6.1years) with history of febrile acute encephalopathy were retrospectively reviewed. These patients experienced febrile encephalopathy at the age of 11months to 4years, with 11 individuals presenting with findings of a biphasic clinical course (n=5), frontal predominant (n=8) lesions, and/or reduced diffusivity in the cerebral white matter on magnetic resonance imaging (MRI; n=3). The remaining 5 patients had unilateral lesions that manifested the phenotype of hemiconvulsion-hemiplegia-epilepsy syndrome (HHES). Epilepsy emerged with a latent period of 2months to 2years after the acute phase of febrile encephalopathy. Head nodding or spasm with subsequent motion arrest and brief tonic seizures were the main seizure phenotypes. Ictal records of epileptic seizures were available in 9 patients. Epileptiform discharges with a focal or uneven distribution appeared at the seizure onset and lasted less than 1s in all patients; these were followed by either generalized attenuation or fast activity in 8 patients with head nodding, spasm, or brief tonic seizures, and by localized fast activity in 1 patient with versive tonic seizures. Notably, the seizure onset area was often located outside the severe lesions on MRI, i.e., in the parietal areas in patients with frontal predominant lesions, and in the spared hemisphere of HHES. Although phenobarbital, zonisamide, carbamazepine, clobazam, clonazepam, and clorazepate were partially effective in some patients, daily seizures persisted in 11 patients. Callosotomy was performed in 2 patients, and beneficial effects were observed in both. These characteristics suggested a broad distribution of augmented excitability in these patients, resulting in the rapid propagation of epileptic activity in the initial phase of ictal

  3. Experimental-clinical validation of the use of amitetravit, ATP and autologous bone marrow in radiation injuries caused by prolonged radiation

    Science.gov (United States)

    Atamanova, O. M.; Vodyakova, L. M.; Gvozdeva, N. I.; Davydova, S. A.; Ignasheva, L. P.; Rogozkin, V. D.; Sbitneva, M. F.; Ostroumova, L. M.; Tikhomirova, M. V.; Fedotenkov, A. G.

    1974-01-01

    Experimental clinical studies show that early pathogenetic treatment against the effects of prolonged radiation includes amitetravit as a means of increasing natural radio resistance, ATP as protective therapeutic agent, and automyelotransplantation for early pathogenetic treatment. The high effectiveness of the combined use of ATP and amitetravit in tests on dogs indicates an ability to prevent primary damages to genetic structures and accelerated processes of reparation in the first stages of radiopathological processes.

  4. Prevalence and clinical relevance of corrected QT interval prolongation during methadone and buprenorphine treatment: a mortality assessment study.

    Science.gov (United States)

    Anchersen, Katinka; Clausen, Thomas; Gossop, Michael; Hansteen, Viggo; Waal, Helge

    2009-06-01

    To determine the prevalence of corrected QT interval (QTc) prolongation among patients in opioid maintenance treatment (OMT) and to investigate mortality potentially attributable to QTc prolongation in the Norwegian OMT programme. Two hundred OMT patients in Oslo were recruited to the QTc assessment study between October 2006 and August 2007. The Norwegian register of all patients receiving OMT in Norway (January 1997-December 2003) and the national death certificate register were used to assess mortality. Mortality records were examined for the 90 deaths that had occurred among 2382 patients with 6450 total years in OMT. The QTc interval was assessed by electrocardiography (ECG). All ECGs were examined by the same cardiologist, who was blind to patient history and medication. Mortality was calculated by cross-matching the OMT register and the national death certificate register: deaths that were possibly attributable to QTc prolongation were divided by the number of patient-years in OMT. In the QTc assessment sample (n = 200), 173 patients (86.5%) received methadone and 27 (13.5%) received buprenorphine. In the methadone group, 4.6% (n = 8) had a QTc above 500 milliseconds; 15% (n = 26) had a QTc interval above 470 milliseconds; and 28.9% (n = 50) had a QTc above 450 milliseconds. All patients receiving buprenorphine (n = 27) had QTc results <450 milliseconds. A positive dose-dependent association was identified between QTc length and dose of methadone, and all patients with a QTc above 500 milliseconds were taking methadone doses of 120 mg or more. OMT patient mortality, where QTc prolongation could not be excluded as the cause of death, was 0.06/100 patient-years. Only one death among 3850 OMT initiations occurred within the first month of treatment. Of the methadone patients, 4.6% had QTc intervals above 500 milliseconds. The maximum mortality attributable to QTc prolongation was low: 0.06 per 100 patient-years.

  5. [Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice].

    Science.gov (United States)

    Chantry, A A; Monier, I; Marcellin, L

    2015-12-01

    The objectives were to on assess the frequency and the duration of breastfeeding in France. On the other hand, the objectives were to identify its benefits and drawbacks, and to study the factors influencing its initiation and its extension. Bibliographic research in Medline, Google Scholar and in the Cochrane Library. Breastfeeding concerns in France about 70% of children at birth (EL2). Its median duration is about 15 weeks and 3 weeks ½ for exclusive breastfeeding. At three months, only one third of children breastfed at birth are still being breastfed (EL2). Whether this is due to the composition of breast milk or the behavior of mothers with their children or their socio-cultural level, or even by all these components at once, breastfeeding is associated with better cognitive development children (EL2). This effect is even more reinforced that mothers breastfeed exclusively and prolonged (EL2). As part of the prevention of many diseases (ear infections, gastrointestinal infections, atopic diseases, obesity and cardiovascular diseases…), exclusive and prolonged breastfeeding (grade B) between 4 to 6 months is recommended (professional consensus). Breastfeeding is not a means of preventing postpartum depression (professional consensus). To reduce the incidence of breast cancer, prolonged breastfeeding is recommended (grade B). In order to increase the rate of initiation of breastfeeding as well as its duration, it is recommended that health professionals work closely with mothers in their project (grade A), the breastfeeding promotion messages include message to husbands (grade B), and to promote breastfeeding on demand without fixed interval between feedings (grade B). However, there is not enough data to recommend the use of a specific position during breastfeeding, or the use of one or two breast or to early start breastfeeding or not (professional consensus). Exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (professional

  6. The importance of polysomnography in the evaluation of prolonged disorders of consciousness: sleep recordings more adequately correlate than stimulus-related evoked potentials with patients' clinical status.

    Science.gov (United States)

    de Biase, Stefano; Gigli, Gian Luigi; Lorenzut, Simone; Bianconi, Claudio; Sfreddo, Patrizia; Rossato, Gianluca; Basaldella, Federica; Fuccaro, Matteo; Corica, Antonio; Tonon, Davide; Barbone, Fabio; Valente, Mariarosaria

    2014-04-01

    The aim of our study was to evaluate the importance of sleep recordings and stimulus-related evoked potentials (EPs) in patients with prolonged disorders of consciousness (DOCs) by correlating neurophysiologic variables with clinical evaluation obtained using specific standardized scales. There were 27 vegetative state (VS) and 5 minimally conscious state (MCS) patients who were evaluated from a clinical and neurophysiologic perspective. Clinical evaluation included the Coma Recovery Scale-Revised (CRS-R), Disability Rating Scale (DRS), and Glasgow Coma Scale (GCS). Neurophysiologic evaluation included 24-h polysomnography (PSG), somatosensory EPs (SEPs), brainstem auditory EPs (BAEPs), and visual EPs (VEPs). Patients with preservation of each single sleep element (sleep-wake cycle, sleep spindles, K-complexes, and rapid eye movement [REM] sleep) always showed better clinical scores compared to those who did not have preservation. Statistical significance was only achieved for REM sleep. In 7 patients PSG showed the presence of all considered sleep elements, and they had a CRS-R score of 8.29±1.38. In contrast, 25 patients who lacked one or more of the sleep elements had a CRS-R score of 4.84±1.46 (Psleep spindles and REM sleep were associated with a much higher CRS-R score (positive interaction, Psleep and sleep spindles. PSG recordings may be considered inexpensive, noninvasive, and easy-to-perform examinations to provide supplementary information in patients with prolonged DOCs. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Ringer's lactate, but not hydroxyethyl starch, prolongs the food intolerance time after major abdominal surgery; an open-labelled clinical trial.

    Science.gov (United States)

    Li, Yuhong; He, Rui; Ying, Xiaojiang; Hahn, Robert G

    2015-05-06

    The infusion of large amounts of Ringer's lactate prolongs the functional gastrointestinal recovery time and increases the number of complications after open abdominal surgery. We performed an open-labelled clinical trial to determine whether hydroxyethyl starch or Ringer's lactate exerts these adverse effects when the surgery is performed by laparoscopy. Eighty-eight patients scheduled for major abdominal cancer surgery (83% by laparoscopy) received a first-line fluid treatment with 9 ml/kg of either 6% hydroxyethyl starch 130/0.4 (Voluven) or Ringer's lactate, just after induction of anaesthesia; this was followed by a second-line infusion with 12 ml/kg of either starch or Ringer's lactate over 1 hour. Further therapy was managed at the discretion of the attending anaesthetist. Outcome data consisted of postoperative gastrointestinal recovery time, complications and length of hospital stay. The order of the infusions had no impact on the outcome. Both the administration of ≥ 2 L of Ringer's lactate and the development of a surgical complication were associated with a longer time period of paralytic ileus and food intolerance (two-way ANOVA, P food intolerance time amounted to 2 days each. The infusion of ≥ 1 L of hydroxyethyl starch did not adversely affect gastrointestinal recovery. Ringer's lactate, but not hydroxyethyl starch, prolonged the gastrointestinal recovery time in patients undergoing laparoscopic cancer surgery. Surgical complications prolonged the hospital stay.

  8. Prolonged impact of home versus clinic-based management of chronic heart failure: extended follow-up of a pragmatic, multicentre randomized trial cohort.

    Science.gov (United States)

    Stewart, Simon; Carrington, Melinda J; Horowitz, John D; Marwick, Thomas H; Newton, Phillip J; Davidson, Patricia M; Macdonald, Peter; Thompson, David R; Chan, Yih-Kai; Krum, Henry; Reid, Christopher; Scuffham, Paul A

    2014-07-01

    We compared the longer-term impact of the two most commonly applied forms of post-discharge management designed to minimize recurrent hospitalization and prolong survival in typically older patients with chronic heart failure (CHF). We followed a multi-center randomized controlled trial cohort of Australian patients hospitalized with CHF and initially allocated to home-based or specialized CHF clinic-based intervention for 1368 ± 216 days. Blinded endpoints included event-free survival from all-cause emergency hospitalization or death, all-cause mortality and rate of all-cause hospitalization and stay. 280 patients (73% male, aged 71 ± 14 years and 73% left ventricular systolic dysfunction) were initially randomized to home-based (n=143) or clinic-based (n=137) intervention. During extended follow-up (complete for 274 patients), 1139 all-cause hospitalizations (7477 days of hospital stay) and 121 (43.2%) deaths occurred. There was no difference in the primary endpoint; 20 (14.0%) home-based versus 13 (7.4%) clinic-based patients remained event-free (adjusted HR 0.89, 95% CI 0.70 to 1.15; p=0.378). Significantly fewer home-based (51/143, 35.7%) than clinic-based intervention (71/137, 51.8%) patients died (adjusted HR 0.62, 95% CI 0.42 to 0.90: p=0.012). Home-based versus clinic-based intervention patients accumulated 592 and 547 all-cause hospitalizations (p=0.087) associated with 3067 (median 4.0, IQR 2.0 to 6.8) versus 4410 (6.0, IQR 3.0 to 12.0) days of hospital stay (p<0.01 for rate and duration of hospital stay). Relative to clinic-based intervention, home-based intervention was not associated with prolonged event-free survival. Home-based intervention was, however, associated with significantly fewer all-cause deaths and significantly fewer days of hospital stay in the longer-term. Australian New Zealand Clinical Trials Registry number 12607000069459 (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=81803). Copyright © 2013 Elsevier Ireland

  9. Prolonged-release melatonin versus placebo for benzodiazepine discontinuation in patients with schizophrenia: a randomized clinical trial - the SMART trial protocol

    Directory of Open Access Journals (Sweden)

    Oranje Bob

    2011-10-01

    Full Text Available Abstract Background Treatment of schizophrenia frequently includes prolonged benzodiazepine administration despite a lack of evidence of its use. It is often difficult to discontinue benzodiazepines because of the development of dependence. We aim to assess if melatonin can facilitate the withdrawal of prolonged benzodiazepine administration in patients with schizophrenia. Furthermore, we aim to investigate the association of benzodiazepine dose reduction with the following clinically important variables: sleep, psychophysiology, cognition, social function, and quality of life. Methods/Design Randomized, blinded, two-armed, parallel superiority trial. We plan to include 80 consenting outpatients diagnosed with schizophrenia or schizoaffective disorder, 18-55 years of age, treated with antipsychotic drug(s and at least one benzodiazepine derivative for the last three months before inclusion. Exclusion criteria: currently under treatment for alcohol or drug abuse, aggressive or violent behavior, known mental retardation, pervasive developmental disorder, dementia, epilepsy, terminal illness, severe co morbidity, inability to understand Danish, allergy to melatonin, lactose, starch, gelatin, or talc, hepatic impairment, pregnancy or nursing, or lack of informed consent. After being randomized to prolonged-release melatonin (Circadin® 2 mg daily or matching placebo, participants are required to slowly taper off their benzodiazepine dose. The primary outcome measure is benzodiazepine dose at 6 months follow-up. Secondary outcome measures include sleep, psychophysiological, and neurocognitive measures. Data are collected at baseline and at 6 months follow-up regarding medical treatment, cognition, psychophysiology, sleep, laboratory tests, adverse events, psychopathology, social function, and quality of life. Data on medical treatment, cognition, psychophysiology, adverse events, social function, and quality of life are also collected at 2 and 4

  10. The Role of Bituminous Sands in Extending the Petroleum Era Beyond 2000 A. D. (Summary Lele des sables bitumineux pour prolonger l'ère du pétrole au-delà de l'an 2000 (résumé

    Directory of Open Access Journals (Sweden)

    Carrigy M.

    2006-10-01

    'énergie; la communauté internationale montre un intérêt très fort pour une coopération afin de développer de nouvelles méthodes d'exploration et de résoudre les problèmes technologiques communs pour réduire le délai avant que devienne accessible l'huile provenant de cette source gigantesque d'énergie. La connaissance détaillée de la situation géologique et du réservoir a une importance fondamentale pour l'évaluation de la taille des ressources, pour le succès de leur exploitation et pour la transposition de la technologie hautement compliquée d'un gîte à un autre. Il reste beaucoup de recherches à poursuivre pour améliorer notre intelligence de l'origine du bitume et des facteurs qui contrôlent l'emplacement des accumulations. Sur la base des informations actuellement à notre disposition, on peut estimer à 5 ou 10 x 10. 12 (trillions de barils la quantité de bitume contenu dans les dépôts de sables bitumineux, ce qui peut apporter une sérieuse contribution pour prolonger l'ère du pétrole jusqu'à ce que soient développées les énergies de remplacement. Cependant une large part de l'huile synthétique ainsi produite ne devrait pas apparaître sur les marchés avant l'an 2000, à cause des capitaux gigantesques nécessaires et du nombre élevé de techniciens hautement qualifiés requis pour mettre les sables en production. Dans les nations plus industrialisées où la demande de combustibles liquides est la plus forte, en particulier le Canada, le Venezuela et les États-Unis, des milliards de dollars sont actuellement consacrés à l'exploration et à l'exploitation de leurs sables bitumineux. Ce serait surtout dans les pays en cours de développement qui ne peuvent assurer leurs achats de brut léger, et qui ont des dépôts bitumineux que l'exploitation de ces ressources auraient l'impact le plus profond. Il est donc indispensable que tous les géologues soient au courant des technologies nouvelles maintenant disponibles pour transformer

  11. [Current status of clinical nutrition at the network of public hospitals from Castilla y León].

    Science.gov (United States)

    de Luis, D; Ballesteros, M; Cano, I; Fernández, M; Izaola, O; de la Lama, G; López Guzmán, A; Maldonado, A; Martín, M A; Muñoz, C; Ruiz, E

    2006-01-01

    Clinical nutrition is an activity realized in most of Health Centres of France, Canada, Great Britain and USA. The aim of our work was to determine activity and resources of Nutrition Units of Hospitals in the Community of Castilla y León. A questionnaire was send to all Hospitals of Castilla y León (SACYL); Hospital Universitario Rio Hortega, Hospital Clinico Universitario, Hospital Comarcal de Medina del Campo, Hospital General Yagüe-Divino Vallés (Burgos), Complejo Hospitalario de Le6n, Hospital General de Segovia, Hospital Virgen de Sonsoles de Avila, Hospital Virgen de la Concha de Zamora, Hospital Comarcal de Aranda de Duero, Hospital Comarcal de Miranda, Hospital General de Soria, Hospital Clinico Universitario de Salamanca. Nine Centres responded questionnaire (75%). A total of 5 Hospitals had a Unit of Nutrition (55.6%). The results showed an average of 0.37 +/- 0.55 specialists for each 400 beds, 0.87 +/- 0.63 nurses for each 400 beds and 1.91 +/- 2.3 auxiliaries for each 400 beds, with an average of 0.21 +/- 0.41 specialists for each 100,000 habitants, 0.49 +/- 0.36 nurses for each 100,000 habitants and 1.09 +/- 1.2 auxiliaries for each 100,000 habitants. The activity of these Units is demanded by other Units, with an average of 3.2 +/- 3.4 consultations per day. The main diseases of this activity were 33.3% tumoral pathology, 55.6% surgery and 11.1% neurological pathology. Oral supplements were the first intervention tool. Only 3 Centres had a home artificial nutrition consultation. The main diseases of this activity were post surgical patients (33,3%), tumoral pathology (33,3%), neurological pathology (22%) and inflammatory bowel disease (11%). Resources in Units of Nutrition of Castilla y Leon were limited. However, activity in Hospital an in home is equal than other areas. New actions of Local Administration are necessaries to follow recommendations of Council of Europe.

  12. Prolonged-release melatonin versus placebo for benzodiazepine discontinuation in patients with schizophrenia: a randomized clinical trial - the SMART trial protocol

    DEFF Research Database (Denmark)

    Baandrup, Lone; Fagerlund, Birgitte; Jennum, Poul

    2011-01-01

    Treatment of schizophrenia frequently includes prolonged benzodiazepine administration despite a lack of evidence of its use. It is often difficult to discontinue benzodiazepines because of the development of dependence. We aim to assess if melatonin can facilitate the withdrawal of prolonged...

  13. [Clinical practice data regarding tapentadol prolonged release treatment for severe chronic pain - improvement of analgesia, functional competence and quality of life in particular under tapentadol monotherapy].

    Science.gov (United States)

    Lange, Thomas; Krings, Doris; Waldmann-Rex, Susanne

    2015-04-01

    To assess effectiveness and tolerability of tapentadol prolonged release (PR, Palexia® retard) for the treatment of severe chronic pain under routine clinical practice conditions in Germany. In this prospective non-interventional study, data regarding previous and concomitant analgesic treatment, tapentadol dosage, pain intensity, functionality, quality of life, and tolerability of tapentadol PR were collected over a 3-month observation period. A total of 5,002 patients were included in the effectiveness analysis; a subgroup analysis assessed effectiveness for all patients receiving tapentadol monotherapy (n = 1476). Nearly all patients of the total study population (95.9%) had already received analgesic long-term treatment (31.7% strong opioids) prior to the start of the study. Treatment with tapentadol PR (mean daily dose 216 ± 103 mg at end of observation) resulted in a reduction in pain intensity of 3.9 points from 7.2 ± 1.4 at baseline (95%CI -3.93; -3.83; p ≤ 0.001; NRS-11); clinically relevant pain relief ≥ 50% was documented for 65.1% of the patients. All 4 evaluated aspects regarding pain-related functionality, and quality of life of the patients also improved significantly. Compared to the total patient population, pain relief was greater in the subgroup receiving tapentadol monotherapy; baseline pain intensity was comparable between the groups. Pain-related functional impairment also declined to a slightly greater extent, and quality of life was rated more positively at end of observation. Analgesic treatment with tapentadol PR in routine clinical practice resulted in a marked reduction of severe chronic pain with significant improvements of functionality and quality of life. On the basis of these results and the favourable safety profile, tapentadol PR can thus be considered an alternative to classical opioids in the treatment of severe chronic pain.

  14. Efficacy and safety of prolonged-release melatonin for insomnia in middle-aged and elderly patients with hypertension: a combined analysis of controlled clinical trials

    Directory of Open Access Journals (Sweden)

    Lemoine P

    2012-01-01

    Full Text Available Patrick Lemoine1, Alan G Wade2, Amnon Katz3, Tali Nir3, Nava Zisapel3,41The Clinique Lyon-Lumière, Meyzieu, France; 2CPS Research, 3 Todd Campus, Glasgow, UK; 3Neurim Pharmaceuticals Ltd, Tel-Aviv, Israel; 4Department of Neurobiology Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv, IsraelBackground: Add-on prolonged-release melatonin (PRM in antihypertensive therapy has been shown to ameliorate nocturnal hypertension. Hypertension is a major comorbidity among insomnia patients. The efficacy and safety of PRM for primary insomnia in patients aged 55 years and older who are treated with antihypertensive drugs were evaluated.Methods: Post hoc analysis of pooled antihypertensive drug-treated subpopulations from four randomized, double-blind trials of PRM and placebo for 3 weeks (N[PRM] = 195; N[placebo] = 197 or 28 weeks (N[PRM] = 157; N[placebo] = 40. Efficacy measurements included Leeds Sleep Evaluation Questionnaire scores of quality of sleep and alertness and behavioral integrity the following morning after 3 weeks, and sleep latency (daily sleep diary and Clinical Global Impression of Improvement (CGI-I after 6 months of treatment. Safety measures included antihypertensive drug-treated subpopulations from these four and three additional single-blind and open-label PRM studies of up to 1 year (N[PRM] = 650; N[placebo] = 632.Results: Quality of sleep and behavior following wakening improved significantly with PRM compared with placebo (P < 0.0001 and P < 0.0008, respectively. Sleep latency (P = 0.02 and CGI-I (P = 0.0003 also improved significantly. No differences were observed between PRM and placebo groups in vital signs, including daytime blood pressure at baseline and treatment phases. The rate of adverse events normalized per 100 patient-weeks was lower for PRM (3.66 than for placebo (8.53.Conclusions: The findings demonstrate substantive and sustained efficacy of PRM in primary insomnia patients treated with antihypertensive drugs

  15. 17-Hydroxyprogesterone caproate to prolong pregnancy after preterm rupture of the membranes: early termination of a double-blind, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Combs C Andrew

    2011-12-01

    Full Text Available Abstract Background Progestational agents may reduce the risk of preterm birth in women with various risk factors. We sought to test the hypothesis that a weekly dose of 17-hydroxyprogesterone caproate (17P given to women with preterm rupture of the membranes (PROM will prolong pregnancy and thereby reduce neonatal morbidity. Methods Double-blind, placebo-controlled randomized clinical trial. Women with PROM at 23.0 to 31.9 weeks of gestation were randomly assigned to receive a weekly intramuscular injection of 17P (250 mg in 1 mL castor oil or placebo (1 mL castor oil. The primary outcome was the rate of continuing the pregnancy until 34.0 weeks of gestation or until documentation of fetal lung maturity at 32.0 to 33.9 weeks of gestation. Planned secondary outcomes were duration of latency period and rate of composite neonatal morbidity. Enrollment of 111 participants per group, 222 total, was planned to yield 80% power to detect an increase in the primary outcome from 30% with placebo to 50% with 17P. Results Twelve women were enrolled of whom 4 were randomly assigned to receive 17P and 8 to receive placebo. The trial was terminated prematurely because of two separate issues related to the supply of 17P. No adverse events attributable to 17P were identified. Conclusion Because of premature termination, the trial does not have adequate statistical power to evaluate efficacy or safety of 17P in women with PROM. Nonetheless, ethical principles dictate that we report the results, which may contribute to possible future metaanalyses and systematic reviews. Trial Registration ClinicalTrials.gov: NCT01119963 Supported by a research grant from the Center for Research, Education, and Quality, Pediatrix Medical Group, Sunrise, FL

  16. Serial analysis of clinical and imaging indices reveals prolonged efficacy of TNF-α and IL-6 receptor targeted therapies in refractory Takayasu arteritis.

    Science.gov (United States)

    Youngstein, Taryn; Peters, James E; Hamdulay, Shahir S; Mewar, Devesh; Price-Forbes, Alec; Lloyd, Mark; Jeffery, Rachel; Kinderlerer, Anne R; Mason, Justin C

    2014-01-01

    We analysed a large cohort of patients with Takayasu arteritis, seeking robust clinical evidence for prolonged responses to tumour necrosis factor-α (TNF-α) and interleukin-6 receptor (IL-6R) antagonists in severe refractory disease. Case notes from ninety-eight patients with Takayasu arteritis were retrospectively reviewed. Drug treatment, laboratory and serial non-invasive imaging data were analysed, and the Indian Takayasu arteritis activity (ITAS) and damage scores (TADs) calculated. Nine patients were treated with biologic therapies. All had previously received high dose prednisolone and ≥1 conventional immunosuppressant. Five patients had failed cyclophosphamide. The patients prescribed biologics had more extensive arterial injury than the remainder of the cohort and persistent active disease (ITAS range 2-9, CRP 12-206 mg/L, TADs 3--1). Eight patients were prescribed anti-TNF-α therapy, three IL-6R blockade. The mean duration of anti-TNF-α treatment was 42 months (maximum 8 years). One patient developed new arterial stenoses while receiving anti-TNF-α and subsequently achieved disease remission with tocilizumab. Two patients have now demonstrated sustained responses to IL-6R inhibition at 19 and 20 months. Following introduction of biologic therapy, serial non-invasive imaging has revealed no significant progression in arterial injury. A significant fall in CRP (p<0.01), prednisolone dose (p<0.01) and ITAS (p<0.01) was observed, with no increase in TADs. We report for the first time sustained responses to both anti-TNF-α and IL6R antagonists in refractory Takayasu arteritis. As 5/9 patients were cyclophosphamide non-responders, we propose that biologics should now be considered ahead of cyclophosphamide in these young patients.

  17. Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial.

    Science.gov (United States)

    van den Berg, David P G; de Bont, Paul A J M; van der Vleugel, Berber M; de Roos, Carlijn; de Jongh, Ad; Van Minnen, Agnes; van der Gaag, Mark

    2015-03-01

    The efficacy of posttraumatic stress disorder (PTSD) treatments in psychosis has not been examined in a randomized clinical trial to our knowledge. Psychosis is an exclusion criterion in most PTSD trials. To examine the efficacy and safety of prolonged exposure (PE) therapy and eye movement desensitization and reprocessing (EMDR) therapy in patients with psychotic disorders and comorbid PTSD. A single-blind randomized clinical trial with 3 arms (N = 155), including PE therapy, EMDR therapy, and waiting list (WL) of 13 outpatient mental health services among patients with a lifetime psychotic disorder and current chronic PTSD. Baseline, posttreatment, and 6-month follow-up assessments were made. Participants were randomized to receive 8 weekly 90-minute sessions of PE (n = 53), EMDR (n = 55), or WL (n = 47). Standard protocols were used, and treatment was not preceded by stabilizing psychotherapeutic interventions. Clinician-rated severity of PTSD symptoms, PTSD diagnosis, and full remission (on the Clinician-Administered PTSD Scale) were primary outcomes. Self-reported PTSD symptoms and posttraumatic cognitions were secondary outcomes. Data were analyzed as intent to treat with linear mixed models and generalized estimating equations. Participants in the PE and EMDR conditions showed a greater reduction of PTSD symptoms than those in the WL condition. Between-group effect sizes were 0.78 (P EMDR. Participants in the PE condition (56.6%; odds ratio [OR], 3.41; P = .006) or the EMDR condition (60.0%; OR, 3.92; P EMDR condition (16.4%; OR, 2.87; P = .10), were more likely to gain full remission than those in the WL condition (6.4%). Treatment effects were maintained at the 6-month follow-up in PE and EMDR. Similar results were obtained regarding secondary outcomes. There were no differences in severe adverse events between conditions (2 in PE, 1 in EMDR, and 4 in WL). The PE therapy and EMDR therapy showed no difference in any of the

  18. Randomised clinical trial of the effects of prolonged-release melatonin, temazepam and zolpidem on slow-wave activity during sleep in healthy people.

    Science.gov (United States)

    Arbon, Emma L; Knurowska, Malgorzata; Dijk, Derk-Jan

    2015-07-01

    Current pharmacological treatments for insomnia include benzodiazepine and non-benzodiazepine hypnotics targeting γ-aminobutyric acid (GABA)A receptors, as well as agonists of the melatonin receptors MT1 and MT2. Melatonin, temazepam and zolpidem are thought to exert their effect through different mechanisms of action, but whether this leads to differential effects on electroencephalogram (EEG) power spectra during sleep in middle-aged people is currently not known. To establish whether the effects of prolonged-release melatonin (2 mg) on the nocturnal sleep EEG are different to those of temazepam (20 mg) and zolpidem (10 mg). Sixteen healthy men and women aged 55-64 years participated in a double-blind, placebo-controlled, four-way cross-over trial. Nocturnal sleep was assessed with polysomnography and spectral analysis of the EEG. The effects of single oral doses of prolonged-release melatonin, temazepam and zolpidem on EEG slow-wave activity (SWA, 0.75-4.5 Hz) and other frequencies during nocturnal non-rapid eye movement (NREM) sleep were compared. In an entire night analysis prolonged-release melatonin did not affect SWA, whereas temazepam and zolpidem significantly reduced SWA compared with placebo. Temazepam significantly reduced SWA compared with prolonged-release melatonin. Prolonged-release melatonin only reduced SWA during the first third of the night compared with placebo. These data show that the effects of prolonged-release melatonin on the nocturnal sleep EEG are minor and are different from those of temazepam and zolpidem; this is likely due to the different mechanisms of action of the medications. © The Author(s) 2015.

  19. Immunosuppression Adherence in Stable Kidney Transplant Patients Converted From Immediate- to Prolonged-Release Tacrolimus in Clinical Practice: A Norwegian Study.

    Science.gov (United States)

    Abedini, Sadollah; Gøransson, Lasse; Cockburn, Elinor; Kilany, Suzanne; Holdaas, Hallvard

    2018-02-01

    This study investigated medication adherence in kidney transplant patients (KTPs) converted from immediate-release tacrolimus (IR-T) to prolonged-release tacrolimus (PR-T)-based immunosuppression in routine practice. Noninterventional, observational, multicenter study in Norway. Included adult KTPs with stable graft function, converted from IR-T (baseline) to PR-T (1 mg:1 mg) in routine practice. Data were collected at baseline, and months 1, 3, 6, and 12 postconversion. Primary endpoint: adherence using the Basel Assessment of Adherence to Immunosuppressive Medication Scale. Secondary assessments: tacrolimus dose and trough levels (target, 3-7 ng/mL), clinical laboratory parameters (eg, estimated glomerular filtration rate [Modified Diet in Renal Disease]), and adverse events. Ninety-one KTPs (mean ± SD age 47.7 ± 14.3 years) were analyzed. Mean ± SD change in PR-T dose from baseline (4.4 ± 2.4 mg/d) to month 12 was -0.1 ± 0.9 mg/d; mean tacrolimus trough levels remained within target. Overall medication adherence increased from 45.6% at baseline to 58.1% at month 1, but was similar to baseline thereafter; taking and timing adherence followed a similar pattern. Odds ratio (OR) for adherence at month 1 (but not at other time points) was greater versus baseline for overall (OR, 1.71; P = 0.0205), taking (OR, 3.38; P = 0.0004), and timing (OR, 1.77, P = 0.0252) dimensions. Mean ± SD Basel Assessment of Adherence to Immunosuppressive Medication Scale visual analogue scale score at baseline was 96.4 ± 5.5%, and increased postconversion. Estimated glomerular filtration rate remained stable (month 12, 61.6 ± 17.7 mL/min per 1.73 m 2 ), as did other laboratory parameters. Two (2.2%) patients had adverse events considered probably/possibly treatment-related. There was disparity between high, patient-perceived and low, actual adherence. Converting stable KTPs from IR-T to PR-T in routine practice did not impact long-term adherence to immunosuppression; renal

  20. Therapeutic Effects of Prolonged Cannabidiol Treatment on Psychological Symptoms and Cognitive Function in Regular Cannabis Users: A Pragmatic Open-Label Clinical Trial.

    Science.gov (United States)

    Solowij, Nadia; Broyd, Samantha J; Beale, Camilla; Prick, Julie-Anne; Greenwood, Lisa-Marie; van Hell, Hendrika; Suo, Chao; Galettis, Peter; Pai, Nagesh; Fu, Shanlin; Croft, Rodney J; Martin, Jennifer H; Yücel, Murat

    2018-01-01

    Introduction: Chronic cannabis use has been associated with impaired cognition and elevated psychological symptoms, particularly psychotic-like experiences. While Δ 9 -tetrahydrocannabinol (THC) is thought to be primarily responsible for these deleterious effects, cannabidiol (CBD) is purported to have antipsychotic properties and to ameliorate cognitive, symptomatic, and brain harms in cannabis users. However, this has never been tested in a prolonged administration trial in otherwise healthy cannabis users. Here, we report the first study of prolonged CBD administration to a community sample of regular cannabis users in a pragmatic trial investigating potential restorative effects of CBD on psychological symptoms and cognition. Materials and Methods: Twenty frequent cannabis users (16 male, median age 25 years) underwent a 10-week open-label trial of 200 mg of daily oral CBD treatment, while continuing to use cannabis as usual. The majority of participants were daily cannabis users who had used cannabis for several years (median 5.5 years of regular use). Participants underwent psychological and cognitive assessments at baseline (BL) and post-treatment (PT) and were monitored weekly throughout the trial. Results: CBD was well tolerated with no reported side effects; however, participants retrospectively reported reduced euphoria when smoking cannabis. No impairments to cognition were found, nor were there deleterious effects on psychological function. Importantly, participants reported significantly fewer depressive and psychotic-like symptoms at PT relative to BL, and exhibited improvements in attentional switching, verbal learning, and memory. Increased plasma CBD concentrations were associated with improvements in attentional control and beneficial changes in psychological symptoms. Greater benefits were observed in dependent than in nondependent cannabis users. Conclusions: Prolonged CBD treatment appears to have promising therapeutic effects for improving

  1. Therapeutic Effects of Prolonged Cannabidiol Treatment on Psychological Symptoms and Cognitive Function in Regular Cannabis Users: A Pragmatic Open-Label Clinical Trial

    Science.gov (United States)

    Solowij, Nadia; Broyd, Samantha J.; Beale, Camilla; Prick, Julie-Anne; Greenwood, Lisa-marie; van Hell, Hendrika; Suo, Chao; Galettis, Peter; Pai, Nagesh; Fu, Shanlin; Croft, Rodney J.; Martin, Jennifer H.; Yücel, Murat

    2018-01-01

    Abstract Introduction: Chronic cannabis use has been associated with impaired cognition and elevated psychological symptoms, particularly psychotic-like experiences. While Δ9-tetrahydrocannabinol (THC) is thought to be primarily responsible for these deleterious effects, cannabidiol (CBD) is purported to have antipsychotic properties and to ameliorate cognitive, symptomatic, and brain harms in cannabis users. However, this has never been tested in a prolonged administration trial in otherwise healthy cannabis users. Here, we report the first study of prolonged CBD administration to a community sample of regular cannabis users in a pragmatic trial investigating potential restorative effects of CBD on psychological symptoms and cognition. Materials and Methods: Twenty frequent cannabis users (16 male, median age 25 years) underwent a 10-week open-label trial of 200 mg of daily oral CBD treatment, while continuing to use cannabis as usual. The majority of participants were daily cannabis users who had used cannabis for several years (median 5.5 years of regular use). Participants underwent psychological and cognitive assessments at baseline (BL) and post-treatment (PT) and were monitored weekly throughout the trial. Results: CBD was well tolerated with no reported side effects; however, participants retrospectively reported reduced euphoria when smoking cannabis. No impairments to cognition were found, nor were there deleterious effects on psychological function. Importantly, participants reported significantly fewer depressive and psychotic-like symptoms at PT relative to BL, and exhibited improvements in attentional switching, verbal learning, and memory. Increased plasma CBD concentrations were associated with improvements in attentional control and beneficial changes in psychological symptoms. Greater benefits were observed in dependent than in nondependent cannabis users. Conclusions: Prolonged CBD treatment appears to have promising therapeutic effects for

  2. Exhaustion from prolonged gambling

    Directory of Open Access Journals (Sweden)

    Fatimah Lateef

    2013-01-01

    Full Text Available Complaints of fatigue and physical exhaustion are frequently seen in the acute medical setting, especially amongst athletes, army recruits and persons involved in strenuous and exertional physical activities. Stress-induced exhaustion, on the other hand, is less often seen, but can present with very similar symptoms to physical exhaustion. Recently, three patients were seen at the Department of Emergency Medicine, presenting with exhaustion from prolonged involvement in gambling activities. The cases serve to highlight some of the physical consequences of prolonged gambling.

  3. Aging Mechanisms and Control. Symposium Part A - Developments in Computational Aero- and Hydro-Acoustics. Symposium Part B - Monitoring and Management of Gas Turbine Fleets for Extended Life and Reduced Costs (Les mecanismes vieillissants et le controle) (Symposium Partie A - Developpements dans le domaine de l’aeroacoustique et I’hydroacoustique numeriques) (Symposium Partie B - Le suivi et la gestion des turbomoteurs en vue du prolongement de l

    Science.gov (United States)

    2003-02-01

    to be present in the rim and outer web than in the bore of the disc, which was consistent with the observations. A conservative probability of this...turbomoteurs pour regrouper les pièces de manière homogène et ne renvoyer en atelier qu’une partie du moteur. Développer la Maintenance Profonde , niveau 3...Pour ce faire, deux concepts doivent être mis en place : Les potentiels par pièces La Maintenance Profonde Le premier concept cible l’intervention

  4. Le Sanskrit

    CERN Document Server

    Balbir, Nalini

    2013-01-01

    Cet ouvrage est destiné à tous ceux qui souhaitent se mettre ou se remettre à l'étude du sanskrit et ne peuvent y consacrer que quelques minutes par jour. En suivant le principe de la méthode quotidienne Assimil, vous acquerrez progressivement le vocabulaire et la grammaire de base qui sont nécessaires à la lecture des textes de la littérature sanskrite classique. Vous trouverez dans cette méthode une approche vivante de la langue et de la culture sanskrite classique à travers des textes d'abord adaptés pour le débutant puis authentiques. En quelques mois, vous manierez la langue sans efforts ni hésitation, de manière très naturelle. Les enregistrements reprennent l'intégralité des textes en sanskrit des leçons et des exercices de traduction du livre. Ils sont interprétés, à un rythme progressif, par des locuteurs natifs professionnels.

  5. Prolonged Intermittent Renal Replacement Therapy.

    Science.gov (United States)

    Edrees, Fahad; Li, Tingting; Vijayan, Anitha

    2016-05-01

    Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety

    Directory of Open Access Journals (Sweden)

    Paphon Sa-ngasoongsong

    2015-01-01

    Full Text Available Background. Recently, combined intra-articular tranexamic acid (IA-TXA injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR. However, until now, none of previous studies revealed the effect of this technique on pharmacokinetics, coagulation, and fibrinolysis. Materials and Methods. An experimental study was conducted, during 2011-2012, in 30 patients undergoing unilateral TKR. Patients received IA-TXA application and then were allocated into six groups regarding clamping drain duration (2-, 4-, 6-, 8-, 10-, and 12-hours. Blood and drainage fluid were collected to measure tranexamic acid (TXA level and related coagulation and fibrinolytic markers. Postoperative complication was followed for one year. Results. There was no significant difference of serum TXA level at 2 hour and 24 hour among groups (p<0.05. Serum TXA level at time of clamp release was significantly different among groups with the highest level at 2 hour (p<0.0001. There was no significant difference of TXA level in drainage fluid, postoperative blood loss, blood transfusion, and postoperative complications (p<0.05.  Conclusions. Low-dose IA-TXA application in TKR with prolonged clamping drain method is a safe and effective blood conservative technique with only minimal systemic absorption and without significant increase in systemic absorption over time.

  7. Antimicrobials and QT prolongation.

    Science.gov (United States)

    Mason, Jay W

    2017-05-01

    Solithromycin, a ketolide/macrolide antibiotic, has recently been reported to be free of the expected QT-prolonging effect of macrolides. It appears that its keto substitution provides a structural basis for this observation, as the other two tested ketolides also have minimal QT effect.Among non-cardiovascular therapies, antimicrobials probably carry the greatest potential to cause cardiac arrhythmias. This is a result of their propensity to bind to the delayed rectifier potassium channel, IKr, inducing QT prolongation and risk of torsades de pointes ventricular tachycardia, their frequent interference with the metabolism of other QT prolongers and their susceptibility to metabolic inhibition by numerous commonly used drugs.Unfortunately, there is evidence that medical practitioners do not take account of the QT/arrhythmia risk of antimicrobials in their prescribing practices. Education on this topic is sorely needed. When a macrolide is indicated, a ketolide should be considered in patients with a QT risk. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Prolonged-release melatonin versus placebo for benzodiazepine discontinuation in patients with schizophrenia: a randomized clinical trial - the SMART trial protocol

    DEFF Research Database (Denmark)

    Baandrup, Lone; Fagerlund, Birgitte; Jennum, Poul

    2011-01-01

    benzodiazepine administration in patients with schizophrenia. Furthermore, we aim to investigate the association of benzodiazepine dose reduction with the following clinically important variables: sleep, psychophysiology, cognition, social function, and quality of life....

  9. Management of prolonged pregnancy

    International Nuclear Information System (INIS)

    Iqbal, S.

    2004-01-01

    Objective: To compare two strategies for management of prolonged pregnancy (= or >294 days) i.e. induction (intervention) versus expectant management (non-intervention) and evaluate the associated feto-maternal risks. Subjects and Methods: One hundred cases of uncomplicated prolonged gestation were selected. The gestational age was confirmed by ultrasound in first trimester. One group (50 patients) was managed by intervention i.e. induction of labour (group A) and other group (50 patients) by non-intervention i.e. expectant management (group B). In group A intervention was done at 42 weeks. In expectant group, the methods of monitoring were fetal kick charting recorded daily by the patient, and ultrasound for amniotic fluid index. The biophysical profile score and NST (non stress test) were performed once a week till 42 weeks and then twice weekly. Results: The frequency of prolonged pregnancy was found to be 10.9%. There was no significant difference in the number of spontaneous vaginal deliveries between the two groups. The rate of LSCS (lower segment caesarean section) was higher in intervention group ( 30% versus 18% ). The neonatal depression at birth was more in group B ( 10% versus 4%) and at 5 minutes almost same between two groups (4% versus 2%). There were 11 cases of meconium aspiration syndrome, leading to one neonatal death. Among nine perinatal deaths two were neonatal deaths. Seven cases of intrauterine deaths in which antepartum deaths occurred because of non compliance of patients. No cause could be detected for the other three fetuses. Conclusion: There was increased LSCS rate in group A. However in expectant group B perinatal mortality was about twice more as compared to intervention group. Active early intervention at 42 weeks is warranted to reduce perinatal morbidity and mortality. (author)

  10. Le barde et le bouffon

    OpenAIRE

    Fasquel, Samuel

    2013-01-01

    La Gatomaquia de Lope de Vega, La Moschea de Villaviciosa et le Poema heroico de las necedades y locuras de Orlando el enamorado de Quevedo constituent un corpus poétique qui réunit les meilleurs fruits produits par la geste burlesque dans l’Espagne du Siècle d’or. Cet article analyse les profondes différences esthétiques qui caractérisent ces œuvres dans le but de montrer que, malgré ces différences et en dépit de l’importance des éléments carnavalesques et grotesques, ces trois poèmes ne pr...

  11. Routine versus needs-based MRI in patients with prolonged low back pain: a comparison of duration of treatment, number of clinical contacts and referrals to surgery

    Directory of Open Access Journals (Sweden)

    Claus Manniche

    2010-07-01

    Full Text Available Abstract Background The routine use of radiology is normally discouraged in patients with low back pain (LBP. Magnetic Resonance Imaging (MRI provides clinicians and patients with detailed knowledge of spinal structures and has no known physical side effects. It is possible that insight into the pathological changes in LBP patients could affect patient management. However, to our knowledge, this has never been tested. Until June 2006, all patients at our specialised out-patient public clinic were referred for MRI on the basis of clinical indications, economic constraints, and availability of MRI (the "needs-based MRI" group. As a new approach, we now refer all patients who meet certain criteria for routine up-front MRI before the clinical examination (the "routine MRI" group. Objectives The aims of this study were to investigate if these two MRI approaches resulted in differences in: (1 duration of treatment, (2 number of contacts with clinicians, and (3 referral for surgery. Design Comparison of two retrospective clinical cohorts. Method Files were retrieved from consecutive patients in both groups. Criteria for referral were: (1 LBP or leg pain of at least 3 on an 11-point Numeric Rating Scale, (2 duration of present symptoms from 2 to12 months and (3 age above 18 years. A comparison was made between the "needs-based MRI" and "routine MRI" groups on the outcomes of duration of treatment and use of resources. Results In all, 169 "needs-based MRI" and 208 "routine MRI" patient files were identified. The two groups were similar in age, sex, and severity of LBP. However, the median duration of treatment for the "needs-based MRI" group was 160 versus 115 days in the "routine MRI" group (p = 0.0001. The median number of contacts with clinicians for the "needs-based MRI" group was 4 versus 3 for the "routine MRI" group (p = 0.003. There was no difference between the two approaches in frequency of referral for back surgery (p = 0.81. When the direct

  12. A randomized clinical trial evaluating prophylactic single-dose vs prolonged course of antibiotics for caesarean section in a high HIV-prevalence setting.

    Science.gov (United States)

    Gidiri, M F; Ziruma, A

    2014-02-01

    The evidence that perioperative antibiotics for caesarean delivery are effective in reducing infective morbidity is unequivocal. In developing countries, especially those with high HIV-prevalence, clinicians have increasingly become anxious about the efficacy of perioperative antibiotics, hence the adoption of treatment regimens, as described in this study. We set out to investigate if these fears have a basis by conducting a randomised clinical trial. The setting was two tertiary units in a developing country with a significant HIV-prevalence. The outcome measures assessed were: pyrexia, wound infection, admission with puerperal sepsis, laparotomy for pelvic abscess and duration of hospital stay. There was no statistically significant difference between the two arms of the study with regard to the above outcomes. Our conclusion is that the two antibiotic regimens are equivalent in preventing infection, therefore there is no justification for subjecting patients to week-long antibiotics and the unnecessary increase in nurse workload.

  13. Clinical Profi le and Predictors of Outcomes of Patients with Peripartum Cardiomyopathy: The Philippine Heart Center Experience.

    Science.gov (United States)

    Cuenza, Lucky R; Manapat, Normita; Jalique, Jundelle Romulo K

    2016-10-01

    Peripartum cardiomyopathy is a rare form of dilated cardiomyopathy characterized by heart failure and left ventricular dysfunction associated with pregnancy. While clinical characteristics of these patients have been previously described in literature, there is limited data regarding the natural history and predictors of outcomes of these patients in Asia, most specifi cally in Filipino patients. Clinical and echocardiographic data of 39 patients diagnosed with peripartum cardiomyopathy were analyzed. Patients were followed up for the occurrence of death and major adverse events (MAE) and outcomes were correlated with patient variables. The mean age of the patients was 28.4 ± 6.9 and the mean ejection fraction (EF) was 27.8 ± 8.4%. Heart failure was the most common symptom (98%) while arrhythmia was the initial presentation in 5 patients (12.8%). 14 patients had recovery of ejection fraction in 6 months (39%) with a mean EF of 55.5 ± 6.3. 16 patients had an initial EF of 25% had a 90% likelihood of survival for 8 years with a higher trend of mortality for patients whose EF did not recover in 6 months. Peripartum cardiomyopathy is associated with signifi cant morbidity and mortality. The degree of left ventricular dysfunction on presentation as well as improvement of EF within 6 months were predictive for the occurrence of death and major adverse events. This study emphasizes the need for aggressive treatment as well as clinical and echocardiographic follow up early in the course of disease in order to improve outcomes.

  14. An Experimental and Clinical Justification for Prolongation of Action of Anti-VEGF Drug in the “Wet” Form Age-related Macular Degeneration by the Introduction in the Back Subtenon Space on the Basis of Viscous Media

    Directory of Open Access Journals (Sweden)

    R. V. Gaybaryan

    2017-01-01

    Full Text Available Purpose. Experimental-clinical substantiation of the effectiveness of subtenon injection of anti-VEGF drug on the viscous media with the purpose of strengthening and prolong of therapeutic effect in the treatment of wet form of age-related macular degeneration (AMD.Material and methods. The experimental part of the work was carried out on 10 rabbits (20 eyes. The main group of rabbits (10 eyes were injected into the back subtenon space 0,5 ml of a 10% solution of fluorescein on the viscous mediа, which was used as a 2% solution of hydroxypropylmethylcellulose; a control (10 eyes — without the viscous medium. After enucleation and isolation of ocular tissues in the posterior pole was performed water extraction of the dye determined the intensity of fluorescence after 3, 7, 10, 14 and 16 days after injection. In the clinical part of the work included 32 patients (34 eyes with the wet form of AMD, to be administered anti-VEGF drug at a dose of 12,5 mg (0,5 ml into the back subtenon space аt the same viscous media. The efficacy and safety were evaluated for 6 months.Results. As a result of the experimental study found that the length of stay in the back subtenon space of fluorescein solution of rabbit’s eye, introduced in the viscous medium to 2 times longer than without it. In a clinical study of stabilization was observed in 52,9 % of cases, improved visual function in 35,3 % of cases. Deterioration in visual functions noted in 11,8 % of cases. It was also noted improvement in photo-stress test. According OCT showed a decrease in central retinal thickness 2 times by reducing the size and volume of lesions by 30%, a significant decrease transsudativ processes in the retina in all patients, indicating that suppression of choroidal neovascularization.Conclusion: Subtenon injections of anti-VEGF drug is safe and has a positive effect in wet AMD, and its application to a viscous media has a prolonged action or property interest in any material or

  15. Le CRDI au Cambodge

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

    Le CRDI a été l'un des premiers bailleurs de fonds à établir des relations avec le Cambodge au début des années 1990, alors que le pays progres- sait vers la paix. Depuis, le Centre aide à reconstruire le Cambodge, qui se remet du régime inhumain des Khmers rouges et de décennies de conflits régionaux. Un État ...

  16. 1910 - Le mouchoir

    NARCIS (Netherlands)

    Winkler, M.F.; Cohen, Nadja; Reverseau, Anne

    2015-01-01

    Une histoire littéraire buissonnière. Ainsi pourrait-on qualifier le parcours original auquel nous convie cet ouvrage, qui propose une lecture insolente et insolite de cinquante années de littérature – de 1900 à 1950 – par le prisme des objets. Objets de tous les jours comme le tabac, le vélo ou le

  17. Breast cancer only detected at US. Incidental finding or clinical evidence?; Le neoplasie mammarie visualizzabili solo con esame ecografico. Reperti incidentali o realta' clinica?

    Energy Technology Data Exchange (ETDEWEB)

    Nori, J.; Masi, A.; Boeri, C.; Vivian, A.; Nori Bufalini, F. [Azienda Ospedaliera Careggi, Florence (Italy). Unita' Operativa di Radiodiagnostica 2; Cariti, G. [Florence Univ., Florence (Italy). Dipt. di Ginecologia e Ostetricia

    2000-06-01

    Mammography is the only technique of proven efficacy in the early diagnosis of breast cancer, even though its sensitivity is much lower in breasts that are dense or with a high parenchymal-stroma component. In the past malignant breast nodules detected at US in patients with negative mammographic and physical findings were considered incidental findings, but more recent papers report increasing numbers of breast cancers detected only at US. It was investigated the yield of US performed as a diagnostic complement in asymptomatic women with mammographic findings that were either negative or poorly readable because of dense breast. 13 women were examined: 37 to 55 years old (mean 47): 9 of them were asymptomatic and 4 had poorly specific physical findings. The patients underwent physical examination, mammography, US, micro histologic biopsy with 14G needles under US guidance and surgery. Fourteen breast lesions 7.0-15 mm in diameter were detected only by US. Mammography (2 or 3 standard views) was negative in all cases. The lesions detected only by US (10% of all carcinomas) were typified with US-guided needle biopsy and finally confirmed surgically. Though obtained in a small series, the results seem to suggest that US should be included in the diagnostic work-up, especially of women with dense breast. Also, any hypoechoic lesion detected at breast US in clinically asymptomatic women with negative mammographic findings should be further investigated with US, needle aspiration or core biopsy to make the final diagnosis. [Italian] Si intende con questo lavoro valutare l'utilita' dell'esame ecografico, eseguito come completamento diagnostico in donne clinicamente negative e con mammografia negativa o comunque scarsamente leggibile in relazione alla elevata densita' del parenchima mammario (mammelle dense). Tredici donne con eta' compresa tra 37 e 55 anni (eta' media 47 anni) asintomatiche o con quadri clinici vaghi o comunque non

  18. Le vieillard et le chevalier

    Directory of Open Access Journals (Sweden)

    Mélanie JECKER

    2010-05-01

    Full Text Available La fin du Moyen Âge fascine. Deux facteurs principaux expliquent l’attraction qu’exerce cette période : elle apparaît d’une part comme un moment historique riche car double, phase de transition entre le Moyen Âge et la Renaissance, où se mêlent des cadres de représentation anciens et nouveaux. L’insinuation d’une pensée humaniste balbutiante s’y traduirait notamment par l’émergence de la notion d’individu, qui constitue l’un des objets de ce travail. Il faut invoquer, d’autre part, l’image macabre d’un bas Moyen Âge hanté par l’idée de la maladie et de la mort depuis l’épidémie de peste noire de 1348, obsédé par la brièveté de la vie humaine. Ces deux facettes de « l’automne du Moyen Âge » tel que l’évoque avec poésie Joan Huizinga sont-elles autre chose qu’une plaisante image d’Epinal? Cette étude cherche précisément à déterminer le degré de validité de ces deux topiques, à travers l’analyse de la représentation des âges de la vie dans un corpus bien défini, celui de la biographie chevaleresque castillane du XVe siècle. L’intérêt porté à l’individu, la conscience de la singularité impliquent en effet celle du caractère mouvant de la personne, or quel thème mieux que celui des âges permet de confirmer ou d’infirmer l’hypothèse du surgissement d’une nouvelle manière de concevoir l’homme, proprement « renaissante », en ce siècle de transition , La nature même du corpus retenu – des récits biographiques – suggère en effet une mutation dans l’appréhension de la personne, une attention prêtée à sa progressive transformation. L’étude de la représentation de la vieillesse, en particulier, révèle non seulement à quel point était alors réelle cette prétendue obsession de la déchéance physique et de la mortalité, mais aussi dans quelle mesure étaient soulignés et valorisés les changements individuels parallèles à l

  19. Genetic influence on prolonged gestation

    DEFF Research Database (Denmark)

    Laursen, Maja; Bille, Camilla; Olesen, Annette Wind

    2004-01-01

    OBJECTIVE: The purpose of this study was to test a possible genetic component to prolonged gestation. STUDY DESIGN: The gestational duration of single, first pregnancies by both female and male twins was obtained by linking the Danish Twin Registry, The Danish Civil Registration System, and the D...... factors. CONCLUSION: Maternal genes influence prolonged gestation. However, a substantial paternal genetic influence through the fetus was not found....

  20. Le gouvernement Mansard

    OpenAIRE

    Curton, Émile de

    2013-01-01

    Le fait même de sa nomination au poste de Gouverneur allait donner au conflit qui opposait Mansard au docteur Alain toute sa dimension. Le Médecin-chef et ses complices avaient manqué leur premier objectif : remettre en cause le ralliement de la colonie avant le départ du Gouverneur de Géry. Toutefois, ils jugeaient toujours possible de saper l’autorité encore fragile du nouveau gouverneur en la contestant. Dans ce but, le chef du service de santé prenait, dès le 15 septembre, une double init...

  1. Clinical and symptomatological study of pigs subjected to a lethal dose of integral gamma irradiation; Etude clinique et symptomatologique chez le porc soumis a une irradiation gamma totale a dose letale

    Energy Technology Data Exchange (ETDEWEB)

    Vaiman, M.; Guenet, J.-L.; Maas, J.; Nizza, P

    1966-05-01

    Results are reported from a clinical and haematological study on a Corsican species of pigs wholly exposed to an approximately lethal dose of {gamma} radiation. The aim of this work was to examine the changes in the irradiation syndrome of irradiation for pigs to make it thus possible to devise further experiments, in particular in the therapeutic field. The dose received was 285 rads (measured as the absorption in the vertical antero-posterior medial plane). Data are presented on cyto-haematological changes in the blood circulating immediately after irradiation, and followed up to death, and changes in the medullary cytology after irradiation. The clinical picture of lethal radiation injury in swine is described. (authors) [French] Les auteurs rapportent les resultats d'une etude clinique et hematologique chez des porcs de race corse irradies in toto a dose sensiblement letale. Le but de cette etude etait de connaitre l'evolution du syndrome aigu d'irradiation chez le porc et de permettre ainsi le developpement d'experimentations ulterieures, en particulier dans le domaine therapeutique. La dose delivree etait de 285 rad (en dose absorbee au niveau du plan median vertical anteroposterieur. L'etude a porte essentiellement: 1. Sur les modifications cyclo-hematologiques du sang circulant immediatement apres l'irradiation, pour les differentes lignees cellulaires; l'evolution de ces modifications a ete notee jusqu'a la mort; 2. Sur les modifications de la cytologie medullaire apres irradiation (evolution du myelogramme et essai d'evaluation de la cellularite de la moelle osseuse);: 3. Sur les signes cliniques, d'ailleurs tres discrets, observes chez les porcs apres irradiation. (auteurs)

  2. Le beau et le vrai

    Directory of Open Access Journals (Sweden)

    Létitia Mouze

    2006-05-01

    Full Text Available La vie des abeilles de Maeterlinck est un ouvrage à la fois scientifique et littéraire, non pas parce qu’il appartiendrait à la science par son exactitude et à la littérature par son style, mais en ce qu’il invite à penser l’unité des deux domaines. Les aspects littéraires de l’ouvrage (beauté de l’écriture, usage des images, de l’analogie, etc. ne sont pas des accessoires, mais des outils indispensables à l’élaboration d’un authentique savoir sur les abeilles, c’est-à-dire un savoir qui reconnaît la part d’inconnu et le mystère qui subsistent en dépit de toutes les explications physiques et mécaniques que l’on peut par ailleurs donner des phénomènes observés. Etre scientifique, dans cette perspective, c’est-à-dire donner à connaître, c’est donc être littéraire. Cette conception de la science repose en dernière instance sur une conception philosophique de l’univers comme un tout où toutes choses sont reliées, unies, par des relations d’analogies, ce qui fonde et justifie l’emploi d’un style symboliste.The life of bees, one of Maeterlinck’s works, is together a scientific and literary book, not because of it scientific exactness and its literary style, but for the reason it suggests the unity of both these domains. Literay’s aspects of this work (writing’s beauty, use of images, analogy, etc. are not secondary but necessary to elaborate an authentic knowledge about bees, that means a knowledge which admit the unknown part and the mistery that subsist despite all the physical and mechanical explanations we can give moreover about the observed phenomenons. Be a scientist, in this sense, that is give something to know, therefore means be literary. Finally, this conception of science consist in a philosophiacl conception of Universe as a whole where everything links together, and is united by analogical relations, that base and justify the use of a symbolist style.

  3. Sequential emergence and clinical implications of viral mutants with K70E and K65R mutation in reverse transcriptase during prolonged tenofovir monotherapy in rhesus macaques with chronic RT-SHIV infection

    Directory of Open Access Journals (Sweden)

    Pedersen Niels C

    2007-04-01

    Full Text Available Abstract Background We reported previously on the emergence and clinical implications of simian immunodeficiency virus (SIVmac251 mutants with a K65R mutation in reverse transcriptase (RT, and the role of CD8+ cell-mediated immune responses in suppressing viremia during tenofovir therapy. Because of significant sequence differences between SIV and HIV-1 RT that affect drug susceptibilities and mutational patterns, it is unclear to what extent findings with SIV can be extrapolated to HIV-1 RT. Accordingly, to model HIV-1 RT responses, 12 macaques were inoculated with RT-SHIV, a chimeric SIV containing HIV-1 RT, and started on prolonged tenofovir therapy 5 months later. Results The early virologic response to tenofovir correlated with baseline viral RNA levels and expression of the MHC class I allele Mamu-A*01. For all animals, sensitive real-time PCR assays detected the transient emergence of K70E RT mutants within 4 weeks of therapy, which were then replaced by K65R mutants within 12 weeks of therapy. For most animals, the occurrence of these mutations preceded a partial rebound of plasma viremia to levels that remained on average 10-fold below baseline values. One animal eventually suppressed K65R viremia to undetectable levels for more than 4 years; sequential experiments using CD8+ cell depletion and tenofovir interruption demonstrated that both CD8+ cells and continued tenofovir therapy were required for sustained suppression of viremia. Conclusion This is the first evidence that tenofovir therapy can select directly for K70E viral mutants in vivo. The observations on the clinical implications of the K65R RT-SHIV mutants were consistent with those of SIVmac251, and suggest that for persons infected with K65R HIV-1 both immune-mediated and drug-dependent antiviral activities play a role in controlling viremia. These findings suggest also that even in the presence of K65R virus, continuation of tenofovir treatment as part of HAART may be

  4. Serum biochemical changes accompanying prolonged ...

    African Journals Online (AJOL)

    Jane

    2010-10-18

    Oct 18, 2010 ... Toxicological evaluation of the whole fruit of Lagenaria breviflora was carried out using the serum biochemical changes accompanying prolonged administration of the ethanolic extract of the fruit in ... glucose in rats administered with the extract of 8000 mg/kg body weight increased two and half-fold.

  5. Measures that Prolong Work Life.

    Science.gov (United States)

    Nusberg, Charlotte

    1986-01-01

    Discusses measures that have been adopted by France, Great Britain, Sweden, the Netherlands, the United States, and Japan to prolong the work life of older workers. Measures include job transfer and exemption, dismissal protection, retirement policies, and reintegration of unemployed older workers. (JOW)

  6. Prolonged unexplained fatigue in paediatrics

    NARCIS (Netherlands)

    Bakker, R.J.

    2010-01-01

    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of

  7. Physiology Of Prolonged Bed Rest

    Science.gov (United States)

    Greenleaf, John E.

    1991-01-01

    Report describes physiological effects of prolonged bed rest. Rest for periods of 24 hours or longer deconditions body to some extent; healing proceeds simultaneously with deconditioning. Report provides details on shifts in fluid electrolytes and loss of lean body mass, which comprises everything in body besides fat - that is, water, muscle, and bone. Based on published research.

  8. Prolonged vs Short Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With or Without Peripheral Arterial Disease: A Subgroup Analysis of the PRODIGY Randomized Clinical Trial.

    Science.gov (United States)

    Franzone, Anna; Piccolo, Raffaele; Gargiulo, Giuseppe; Ariotti, Sara; Marino, Marcello; Santucci, Andrea; Baldo, Andrea; Magnani, Giulia; Moschovitis, Aris; Windecker, Stephan; Valgimigli, Marco

    2016-10-01

    Patients with concomitant peripheral arterial disease (PAD) experience worse cardiovascular outcomes after percutaneous coronary intervention (PCI). To assess the efficacy and safety of prolonged (24 months) vs short (≤6 months) dual antiplatelet therapy (DAPT) in patients with PAD undergoing PCI. This subanalysis of the randomized Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study (PRODIGY) trial assessed unselected patients from tertiary care hospitals with stable coronary artery disease or acute coronary syndromes with or without concomitant PAD from December 2006 to December 2008. Data analysis was performed from January 7 to April 4, 2016. Percutaneous coronary intervention. Rates of the primary efficacy end point, composite of death, myocardial infarction, or cerebrovascular accidents, and occurrence of the key safety end point, a composite of Bleeding Academic Research Consortium type 2, 3, or 5. This analysis comprised 246 and 1724 patients with and without PAD, respectively. In the patients with PAD, mean (SD) age was 73.2 (9.2) in the prolonged group and 75.7 (8.7) years in the short DAPT group, and 97 (82.2%) were male in the prolonged group and 92 (71.9%) were male in the short DAPT group. In the patients without PAD, mean (SD) age was 67.1 (11.2) years in the prolonged group and 66.8 (11.3) years in the short DAPT group, and 667 (76.8%) were male in the prolonged group and 655 (76.6%) were male in the short DAPT group. Status of PAD was associated with a higher risk of death and ischemic events (hazard ratio [HR], 2.80; 95% CI, 2.05-3.83; P < .001). Prolonged vs short DAPT conveyed a lower risk of the primary efficacy end point in patients with PAD (19 [16.1%] vs 35 [27.3%]; HR, 0.54; 95% CI, 0.31-0.95; P = .03) but not in patients without PAD (81 [9.3%] vs 63 [7.4%]; HR, 1.28; 95% CI, 0.92-1.77; P = .15), with positive interaction (P = .01). The risk of definite or probable stent thrombosis

  9. Le CRDI au Vietnam

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

    des agriculteurs trouvent des solutions de rechange à la culture du tabac. □ des responsables de politiques agissent pour réduire la pauvreté. Soutien accordé par le CRDI depuis 1991. 111 activités d'une valeur de 30 millions cad. CRDI. Le CRDI au Vietnam centre de recherches pour le développement international ...

  10. PROLONGED MASSIVE POLYURIA AFTER RENAL TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    A. M. Chernyavskiy

    2012-01-01

    Full Text Available Clinical case of prolonged massive polyuria in patient after renal transplantation is represented in this article. Polyuria lasted for a forty days after kidney transplantation, the larges amount of urine output was 55 litres per day. Analysis of transplant biopsy revealed acute tubular necrosis, initial arteriolosclerosis and suspected acute rejection. Doppler ultrasound study and perfusion scintigraphy detected no pathology. At first we tried to decrease the volume of infusion and fluid intake. Also we performed pulse therapy with methylprednisolone. However, these efforts were not effective. Using of a large doses of «Minerin» (posterior pituitary antidiuretic factor allowed to decrease and stabilize the volume of urine output. The patient was discharge from clinic on day 42 after transplantation. 

  11. Effect of prolonged supine position on the intraocular pressure in patients with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Fang, Sin Yee; Wan Abdul Halim, Wan Haslina; Mat Baki, Marina; Din, Norshamsiah Md

    2018-04-01

    Obstructive sleep apnea syndrome (OSAS) patients are at risk of glaucoma but the risk increases if they have higher intraocular pressure (IOP) while sleeping. We aim to evaluate the postural effect of upright and prolong supine positions on IOP in these patients. This is a cross-sectional study involving 27 patients with symptoms of OSAS seen at a tertiary institutional center and 25 normal controls performed between June 2015 and June 2016. All patients and controls underwent a polysomnography (PSG) test and were diagnosed with OSAS based on the apnea-hypopnea index (AHI). Patients are those with OSAS symptoms and had AHI > 5, whereas controls are staffs from the ophthalmology clinic without clinical criteria for OSAS and had PSG result of AHI < 5. IOP was measured 10 min after sitting, immediately and at 30 min on supine position and immediately after resuming sitting position. The main outcome measures were the changes in mean IOP in different positions. The increase in mean IOP when changing from sitting to supine position was significantly higher in OSAS patients in both the right eye (RE) (1.01 ± 1.14 vs 0.44 ± 0.41 mmHg, p = 0.033) and left eye (LE) (1.20 ± 1.26 vs 0.48 ± 0.62 mmHg, p = 0.044). After 30 min supine, the IOP in OSAS patients showed a further increase in IOP than controls (RE 1.20 ± 1.79 vs 0.12 ± 0.66 mmHg, p = 0.001 and LE 0.59 ± 2.00 vs 0.15 ± 0.78 mmHg, p = 0.246). Higher IOP when sitting post supine is associated with higher IOP on supine position. IOP increase is significantly more in OSAS patients on prolong supine position.

  12. Le Minh Duc

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. Le Minh Duc. Articles written in Bulletin of Materials Science. Volume 36 Issue 5 October 2013 pp 779-788. Study on photocatalysis of TiO2 nanotubes prepared by methanol-thermal synthesis at low temperature · Chau Thanh Nam Wein-Duo Yang Le Minh Duc · More Details ...

  13. Le Bon, Gustave

    DEFF Research Database (Denmark)

    Borch, Christian

    2017-01-01

    Gustave Le Bon (1841–1931) was a French physician and crowd psychologist who published extensively on themes such as crowds, war, race, revolution, socialism, and war. His work on crowd psychology in particular was highly influential, including beyond scholarly circles. Le Bon argued that crowds ...

  14. [Prevalence and clinical characteristics of subclinical hypothyroidism in an opportunistic sample in the population of Castile-León (Spain)].

    Science.gov (United States)

    Mariscal Hidalgo, Ana Isabel; Lozano Alonso, José E; Vega Alonso, Tomás

    2015-01-01

    To describe the distribution of thyroid-stimulating hormone (TSH) values and to estimate the prevalence of subclinical hypothyroidism in the adult population of Castile and León (Spain). An observational study was conducted in an opportunistic sample of 45 primary care centers in Castile and León. TSH was determined in people aged ≥35 years that attended a primary care physician and had a blood test for any reason. Confirmatory analysis included free thyroxine and anti-thyroid peroxidase antibody determination. A total of 3957 analyses were carried out, 63% in women. The mean age was 61.5 years. The median TSH value was 2.3 μIU/mL (2.5 μIU/mL in women and 2.1 μIU/mL in men), with a rising trend with age. TSH values were higher in undiagnosed or untreated subclinical hypothyroidism than in patients under treatment. The lowest levels were found in euthyroidism. The prevalence of subclinical hypothyroidism was 9.2% (95%CI: 8.3-10.2), and hypothyroidism was three times higher in women than in men (12.4% versus 3.7%). Hypothyroidism increased with age, reaching a peak of 16.9% in women aged 45 to 64 years. The prevalence of subclinical hypothyroidism in our sample was high and in the upper limits of values found in previous studies. Proper diagnosis and treatment are important because of the risk of progression to hypothyroidism and the association with multiple diseases and other risk factors. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Le limus rédempteur de Andrej Tarkovski

    Directory of Open Access Journals (Sweden)

    Paolo Mottana

    2015-04-01

    Full Text Available Le cinéma de Tarkovski est riche de présences symboliques. L'essai rend, à travers le contact prolongé et fidèle aux différentes oeuvres du metteur en scène russe, la constellation de ses éléments archetipiques et de ses figures les plus significatives. Le dialogue terre-eau, le travail du feu, la récurrence de l'arbre, du bois, de l'enfance, le flux lent du temps, la phenomenologie poétique de la maison. Dans le cinéma de Tarkovski on se perd, son oeuvre, un vrai opus magnus alchimique, est un voyage dans la survivance d'un halètement mystique profondément incarné dans la matière terrestre. Son parcours circulaire, de l'arbre brûlé d'Ivan à ce qui renaît à la fin du Sacrifice miraculeusement, c'est une cheville fondamentale pour pouvoir expérimenter la puissance de l'imagination créatrice quand encore elle est l' expression d'une sensibilité inspirée à l'âme du monde".

  16. Le laboratoire, le temple et le marché

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

    Chapra est conseiller économique auprès de l'Agence monétaire d'Arabie Saoudite. Il a beaucoup écrit sur l'économie et la finance en pays islamique, et son ouvrage le plus important est Towards a Just Monetary System: A Discussion of Money, Banking, and Monetary Policy in the Light of Islamic Teachings (1985).

  17. Single Prolonged Stress Disrupts Retention of Extinguished Fear in Rats

    Science.gov (United States)

    Knox, Dayan; George, Sophie A.; Fitzpatrick, Christopher J.; Rabinak, Christine A.; Maren, Stephen; Liberzon, Israel

    2012-01-01

    Clinical research has linked post-traumatic stress disorder (PTSD) with deficits in fear extinction. However, it is not clear whether these deficits result from stress-related changes in the acquisition or retention of extinction or in the regulation of extinction memories by context, for example. In this study, we used the single prolonged stress…

  18. Lele des chefs traditionnels au Ghana : un modèle inspirant ...

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

    8 févr. 2011 ... Avec ses partenaires du Sud, avec aussi le soutien du Centre de recherches pour le développement international ( CRDI ), organisme canadien, Ray a étudié lele des chefs traditionnels au Ghana dans la lutte contre le VIH et le sida. Les collectivités politiques antérieures au colonialisme sont une ...

  19. Le dernier Wittgenstein et le dernier Husserl sur le langage

    Directory of Open Access Journals (Sweden)

    Paul Ricoeur

    2014-07-01

    Full Text Available This article presents an edited version of lectures given by Paul Ricœur at Johns Hopkins University in April 1966. Ricœur offers a comparative analysis of Wittgenstein’s and Husserl’s late works, taking the problem of language as the common ground of investigation for these two central figures of phenomenology and analytic philosophy. Ricœur develops his study in two parts. The first part considers Husserl’s approach to language after the Logical Investigations and concentrates on Formal and Transcendental Logic; leaving a transcendental reflection on language behind it re-examines a phenomenological conception, according to which the sphere of logic is not separable from that of experience. The main focus of the second part is Wittgenstein’s later philosophy as it moved on from the conception of an isomorphic relation between language and the world, as set out in the picture theory in the Tractatus Logico-Philosophicus, to the more pragmatic notion of a language-game in the Philosophical Investigations. In order to get beyond the irrevocable differences between the two philosophies and the unresolved theoretical issues on both sides, Ricœur suggests turning to a semiological paradigm based on the Saussurean distinction between “language” and “speaking.” Keyword: Analytic Philosophy, Husserl, Phenomenology, Semiology, Wittgenstein.  Résumé Cet article est une version éditée de conférences données par Paul Ricœur à la Johns Hopkins University en avril 1966. Ricœur propose une analyse comparée des dernières œuvres de Wittgenstein et Husserl, avec le problème du langage comme sol commun d’investigations pour ces deux figures centrales de la phénoménologie et la philosophie analytique. Cette analyse de Ricœur se joue à travers deux parties. La première partie revient sur l'approche du langage chez Husserl depuis Recherches logiques avec une attention particulière aux développements de Logique formelle et

  20. Vaincre le vampire violet | CRDI - Centre de recherches pour le ...

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

    Est depuis le début des années 1990 lorsque le Centre de recherches pour le développement international, une société d'État canadienne, l'a invité à se pencher sur le problème de la striga en Afrique subsaharienne.

  1. Le paludisme au Mexique

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

    Nancy Minogue

    Le paludisme est depuis longtemps un important problème de santé publique au Mexique, où les conditions qui prévalent ... C'est dans les régions côtières que le problème a persisté le plus longtemps, les mesures ... recherche sur l'écologie des moustiques a permis d'en découvrir les raisons. « Les moustiques ne se ...

  2. Prolonged Second Stage: What Is the Optimal Length?

    Science.gov (United States)

    Gimovsky, Alexis C; Berghella, Vincenzo

    2016-11-01

    Prolonged second stage of labor is a clinical dilemma in which controversy exists on whether extending labor in nulliparous women with epidural anesthesia decreases the incidence of cesarean delivery without increasing maternal or neonatal risks. This narrative review was conducted to assess the current literature on management of and risks associated with a prolonged second stage in nulliparous women with epidurals. A review of the current literature was performed to evaluate the incidence of cesarean delivery and the maternal and neonatal outcomes. A total of 11.5% of nulliparous women with epidurals have a prolonged second stage; 80.2% of these women deliver vaginally. There is 1 randomized controlled trial on prolonged second stage in nulliparous women with epidurals. In this study, extending the second stage beyond current guidelines decreased the incidence of cesarean delivery by 55% and did not increase maternal or neonatal risks. Most patients (75.6%) with a prolonged second stage delivered by 5 hours and had a vaginal delivery (80.5%). Women with a fetus in occiput anterior position or who presented in spontaneous labor had decreased risk of cesarean delivery (by 83% and 89%, respectively). Maternal risks include postpartum hemorrhage, chorioamnionitis, and third- and fourth-degree lacerations. Neonatal risks may have a small absolute increase. The change of a vaginal delivery is high (over 80%) beyond 3 hours in the second stage. Maternal and neonatal risks need to be further explored by larger, better-designed retrospective reviews or trials.

  3. Le Jardin de Fleur

    Index Scriptorium Estoniae

    2008-01-01

    Ettevõtja Martin Reinsalu osalusel Marokosse kerkiv kuurortide kompleks Le Jardin de Fleur tunnistati CNBC Araabiamaade kinnisvaraarendusprojektide seas Maroko parimaks arendusprojektiks ning parimaks golfiarenduskeskuseks. Projekt toetub araabia arhitektuurile, mida on kombineeritud kaasaegse maroko disainiga

  4. Le CRDI en Tanzanie

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

    Il y a longtemps que le CRDI appuie la recherche en Tanzanie, une démocratie stable. Depuis la fin des années 1990, le pays jouit d'une croissance économique soutenue, bien qu'il demeure l'un des. États les plus pauvres de la planète. Ses gouvernements successifs ont reconnu que la réduction de la pauvreté passait ...

  5. Le CRDI au Mali

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

    contre le paludisme n les chercheurs contribuent à l'amélioration des services de santé n de jeunes femmes participent à la vie politique. Soutien accordé par le CRDI depuis 1971. 93 activités d'une valeur de 15 millions cad. Les chercheurs ont aidé à offrir l'enseignement primaire dans les langues maternelles. CRDI.

  6. Le CRDI au Maroc

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

    démocratiques. Au Maroc, le Centre d'études et de recherches en sciences sociales analyse ce que pourrait être la réaction du gouverne- ment aux pressions exercées par la population en vue d'un changement sur le plan politique. Rabat. Casablanca. Marrakech. Tan-Tan. Bou Arfa. Zagora. Oujda. Tanger. Fès. ALGÉRIE.

  7. Le CRDI en Afghanistan

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

    Depuis près de 40 ans, le CRDI collabore étroitement avec les chercheurs des pays en développement et les appuie dans leur quête de moyens de créer des sociétés en meilleure santé, plus équitables et plus prospères. Centre de recherches pour le développement international. CP 8500, Ottawa (Ontario) Canada K1G ...

  8. Le CRDI au Bhoutan

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

    Il en résulte des solutions locales, novatrices et durables, qui offrent des choix aux personnes qui en ont le plus besoin et font changer les choses. Centre de recherches pour le développement international. CP 8500, Ottawa (Ontario) Canada K1G 3H9. Pour en savoir plus, consulter la page. Web du Bureau régional de ...

  9. Le CRDI au Kenya

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

    afin d'y favoriser la croissance et le développement. Il en résulte des solutions novatrices et durables qui ont pour but d'améliorer les conditions de vie et les moyens de subsistance. Centre de recherches pour le développement international. CP 8500, Ottawa (Ontario) Canada K1G 3H9. Pour en savoir plus, consulter.

  10. Le CRDI en Jordanie

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

    ... dans les pays en développement afin d'y favoriser la croissance et le développement. Il en résulte des solutions novatrices et durables qui ont pour but d'améliorer les conditions de vie et les moyens de subsistance. Centre de recherches pour le développement international. CP 8500, Ottawa (Ontario) Canada K1G 3H9.

  11. Le CRDI en Bolivie

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

    plus grandes responsabilités aux munici- palités en matière de développement économique. De 2002 à 2007, le CRDI a appuyé la collaboration entre l'Atlantic. Community Economic Development. Institute, de Halifax, en Nouvelle-Écosse, et deux organismes boliviens, le Centro de Servicios Agropecuarios Técnicos, du.

  12. Le faussaire roman

    CERN Document Server

    D'Anna, Gianfranco

    2016-01-01

    À l'aube du XXIe siècle, le monde de la science est sur le point de vivre une révolution. Le jeune physicien allemand Albert Hendrick Thebell, des célèbres laboratoires de recherche B-Labs, à Summit, dans le New Jersey, publie, dans les plus grandes revues scientifiques internationales, une série d'articles dans lesquels il prétend avoir obtenu des résultats extraordinaires qui pourraient révolutionner les bases mêmes de la technologie. Rapidement, la communauté scientifique puis les médias saluent en lui un futur prix Nobel; on compare même son génie à celui d'Albert Einstein. Le progrès scientifique semble avoir franchi une étape décisive, susceptible d'amener un futur meilleur. Mais ces découvertes sont-elles authentiques ? Car pendant ce temps, dans les mêmeslaboratoires, des voix s'élèvent pour contester non seulement les théories de Thebell mais aussi la légitimité même de ses expériences ; certains le soupçonnent d'avoir combiné la plus grande fraude scientifique de tous l...

  13. Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice?

    DEFF Research Database (Denmark)

    Warnier, Miriam Jacoba; Rutten, Frans Hendrik; Souverein, Patrick Cyriel

    2015-01-01

    PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed...... starting a new QT-prolonging drug is extremely low, when haloperidol is taken as an example....

  14. Prolonged QT interval in Rett syndrome

    OpenAIRE

    Ellaway, C; Sholler, G; Leonard, H; Christodoulou, J

    1999-01-01

    Rett syndrome is a severe neurodevelopmental disorder of unknown aetiology. A prolonged QT interval has been described previously in patients with Rett syndrome. To investigate QT prolongation and the presence of cardiac tachyarrhythmias in Rett syndrome electrocardiography and 24 hour Holter monitoring were performed prospectively in a cohort of 34 girls with Rett syndrome. The corrected QT value was prolonged in nine patients. Compared with a group of healthy controls of a...

  15. Le modèle basque

    Directory of Open Access Journals (Sweden)

    Juan-Angel PORTUGAL

    1986-12-01

    Full Text Available À l'intérieur du quadrilatère basque se dessine un sous-espace triangulaire dont les sommets sont les capitales provinciales; les côtés délimitent une aire prospère. La localisation de ces trois noyaux résulte d'une décision politico-économique et d'une diffusion de l'industrialisation. Ce triangle est un espace dynamique et attractif, autant dans le domaine de la démographie que du développement économique et industriel.

  16. Le sens du portrait.

    Directory of Open Access Journals (Sweden)

    Christophe Apprill

    2007-01-01

    Full Text Available À l’entrée du vieux port de Marseille, le projet Euroméditerranée prévoit la construction d’un musée, le Musée des Civilisations de l’Europe et de la Méditerranée (M ucem . Il accueillera les anciennes collections du Musée National des Arts et Traditions Populaires (M natp que les badauds en promenade au jardin d’acclimatation croisaient sans le savoir. Un concours d’architecture a été lancé, remporté par un architecte de la région, Rudy Riccioti. Son projet ...

  17. Le stockage inertiel

    OpenAIRE

    KAUV, J; BONAL, J

    2010-01-01

    La fourniture d'une énergie propre et abondante à une population mondiale largement appelée à croître va être un défi considérable pour le XXIe siècle. Aujourd'hui nous dépendons encore considérablement des énergies fossiles, certes très énergétiques et d'utilisation commode, mais épuisables et productrices de CO2 responsable du réchauffement climatique. Le stockage d'énergie électrique et de chaleur est un domaine technique difficile et délicat, mais dont le développement est indispensable p...

  18. Le Nouveau Monde

    Directory of Open Access Journals (Sweden)

    Alain Musset

    2006-04-01

    Full Text Available L’histoire de la conquête du Nouveau Monde par les Européens semble devoir se résumer au destin de deux femmes chargées d’assurer le truchement entre les deux mondes et de jouer lele d’intermédiaire amoureuse ou de grande traîtresse : au Nord, Pocahontas, au Sud, La Malinche. Quand Cortés débarque en 1519 sur les côtes du Tabasco, un cacique désireux de lui plaire lui offre vingt femmes dont une superbe jeune fille, Malintzin (la Malinche, rebaptisée Marina. Celle-ci deviendra sa maîtres...

  19. Safety information on QT-interval prolongation

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Holtkamp, Frank A; Rutten, Frans H

    2014-01-01

    Prolongation of the QT interval can predispose to fatal ventricular arrhythmias. Differences in QT-labeling language can result in miscommunication and suboptimal risk mitigation. We systematically compared the phraseology used to communicate on QT-prolonging properties of 144 drugs newly approve...

  20. Prolonged fever in peritoneal tuberculosis: A case report

    Science.gov (United States)

    Zein, U.; Irwandi, S.; Habib, H.; Lim, H.; Pasha, M.; Janis, I.; Saragih, R. H.; Ginting, Y.; Effendy-Y S, R.

    2018-03-01

    Peritoneal tuberculosis may lead to delayed diagnosis because of the nonspecific features such as fever, abdominal distension, abdominal tenderness, ascites, and weight loss. Here, wereported a case of prolonged fever and abdominal pain which was due to peritoneal tuberculosis. Initial examinations including acomplete blood test and serologic tests did not lead to the diagnosis. A final diagnosis was made by abdominal CT-scan and laparoscopy combined with histopathological studies. Antituberculous medications provided a good clinical response in this patient.

  1. Intrinsic motivation and amotivation in first episode and prolonged psychosis.

    Science.gov (United States)

    Luther, Lauren; Lysaker, Paul H; Firmin, Ruth L; Breier, Alan; Vohs, Jenifer L

    2015-12-01

    The deleterious functional implications of motivation deficits in psychosis have generated interest in examining dimensions of the construct. However, there remains a paucity of data regarding whether dimensions of motivation differ over the course of psychosis. Therefore, this study examined two motivation dimensions, trait-like intrinsic motivation, and the negative symptom of amotivation, and tested the impact of illness phase on the 1) levels of these dimensions and 2) relationship between these dimensions. Participants with first episode psychosis (FEP; n=40) and prolonged psychosis (n=66) completed clinician-rated measures of intrinsic motivation and amotivation. Analyses revealed that when controlling for group differences in gender and education, the FEP group had significantly more intrinsic motivation and lower amotivation than the prolonged psychosis group. Moreover, intrinsic motivation was negatively correlated with amotivation in both FEP and prolonged psychosis, but the magnitude of the relationship did not statistically differ between groups. These findings suggest that motivation deficits are more severe later in the course of psychosis and that low intrinsic motivation may be partially independent of amotivation in both first episode and prolonged psychosis. Clinically, these results highlight the importance of targeting motivation in early intervention services. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Prolonged cholestasis and ductopenia associated with tenoxicam.

    Science.gov (United States)

    Trak-Smayra, Viviane; Cazals-Hatem, Dominique; Asselah, Tarik; Duchatelle, Veronique; Degott, Claude

    2003-07-01

    Cholestatic liver diseases leading to progressive destruction of intra-hepatic bile ducts and ductopenia encompass multiple etiologies. Pathophysiology and natural history of drug-induced cholangiopathies remain unclear. We report a case of prolonged ductopenia attributed to Tenoxicam (Tilcotil o--a non-steroidal anti-inflammatory drug of the oxicam family) ingested at therapeutic dose. A 36 year-old male patient was admitted for jaundice and Lyell syndrome starting 1 week after the ingestion of Tenoxicam. Liver biopsy showed cholestasis, non-suppurative cholangitis and polymorphous inflammatory infiltrate of the portal tracts (round cells, macrophages an eosinophils). Treatment with ursodesoxycholic acid and cholestyramine was instituted and the patient was asymptomatic 1 year after. Three years later mild biological cholestasis persisted and ductopenia was evidenced on liver biopsy. In this report we found that: (1) The toxicity of tenoxicam was probably mediated by an immunoallergic mechanism (Lyell syndrome and eosinophils on histology); (2) ductopenia was secondary to inflammatory cholangitis. Factors responsible for this chronic evolution are still unknown (genetic predisposition, vascular factors, etc.); and (3) the presence of ductopenia contrasted with the "clinical recovery" of the disease suggesting accessory bile drainage by cholangioles or partial reconstruction of the biliary tree.

  3. Gluteal Compartment Syndrome After Prolonged Immobilisation

    Directory of Open Access Journals (Sweden)

    H.L. Liu

    2009-04-01

    Full Text Available Muscles in the gluteal region are confined by distinct fascial attachments which can potentially result in compartment syndrome. A 74-year-old chronic drinker was admitted to the medical ward after being found drunk on the street. He noticed acute painful swelling of the right side of his buttock the following morning and recalled a slip and fall prior to his blackout. The whole right half of the buttock was tense with erythematous overlying skin. Examination revealed sciatic nerve palsy and myoglobinuria. Emergency fasciotomy and debridement were performed. Intra-operative pressure measurement confirmed a grossly elevated intra-compartmental pressure. Gluteal compartment syndrome is an extremely rare condition and has only been scantily documented previously in case reports. Early diagnosis is crucial but delay recognition is common from lack of knowledge of the condition and readily results in permanent sciatic nerve injury and acute renal shutdown from myoglobinuria. Awareness of the condition, early diagnosis and prompt exploration provide the only chance of avoiding these devastating consequences. Acute swelling diffusely affecting the whole or one side of the buttock, a history of trauma and prolonged local pressure impingement associated with pain out of proportion to the clinical signs should raise a suspicion of this rare condition.

  4. CLINICAL AND DEMOGRAPHIC PROFI LE OF HIV/AIDS PATIENTS IN BLDEU ’S SHRI B. M. PATIL MEDICAL COLLEGE, HOSPITAL AND RESEARCH CENTRE, VIJAYA PUR

    Directory of Open Access Journals (Sweden)

    Prakash G.

    2015-04-01

    Full Text Available BACKGROUND : Our aim was to study the clinical and demographic profile of patients infected with HIV infection. MATERIAL AND METHODS : The prospective study was conducted at a tertiary care referral teaching hospital in Vijayapur, India. The study was conducted on a group of 290 patients confirmed as HIV positive. They were studied for their clinical spectrum and different demographic parameters. RESULTS : The mean age of present ation was 36.32+/ - 12.42 years and majority of the patients belonged to the age group 31 - 40 years. Predominant route of transmission seen in these patients was heterosexual contact. The most common symptoms observed in the study group were fever, cough, bre athlessness, diarrhea, ab dominal pain. Tuberculosis and O ropharyngeal candidiasis were the most common opportunistic infections. CONCLUSION : The initial presentation of HIV - infected patients to health care assistance is occurring at a late stage of the dis ease, when signs and symptoms of immunodeficiency are already established. Efforts are necessary to construct strategies to make an early diagnosis of these patients, improve the quality of care, and guarantee the benefits of antiretroviral therapy, when i t is indicated

  5. Oser le corps

    Directory of Open Access Journals (Sweden)

    Alex Cormanski

    2015-05-01

    Full Text Available Le corps est la voie primordiale dans le processus d’énonciation, mais reste encore (trop souvent corps étranger dans le processus d’enseignement/apprentissage des langues étrangères. Or entrer dans une langue étrangère, se l’approprier physiquement, sonner juste dans une autre langue, précisément pour qu’elle ne soit plus étrangère, implique un travail sur le corps, peut impliquer un transfert de corporéité. Oser les pratiques de corps dans la classe de langue : voie incontournable pour éviter les voix dissonantes. Dare the body voice Abstract: Focusing and working on the body is inescapable in the process of enunciation, but unfortunately not sufficiently put into practice in language learning. Speaking a foreign language, being attuned in that target language, i.e. to sound as close as possible to a native speaker, implies to work on the body physically as well as mentally, which means dealing with representation because of the transfer of identity the user may experience. Dare the body voice for a body change when switching from a language to another is a necessary direction the teacher ought to lead the learners to work on.

  6. Candide et le physicien

    CERN Document Server

    Espagnat, Bernard d'

    2008-01-01

    Les avancées considérables de la physique d'après guerre n'ont - on le sait - été possibles qu'au prix d'une vraie rupture entre elle et la physique dite " classique ". A quels changements cette rupture nous contraint-elle en ce qui concerne des notions essentielles, telles celles d'espace, de temps, d'objet et d'objectivité ? Quelles en sont les incidences quant à la portée de la connaissance, au rôle de la conscience, aux relations entre science et ontologie ? Ce sont là des questions de fond, fort délicates, auxquelles les personnes de tendance quelque peu philosophique sont plus sensibles que ne le sont les physiciens. Malheureusement, les premières ne disposent normalement pas des connaissances de pointe qui seules permettent d'approfondir de tels problèmes sans trop risquer de s'égarer. Etant donné l'impact que, par ses applications, la science a sur nos vies, nombreux sont ceux qui souhaitent se former une idée plus juste de ce qu'elle implique vraiment. Le présent ouvrage prend la for...

  7. Le vase de Pandore

    Directory of Open Access Journals (Sweden)

    Nicola Panichi

    2000-06-01

    Full Text Available Il s’agit ici de suivre les stratégies discursives par lesquelles Érasme situe sa Lingua sous le patronage symbolique de deux mythes des plus opératoires à la Renaissance : le vase de Pandore et la tour de Babel, tous deux verrouillant le texte, l’un en guise d’incipit, l’autre d’explicit, dans un dialogue où chacun use de l’autre pour renforcer les significations et instaurer le régime sémantique du texte, tant linguistique qu’éthique. Ce sont ces jeux complexes entre différents niveaux de discours dont dépend le sens ultime de l’œuvre que cet article s’attache à saisir.Se trata de seguir aquí las estrategias discursivas mediante las cuales Erasmo sitúa su Lingua bajo el dominio simbólico de dos de los mitos más funcionales del Renacimiento: el vaso de Pandora y la torre de Babel, los cuales limitan el texto, uno a modo de íncipit, otro de excipit, en un diálogo en el que se valen el uno del otro para reforzar los significados y establecer el régimen semántico del texto, tanto lingüístico como ético. Son esos juegos complejos entre diferentes niveles de discurso, de los que depende el sentido último de la obra, que este artículo intenta captar.

  8. Place of the nuclear medicine in the clinical development of the gene therapy; Place de la medecine nucleaire dans le developpement clinique de la therapie genique

    Energy Technology Data Exchange (ETDEWEB)

    Crochet, T. [Montpellier-1 Univ., 34 (France); Vis, J. de [Centre Hospitalier Universitaire, Hopital Saint Eloi, Institut de Recherche en Biotherapie, 34 - Montpellier (France); Vincent, D. [Centre Hospitalier Universitaire de Nimes, Service de Medecine Interne, Hopital Caremeau, 30 - Nimes (France); Zanca, M. [Centre Hospitalier Universitaire, Hopital Guy de Chauliac, Service de Medecine Nucleaire, 34 - Montpellier (France)

    2006-10-15

    Although gene therapy has been proposed first for genetic diseases, its concept has been extended to many acquired diseases, owing to a better understanding of pathology at a molecular level. Overall, very few trials have shown to be efficient, and safety concerns have emerged, as a result of several patients deaths. There is a need for new techniques able to improve both the knowledge of the therapeutic gene fate once administered and the early detection of events likely to lead to serious adverse events. In vivo imaging of a reporter gene associated with the therapeutic one is certainly the most promising technique for these goals. Among available imaging modalities, nuclear imaging is the most likely to be applied to patients. This review begins with a summary of current knowledge about the steps that a therapeutic gene has to cross from vector delivery to appropriate expression in target cells. We show how gene imaging could allow to investigate many pitfalls of trials by providing a better understanding of these steps in patients. The reporter genes available for nuclear imaging are presented in the second section, through animal studies. Then, relevant examples of clinical trials are presented. These include cancer (suicide gene therapy and adoptive immunotherapy), ischemic heart diseases and cystic fibrosis. The results are commented with emphasis on the role of nuclear imaging to address the questions raised by these studies, and imaging studies carried out on animals or patients for the corresponding diseases or organs are presented. The results obtained in animal studies warrant the introduction of gene imaging in clinical trials. (authors)

  9. Visual Impairment Screening at the Geriatric Frailty Clinic for Assessment of Frailty and Prevention of Disability at the Gérontopôle.

    Science.gov (United States)

    Soler, V; Sourdet, S; Balardy, L; Abellan van Kan, G; Brechemier, D; Rougé-Bugat, M E; Tavassoli, N; Cassagne, M; Malecaze, F; Nourhashémi, F; Vellas, B

    2016-01-01

    To evaluate visual performance and factors associated with abnormal vision in patients screened for frailty at the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability at Toulouse University Hospital. Retrospective, observational cross-sectional, single-centre study. Institutional practice. Patients were screened for frailty during a single-day hospital stay between October 2011 and October 2014 (n = 1648). Collected medical records included sociodemographic data (including living environment and educational level), anthropometric data, and clinical data. The general evaluation included the patient's functional status using the Activities of Daily Living (ADL) scale and the Instrumental Activity of Daily Living (IADL) scale, the Mini-Mental State Examination (MMSE) for cognition testing, and the Short Physical Performance Battery (SPPB) for physical performance. We also examined Body Mass Index (BMI), the Mini-Nutritional Assessment (MNA), and the Hearing Handicap Inventory for the Elderly Screening (HHIE-S) tool. The ophthalmologic evaluation included assessing visual acuity using the Snellen decimal chart for distant vision, and the Parinaud chart for near vision. Patients were divided into groups based on normal distant/near vision (NDV and NNV groups) and abnormal distant/near vision (ADV and ANV groups). Abnormal distant or near vision was defined as visual acuity inferior to 20/40 or superior to a Parinaud score of 2, in at least one eye. Associations with frailty-associated factors were evaluated in both groups. The mean age of the population was 82.6 ± 6.2 years. The gender distribution was 1,061 females (64.4%) and 587 males (35.6%). According to the Fried criteria, 619 patients (41.1%) were pre-frail and 771 (51.1%) were frail. Distant and near vision data were available for 1425 and 1426 patients, respectively. Distant vision was abnormal for 437 patients (30.7%). Near vision was abnormal for 199 patients (14%). Multiple

  10. The efficacy of antipsychotics for prolonged delirium with renal dysfunction

    Directory of Open Access Journals (Sweden)

    Asano S

    2017-11-01

    Full Text Available Satoko Asano, Yasuto Kunii, Hiroshi Hoshino, Yusuke Osakabe, Tetsuya Shiga, Shuntaro Itagaki, Itaru Miura, Hirooki Yabe Department of Neuropsychiatry, School of Medicine Fukushima Medical University, Fukushima, Japan Aim: Delirium is commonly encountered in daily clinical practice. To identify predictors influencing outcomes, we retrospectively examined the characteristics of inpatients with delirium who required psychiatric medication during hospitalization.Methods: We extracted all new inpatients (n=523 consulted for psychiatric symptoms at Fukushima Medical University Hospital between October 2011 and September 2013. We selected 203 inpatients with delirium diagnosed by psychiatrists. We analyzed data from 177 inpatients with delirium who received psychiatric medication. We defined an “early improvement group” in which delirium resolved in ≤3 days after starting psychiatric medication, and a “prolonged group” with delirium lasting for >3 days. Among the 83 inpatients with renal dysfunction (estimated glomerular filtration rate <60 mL/min/1.73 m2, we defined an “early improvement group with renal dysfunction” in which delirium resolved in ≤3 days after starting psychiatric medication and a “prolonged group with renal dysfunction” with delirium lasting for >3 days. We then examined differences between groups for different categorical variables.Results: Dose of antipsychotic medication at end point was significantly lower in the prolonged group with renal dysfunction than in the early improvement group with renal dysfunction.Conclusion: The results suggest that maintaining a sufficient dose of antipsychotics from an early stage may prevent prolongation of delirium even in inpatients with renal dysfunction. Keywords: antipsychotic, prolonged delirium, chronic kidney disease, pharmacokinetics 

  11. Prolonged Pregnancy: Methods, Causal Determinants and Outcome

    DEFF Research Database (Denmark)

    Olesen, Annette Wind

    ) to study the incidence of prolonged pregnancy as a function of methods for determining gestational age; 2) to determine the risk of obstetrical and fetal complications in prolonged pregnancy; 3) to validate the self-reported gestational age in the National Birth Cohort; 4) to determine whether...... an ultrasound scan in the first or second trimester, or menstrual history was best at predicting the day of delivery; 5) to study the risk of recurrence of prolonged pregnancy as a function of change in male partner, social status and municipality; and 6) to detect prenatal risk indicators of prolonged...... pregnancy. Data from the Medical Birth Registry and the National Discharge Register from the period 1978 to 1995 were used to study the incidence of post-term delivery and determine the risk of complications associated with this condition (I). Data were furthermore linked to the Fertility Database to study...

  12. Prenatal risk indicators of a prolonged pregnancy

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Westergaard, Jes Grabow; Olsen, Jørn

    2006-01-01

    . Statistical analyses were done using logistic regression. RESULTS: Women with a pre-pregnancy body mass index of 25 kg/m2 or more had a high risk of prolonged pregnancy. If the pre-pregnancy body mass index was 35 kg/m2 or more the odds ratio was 1.52 (95% CI 1.28-1.82). Nulliparity also increased the risk......BACKGROUND: Few prenatal risk factors of prolonged pregnancy, a pregnancy of 42 weeks or more, are known. The objective was to examine whether sociodemographic, reproductive, toxicologic, or medical health conditions were associated with the risk of prolonged pregnancy. METHODS: Data from...... of prolonged pregnancy (OR (95% CI) = 1.35 (1.27-1.44)). CONCLUSIONS: The risk of post-term delivery was high in women with a pre-pregnancy body mass index of 25 kg/m2 or more, and in nulliparous women....

  13. The Importance of Prolonged Provocation in Drug Allergy

    DEFF Research Database (Denmark)

    Fransson, Sara; Mosbech, Holger; Kappel, Mogens

    2017-01-01

    BACKGROUND: Drug provocation is the "Gold Standard" in drug allergy investigation. Recent studies suggest that a negative drug provocation on first dose should be followed by a prolonged provocation over several days. OBJECTIVE: To evaluate drug allergy investigations on the basis of drug provoca...... should always be considered when drug provocation is included in allergy investigations. Most provocations were with penicillins, reflecting the pattern of antibiotic use in Denmark, which differs from that in other countries, especially outside Northern Europe.......BACKGROUND: Drug provocation is the "Gold Standard" in drug allergy investigation. Recent studies suggest that a negative drug provocation on first dose should be followed by a prolonged provocation over several days. OBJECTIVE: To evaluate drug allergy investigations on the basis of drug...... provocation, including prolonged provocation. METHODS: Data from adult patients investigated for drug allergy in a Danish Allergy Clinic during the period 2010 to 2014 were entered into a database. Data included clinical details and results of provocations with suspected culprit drug (for penicillins...

  14. Le monde quantique

    CERN Document Server

    Aspect, A; Bensaude-Vincent, B; Castiel, A; Chevalley, C; Darrigol, O; Deligeorges, S; D'Espagnat, B; Laloë, F; Lévy-Leblond, J-M; Messiah, A; Paty, M; Vuillemin, J; Wheaton, B R

    1984-01-01

    Le monde quantique La physique quantique, après trois quarts de siècle, n'en finit pas d'être moderne. Elle est présente quotidiennement dans les laboratoires où les physiciens étudient atomes, noyaux et particules. Elle est entrée dans l'industrie où lasers, transistors et supraconducteurs lui doivent d'exister. Et elle continue à alimenter le débat philosophique sur la nature de la réalité dont elle montre la non-séparabilité fondamentale. Ses concepts de base, son développement, ses applications, ses controverses sont ici présentés par une pléiade de physiciens, d'historiens et de philosophes.

  15. Le charme slave

    Directory of Open Access Journals (Sweden)

    Antonella Mauri

    2012-09-01

    Full Text Available Antonella Mauri analyse l’image des femmes slaves immigrées en Italie telle qu’elle apparaît à travers la publicité, la littérature romanesque (La ballata dei lavavetri de Peter Del monte, Luce Profuga de Valerio Aiolli, Pornokiller de Bruno Ventavoli, le cinéma, la bande dessinée (Danilo Maramotti, image qu’elle oppose aux résultats d’une enquête qu’elle a menée sur le terrain. Elle s’interroge en particulier sur la permanence des stéréotypes liés à la femme slave.

  16. Le Nordais on schedule

    International Nuclear Information System (INIS)

    Anon.

    1998-01-01

    The first phase of the Le Nordais wind farm project in the Gaspe Peninsula in Quebec is on schedule. It was announced that the project's first turbines will be turning by September 1998. Hydro-Quebec has agreed to buy power from the 100 MW wind farm. The Le Nordais consortium plans to have 76,750 kW turbines in service in Cap-Chat by December 1998. Many of the foundations for the towers are poured and a substation is under construction. The turbines that are currently in use come from Denmark, but 20 of the 76 turbines being slated for installation this year will come from NEG Micon Canada Inc.'s assembly plant in Quebec. The Quebec government is providing a $5.6 million grant for their production and for turbine assembly in Quebec. During phase two, an additional 57 turbines will be installed in Matane by the end of 1999. 1 fig

  17. Le forme del fondo

    Directory of Open Access Journals (Sweden)

    Michel Maffesoli

    2004-12-01

    Full Text Available Non è vero che la natura ha paura del vuoto. Forse addirittura si completa. Il vuoto è anche una modalità dell'essere. È possibile nidificarvisi, avvolgersi pigramente e, così, proteggersi dall'angoscia del tempo che passa. Il vuoto delle apparenze è, in alcuni momenti, una delle forme d'espressione della vita sociale. Oltretutto occorre saperle riconoscere. Certamente, abbiamo tutti un'esistenza personale, ma siamo, ugualmente, i rappresentanti, a volte anche le vittime, di uno "spirito comune", forse anche di un "inconscio collettivo" che si è costituito di secolo in secolo. E, molto spesso, quando crediamo di esprimere le nostre idee, siamo soltanto dei portavoce, comparse di un vasto "theatrum mundi" dalle dimensioni infinite.

  18. Garder le rythme

    OpenAIRE

    Arnaud-Demir, Françoise

    2015-01-01

    Chez les Alévis de Turquie, hommes et femmes se réunissent pour de longues assemblées nocturnes, le cem ou « cérémonie collective », sous la houlette d’un guide spirituel appelé dede (« grand-père, ancêtre »), lui-même assisté par des bardes (aşık) et divers officiants. Ces cérémonies se composent de chants et de danses accompagnés au luth saz. Près de Divriği, dans la province de Sivas, cette danse rituelle, le semah (d’un étymon arabe signifiant « écoute »), applique un schéma complexe, alt...

  19. Atraumatic femoral neck fracture secondary to prolonged lactation induced osteomalacia

    Directory of Open Access Journals (Sweden)

    Dhammapal Sahebrao Bhamare

    2013-01-01

    Full Text Available Presenting a case of atraumatic fracture neck femur secondary to 2 years of prolonged lactation. A 26-year-old lactating mother presented with pain in left hip from last 12 months. She was apparently alright before and during pregnancy. Plain radiograph showed a complete undisplaced fracture of femoral neck. Osteomalacia was diagnosed by radiological and serological investigations. The fracture was fixed using AO type cannulated cancellous screws. The fracture showed good clinical and radiological union at 3 months. Literature review shows that this is a first case of atraumatic fracture of neck femur due to prolonged lactational osteomalacia. It showed that even apparently healthy Indians are susceptible to osteomalacia, more so during pregnancy and lactation and can be presented as atraumatic fracture. Although considered relatively stable, a compression type incomplete fracture neck femur may progress to a complete fracture if not treated in time.

  20. Le CRDI en Mongolie

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

    touchent la steppe de même que les régions forestières et montagneuses. Utilisation des technologies numériques. Dès le début des années 1990, grâce à des subventions et à des conseils techniques du CRDI, un fournisseur local de services de communication de données, Datacom, a pu fournir l'accès Internet à la ...

  1. Le CRDI au Ghana

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

    pour prévenir le paludisme, des études ayant démontré que leur utilisation pouvait réduire considérablement la mortalité infantile. Les chercheurs ont également suggéré aux gouvernements différents moyens pour inciter les gens à acheter les moustiquaires et à les utiliser correctement. Les TI au service de la démocratie.

  2. Le CRDI en Chine

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

    les employés du secteur non structuré ont de meilleures conditions de travail. □ les citoyens influencent les décisions relatives aux dépenses publiques. Soutien accordé par le CRDI depuis 1981. 222 activités d'une valeur de 59 millions CAD. Chercheurs et agriculteurs s'emploient à améliorer les moyens de subsistance.

  3. Le CRDI en Tunisie

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

    les citoyens arabes sont plus présents sur Internet. Soutien accordé depuis 1975. 49 activités. 8 millions cad. Dans la foulée du Printemps arabe, les chercheurs conçoivent des réformes visant à assurer l'essor de la démocratie et en examinent la validité. CRDI centre de recherches pour le développement international.

  4. Le CRDI au Bangladesh

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

    d'agriculteurs ont trouvé des solutions de remplacement à la culture du tabac. Petit à petit, les agriculteurs améliorent ... réduire la pollution de l'air et à mieux utiliser l'eau. Soutien accordé par le CRDI depuis 1974 ... violence endémique, car la cause profonde du mécontentement — l'absence de démocra- tie plutôt que les ...

  5. Le CRDI en Colombie

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

    activités de longue haleine qui ont eu pour but d'appuyer la réinsertion des anciens combattants ... Internet à son programme d'insertion sociale des enfants de la rue victimes d'exploitation ... Des travaux subventionnés par le CRDI ont aidé une fondation à intégrer Internet à son programme d'insertion sociale des enfants ...

  6. Translating QT interval prolongation from conscious dogs to humans.

    Science.gov (United States)

    Dubois, Vincent F S; Smania, Giovanni; Yu, Huixin; Graf, Ramona; Chain, Anne S Y; Danhof, Meindert; Della Pasqua, Oscar

    2017-02-01

    In spite of screening procedures in early drug development, uncertainty remains about the propensity of new chemical entities (NCEs) to prolong the QT/QTc interval. The evaluation of proarrhythmic activity using a comprehensive in vitro proarrhythmia assay does not fully account for pharmacokinetic-pharmacodynamic (PKPD) differences in vivo. In the present study, we evaluated the correlation between drug-specific parameters describing QT interval prolongation in dogs and in humans. Using estimates of the drug-specific parameter, data on the slopes of the PKPD relationships of nine compounds with varying QT-prolonging effects (cisapride, sotalol, moxifloxacin, carabersat, GSK945237, SB237376 and GSK618334, and two anonymized NCEs) were analysed. Mean slope estimates varied between -0.98 ms μM -1 and 6.1 ms μM -1 in dogs and -10 ms μM -1 and 90 ms μM -1 in humans, indicating a wide range of effects on the QT interval. Linear regression techniques were then applied to characterize the correlation between the parameter estimates across species. For compounds without a mixed ion channel block, a correlation was observed between the drug-specific parameter in dogs and humans (y = -1.709 + 11.6x; R 2  = 0.989). These results show that per unit concentration, the drug effect on the QT interval in humans is 11.6-fold larger than in dogs. Together with information about the expected therapeutic exposure, the evidence of a correlation between the compound-specific parameter in dogs and in humans represents an opportunity for translating preclinical safety data before progression into the clinic. Whereas further investigation is required to establish the generalizability of our findings, this approach can be used with clinical trial simulations to predict the probability of QT prolongation in humans. © 2016 The British Pharmacological Society.

  7. Le nouveau modèle africain | IDRC - International Development ...

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

    22 juil. 2011 ... L'annulation de la dette, un commerce plus équitable, davantage d'aide : voilà le plan d'action mondial dont on convient qu'il faut de toute urgence mettre en oeuvre en vue d'accélérer le développement en Afrique. Or, ce serait rater le bateau que de ne pas s'engager dans la voie tout autre que les ...

  8. Le Conseil des gouverneurs | CRDI - Centre de recherches pour le ...

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

    Le Conseil des gouverneurs guide le travail du CRDI en lui fournissant une orientation stratégique, en examinant ses activités et en approuvant ses budgets. Les gouverneurs – un maximum de 14 – sont nommés par le gouverneur en conseil du Canada pour un mandat d'au plus quatre ans, qui peut être reconduit. La Loi ...

  9. A multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and co morbid post traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis.

    Science.gov (United States)

    de Bont, Paul A J M; van den Berg, David P G; van der Vleugel, Berber M; de Roos, Carlijn; Mulder, Cornelis L; Becker, Eni S; de Jongh, Ad; van der Gaag, Mark; van Minnen, Agnes

    2013-05-23

    Trauma contributes to psychosis and in psychotic disorders post-traumatic stress disorder (PTSD) is often a comorbid disorder. A problem is that PTSD is underdiagnosed and undertreated in people with psychotic disorders. This study's primary goal is to examine the efficacy and safety of prolonged exposure and eye movement desensitization and reprocessing (EMDR) for PTSD in patients with both psychotic disorders and PTSD, as compared to a waiting list. Secondly, the effects of both treatments are determined on (a) symptoms of psychosis, in particular verbal hallucinations, (b) depression and social performance, and (c) economic costs. Thirdly, goals concern links between trauma exposure and psychotic symptomatology and the prevalence of exposure to traumatic events, and of PTSD. Fourthly predictors, moderators, and mediators for treatment success will be explored. These include cognitions and experiences concerning treatment harm, credibility and burden in both participants and therapists. A short PTSD-screener assesses the possible presence of PTSD in adult patients (21- to 65- years old) with psychotic disorders, while the Clinician Administered PTSD Scale interview will be used for the diagnosis of current PTSD. The M.I.N.I. Plus interview will be used for diagnosing lifetime psychotic disorders and mood disorders with psychotic features. The purpose is to include consenting participants (N = 240) in a multi-site single blind randomized clinical trial. Patients will be allocated to one of three treatment conditions (N = 80 each): prolonged exposure or EMDR (both consisting of eight weekly sessions of 90 minutes each) or a six-month waiting list. All participants are subjected to blind assessments at pre-treatment, two months post treatment, and six months post treatment. In addition, participants in the experimental conditions will have assessments at mid treatment and at 12 months follow-up. The results from the post treatment measurement can be considered

  10. Sequential thrombosis and bleeding in a woman with a prolonged activated partial thromboplastin time

    Directory of Open Access Journals (Sweden)

    Pearce Michael I

    2011-10-01

    Full Text Available Abstract Simultaneous or sequential haemorrhage and thrombosis in the presence of a prolonged activated partial thromboplastin time (aPTT is a rare occurrence: we describe the case a 37 year old lady who developed post-delivery deep vein thrombosis treated with low molecular heparin and warfarin followed a week later by extensive bruising over legs and forearms, a significant drop in haemoglobin and a very prolonged aPTT. Further tests revealed an acquired factor VIII inhibitor at 35 Bethesda Units. We discuss the clinical and laboratory implications and provide a literature review of simultaneous thrombophilia and haemophilia in the presence of a prolonged aPTT.

  11. Butyrylcholinesterase gene mutations in patients with prolonged apnea after succinylcholine for electroconvulsive therapy

    DEFF Research Database (Denmark)

    Mollerup, Hannah Malthe; Gätke, M R

    2011-01-01

    patients undergoing electroconvulsive therapy (ECT) often receive succinylcholine as part of the anesthetic procedure. The duration of action may be prolonged in patients with genetic variants of the butyrylcholinesterase enzyme (BChE), the most common being the K- and the A-variants. The aim of ...... of the study was to assess the clinical significance of genetic variants in butyrylcholinesterase gene (BCHE) in patients with a suspected prolonged duration of action of succinylcholine after ECT....

  12. Butyrylcholinesterase gene mutations in patients with prolonged apnea after succinylcholine for electroconvulsive therapy

    DEFF Research Database (Denmark)

    Mollerup, Hannah Malthe; Gätke, M R

    2011-01-01

    patients undergoing electroconvulsive therapy (ECT) often receive succinylcholine as part of the anesthetic procedure. The duration of action may be prolonged in patients with genetic variants of the butyrylcholinesterase enzyme (BChE), the most common being the K- and the A-variants. The aim...... of the study was to assess the clinical significance of genetic variants in butyrylcholinesterase gene (BCHE) in patients with a suspected prolonged duration of action of succinylcholine after ECT....

  13. Anti-N-methyl-D-aspartate receptor encephalitis with favorable outcome despite prolonged status epilepticus

    OpenAIRE

    Finné Lenoir, Xavier; Sindic, Christian; Van Pesch, Vincent; El Sankari, Souraya; de Tourtchaninoff, Marianne; Denays, Roger; Hantson, Philippe

    2013-01-01

    BACKGROUND: To describe a case of auto-immune encephalitis in an adolescent with favorable outcome despite prolonged status epilepticus. METHODS: A 17 year old Asian man without previous medical history developed alteration of consciousness and partial seizures. The diagnosis of anti-N-methyl-D-aspartate receptor encephalitis was confirmed by the detection of specific antibodies in both cerebrospinal fluid and serum. RESULTS: The clinical course was complicated by prolonged status epilepticus...

  14. Sur le genre Apoleon, Gorh

    NARCIS (Netherlands)

    Fairmaire, L.

    1887-01-01

    Dans les »Notes from the Leyden Museum”, vol. VII (1885) p. 51, Mr. Gorham a décrit sous le nom d’ ’Apoleon un nouveau genre de Bostrychide, créé pour un insecte de Malacca, rencontré aussi au Laos, à Bornéo et à Sumatra, A. edax. Ce genre est identique avec le genre Dysides Perty, dont le type, D.

  15. Predictive models of prolonged mechanical ventilation yield moderate accuracy.

    Science.gov (United States)

    Figueroa-Casas, Juan B; Dwivedi, Alok K; Connery, Sean M; Quansah, Raphael; Ellerbrook, Lowell; Galvis, Juan

    2015-06-01

    To develop a model to predict prolonged mechanical ventilation within 48 hours of its initiation. In 282 general intensive care unit patients, multiple variables from the first 2 days on mechanical ventilation and their total ventilation duration were prospectively collected. Three models accounting for early deaths were developed using different analyses: (a) multinomial logistic regression to predict duration > 7 days vs duration ≤ 7 days alive vs duration ≤ 7 days death; (b) binary logistic regression to predict duration > 7 days for the entire cohort and for survivors only, separately; and (c) Cox regression to predict time to being free of mechanical ventilation alive. Positive end-expiratory pressure, postoperative state (negatively), and Sequential Organ Failure Assessment score were independently associated with prolonged mechanical ventilation. The multinomial regression model yielded an accuracy (95% confidence interval) of 60% (53%-64%). The binary regression models yielded accuracies of 67% (61%-72%) and 69% (63%-75%) for the entire cohort and for survivors, respectively. The Cox regression model showed an equivalent to area under the curve of 0.67 (0.62-0.71). Different predictive models of prolonged mechanical ventilation in general intensive care unit patients achieve a moderate level of overall accuracy, likely insufficient to assist in clinical decisions. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The Significance of Prolonged and Saddleback Fever in Hospitalised Adult Dengue.

    Directory of Open Access Journals (Sweden)

    Deborah Hl Ng

    Full Text Available Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study. Sixty-nine percent of them were male with a median age of 34 years. Prolonged fever (fever > 7 days duration was present in 572 (20.1% of patients. Dengue hemorrhagic fever (DHF, dengue shock syndrome (DSS and severe dengue (SD were significantly more likely to occur in patients with prolonged fever. Mucosal bleeding, anorexia, diarrhea, abdominal pain, nausea or vomiting, lethargy, rash, clinical fluid accumulation, hepatomegaly, nosocomial infection, leukopenia, higher neutrophil count, higher hematocrit, higher alanine transaminase (ALT and aspartate transaminase (AST, higher creatinine, lower protein and prolonged activated partial thromboplastin time (APTT were significantly associated with prolonged fever but not platelet count or prothrombin time (PT. Saddleback fever was present in 165 (5.8%. Although DHF and SD were more likely to occur in patients in those with saddleback fever, DSS was not. Compared with prolonged fever, saddleback fever did not show many significant associations except for diarrhea, abdominal pain, clinical fluid accumulation, hematocrit and platelet change, and lower systolic blood pressure. This study demonstrates that prolonged fever may be associated with various warning signs and more severe forms of dengue (SD, DSS, DHF, while saddleback fever showed associations with DHF and SD but not DSS. The presence of prolonged or saddleback fever in dengue patients should therefore

  17. The Significance of Prolonged and Saddleback Fever in Hospitalised Adult Dengue.

    Science.gov (United States)

    Ng, Deborah Hl; Wong, Joshua Gx; Thein, Tun-Linn; Leo, Yee-Sin; Lye, David C

    2016-01-01

    Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR) confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study. Sixty-nine percent of them were male with a median age of 34 years. Prolonged fever (fever > 7 days duration) was present in 572 (20.1%) of patients. Dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and severe dengue (SD) were significantly more likely to occur in patients with prolonged fever. Mucosal bleeding, anorexia, diarrhea, abdominal pain, nausea or vomiting, lethargy, rash, clinical fluid accumulation, hepatomegaly, nosocomial infection, leukopenia, higher neutrophil count, higher hematocrit, higher alanine transaminase (ALT) and aspartate transaminase (AST), higher creatinine, lower protein and prolonged activated partial thromboplastin time (APTT) were significantly associated with prolonged fever but not platelet count or prothrombin time (PT). Saddleback fever was present in 165 (5.8%). Although DHF and SD were more likely to occur in patients in those with saddleback fever, DSS was not. Compared with prolonged fever, saddleback fever did not show many significant associations except for diarrhea, abdominal pain, clinical fluid accumulation, hematocrit and platelet change, and lower systolic blood pressure. This study demonstrates that prolonged fever may be associated with various warning signs and more severe forms of dengue (SD, DSS, DHF), while saddleback fever showed associations with DHF and SD but not DSS. The presence of prolonged or saddleback fever in dengue patients should therefore prompt

  18. Le regard anachronique

    Directory of Open Access Journals (Sweden)

    Jean-Paul Aubert

    2011-01-01

    Full Text Available Cet article a pour objet l’anachronisme dans le film historique. Il s’appuie sur l’étude du long métrage Goya à Bordeaux, réalisé en 1999 par le cinéaste espagnol Carlos Saura. Cette biographie filmée du peintre Francisco de Goya fait mieux que composer avec l’anachronisme inhérent à toute reconstitution historique. Il l’assume et le revendique. La mise en cause de la chronologie et l’effacement de l’Histoire prennent sens dans la perspective d’une réflexion originale sur l’Histoire de l’art conçue comme un dialogue entre les œuvres et entre les époques.Este artículo está dedicado al problema del anacronismo en las películas históricas. Se basa en el estudio de Goya en Burdeos, un largo metraje rodado en 1999 por el director de cine español Carlos Saura. Esta biografía de Goya no sólo se acomoda con el anacronismo propio de la reconstitución histórica sino que lo asume y lo reivindica. El cuestionamiento de la cronología y el desinterés por la Historia cobran un nuevo sentido en el marco de una reflexión original sobre la Historia del arte concebida como un diálogo entre las obras y entre las épocas.

  19. QT prolongation is associated with increased mortality in end stage liver disease

    Science.gov (United States)

    Kim, Sun Moon; George, Bennet; Alcivar-Franco, Diego; Campbell, Charles L; Charnigo, Richard; Delisle, Brian; Hundley, Jonathan; Darrat, Yousef; Morales, Gustavo; Elayi, Samy-Claude; Bailey, Alison L

    2017-01-01

    AIM To determine the prevalence of QT prolongation in a large series of end stage liver disease (ESLD) patients and its association to clinical variables and mortality. METHODS The QT interval was measured and corrected for heart rate for each patient, with a prolonged QT cutoff defined as QT > 450 ms for males and QT > 470 ms for females. Multiple clinical variables were evaluated including sex, age, serum sodium, international normalized ratio, creatinine, total bilirubin, beta-blocker use, Model for End-Stage Liver Disease (MELD), MELD-Na, and etiology of liver disease. RESULTS Among 406 ESLD patients analyzed, 207 (51.0%) had QT prolongation. The only clinical variable associated with QT prolongation was male gender (OR = 3.04, 95%CI: 2.01-4.60, P < 0.001). During the study period, 187 patients (46.1%) died. QT prolongation was a significant independent predictor of mortality (OR = 1.69, 95%CI: 1.03-2.77, P = 0.039). In addition, mortality was also associated with viral etiology of ESLD, elevated MELD score and its components (P < 0.05 for all). No significant reversibility in the QT interval was seen after liver transplantation. CONCLUSION QT prolongation was commonly encountered in an ESLD population, especially in males, and served as a strong independent marker for increased mortality in ESLD patients. PMID:28515853

  20. La piraterie sur le web

    CERN Multimedia

    2002-01-01

    Les échanges de toutes sortes sont facilités à l'extrême par le web: des forums, des vidéoconférences, le commerce à distance, ou tout simplement la célérité des courriers électroniques ou la convivialité des chats, tout cela participe de la société de communication. Une certaine partie du monde découvre le nouvel horizon des échanges quasi instantanés, mais... les transactions sur le web sont-elles vraiment s res?

  1. Le donne briganti

    OpenAIRE

    Cosco, Silvio

    2013-01-01

    Texto completo descargado desde Teseo Le donne briganti es una tesis interdisciplinaria, de carácter histórico-filológico con un enfoque de estudio de género. Es un trabajo que nace del interés por un argumento, el bandolerismo de la primera década del Reino de Italia, que durante mucho tiempo y a sabiendas, ha sido tratado como una reacción menor y criminal al proyecto de unificación italiana, callando las razones de las poblaciones meridionales afectada antes por la invasión y luego por...

  2. Travailler le vison

    OpenAIRE

    Gorre, Jean-François

    2007-01-01

    Dans notre société, la fourrure est porteuse de valeurs symboliques. D'autres travaux ont montré comment elle est l'expression du jeu entre nature et culture : investissement de la force de l'animal, expression du sauvage, marque de la domestication de la nature (Delort 1973, Pouchelle 1981). Notre propos sera différent. Nous étudierons dans le cadre du métier de fourreur, à travers une technique particulière, l'« allonge », la teneur de l'affrontement entre deux groupes socio-professionnels....

  3. Le CRDI au Bhoutan

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

    tance. Le collège a adopté une application. Web qui permet aux enseignants de créer des sites d'apprentissage en ligne, il a offert des cours en informatique aux enseignants et aux étudiants et il a conçu son propre site Web. Il a également établi neuf centres d'études régionaux dans des écoles. La mesure des progrès.

  4. Tetrodotoxin-Bupivacaine-Epinephrine Combinations for Prolonged Local Anesthesia

    Directory of Open Access Journals (Sweden)

    Christina Bognet

    2011-12-01

    Full Text Available Currently available local anesthetics have analgesic durations in humans generally less than 12 hours. Prolonged-duration local anesthetics will be useful for postoperative analgesia. Previous studies showed that in rats, combinations of tetrodotoxin (TTX with bupivacaine had supra-additive effects on sciatic block durations. In those studies, epinephrine combined with TTX prolonged blocks more than 10-fold, while reducing systemic toxicity. TTX, formulated as Tectin, is in phase III clinical trials as an injectable systemic analgesic for chronic cancer pain. Here, we examine dose-duration relationships and sciatic nerve histology following local nerve blocks with combinations of Tectin with bupivacaine 0.25% (2.5 mg/mL solutions, with or without epinephrine 5 µg/mL (1:200,000 in rats. Percutaneous sciatic blockade was performed in Sprague-Dawley rats, and intensity and duration of sensory blockade was tested blindly with different Tectin-bupivacaine-epinephrine combinations. Between-group comparisons were analyzed using ANOVA and post-hoc Sidak tests. Nerves were examined blindly for signs of injury. Blocks containing bupivacaine 0.25% with Tectin 10 µM and epinephrine 5 µg/mL were prolonged by roughly 3-fold compared to blocks with bupivacaine 0.25% plain (P < 0.001 or bupivacaine 0.25% with epinephrine 5 µg/mL (P < 0.001. Nerve histology was benign for all groups. Combinations of Tectin in bupivacaine 0.25% with epinephrine 5 µg/mL appear promising for prolonged duration of local anesthesia.

  5. Le survivant sans le syndrome Schreber

    Directory of Open Access Journals (Sweden)

    Richard Figuier

    2006-09-01

    Full Text Available On a pensé la catastrophe, mais a-t-on suffisamment pensé la survivance et la figure du survivant ? Ce n'est pas un hasard si celle-ci est au centre de Masse et puissance, oeuvre dans laquelle Canetti interroge la « mauvaise » survivance responsable de la poursuite de la logique de guerre. Mais où trouver la « bonne » ? Revenir de la catastrophe ne suffit pas pour être un « survivant authentique », selon l'expression de Kafka. Il faut avoir dépassé, avec Primo Levi et Robert Antelme, l'opposition de la vie comme croissance continue et de la mort comme son horrible contraire, par le don, dans la pauvreté solidaire, de cette vie retrouvée.Hemos reflexionado acerca de la catástrofe, pero ¿hemos meditado lo suficiente sobre la supervivencia y el superviviente? No es una coincidencia si el superviviente es el tema principal de Masse et puissance, obra en la cual Canetti analiza la «mala» supervivencia responsable de la persistencia de la lógica de guerra ¿Dónde sin embargo podemos encontrar la «buena» supervivencia? Superar la catástrofe no es suficiente para ser un «auténtico superviviente», según Kafka. Es fundamental ir más allá, con Primo Levi y Robert Antelme, de la oposición entre la vida, como crecimiento continuo, y la muerte, como su espantoso contrario, mediante la donación de forma solidaria de esta vida reencontrada.Disaster is the theme of many studies, but what about survival and of the figure of the survivor? This issue is central in Mass and power, work in which Canetti questions the “bad” survival, responsible for the continuation of the logic of war. But is there any “good” survival? Coming back from the catastrophe is not enough to be an “authentic survivor”, according to Kafka’s expression. To achieve this, it is necessary to have exceeded, with PrimoLevi and Robert Antelme, the opposition of life as a continuous growth and of death as its horrible opposite, by the gift, in a

  6. Prolonged pregnancy: Methods, Causal Determinants and Outcome

    DEFF Research Database (Denmark)

    Olesen, Annette Wind

    an ultrasound scan in the first or second trimester, or menstrual history was best at predicting the day of delivery; 5) to study the risk of recurrence of prolonged pregnancy as a function of change in male partner, social status and municipality; and 6) to detect prenatal risk indicators of prolonged...... from the National Hospital Discharge Register and with ultrasound-estimated gestational age in Vejle county (II). An ultrasound scan in the second trimester was the most valid method to predict the day of delivery, followed by an ultrasound scan in the first trimester, and a corrected last menstrual...

  7. Prolonged Pregnancy: Methods, Causal Determinants and Outcome

    DEFF Research Database (Denmark)

    Olesen, Annette Wind

    an ultrasound scan in the first or second trimester, or menstrual history was best at predicting the day of delivery; 5) to study the risk of recurrence of prolonged pregnancy as a function of change in male partner, social status and municipality; and 6) to detect prenatal risk indicators of prolonged...... from the National Hospital Discharge Register and with ultrasound-estimated gestational age in Vejle county (II). An ultrasound scan in the second trimester was the most valid method to predict the day of delivery, followed by an ultrasound scan in the first trimester, and a corrected last menstrual...

  8. Le Conseil des gouverneurs | CRDI - Centre de recherches pour le ...

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

    2 nov. 2010 ... La gouvernance du CRDI. Reddition de comptes, transparence et efficacité. Au cours de l'exercice 2009–2010, le Conseil des gouverneurs du CRDI a adopté un nouveau cadre stratégique quinquennal, Le développement par l'innovation. Pendant de nombreux mois, les gouverneurs et les membres de la ...

  9. Le rateau faucardeur relevable

    Directory of Open Access Journals (Sweden)

    ARRIGNON J.

    1976-07-01

    Full Text Available Un rateau monté sur deux bras mobiles à l'avant d'un bateau faucardeur permet de récupérer les végétaux coupés et de les déposer sur la berge. Le positionnement de la grille horizontale permet en outre l'enlèvement en profondeur des végétaux mous et notamment des algues filamenteuses ainsi que la récupération en surface des lentilles d'eau. La simplicité de la conception, la légèreté de l'outil, sa maniabilité et son coût modique s'associent à son efficacité pour le désigner comme une solution séduisante du problème de l'enlèvement des lentilles d'eau et des produits de faucardement dans les étangs et canaux.

  10. Le tournoi des ombres

    CERN Document Server

    Treille, Daniel

    2017-01-01

    Le lecteur, transporté avec le narrateur dans une région hors norme, est invité à partager sa fascination pour la beauté du lieu, à découvrir la chronique de son passé, rude et pittoresque. Il va côtoyer une galerie de personnages très attachants, mais aux destinées bousculées par l histoire, et assister à l agitation montante du présent dans un contexte d une actualité brûlante. Ce quatrième roman de Daniel Treille, mêlant hardiment les genres, du quotidien trivial au récit épique, de considérations géopolitiques à quelques avancées de la science moderne, confirme son talent à mener, d une écriture très aboutie, une histoire complexe, peuplée de héros singuliers

  11. Le principe roman

    CERN Document Server

    Ferrari, Jérôme

    2015-01-01

    Fasciné par la figure du physicien allemand Werner Heisenberg (1901-1976), fondateur de la mécanique quantique, inventeur du célèbre "principe d'incertitude" et Prix Nobel de physique en 1932, un jeune aspirant-philosophe désenchanté s'efforce, à l'aube du XXIe siècle, de considérer l'incomplétude de sa propre existence à l'aune des travaux et de la destinée de cet exceptionnel homme de sciences qui incarne pour lui la rencontre du langage scientifique et de la poésie, lesquels, chacun à leur manière, en ouvrant la voie au scandale de l'inédit, dessillent les yeux sur le monde pour en révéler la mystérieuse beauté que ne cessent de confisquer le matérialisme à l'œuvre dans l'Histoire des hommes.

  12. Amelioration de la perfusion des organes vitaux par la valve d’impedance inspiratoire et le concept de pompe respiratoire: rationnel physiologique et application clinique (Improving Vital Organs Perfusion by the Respiratory Pump: Physiology and Clinical Use)

    Science.gov (United States)

    2013-09-01

    release, distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...d’éjection systolique du ventricule gauche, débit cardiaque et résistance périphérique systémique chez 20 sujets humains respirant à travers une...dans ce modèle humain d’hémorragie a permis une élévation de la PA et une meilleure tolérance sur une plus longue période de stress hémodynamique

  13. Acute Right Ventricular Dysfunction Complicating Prolonged ...

    African Journals Online (AJOL)

    We report a case of transient right ventricular dysfunction associated with prolonged cardiac tamponade, an unusual complication of uncertain etiology. We believe that in this case dynamic coronary flow restriction resulted in ischemic injury and stunning of the right ventricle. Other possible causes are briefly reviewed. Right ...

  14. Hippocampal Abnormalities after Prolonged Febrile Convulsions

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-11-01

    Full Text Available Hippocampal volume and T2 relaxation times were determined in an MRI study of 14 children with prolonged febrile convulsions (PFC who were investigated, 1 within 5 days of a PFC, and 2 at follow-up 4-8 months after the acute study, at the Institute of Child Health, University College, and Great Ormond Street Hospital, London, UK.

  15. Prolonged displacement may compromise resilience in Eritrean ...

    African Journals Online (AJOL)

    Objective: to assess the impact of prolonged displacement on the resilience of Eritrean mothers. Methods: an adapted SOC scale (short form) was administered. Complementary qualitative data were gathered from study participants' spontaneous reactions to and commentaries on the SOC scale. Results: Displaced ...

  16. SALIVARY ANTIMICROBIAL PROTEIN RESPONSE TO PROLONGED RUNNING

    Directory of Open Access Journals (Sweden)

    Suzanne Schneider

    2013-01-01

    Full Text Available Prolonged exercise may compromise immunity through a reduction of salivary antimicrobial proteins (AMPs. Salivary IgA (IgA has been extensively studied, but little is known about the effect of acute, prolonged exercise on AMPs including lysozyme (Lys and lactoferrin (Lac. Objective: To determine the effect of a 50-km trail race on salivary cortisol (Cort, IgA, Lys, and Lac. Methods: 14 subjects: (6 females, 8 males completed a 50km ultramarathon. Saliva was collected pre, immediately after (post and 1.5 hrs post race ( 1.5. Results: Lac concentration was higher at 1.5 hrs post race compared to post exercise (p0.05. IgA concentration, secretion rate, and IgA/Osm were lower 1.5 hrs post compared to pre race (p<0.05. Cort concentration was higher at post compared to 1.5 (p<0.05, but was unaltered from pre race levels. Subjects finished in 7.81 ± 1.2 hrs. Saliva flow rate did not differ between time points. Saliva Osm increased at post (p<0.05 compared to pre race. Conclusions: The intensity could have been too low to alter Lys and Lac secretion rates and thus, may not be as sensitive as IgA to changes in response to prolonged running. Results expand our understanding of the mucosal immune system and may have implications for predicting illness after prolonged running.

  17. Sperm Quality and Fertility Following Prolonged Immobilization ...

    African Journals Online (AJOL)

    Sperm Quality and Fertility Following Prolonged Immobilization Stress in Wistar Rats. ... All the females that were mated with the control males became pregnant and produced litters. On the ... These results therefore, confirm and expand existing literatures reporting impaired fertility following long-term exposure to stress.

  18. Carotid Baroreflex Function During Prolonged Exercise

    Science.gov (United States)

    Raven, P. B.

    1999-01-01

    Astronauts are often required to work (exercise) at moderate to high intensities for extended periods while performing extra-vehicular activities (EVA). Although the physiologic responses associated with prolonged exercise have been documented, the mechanisms involved in blood pressure regulation under these conditions have not yet been fully elucidated. An understanding of this issue is pertinent to the ability of humans to perform work in microgravity and complies with the emphasis of NASA's Space Physiology and Countermeasures Program. Prolonged exercise at a constant workload is know to result in a progressive decrease in mean arterial pressure (MAP) concomitant with a decrease in stroke volume and a compensatory increase in heart rate. The continuous decrease in MAP during the exercise, which is related to the thermoregulatory redistribution of circulating blood volume to the cutaneous circulation, raises the question as to whether there is a loss of baroreflex regulation of arterial blood pressure. We propose that with prolongation of the exercise to 60 minutes, progressive increases on central command reflect a progressive upward resetting of the carotid baroreflex (CBR) such that the operating point of the CBR is shifted to a pressure below the threshold of the reflex rendering it ineffectual in correcting the downward drift in MAP. In order to test this hypothesis, experiments have been designed to uncouple the global hemodynamic response to prolonged exercise from the central command mediated response via: (1) continuous maintenance of cardiac filling volume by intravenous infusion of a dextran solution; and (2) whole body surface cooling to counteract thermoregulatory cutaneous vasodialation. As the type of work (exercise) performed by astronauts is inherently arm and upper body dependent, we will also examine the physiologic responses to prolonged leg cycling and arm ergometry exercise in the supine positions with and without level lower body negative

  19. Le Milton de Toland

    Directory of Open Access Journals (Sweden)

    James C. BROWN

    2003-10-01

    Full Text Available Alors que l’œuvre de John Milton suscite encore de nombreuses critiques et interprétations, je vous propose un retour en arrière afin d’étudier l’un des premiers écrits biographiques dédié à la vie et à l’œuvre du poète anglais signé par le philosophe irlandais John Toland. Paru en 1698, Life of John Milton dresse un portrait plus complet que ceux que l’on trouve dans les précédentes biographies du poète anglais (Darbishire xxix. Ayant été l’un des premiers biographes de Milton, Toland a pub...

  20. Le Baratze (ou

    Directory of Open Access Journals (Sweden)

    Jacques Blot

    1998-01-01

    Full Text Available El círculo de piedras Mendizabal 7, de 8 metros de diámetro,   presenta una corona externa constituida de grandes bloques   hincados en la tierra, y otra interna y tangente, de elementos idénticos sólo puestos en el suelo. El cajón central está compuesto de cuatro losas y una tapa. No hay depósito de huesos ni de carbón de leña ; sólo se encuentran dos herraduras, entre las cuales una completa de tipo medieval, que podrían permitir de pensar en una construcción del círculo en el periodo histórico.

  1. Le tourisme alpin

    Directory of Open Access Journals (Sweden)

    Andrea Macchiavelli

    2009-06-01

    Full Text Available La forte croissance qu’ont connue les pays alpins dans les dernières décennies a surtout été fondée sur l’offre des activités du ski, avec comme conséquence, un massif développement immobilier, la multiplication d’infrastructures et l’extension des domaines. Aujourd’hui, le marché du ski semble arriver à saturation, la Convention alpine a mis un frein à la poursuite du développement des domaines skiables et on observe donc avec intérêt la diversification de l’offre soutenue par l’innovation. Après avoir rappelé les facteurs de changement en cours les plus significatifs dans le tourisme montagnard, l’article présente une grille interprétative de l’évolution des destinations touristiques alpines, identifiant les phases qui ont caractérisé son développement. Puis il propose une réflexion sur certaines conditions qui peuvent favoriser l’innovation dans le tourisme alpin, ainsi que sur les contradictions qui les accompagnent souvent. Dans la plupart des cas l’innovation est le résultat d’un processus qui a été lancé et qui s’est développé au sein de la communauté alpine, souvent favorisé et soutenu par des institutions nationales et internationales, et grâce auquel les difficultés structurelles qui ont déjà été abordées précédemment ont pu être surmontées avec succès.The spectacular increase in tourism in the Alps in recent decades has been founded mainly on the boom in skiing, resulting in both strong real estate development and an increasing array of infrastructures and ski runs. Today the ski market seems to have virtually reached saturation point and the winter sports sector needs to diversify its offer through innovation. After a review of the main factors of change in mountain tourism, the paper presents a grid for interpreting the life cycle of alpine destinations, identifying the phases that characterize their evolution. The conditions that may favour innovation in alpine

  2. Le grand inventaire

    Directory of Open Access Journals (Sweden)

    Michel Melot

    2012-05-01

    Full Text Available Depuis quarante ans qu’il existe, l’Inventaire général des monuments et des richesses artistiques de la France n’a pas seulement progressé, couvrant près de dix mille communes, documentant plus de vingt mille dans cinq millions de pages, trois millions de photographies, et cent mille dessins. Il est devenu ce que ses fondateurs désiraient qu’il fût. Il n’est pas une liste d’objets plus ou moins singuliers qu’on aurait oubliés, mais l’observation méthodique de l’émergence dans le monde de l’ar...

  3. Le citoyen rieur

    Directory of Open Access Journals (Sweden)

    Anna Rycman

    2009-11-01

    Full Text Available Dans la Pologne d’aujourd’hui, l’évolution des modèles d’engagement civique et politique s’opère plus particulièrement auprès des jeunes générations. Parmi les expériences nouvelles de participation politique, les nouvelles technologies de l’information et de la communication offrent des opportunités radicales de reconfigurer l’espace public. La jeunesse polonaise investit en masse le Web. Dans le flux de paroles affranchies circulant et dialoguant dans le cyberespace, nous nous intéressons ici au développement d’un discours qui emprunte au registre de la dérision et de la satire politiques. Une multitude de sites critiques, de nature apparemment contestataire, des sites d’opposition fondés sur le genre satirique, ont émergé comme réponse apportée à la situation politique. Cet espace public électronique représente une forme moderne de « folklore politique », contribuant au processus de socialisation des jeunes citoyens polonais.The laughing citizen. A modern form of civic commitment in democratic Poland?In present day Poland, the evolution of civic and political commitment models is above all the affaire of the younger generations. Among the current opportunities for political participation, the new information and communication technologies offer radical opportunities to reconfigure the public arena. Polish youth are flocking to the Web. Amongst the flux of frank points of views circulating and dialoguing in cyberspace, our interest here is the development of a discourse inspired by political and satirical derision. A multitude of critical, apparently anti-establishment, sites and general opposition sites using the satirical style have emerged as a response to the political situation. This public electronic space represents a modern form of « political folklore », contributing to the socialising processes of young polish citizens.El ciudadano que rie. ¿Nueva forma del compromiso cívico en la

  4. INVESTIR DANS LE SAVOIR : le soutien que le CRDI consent à des ...

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

    5 nov. 2010 ... ... 40 ans, le Cenre de recherches pour le développement international (CRDI), en plus d'appuyer des travaux de recherche dans l'ensemble des pays en développement, encourage des générations successives de jeunes chercheurs par l'entremise de son Programme de formation et de bourses (PFB).

  5. Lele des chefs traditionnels au Ghana : un modèle inspirant ...

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

    … en Afrique. À l'université, Ray pouvait étudier la politique canadienne ou la politique africaine. « J'ai cru que je comprendrais mieux mon pays si j'allais voir ce qui se passe ailleurs dans le monde, puis en tirais des leçons ...

  6. Dans le tourbillon des particules

    CERN Document Server

    Zito, Marco

    2015-01-01

    Accélérateurs géants, détecteurs complexes, particules énigmatiques... La physique subatomique peut sembler bien intimidante pour le novice. Et pourtant, qui n a jamais entendu parler du boson de Higgs et du CERN, le laboratoire européen où il a été découvert en 2012 ? Nul besoin d être un spécialiste pour comprendre de quoi il s agit. Aujourd hui, une théorie extraordinairement élégante, le Modèle Standard, décrit tous les résultats des expériences dans le domaine. Trente-sept particules élémentaires et quatre forces fondamentales : c est tout ce dont nous avons besoin pour expliquer la matière et l Univers ! Ce livre, destiné à un large public, raconte sans équations le long parcours qui a abouti au Modèle Standard. Ce parcours, parfois sinueux, a été entamé lorsque les Grecs anciens, et peut-être d autres avant eux, ont imaginé que la matière est composée de petites « billes ». Il faudra attendre plusieurs siècles pour qu on réalise que la matière, à l échelle micros...

  7. Rapport sur le développement dans le monde

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

    Parlement International Development Research Centre Centre de recherches pour le développement international Centro Internacional de Investigaciones ..... Other donors include the Swedish International Development Cooperation Agency (Sida), the Norwegian Agency for Development Cooperation (Norad) and the ...

  8. [Prolonged pain in neonates: retrospective analysis].

    Science.gov (United States)

    Lilla, Michèle; Stadelman-Diaw, Corinne; Ramelet, Anne-Sylvie

    2013-12-01

    Infants hospitalised in neonatology are inevitably exposed to pain repeatedly. Premature infants are particularly vulnerable, because they are hypersensitive to pain and demonstrate diminished behavioural responses to pain. They are therefore at risk of developing short and long-term complications if pain remains untreated. Compared to acute pain, there is limited evidence in the literature on prolonged pain in infants. However, the prevalence is reported between 20 and 40 %. This single case study aimed to identify the bio-contextual characteristics of neonates who experienced prolonged pain. This study was carried out in the neonatal unit of a tertiary referral centre in Western Switzerland. A retrospective data analysis of seven infants' profile, who experienced prolonged pain ,was performed using five different data sources. The mean gestational age of the seven infants was 32weeks. The main diagnosis included prematurity and respiratory distress syndrome. The total observations (N=55) showed that the participants had in average 21.8 (SD 6.9) painful procedures that were estimated to be of moderate to severe intensity each day. Out of the 164 recorded pain scores (2.9 pain assessment/day/infant), 14.6 % confirmed acute pain. Out of those experiencing acute pain, analgesia was given in 16.6 % of them and 79.1 % received no analgesia. This study highlighted the difficulty in managing pain in neonates who are exposed to numerous painful procedures. Pain in this population remains underevaluated and as a result undertreated.Results of this study showed that nursing documentation related to pain assessment is not systematic.Regular assessment and documentation of acute and prolonged pain are recommended. This could be achieved with clear guidelines on the Assessment Intervention Reassessment (AIR) cyclewith validated measures adapted to neonates. The adequacy of pain assessment is a pre-requisite for appropriate pain relief in neonates.

  9. Prolonged Exposure: a Rapid Treatment for Phobias

    Science.gov (United States)

    Watson, J. P.; Gaind, R.; Marks, I. M.

    1971-01-01

    Ten adult patients with long-standing specific phobias were treated by prolonged continuous exposure to their phobic objects in fantasy and reality without avoidance. All patients were greatly helped by four to five hours' treatment in two or three sessions, and all improved more after practice than after imaginal sessions. The treatment method is more economical and efficient than other methods described so far. PMID:5539135

  10. Variation in Definition of Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Rose, Louise; McGinlay, Michael; Amin, Reshma; Burns, Karen Ea; Connolly, Bronwen; Hart, Nicholas; Jouvet, Philippe; Katz, Sherri; Leasa, David; Mawdsley, Cathy; McAuley, Danny F; Schultz, Marcus J; Blackwood, Bronagh

    2017-10-01

    Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym. We screened 5,331 references, reviewed 539 full-text references, and excluded 120. Of the 419 studies (representing 38 countries) meeting inclusion criteria, 297 (71%) reported data on a heterogeneous subject cohort, and 66 (16%) included surgical subjects only (46 of those 66, 70% cardiac surgery). Other studies described COPD (16, 4%), trauma (22, 5%), neuromuscular (17, 4%), and sepsis (1, 0.2%) cohorts. A total of 741 terms were used to refer to the 419 study cohorts. The most common terms were: prolonged mechanical ventilation (253, 60%), admission to specialized unit (107, 26%), and long-term mechanical ventilation (79, 19%). Some authors (282, 67%) defined their cohorts based on duration of mechanical ventilation, with 154 studies (55%) using this as the sole criterion. We identified 37 different durations of ventilation ranging from 5 h to 1 y, with > 21 d being the most common (28 of 282, 7%). For studies describing a surgical cohort, minimum ventilation duration required for inclusion was ≥ 24 h for 20 of 66 studies (30%). More than half of all studies (237, 57%) did not provide a reason/rationale for definitional criteria used, with only 28 studies (7%) referring to a consensus definition. We conclude that substantial variation exists in the terminology and definitional criteria for cohorts of subjects receiving prolonged mechanical ventilation. Standardization of

  11. Le FIVB annonce le financement de huit autres projets | CRDI ...

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

    5 avr. 2018 ... Découvrez les derniers récents projets soutenus par le Fonds d'innovation en matière de vaccins pour le bétail : Maladie de Newcastle · Pleuropneumonie contagieuse caprine – cowdriose · Plateforme de modification génétique CRISPR/cas9 · Entérotoxémie, la bactérie Pasteurella et la fièvre de la vallée ...

  12. Prolonged signal-averaged P wave duration as a prognostic marker for morbidity and mortality in patients with congestive heart failure

    DEFF Research Database (Denmark)

    Dixen, Ulrik; Wallevik, Laura; Hansen, Maja

    2003-01-01

    To evaluate the prognostic roles of prolonged signal-averaged P wave duration (SAPWD), raised levels of natriuretic peptides, and clinical characteristics in patients with stable congestive heart failure (CHF).......To evaluate the prognostic roles of prolonged signal-averaged P wave duration (SAPWD), raised levels of natriuretic peptides, and clinical characteristics in patients with stable congestive heart failure (CHF)....

  13. Maternal-fetal outcomes in prolonged pregnancy.

    Science.gov (United States)

    Cucco, C; Osborne, M A; Cibils, L A

    1989-10-01

    The intrapartum fetal heart rate changes, type of labor, mode of delivery, and neonatal outcome were evaluated in 379 consecutive continuously monitored prolonged pregnancies (greater than 42 weeks by history and early examination). These represent only a fraction of the total prolonged gestation population. There were 56% multiparous women, 33% less than 20 years of age, and 95% with cephalic presentation. Oxytocin was given to 76% (48% induced, 28% enhanced). Delivery was by cesarean section in 13% of patients (9% of induced cases), and 15% had forceps deliveries. Fetal heart rate alterations were observed in high proportion. Cesarean section for cephalopelvic disproportion was indicated in 60% of operations, and 13% of the fetuses weighed greater than 4000 gm. Depression occurred in 15% of infants at 1 minute and in 4% at 5 minutes. Prolonged hospital stay was seen in 9%, and postmaturity syndrome in 19%. There were four perinatal deaths (two corrected). Active induction does not appear to increase the cesarean section rate. The durations of predelivery observation may be longer because the cervices are frequently unripe. There is a high incidence of fetal heart rate alterations. Induction appears justified as an active intervention to prevent some sudden unexplained deaths.

  14. Infectious Thromboembolism related to prolonged reduced motility in ill acute patients

    Directory of Open Access Journals (Sweden)

    F. Dodi

    2011-01-01

    Full Text Available Update in new clinic complications related to infectious diseases reveals emergent, at present, the thromboembolic risk. Clinicians must examine carefully thromboembolism related to prolonged reduced motility during acute invalidating infectious diseases because it represents major risk during clinical conditions involving enzimatic procoagulant activity, fibronectine production, procoagulant autoimmunitary damage. Recent experimental data show that pathogenesis of thromboembolic lesions involves clinical risk factors, vascular anatomic features and bacterial genetic properties.

  15. Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation.

    Science.gov (United States)

    Oliveira, Ana Carolina Martins de; Friche, Amélia Augusta de Lima; Salomão, Marina Silva; Bougo, Graziela Chamarelli; Vicente, Laélia Cristina Caseiro

    2017-09-13

    Lesions in the oral cavity, pharynx and larynx due to endotracheal intubation can cause reduction in the local motility and sensitivity, impairing the swallowing process, resulting in oropharyngeal dysphagia. To verify the predictive factors for the development of oropharyngeal dysphagia and the risk of aspiration in patients with prolonged orotracheal intubation admitted to an intensive care unit. This is an observational, analytical, cross-sectional and retrospective data collection study of 181 electronic medical records of patients submitted to prolonged orotracheal intubation. Data on age; gender; underlying disease; associated comorbidities; time and reason for orotracheal intubation; Glasgow scale on the day of the Speech Therapist assessment; comprehension; vocal quality; presence and severity of dysphagia; risk of bronchoaspiration; and the suggested oral route were collected. The data were analyzed through logistic regression. The level of significance was set at 5%, with a 95% Confidence Interval. The prevalence of dysphagia in this study was 35.9% and the risk of aspiration was 24.9%. As the age increased, the altered vocal quality and the degree of voice impairment increased the risk of the presence of dysphagia by 5-; 45.4- and 6.7-fold, respectively, and of aspiration by 6-; 36.4- and 4.8-fold. The increase in the time of orotracheal intubation increased the risk of aspiration by 5.5-fold. Patients submitted to prolonged intubation who have risk factors associated with dysphagia and aspiration should be submitted to an early speech-language/audiology assessment and receive appropriate and timely treatment. The recognition of these predictive factors by the entire multidisciplinary team can minimize the possibility of clinical complications inherent to the risk of dysphagia and aspiration in extubated patients. Copyright © 2017. Published by Elsevier Editora Ltda.

  16. Le Valais et ses Reines

    Directory of Open Access Journals (Sweden)

    Alberto Campi

    2012-06-01

    Full Text Available Combat de ReinesAu premier plan (la corde dans la main, un propriétaire de vaches. Dans l'arène se trouve le rabatteur. Les Reines sur la photo sont des reines de première catégorie (ainsi que le montre le « I » sur leur cuisse .Dimanche 6 mai 2012, « Schakira », la vache numéro 42, a gagné, non sans polémique, le titre de Reine. Elle peut donc être considérée comme la Reine des Reines, titre qu’elle a gagné en se battant contre ses rivales dans différents combats, qui ont commencé pour Sch...

  17. Sur le chemin de Buchenwald

    OpenAIRE

    Bessière, Bernard

    2017-01-01

    En 1963, âgé de 37 ans, l’activiste communiste Jorge Semprún publie en français le roman Le Grand Voyage dans lequel il raconte le périple de 800 km qui l’avait conduit en train de Compiègne jusqu’à Buchenwald en septembre 1943. Il avait alors 19 ans. C’est dans ce camp de la mort situé près de Weimar – cité de Goethe, que Semprún admirait – qu’il sera interné jusqu’à sa libération par les troupes américaines en avril  1945. Pendant les quatre jours et cinq nuits de ce « grand voyage », le dé...

  18. Le bal du loup

    CERN Multimedia

    Happy Children's Home

    2013-01-01

    The Bord'eau amateur theatre group will graciously perform a play of their creation Le bal du loup Saturday 19 October 2013 at 20:00 Sunday 20 October at 17:00 in the Théâtre des Grottes Rue Louis Favre 43, 1201 Genève Children from age 12 upwards. Summary: The new-elected mayoress of a small village would like to clean up the town by prohibiting alcohol and getting rid of its prostitutes. Then along comes « Massimo Lupo » the pimp... The performances will be given to support the Happy Children's Home charity, which runs a foster-home in Pokhara for Nepali children:  http://www.happychildrenshome.org/ Admission : minimum charge of 10 CHF per person requested, to cover the cost of technical assistance and theatre rental. Any profit will be used solely for the foster-home. At the end of each performance members of the HCH charity will be happy to answer any questions you may have. The theatre has 86 seats, thank you for reserv...

  19. Le CRDI dans les Philippines

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

    Le CRDI appuie la recherche dans les. Philippines depuis 1972. Le travail qu'y ont accompli des universités et des instituts de recherche vigoureux et la participation active de la société civile ont entraîné d'importantes améliorations dans les domaines de l'agriculture, du suivi de la pauvreté et de la gestion des forêts.

  20. Un oiseau "sabote" le CERN

    CERN Multimedia

    Colson, Sébastien

    2009-01-01

    Un oiseau, un simple oiseau, est parvenu à bloquer à lui tout seul l'accélérateur à particules à 3,7 milliards d'euros. UNe histoire quasiment bulresque qui a toutefois impacté le fonctionnement de la machine durant près de cinq jours, puisque c'est le système de refroidissement qui a été affecté. (1 page)

  1. Le cas de la Chine

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

    pwust

    Des changements récents dans le milieu de l'élaboration des politiques du pays semblent propices à la ... centrale, la Chine fait l'expérience de nouveaux partenariats d'aide au développement où .... 2 Le Service des prêts à des conditions libérales de la Banque d'import-export de Chine gère les prêts assortis de.

  2. Le livre sur le livre traité de documentation

    CERN Document Server

    Otlet, Paul

    2015-01-01

    Paul Otlet est considéré comme le père des sciences de l'information. Ouvrage fondateur et fondamental, le Traité de documentation. Le livre sur le livre (1934) est l'aboutissement de son travail inlassable pour rassembler, classer et partager les connaissances. Otlet y propose une remarquable synthèse du savoir sur le livre et le document en même temps qu'il anticipe Internet et l'hypertexte. La réédition du Traité de documentation, 70 ans après la disparition de son auteur, coïncide avec la réouverture du Mundaneum à Mons, où le fabuleux héritage documentaire légué par Paul Otlet et Henri La Fontaine est conservé. « Ici, la table de travail n'est plus chargée d'aucun livre. À leur place se dresse un écran et à portée un téléphone. Là-bas, au loin, dans un édifice immense, sont tous les livres et tous les renseignements. De là, on fait apparaître sur l'écran la page à lire pour connaître la réponse aux questions posées par téléphone. » Préfaces de Benoît Peeters (éc...

  3. Le modèle spatial de la capitale allemande

    Directory of Open Access Journals (Sweden)

    Antoine Laporte

    2013-06-01

    Full Text Available En Allemagne, en 1999, le Chancelier fédéral et son gouvernement ont quitté Bonn pour Berlin. Ce transfert du pouvoir est accompagné de celui d’une grande partie de l’appareil d’État et de la haute administration, et des fonctions qui leur sont traditionnellement attribuées comme la presse, les lobbys ou encore la diplomatie. Le déplacement du statut de capitale effective de l’Allemagne de Bonn à Berlin est le résultat des évolutions géopolitiques d’un pays ayant recouvré son unité et sa pleine et entière souveraineté. Installer le pouvoir exécutif et législatif à Berlin était une démarche hautement symbolique, visant à normaliser la position de l’ancienne capitale de la RDA et du IIIe Reich comme véritable centre politique de l’Allemagne. Or le déplacement des institutions fédérales n’est pas qu’un acte symbolique. Il entraîne également à l’échelle intra-urbaine des dynamiques très concrètes sur le tissu urbain et participe à la mise en place de nouvelles centralités dans la ville. En effet, le statut de capitale d’État prédestine l’agglomération à la coprésence de nombreuses fonctions urbaines spécifiques plus ou moins directement liées à l’exercice ou à la symbolique du pouvoir.

  4. Prolonged labour as indication for emergency caesarean section

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Sorensen, B L; Onesmo, R

    2012-01-01

    To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour.......To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour....

  5. Prolonged morphine administration alters protein expression in the rat myocardium

    Directory of Open Access Journals (Sweden)

    Drastichova Zdenka

    2011-11-01

    Full Text Available Abstract Background Morphine is used in clinical practice as a highly effective painkiller as well as the drug of choice for treatment of certain heart diseases. However, there is lack of information about its effect on protein expression in the heart. Therefore, here we aimed to identify the presumed alterations in rat myocardial protein levels after prolonged morphine treatment. Methods Morphine was administered to adult male Wistar rats in high doses (10 mg/kg per day for 10 days. Proteins from the plasma membrane- and mitochondria-enriched fractions or cytosolic proteins isolated from left ventricles were run on 2D gel electrophoresis, scanned and quantified with specific software to reveal differentially expressed proteins. Results Nine proteins were found to show markedly altered expression levels in samples from morphine-treaded rats and these proteins were identified by mass spectrometric analysis. They belong to different cell pathways including signaling, cytoprotective, and structural elements. Conclusions The present identification of several important myocardial proteins altered by prolonged morphine treatment points to global effects of this drug on heart tissue. These findings represent an initial step toward a more complex view on the action of morphine on the heart.

  6. 3. Le moraliste, le sociologue et le juge : objectivation et production de la connaissance

    OpenAIRE

    Noreau, Pierre

    2018-01-01

    Commedia del diritto Œuvre spécialement réalisée pour cet ouvrage par Maya Pankalla Le rapport qu’entretiennent les sciences sociales et le monde des valeurs est traversé par l’ambiguïté. Ce que nous pourrions appeler ici l’« engagement sociologique » de Guy Rocher témoigne de cette tension continue ; il exemplifie les relations complexes qui lient le mouvement de la pensée au monde de l’action. Comme il le rappelle lui-même dans ses entretiens avec Georges Khal, à la fin d’u...

  7. Le plomb, le cadmium et le mercure dans les produits de la mer

    OpenAIRE

    Thibaud, Yves

    1987-01-01

    Trois contaminants métalliques, toxiques vis-à-vis de l'homme : le plomb, le cadmium et le mercure, sont considérés sous l'angle de leur cheminement dans l'environnement, en particulier celui de l'accès au consommateur par les aliments d'origine marine. En plus des réglementations visant au contrôle des produits de la pêche destinés à la consommation et des mesures visant à limiter lés disséminations, il existe en France un système de surveillance continue des niveaux de contamination du litt...

  8. Prolonged Temozolomide Maintenance Therapy in Newly Diagnosed Glioblastoma.

    Science.gov (United States)

    Skardelly, Marco; Dangel, Elena; Gohde, Julia; Noell, Susan; Behling, Felix; Lepski, Guilherme; Borchers, Christian; Koch, Marilin; Schittenhelm, Jens; Bisdas, Sotirios; Naumann, Aline; Paulsen, Frank; Zips, Daniel; von Hehn, Ulrike; Ritz, Rainer; Tatagiba, Marcos Soares; Tabatabai, Ghazaleh

    2017-05-01

    The impact of prolonging temozolomide (TMZ) maintenance beyond six cycles in newly diagnosed glioblastoma (GBM) remains a topic of discussion. We investigated the effects of prolonged TMZ maintenance on progression-free survival (PFS) and overall survival (OS). In this retrospective single-center cohort study, we included patients with GBM who were treated with radiation therapy with concomitant and adjuvant TMZ. For analysis, patients were considered who either completed six TMZ maintenance cycles (group B), continued with TMZ therapy beyond six cycles (group C), or stopped TMZ maintenance therapy within the first six cycles (group A). Patients with progression during the first six TMZ maintenance cycles were excluded. Clinical data from 107 patients were included for Kaplan-Meier analyses and 102 for Cox regressions. Median PFS times were 8.1 months (95% confidence interval [CI] 6.1-12.4) in group A, 13.7 months (95% CI 10.6-17.5) in group B, and 20.9 months (95% CI 15.2-43.5) in group C. At first progression, response rates of TMZ/lomustine rechallenge were 47% in group B and 13% in group C. Median OS times were 12.7 months (95% CI 10.3-16.8) in group A, 25.2 months (95% CI 17.7-55.5) in group B, and 28.6 months (95% CI 24.4-open) in group C. Nevertheless, multivariate Cox regression for patients in group C compared with group B that accounted for imbalances of other risk factors showed no different relative risk (RR) for OS (RR 0.77, p  = .46). Our data do not support a general extension of TMZ maintenance therapy beyond six cycles. The Oncologist 2017;22:570-575 IMPLICATIONS FOR PRACTICE: Radiation therapy with concomitant and adjuvant temozolomide (TMZ) maintenance therapy is still the standard of care in patients below the age of 65 years in newly diagnosed glioblastoma. However, in clinical practice, many centers continue TMZ maintenance therapy beyond six cycles. The impact of this continuation is controversial and has not yet been addressed in

  9. Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs.

    Science.gov (United States)

    Rutt, Benjamin T; Oehlert, Mary E; Krieshok, Thomas S; Lichtenberg, James W

    2018-04-01

    Objective This study evaluated the effectiveness of cognitive processing therapy and prolonged exposure in conditions reflective of current clinical practice within the Veterans Health Administration. Method This study involved a retrospective review of 2030 charts. A total of 750 veterans from 10 U.S. states who received cognitive processing therapy or prolonged exposure in individual psychotherapy were included in the study (participants in cognitive processing therapy, N = 376; participants in prolonged exposure, N = 374). The main dependent variable was self-reported posttraumatic stress disorder symptoms as measured by total scores on the Posttraumatic Stress Disorder Checklist. The study used multilevel modeling to evaluate the absolute and relative effectiveness of both treatments and determine the relationship between patient-level variables and total Posttraumatic Stress Disorder Checklist scores during treatment. Results Cognitive processing therapy and prolonged exposure were equally effective at reducing total Posttraumatic Stress Disorder Checklist scores. Veterans who completed therapy reported significantly larger reductions in the Posttraumatic Stress Disorder Checklist than patients who did not complete therapy. There were no significant differences in the improvement of posttraumatic stress disorder symptoms with respect to age and three racial/ethnic groups (Caucasian, African American, and Hispanic). Conclusions Cognitive processing therapy and prolonged exposure were shown to be effective in conditions highly reflective of clinical practice and with a highly diverse sample of veterans. Challenges related to dropout from trauma focused therapy should continue to be researched.

  10. Le nouveau modèle africain | CRDI - Centre de recherches pour le ...

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

    22 juil. 2011 ... Or, ce serait rater le bateau que de ne pas s'engager dans la voie tout autre que les Africains proposent maintenant — à savoir se défaire du syndrome de la dépendance qui afflige l'Afrique depuis des décennies. Le Canada et les autres pays riches du Nord reconnaissent généralement qu'ils ne peuvent ...

  11. Lele des intervenants non gouvernementaux dans le ...

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

    Ce projet servira à déterminer les facteurs stratégiques et réglementaires qui ont contribué ou nui aux efforts visant à permettre aux fournisseurs non gouvernementaux de participer au renforcement des systèmes de santé. Lele des fournisseurs de ... Climate Change and Water Adaptation Options. The impacts of climate ...

  12. Laryngotracheal Injury following Prolonged Endotracheal Intubation

    Directory of Open Access Journals (Sweden)

    J. Mehdizadeh

    2006-07-01

    Full Text Available Background: Prolonged endotracheal intubation is a growing method for supporting ventilation in patients who require intensive care. Despite considerable advancement in endotracheal intubation, this method still has some complications; the most important is laryngo-tracheal injuries. Methods: Over a 2-year period, this retrospective study was conducted on 57 patients with history of prolonged intubation who were referred to the ENT Department of Amir Alam Hospital. For each patient, a complete evaluation including history, physical examination, and direct laryngoscopy and bronchoscopy was done under general anesthesia. Results: Fifty-seven patients (44 male; mean age, 23.014.7 years were studied. Mean intubation period was 15.88 days. The most common presenting symptom was dyspnea (62%. Head trauma was responsible for most cases of intubation (72.4%. The most common types of tracheal and laryngeal lesions were tracheal (56.9% and subglottic (55.2% stenosis, respectively. Mean length of tracheal stenosis was 0.810.83 cm. There was a statistically significant relationship between length of tracheal stenosis and intubation period (P=0.0001 but no relation was observed between tracheal stenosis and age, sex, and etiology of intubation (All P=NS. Among the glottic lesions, inter- arytenoids adhesion was the most common lesion (25.9%. No statistically significant relation was found between glottic and subglottic lesions and age, sex and intubation period (all P=NS. Length of stenosis and intubation period was significantly greater in tracheal/ subglottic lesions than those in glottic/ supraglottic lesions (all P=NS. Conclusion: After prolonged endotracheal intubation, laryngo-tracheal lesions had no relation with patient’s age, sex, and cause of intubation.There was direct relation between length of tracheal stenosis and intubation period. Glottic lesions were more commonly observed in head trauma patients. Lesion length and intubation

  13. Le corps, instrument de connaissance du monde: la connaissance des Anciens Toltèques

    Directory of Open Access Journals (Sweden)

    Mabel Franzone

    2009-10-01

    Full Text Available Cet article traite le corps comme instrument de la connaissance de l’univers. Le corps s’étend vers des contrées infinies, se prolonge, atteint d’autres règnes, cherche l’unité absolue de ce qu’on appelle l’intention. L’intention est le mot clé pour les Anciens Toltèques, réunissant sous ce mot le visible et l’invisible, la volonté de la Nature et celle de l’univers. Le corps n’est qu’un instrument et pour arriver à le parfaire devons chercher la totalité de nous-mêmes, réussir la communication de deux côtés, droit et gauche, aller à la quête d’autres expériences, inimaginables. Les conditions nécessaires sont d’avoir un corps puissant et d’emmagasiner de l’énergie. Tout l’enseignement des sorciers est fondé dans un vrai changement de conception du monde et de la perception de ce monde. L’objectif final est celui de pouvoir choisir sa propre mort ; la vraie, la seule, l’unique liberté de l’homme.

  14. Prolonged Exposure Treatment of Chronic PTSD in Juvenile Sex Offenders: Promising Results from Two Case Studies

    Science.gov (United States)

    Hunter, John A.

    2010-01-01

    Prolonged exposure (PE) was used to treat chronic PTSD secondary to severe developmental trauma in two adolescent male sex offenders referred for residential sex offender treatment. Both youth were treatment resistant prior to initiation of PE and showed evidence of long-standing irritability and depression/anxiety. Clinical observation and…

  15. Low liver stiffness among cirrhotic patients with hepatitis B after prolonged treatment with nucleoside analogs

    DEFF Research Database (Denmark)

    Andersen, Ellen Sloth; Weiland, Ola; Leutscher, Peter

    2011-01-01

    Case reports and short-term clinical trials have suggested that treatment for chronic hepatitis B (CHB) may lead to improvement of cirrhosis. The aim of the present study was to measure liver stiffness in patients diagnosed with advanced fibrosis or cirrhosis prior to prolonged treatment...

  16. Substantial molecular evolution and mutation rates in prolonged latent Mycobacterium tuberculosis infection in humans

    DEFF Research Database (Denmark)

    Lillebaek, Troels; Norman, Anders; Rasmussen, Erik Michael

    2016-01-01

    The genome of Mycobacterium tuberculosis (Mtb) of latently infected individuals may hold the key to understanding the processes that lead to reactivation and progression to clinical disease. We report here analysis of pairs of Mtb isolates from putative prolonged latent TB cases. We identified tw...

  17. Impact of clinical presentation on ischaemic and bleeding outcomes in patients receiving 6- or 24-month duration of dual-antiplatelet therapy after stent implantation: a pre-specified analysis from the PRODIGY (Prolonging Dual-Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia) trial.

    Science.gov (United States)

    Costa, Francesco; Vranckx, Pascal; Leonardi, Sergio; Moscarella, Elisabetta; Ando, Giuseppe; Calabro, Paolo; Oreto, Giuseppe; Zijlstra, Felix; Valgimigli, Marco

    2015-05-21

    We investigated if acute coronary syndrome (ACS) rather than stable coronary artery disease (SCAD) presentation is an outcome modifier with respect to the duration of dual-antiplatelet therapy (DAPT) in patients undergoing coronary stenting. In the Prolonging Dual-Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia (PRODIGY) trial, a total of 1465 (74.3%) patients presented ACS whereas 505 (25.7%) had SCAD and were randomized to 6- or 24-month DAPT. At 24 months, the composite of death, myocardial infarction (MI), or cerebrovascular accident (CVA) did not differ between the long- and short-term DAPT arms in both ACS (11.1 vs. 11.7%; P = 0.67) and SCAD (7.5 vs. 4.8%; P = 0.21) patients, respectively. Long-term DAPT was associated with a 75% increase of Bleeding Academic Research Consortium (BARC)-class 2, 3, or 5 bleeding in ACS [7.1 vs. 4.1%; hazard ratio (HR) 1.75, 95% confidence interval (CI) 1.11-2.74, P = 0.015; number needed to treat for harm (NNTH): 33.3] and a five-fold increase in SCAD (8.2 vs. 1.6%; HR 5.37, 95% CI 1.84-15.74, P = 0.002; NNTH: 15.1) patients, with a borderline quantitative interaction (PINT = 0.056). As a result, net adverse cardiovascular events (death, MI, CVA, BARC class 2, 3, or 5 bleeding) were more than doubled in SCAD patients receiving 24-month DAPT, whereas they did not differ in ACS patients (PINT = 0.024). This analysis suggests that clinical presentation may be a treatment modifier with respect to DAPT duration after stenting consistent with the hypothesis that SCAD-but not ACS-patients are exposed to a significant increase in bleeding and net adverse clinical events when treated with 24-month compared with 6-month therapy. clinicaltrials.gov Identifier: NCT00611286. http://clinicaltrials.gov/ct2/show/NCT00611286?term=prodigy&rank=2. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  18. Prevalence and Outcome of High-Risk QT Prolongation Recorded in the Emergency Department from an Institution-Wide QT Alert System.

    Science.gov (United States)

    Anderson, Heather N; Bos, J Martijn; Haugaa, Kristina H; Morlan, Bruce W; Tarrell, Robert F; Caraballo, Pedro J; Ackerman, Michael J

    2018-01-01

    QT prolongation is an independent risk factor for sudden death, stroke, and all-cause mortality. However, additional studies have shown that in certain settings, QT prolongation may be transient and a result of external factors. In this study, we evaluated the clinical characteristics and outcomes of patients seen in the emergency department (ED) with QT prolongation. Between November 2010 and June 2011, 7522 patients had an electrocardiogram (ECG) obtained during their evaluation in the ED. Clinical, laboratory, and therapeutic information was collected for all patients with QT prolongation (i.e., ≥ 500 ms and QRS alert was activated in 93 (1.2%; mean QTc 521 ± 34 ms). The majority of ED patients (64%) had more than one underlying condition associated with QT prolongation, with electrolyte disturbances in 51%, a QT prolonging condition in 56%, and QT-prolonging drugs in 77%. Thirty-day mortality was 13% for patients with QT prolongation noted in the ED. One percent of patients evaluated with an ECG in the ED activated our prolonged QTc warning system, with most demonstrating > 1 QT-prolonging condition. Thirty-day mortality was significant, but it requires further investigation to determine whether the QTc simply provided a non-invasive indicator of increased risk or heralded the presence of a vulnerable host at risk of a QT-mediated sudden dysrhythmic death. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Le clerc et le ménestrel

    OpenAIRE

    Szkilnik, Michelle

    2007-01-01

    Quand au début du XIVe siècle, un auteur inconnu imagine de raconter l’histoire d’un roi d’Angleterre tout aussi inconnu, Perceforest, il choisit « naturellement » la prose. « Naturellement » parce que le Perceforest se veut la pré-histoire du monde arthurien, qu’il prétend donc se rattacher, comme l’avait fait L’Estoire del Saint Graal, à l’avant des grands cycles en prose du XIIIe siècle, le Lancelot-Graal en particulier. Il opte donc pour le même mode d’écriture que les œuvres qu’il vient ...

  20. Migraine with prolonged aura: phenotype and treatment.

    Science.gov (United States)

    Viana, Michele; Afridi, Shazia

    2018-01-01

    We review the published literature on migraine with prolonged aura (PA), specifically with regards to the phenotype and treatment options. PA is not uncommon. A recent study found that about 17% of migraine auras are prolonged and that 26% of patients with migraine with aura have experienced at least one PA. The characteristics of PA are similar to most typical auras with the exception of a higher number of aura symptoms (in particular sensory and/or dysphasic). There are no well-established treatments at present which target the aura component of migraine. Other than case reports, there have been open-label studies of lamotrigine and greater occipital nerve blocks. The only randomised, blinded, controlled trial to date has been of nasal ketamine showing some reduction in aura severity but not duration. A small open-labelled pilot study of amiloride was also promising. Larger randomised, controlled trials are needed to establish whether any of the existing or novel compounds mentioned are significantly effective and safe.

  1. Upper thymic prolongation simulating mediastinal lymphadenomegaly

    Directory of Open Access Journals (Sweden)

    Cristiane Wosny

    2009-09-01

    Full Text Available The thymus is located in the anterior portion of the upper mediastinum, immediately behind the sternal manubrium, and extends to the anterior mediastinum, anteriorly to the pericardium. Two patients were evaluated due to nodulations at the transition from the cervical region to the anterior mediastinum, which simulated lymphadenomegaly. The first patient, a seven-year-old male, presented with a rhabdomyosarcoma of the masticatory space; during progressive follow-up, a nodule was noted with FDG uptake on the positron emission tomography coupled with the computed tomography (PET-CT. The second patient, a 51-year-old female, presented with a nodulation characterized on the magnetic resonance image for follow-up of a papilliferous carcinoma of the thyroid. In both cases, the nodulation displayed an upper prolongation of the thymus. These nodulations showed the same density on the computed tomography and the same signal intensity on the magnetic resonance image as the adjacent thymic tissue, and there was no adipose tissue layer between the nodulations and the thymus. Knowledge of the upper prolongation of the thymus as an anatomical variation is vital for differentiating it from mediastinal lymphadenomegaly, thus avoiding unnecessary biopsies or procedures.

  2. Parasitic causes of prolonged diarrhoea in travellers - diagnosis and management.

    Science.gov (United States)

    Slack, Andrew

    2012-10-01

    Prolonged infectious diarrhoea in the returning traveller is generally caused by protozoal and occasionally by helminth parasites. This article provides a framework for the diagnosis, management and prevention of the diseases that cause persistent diarrhoea in the traveller. A large proportion of disease is caused by Giardia lamblia, Cryptosporidium parvum and Entamoeba histolytica. However, given the ease of travel with comorbid conditions such as human immunodeficiency virus, there is an expanding list of organisms that can cause persistent diarrhoea. An awareness of the likely aetiological agents and their clinical features enables a more effective diagnosis and management of the patient's condition using an appropriate antiparasitic agent. Prevention strategies need to be initiated before travel and should consist of simple but memorable advice. Noninfectious causes of diarrhoea should be considered as diarrhoea can be a prominent feature of conditions such as hyperthyroidism or coeliac disease.

  3. Le sacré sauvage

    Directory of Open Access Journals (Sweden)

    Roger Bastide

    2010-09-01

    Full Text Available Conférence prononcée le 13 septembre 1973 dans le cadre des Rencontres Internationales de Genève qui avaient pour thème cette année-là « Le besoin religieux ». Cette conférence figure dans les Actes de cette rencontre (Le Besoin religieux, Éditions de la Baconnière, Neuchâtel, 1974, pp. 123-145. Elle a été republiée dans un ouvrage posthume dont elle est l’éponyme, ouvrage édité par Henri Desroche (Paris, éditions Stock, 1975. Nous reproduisons ici le texte intégral original, avec l’aimable autorisation des Rencontres Internationales de Genève auxquelles SociologieS adresse ses remerciements.The wild sacredText of a lecture taken on November the 13th 1973 during the Rencontres Internationales de Genève whom theme was "The religious need". This lecture was first published in: Le Besoin religieux (La Baconnière Editions, Neuchâtel, 1974, pp. 123-145, and published once again in a posthumous book: Le sacré sauvage ("The wild sacred" edited by Henri Desroche (Paris, Stock Editions, 1975. It is reproduced here with the kind authorization of the Rencontres Internationales de Genève. SociologieS gives them sincere thanks.Le Sacré sauvage (Lo sagrado en el mundo primitivoConferencia efectuada el 13 de septiembre de 1973 en el marco de las Rencontres Internationales de Genève (Encuentros Internacionales de Ginebra que tenia como tema general la necesidad de la experiencia religiosa (“Le besoin religieux”, Éditions de la Baconnière, Neuchâtel, 1974, pp. 123-145. Esta conferencia fue publicada de nuevo en un trabajo póstumo que lleva el mismo título, editado por Henri Desroche (Paris, Éditions Stock, 1975. Reproducimos aquí la integralidad del texto original con la amable autorización de las Rencontres Internationales de Genève, a las cuales la revista SociologieS expresa su agradecimiento.

  4. Le LHC, un tunnel cosmique

    CERN Document Server

    CERN. Geneva

    2009-01-01

    Et si la lumière au bout du tunnel du LHC était cosmique ? En d’autres termes, qu’est-ce que le LHC peut nous apporter dans la connaissance de l’Univers ? Car la montée en énergie des accélérateurs de particules nous permet de mieux appréhender l’univers primordial, chaud et dense. Mais dans quel sens dit-on que le LHC reproduit des conditions proches du Big bang ? Quelles informations nous apporte-t-il sur le contenu de l’Univers ? La matière noire est-elle détectable au LHC ? L’énergie noire ? Pourquoi l’antimatière accumulée au CERN est-elle si rare dans l’Univers ? Et si le CERN a bâti sa réputation sur l’exploration des forces faibles et fortes qui opèrent au sein des atomes et de leurs noyaux, est-ce que le LHC peut nous apporter des informations sur la force gravitationnelle qui gouverne l’évolution cosmique ? Depuis une trentaine d’années, notre compréhension de l’univers dans ses plus grandes dimensions et l’appréhension de son comportement aux plus peti...

  5. Le paludisme, le tsunami silencieux d'Afrique | IDRC - International ...

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

    12 janv. 2011 ... Dans un élan de compassion fort justifié, le monde s'est porté au secours des victimes du tsunami qui a touché récemment la région de l'océan Indien. Mais il ignore qu'un « tsunami silencieux », le paludisme, s'abat sans cesse sur l'Afrique et y fait chaque année plus de 1,5 million de victimes, surtout de ...

  6. Le même et le différent

    OpenAIRE

    Tixier, Nicolas

    2015-01-01

    À partir de Smoke de Paul Auster et Wayne Wang; International audience; Auggie Wren (joué par Harvey Keitel) tient un débit de tabac à Brooklyn au coin de la 16e rue et de Prospect Park West. Chaque matin il traverse le carrefour face à sa boutique et dispose avec attention, toujours au même endroit, son appareil photo sur un trépied. Il regarde sa montre, attend la bonne heure et appuie sur le déclencheur. Cette photo rejoindra un album où jour après jour, page après page, depuis de nombreus...

  7. Secondary focal form of yersinia enterocolitica infection with prolonged polyarthritis in young caucasian male: a case report.

    Science.gov (United States)

    Sydorchuk, Aniuta S; Holyar, Oksana I; Randiuk, Yurii O; Sorokhan, Vasyl D; Sydorchuk, Leonid I; Bohachyk, Nonna A; Venglovska, Yadviga V; Sokol, Andrii M

    Current issue deals with an interesting clinical case of a rare infectious disease in a Caucasian young male patient, caused by Yersinia enterocоlitica. Infection proceeded in the development of secondary focal form, which was accompanied by prolonged polyarthritis. We described a clinical case of secondary focal form with prolonged polyarthritis caused by Y. enterocolitica O:3 serogroup in young patient with the purpose of focusing on the early clinical and laboratory diagnosistics of Yersiniosis that would minimize the role of medical errors in diagnostics made by general practitioners. This case deserves the attention of internal medicine specialists, physicians of the specialty ≪general practitioners≫, rheumatologists, infectious disease specialists taking into consideration the clinics and immunopathogenesis, as well as a high evidence of a prolonged clinical course and chronicity of this disease. It has accented on the feasibility of early serological diagnostics and etiotropic antibiotic therapy of the disease.

  8. Le Fleix – Bourg Ouest

    OpenAIRE

    Gineste, Marie-Christine

    2013-01-01

    Date de l'opération : 2009 (EX) Le projet d’extension d’une cantine scolaire est à l’origine de cette prescription. Il concerne une parcelle de 1 438 m2 située sur un replat de la terrasse holocène, en bordure d’un affluent de la Dordogne ; le Lasolle du Bost, dans le périmètre supposé de l’agglomération antique appelée « ville de Meille ». L’assiette du projet correspond au XIXe siècle à un secteur agricole non bâti. Deux tranchées ont été réalisées, occasionnant la découverte, surtout au no...

  9. Le Corbusier’s Dioramas

    Directory of Open Access Journals (Sweden)

    José Ramón Alonso Pereira

    2013-10-01

    Full Text Available AbstractLe Corbusier symbolizes the modern rational urbanism, whose rigorous effort of town planning demands a parallel effort of comprehension. It opposes to these contemporary urbanism that wish to perceive and to enjoy cities in a sensible way. Nevertheless, sentiment and reason are not adverses and Le Corbusier gives us at his  moment keys to intent a synthesis, joined them in a singular way by means of his ‘boîtes à miracles’ or ‘magic boxes’: those "architectural spectacles of synthesis" that he defined in 1951 Ciam. Here we try to approach to the first of those ‘spectacles’: the ‘diorama’, considering it as a corbusean strategy of mediation between rational and sensible in modern and contemporary city.Key wordsLe Corbusier, diorama, Ville Contemporaine, Plan Voisin, Plan Maciá

  10. La preuve par le nombre

    Directory of Open Access Journals (Sweden)

    Hélène Verdier

    2012-04-01

    Full Text Available S’il en était besoin, la question des usages et de la finalité des résultats de l’inventaire général pourrait être abordée par le nombre : nombre d’œuvres répertoriées, de communes inventoriées, de clichés photographiques réalisés, de dossiers, de consultations des notices dans les bases de données… Les additions aujourd’hui sont éloquentes, mais elles laissent dans l’ombre lele de l’inventaire qui, en mettant en œuvre une démarche systématique de connaissance, participe à l’ identificatio...

  11. Le front oriental de Lille

    Directory of Open Access Journals (Sweden)

    Étienne Poncelet

    2011-06-01

    Full Text Available De la porte d’eau de la Basse Deûle jusqu’au fort Saint-Sauveur, le front oriental de Lille, fortifié à l’époque espagnole, glisse ses courtines dans les entrelacs du périphérique et des gares. L’enjeu urbain actuel consiste à s’appuyer sur ces murs historiques pour « passer malgré tout » à travers cet écheveau urbain et retisser les fils de la continuité des promenades au cœur de la ville. Moins connus que le front occidental de la reine des citadelles, ces anciens espaces militaires sont une chance pour l’urbanisme de demain dont les opérations en cours de la Porte de Gand et de la Basse Deûle témoignent déjà.The east wall, at Lille, fortified during the period of Spanish occupation, extends from the Porte d'Eau de la Basse-Deûle to the Saint-Sauveur fort. Its curtain walls emerge today in a landscape of ring roads and railway territories. The issue today is to profit from these historic walls in order to make some sense of the urban chaos and to reinstate some urban continuity in the city-centre walkways. Although they are not as well known as the western wall of this major fortified city, these former military properties are an exciting opportunity for tomorrow's town-planners, as the operations already underway at the Porte de Gand et de la Basse Deûle suggest.

  12. Prolonged QTc interval in association with medium-chain acyl-coenzyme A dehydrogenase deficiency.

    Science.gov (United States)

    Wiles, Jason R; Leslie, Nancy; Knilans, Timothy K; Akinbi, Henry

    2014-06-01

    Medium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency is the most common disorder of mitochondrial fatty acid oxidation. We report a term male infant who presented at 3 days of age with hypoglycemia, compensated metabolic acidosis, hypocalcemia, and prolonged QTc interval. Pregnancy was complicated by maternal premature atrial contractions and premature ventricular contractions. Prolongation of the QTc interval resolved after correction of metabolic derangements. The newborn screen was suggestive for MCAD deficiency, a diagnosis that was confirmed on genetic analysis that showed homozygosity for the disease-associated missense A985G mutation in the ACADM gene. This is the first report of acquired prolonged QTc in a neonate with MCAD deficiency, and it suggests that MCAD deficiency should be considered in the differential diagnoses of acute neonatal illnesses associated with electrocardiographic abnormality. We review the clinical presentation and diagnosis of MCAD deficiency in neonates. Copyright © 2014 by the American Academy of Pediatrics.

  13. Spreading depolarizations have prolonged direct current shifts and are associated with poor outcome in brain trauma

    DEFF Research Database (Denmark)

    Hartings, Jed A; Watanabe, Tomas; Bullock, M Ross

    2011-01-01

    depolarizations are associated with worse clinical outcome after traumatic brain injury. Furthermore, based on animal models of brain injury, the prolonged durations of depolarizations raise the possibility that these events may contribute to maturation of cortical lesions. Prolonged depolarizations, measured......Cortical spreading depolarizations occur spontaneously after ischaemic, haemorrhagic and traumatic brain injury. Their effects vary spatially and temporally as graded phenomena, from infarction to complete recovery, and are reflected in the duration of depolarization measured by the negative direct...... current shift of electrocorticographic recordings. In the focal ischaemic penumbra, peri-infarct depolarizations have prolonged direct current shifts and cause progressive recruitment of the penumbra into the core infarct. In traumatic brain injury, the effects of spreading depolarizations are unknown...

  14. Ligeti, Le Grand Macabre (1978)

    OpenAIRE

    Amaral, Pedro

    2011-01-01

    Le Grand Macabre, de Györgi Ligeti, uma obra que, em plenos anos setenta, retoma e reinventa a grande tradição da ópera de repertório. Escrita para a Ópera de Estocolmo, estreada em Abril de 1978, Le Grand Macabre é uma das obras mais marcantes e uma das mais consagradas, internacionalmente, no plano da música dramática da segunda metade do século XX. Escrita a partir de uma peça do dramaturgo belga Michel de Ghelderode, “A Balada do Grande Macabro”, de 1934, a obra de Ligeti retoma um...

  15. Agir sur le gaspillage alimentaire

    OpenAIRE

    Jan, Sophie; Baron, Florence

    2016-01-01

    On estime aujourd'hui à 25% les pertes d'aliments post-récolte et en aval, en raison de leur altération par des microorganismes. L'étude menée ici illustre le risque d'altération engendré par une rupture dans la chaîne du froid, en prenant comme modèle un aliment liquide pasteurisé et réfrigéré, riche en nutriments et dont la température ne doit pas dépasser 4°C.

  16. Esthesioneuroblastoma: A case with prolonged disease control

    Directory of Open Access Journals (Sweden)

    Andreia Coelho

    2016-10-01

    Full Text Available Esthesioneuroblastoma, a rare tumor arising from the olfactory vault, varies from being indolent to extremely aggressive. Owing to its rarity, the diagnosis, staging, and treatment of the disease are not well defined. According to a number of small observational retrospective studies and case reports, the disease’s actual treatment involves surgery, radiotherapy, and/or chemotherapy (either as a single treatment or used in combination, depending on the disease’s staging. Optimal treatment has not been standardized, particularly regarding the role of chemotherapy. We describe a case of advanced esthesioneuroblastoma with prolonged disease control, subjected to a multimodal therapy with surgery, radiotherapy, and chemotherapy, illustrating the benefits of this approach in managing a patient with esthesioneuroblastoma. Herein, we analyze the most important and controversial issues of this type of neoplasia.

  17. Neurohumoral responses during prolonged exercise in humans

    DEFF Research Database (Denmark)

    Nybo, Lars; Nielsen, Bodil; Blomstrand, Eva

    2003-01-01

    , and the metabolic precursor of serotonin, tryptophan, were evaluated in eight endurance-trained subjects during exercise randomized to be with or without hyperthermia. The core temperature stabilized at 37.9 +/- 0.1 degrees C (mean +/- SE) in the control trial, whereas it increased to 39.7 +/- 0.2 degrees C......This study examined neurohumoral alterations during prolonged exercise with and without hyperthermia. The cerebral oxygen-to-carbohydrate uptake ratio (O2/CHO = arteriovenous oxygen difference divided by arteriovenous glucose difference plus one-half lactate), the cerebral balances of dopamine...... in the hyperthermic trial, with a concomitant increase in perceived exertion (P exercise trials. Both the arterial and jugular venous dopamine levels...

  18. Neurohumoral responses during prolonged exercise in humans

    DEFF Research Database (Denmark)

    Nybo, Lars; Nielsen, Bodil; Blomstrand, Eva

    2003-01-01

    in the hyperthermic trial, with a concomitant increase in perceived exertion (P brain had a small release of tryptophan (arteriovenous difference of -1.2 +/- 0.3 micromol/l), whereas a net balance was obtained during the two exercise trials. Both the arterial and jugular venous dopamine levels...... became elevated during the hyperthermic trial, but the net release from the brain was unchanged. During exercise, the O2/CHO was similar across trials, but, during recovery from the hyperthermic trial, the ratio decreased to 3.8 +/- 0.3 (P ...This study examined neurohumoral alterations during prolonged exercise with and without hyperthermia. The cerebral oxygen-to-carbohydrate uptake ratio (O2/CHO = arteriovenous oxygen difference divided by arteriovenous glucose difference plus one-half lactate), the cerebral balances of dopamine...

  19. Le developpement autocentre avec integration dans le marche ...

    African Journals Online (AJOL)

    -arabe, que l'Europe accepterait à cause de son intérêt à stabiliser les pays du sud de la Méditerranée sur le plan social et politique. Mots Clés: Industrialisation, Rente, Exportation de produits manufacturés, Coopération euro-arabe ...

  20. [Diagnosis of congenital endocrinological disease in newborns with prolonged jaundice and hypoglycaemia].

    Science.gov (United States)

    Braslavsky, D; Keselman, A; Chiesa, A; Bergadá, I

    2012-03-01

    The association of prolonged neonatal jaundice and hypoglycaemia may be secondary to an endocrinological disease. Pituitary insufficiency and primary adrenal insufficiency are the most likely endocrine diseases that need to be ruled out. We retrospectively analysed the clinical and laboratory characteristics of thirteen patients referred to the Hospital de Niños Ricardo Gutiérrez between years 2003 and 2008 due to prolonged neonatal jaundice and hypoglycaemia secondary to pituitary insufficiency in twelve patients, and in one secondary to primary adrenal insufficiency. All patients had a history of neonatal hypoglycaemia. Ten patients had conjugated hyperbilirubinaemia and six also had elevated transaminases. Combined pituitary hormone deficiency was observed in the twelve hypopituitarism patients. Hormonal replacement normalised liver function and resolved the prolonged jaundice in all the patients. None of them underwent liver biopsy. Hypoglycaemia also remitted after hormonal therapy. Prolonged or cholestatic jaundice associated with neonatal hypoglycaemia is highly likely to be due to pituitary hormone deficiency or primary adrenal insufficiency. Early diagnosis and treatment of these children reverts the prolonged jaundice and prevents morbidity and mortality due to recurrent hypoglycaemia and hormone deficiencies. Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  1. I comportamenti violenti nel sonno REM: aspetti clinici, criminologici e medico-legali / Les comportements violents pendant le sommeil MOR : aspects cliniques, criminologiques et médico-légaux / The Violent Behaviour in REM Sleep-related: Clinical, Criminological and Forensic Aspects

    Directory of Open Access Journals (Sweden)

    Cimino Luca

    2011-04-01

    Full Text Available The violent behaviour of sleep represents a new frontier of forensic interest. After examining the clinical aspects of a particular form of parasomnia related to REM stage of sleep, called REM Behavior Disorder-RBD, the author highlights the criminological and forensic implications emphasizing the distinctive features in terms of responsibility and imputability.Les comportements violents pendant le sommeil MOR représentent une nouvelle “frontière” d’intérêt de la psychologie médico-légale. Après avoir examiné les aspects cliniques d’une forme particulière de parasomnie liée à la phase MOR du sommeil (denominata REM Behaviour Disorders-RBD, l’auteur de l’article met en évidence ses implications criminologiques et médico-légales; en outre, il souligne les aspects particuliers de cette parasomnie en matière de responsabilité et d’imputabilité.I comportamenti violenti del sonno rappresentano una nuova “frontiera” di interesse forense. L’autore, dopo aver esaminato gli aspetti clinici di una particolare forma di parasonnia legata alla fase REM del sonno, denominata REM Behaviour Disorders-RBD, ne sottolinea le implicazioni criminologiche e medico-legali sottolineandone gli aspetti peculiari in tema di colpa ed imputabilità.

  2. INFLUENCE DES TEMPERATURES OPERATIONNELLES SUR LA PERFORMANCE D’UN REFRIGERATEUR SOLAIRE A ADSORPTION QUI FONCTIONNE AVEC LE COUPLE CHARBON ACTIF-METHANOL

    OpenAIRE

    H SOUALMI; Z SAADI; A RAHMANI

    2014-01-01

    Le séchage des produits alimentaires au soleil est un moyen efficace, facile et économique pour conserver les aliments, en particulier les fruits. Le séchoir solaire est l'équipement le plus populaire pour le séchage des fruits. En raison de la nature intermittente de l'énergie solaire, le stockage de l'énergie thermique est nécessaire pour assurer un fonctionnement prolongé du séchoir. L'objectif principal de cette étude est d'évaluer l'efficacité du séchoir solaire intégré avec un lit en gr...

  3. Increased hexose transport in the roots of tomato plants submitted to prolonged hypoxia.

    Science.gov (United States)

    Gharbi, Imène; Ricard, Bérénice; Smiti, Samira; Bizid, Essia; Brouquisse, Renaud

    2009-07-01

    We investigated the effects of prolonged hypoxia on the sugar uptake in tomato (Solanum lycopersicum L. var. MP-1) roots. Hydroponic cultures of whole tomato plants were submitted to hypoxic treatment for 1 week, and the roots were analyzed for sugar concentrations, hexose uptake and hexose transporter expression level. Contrary to what has been observed after anoxic shock or short-term hypoxic treatment, we show that sugar concentrations increase and hexose uptake is up-regulated in the roots after 1 week of hypoxic treatment. Increased hexose transport is concomitant with the induction of the hexose transporter gene LeHT2. These responses may be due either to a direct effect of low O(2) supply, or to a secondary effect associated with the increase in sugar concentrations, which, typically, develops in most hypoxic plants.

  4. Rapport sur le développement dans le monde sur le thème du rôle ...

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

    ... rural et sont tributaires principalement de l'agriculture pour assurer leur subsistance. Ce projet permettra de veiller à ce qu'une place soit accordée aux travaux de recherche financés par le CRDI, aux points de vue différents et aux auteurs de l'hémisphère Sud dans le Rapport sur le développement dans le monde 2008.

  5. Le profil entrepreneurial : Facteur discriminant du developpement ...

    African Journals Online (AJOL)

    Le développement économique est un objectif majeur pour tout pays. Selon le classement établi par le Forum économique mondial, le développement économique dépend du niveau du PIB per capita et de la part des exportations des biens minéraux dans l'exportation totale. A partir de la base de données GEM Algérie, ...

  6. Quand le dentier devient danger!

    Science.gov (United States)

    Sadak, Nouzha; Herrak, Laila; Achachi, Leila; El Ftouh, Mustapha

    2017-01-01

    Bien que rare chez l'adulte, l'inhalation de corps étranger (CE) est un accident grave pouvant mettre en jeu le pronostic vital ou entrainer des séquelles importantes. Nous rapportons l'observation d'un patient de 50 ans, sans antécédents pathologiques particuliers, qui s'est présentée aux urgences pour douleur thoracique, toux intermittente et dyspnée d'effort, six jours après avoir inhalé, accidentellement, sa prothèse dentaire en plastique lors d'un repas. L'examen clinique était sans particularités. La radiographie thoracique ainsi que l'ASP ne montraient pas d'anomalie. Une bronchoscopie souple sous anesthésie générale a permis de visualiser le CE au niveau du tronc intermédiaire et l'extraction a été réalisée avec succès évitant ainsi le recours à un geste beaucoup plus invasif. La radiographie standard peut s'avérer utile en visualisant les CE radio-opaque ou par des signes indirects évoquant la présence d'un CE, mais le recours à la bronchoscopie à visée diagnostique et thérapeutique est primordial. PMID:28904706

  7. Nanostructures pour le développement de vaccins contre le virus de ...

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

    Institut national de la recherche agronomique (France). Ce projet est financé par le fonds d'innovation en vaccins pour le bétail, un partenariat entre la fondation Bill et Melinda Gates, Affaires Mondiales Canada et le Centre de recherches pour le ...

  8. Le Kenya nomme le titulaire de sa première chaire de recherche

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

    14 avr. 2016 ... De concert avec le CRDI, la National Commission for Science, Technology and Innovation (NACOSTI) du Kenya a inauguré sa première chaire de recherche à Nairobi, le 31 mars 2015. Le professeur Fabian Omoding Esamai, qui dirige actuellement le College of Health Sciences de la Moi University, a été ...

  9. Le LHC, priorité absolue

    CERN Multimedia

    Huet, S

    2002-01-01

    Le LHC, sa mise en est repoussee a 2007 quand les physiciens esperaient 2006. Le CERN a sous-estime les couts, environ 11% pour les 1 200 aimants supraconducteurs. Les Etats membres n'augmenteront pas leurs subventions, il propose donc cette semaine un plan drastique : tout pour le LHC (1/2 page).

  10. Le CERN ouvre ses entrailles au public

    CERN Multimedia

    2004-01-01

    "Le CERN se lance dans une grande opération de relations publiques pour son cinquantième anniversaire. Le centre de recherche organisera une journée portes ouvertes le 16 octobre. Quelque 50 sites pourrant être visités" (1/2 page)

  11. LE CORBUSIER: CONCURSOS Y PALACIOS / Le Corbusier: competitions and palaces

    Directory of Open Access Journals (Sweden)

    Fernando Zaparaín Hernández

    2012-11-01

    Full Text Available RESUMEN Cuando Le Corbusier ya había pasado de los cuarenta años se enfrentó a dos concursos internacionales: el Palacio de las Naciones en Ginebra (1926–31 y el Palacio de los Soviets en Moscú (1931–32 con los que intentaba acceder a grandes encargos de estado con mayor escala urbana en los que poner a prueba su ideario moderno sobre arquitectura y urbanismo. En ambos casos estuvo entre los vencedores pero por conveniencia e indecisión, los poderes políticos optaron por soluciones academicistas. Al conocer las decisiones definitivas, Le Corbusier y todos sus contactos del Movimiento Moderno orquestaron diversas polémicas ante los medios de comunicación y los gobernantes por entender que el progreso se veía lastrado por el triunfo de propuestas reaccionarias. Mediante el estudio de la correspondencia con personas particulares como Moser, Giedion, Colly o Stonorov, conservada en la Fundación Le Corbusier, se analizan las relaciones y el tono ideológico en torno a aquellas protestas. En esos textos quedan reflejados los principales rasgos que caracterizan la modernidad como su internacionalización, la seguridad en la propia misión, la defensa de lo nuevo o el método dialéctico. SUMMARY When Le Corbusier had already passed the age of forty he confronted two international competitions: the Palais des Nations in Geneva (1926–1931 and the Palace of the Soviets in Moscow (1931–32, with which he attempted to access large state commissions, with greater urban scale, in which to test his ideas about modern architecture and urbanism. In both cases he was among the winners, but through convenience and indecision the political powers opted for solutions from academicians. Upon knowing the final decisions, Le Corbusier and all his contacts in the Modern Movement orchestrated several controversies with the media, and the people in power, to convey that progress seemed burdened by the triumph of reactionary proposals. The relationships

  12. LE CORBUSIER: CONCURSOS Y PALACIOS / Le Corbusier: competitions and palaces

    Directory of Open Access Journals (Sweden)

    Fernando Zaparaín Hernández

    2012-11-01

    Full Text Available RESUMEN Cuando Le Corbusier ya había pasado de los cuarenta años se enfrentó a dos concursos internacionales: el Palacio de las Naciones en Ginebra (1926–31 y el Palacio de los Soviets en Moscú (1931–32 con los que intentaba acceder a grandes encargos de estado con mayor escala urbana en los que poner a prueba su ideario moderno sobre arquitectura y urbanismo. En ambos casos estuvo entre los vencedores pero por conveniencia e indecisión, los poderes políticos optaron por soluciones academicistas. Al conocer las decisiones definitivas, Le Corbusier y todos sus contactos del Movimiento Moderno orquestaron diversas polémicas ante los medios de comunicación y los gobernantes por entender que el progreso se veía lastrado por el triunfo de propuestas reaccionarias. Mediante el estudio de la correspondencia con personas particulares como Moser, Giedion, Colly o Stonorov, conservada en la Fundación Le Corbusier, se analizan las relaciones y el tono ideológico en torno a aquellas protestas. En esos textos quedan reflejados los principales rasgos que caracterizan la modernidad como su internacionalización, la seguridad en la propia misión, la defensa de lo nuevo o el método dialéctico.SUMMARY When Le Corbusier had already passed the age of forty he confronted two international competitions: the Palais des Nations in Geneva (1926–1931 and the Palace of the Soviets in Moscow (1931–32, with which he attempted to access large state commissions, with greater urban scale, in which to test his ideas about modern architecture and urbanism. In both cases he was among the winners, but through convenience and indecision the political powers opted for solutions from academicians. Upon knowing the final decisions, Le Corbusier and all his contacts in the Modern Movement orchestrated several controversies with the media, and the people in power, to convey that progress seemed burdened by the triumph of reactionary proposals. The relationships and

  13. Fermionic covariant prolongation structure theory for supernonlinear evolution equation

    International Nuclear Information System (INIS)

    Cheng Jipeng; Wang Shikun; Wu Ke; Zhao Weizhong

    2010-01-01

    We investigate the superprincipal bundle and its associated superbundle. The super(nonlinear)connection on the superfiber bundle is constructed. Then by means of the connection theory, we establish the fermionic covariant prolongation structure theory of the supernonlinear evolution equation. In this geometry theory, the fermionic covariant fundamental equations determining the prolongation structure are presented. As an example, the supernonlinear Schroedinger equation is analyzed in the framework of this fermionic covariant prolongation structure theory. We obtain its Lax pairs and Baecklund transformation.

  14. Prolonged partial upper airway obstruction during sleep – an underdiagnosed phenotype of sleep-disordered breathing

    Directory of Open Access Journals (Sweden)

    Ulla Anttalainen

    2016-09-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a well-recognized disorder conventionally diagnosed with an elevated apnea–hypopnea index. Prolonged partial upper airway obstruction is a common phenotype of sleep-disordered breathing (SDB, which however is still largely underreported. The major reasons for this are that cyclic breathing pattern coupled with arousals and arterial oxyhemoglobin saturation are easy to detect and considered more important than prolonged episodes of increased respiratory effort with increased levels of carbon dioxide in the absence of cycling breathing pattern and repetitive arousals. There is also a growing body of evidence that prolonged partial obstruction is a clinically significant form of SDB, which is associated with symptoms and co-morbidities which may partially differ from those associated with OSAS. Partial upper airway obstruction is most prevalent in women, and it is treatable with the nasal continuous positive pressure device with good adherence to therapy. This review describes the characteristics of prolonged partial upper airway obstruction during sleep in terms of diagnostics, pathophysiology, clinical presentation, and comorbidity to improve recognition of this phenotype and its timely and appropriate treatment.

  15. Publications | Page 95 | CRDI - Centre de recherches pour le ...

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

    Le CRDI et la lutte contre le paludisme. DOCUMENT D'INFORMATION. Le paludisme tue un enfant africain toutes les 30 secondes. Avec le VIH/sida et la tuberculose, le paludisme est l'un des principaux problèmes de santé publique menaçant le.

  16. pour le trimestre qui a pris fin le 30 septembre 2017

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

    Sophie Comeau

    30 sept. 2017 ... Régi par la Loi sur le Centre de recherches pour le développement international (1970), le Centre de recherches pour le développement international (le Centre ou CRDI) vise à « lancer, encourager, appuyer et mener des recherches sur les problèmes des régions du monde en voie de développement et ...

  17. Reflexion sur le climat, l'effet de serre et le rechauffement global ...

    African Journals Online (AJOL)

    Le climat de la Terre est largement influencé par l'état de son atmosphère. Le rayonnement solaire jouerait un rôle primordial dans la climatologie terrestre certes, néanmoins, il n'est plus en mesure à lui tout seul d'expliquer le climat qui prédomine, en moyenne, à la surface de la terre. L'effet de serre serait le phénomène ...

  18. Rapport financier trimestriel pour le trimestre qui a pris fin le 31 ...

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

    Office 2004 Test Drive User

    31 déc. 2016 ... Lʼinformation et les divulgations contenues dans le Rapport annuel 2015-2016 sʼappliquent au trimestre sur lequel porte le présent rapport trimestriel, sauf indication contraire. Budget 2016-2017 révisé. Le Conseil des gouverneurs a approuvé le budget 2016-2017 avant le début de lʼexercice. Cʼest.

  19. Le contrôle de gestion des entreprises familiales : un contrôle non-financiarisé ?

    OpenAIRE

    Barbelivien, Dominique

    2016-01-01

    Nous examinons la tendance décrite dans la littérature quant à la financiarisation de la fonction de contrôle de gestion en nous appuyant sur le cas d’une entreprise de taille intermédiaire familiale. Nous constatons que le contrôle de gestion dans le cas étudié correspond à une rationalisation des décisions opérationnelles et développons les raisons qui peuvent expliquer la persistance d’un contrôle de gestion très opérationnel. Le contexte d’entreprise familiale dans laquelle il y a confusi...

  20. GPCR desensitization: Acute and prolonged phases.

    Science.gov (United States)

    Rajagopal, Sudarshan; Shenoy, Sudha K

    2018-01-01

    G protein-coupled receptors (GPCRs) transduce a wide array of extracellular signals and regulate virtually every aspect of physiology. While GPCR signaling is essential, overstimulation can be deleterious, resulting in cellular toxicity or uncontrolled cellular growth. Accordingly, nature has developed a number of mechanisms for limiting GPCR signaling, which are broadly referred to as desensitization, and refer to a decrease in response to repeated or continuous stimulation. Short-term desensitization occurs over minutes, and is primarily associated with β-arrestins preventing G protein interaction with a GPCR. Longer-term desensitization, referred to as downregulation, occurs over hours to days, and involves receptor internalization into vesicles, degradation in lysosomes and decreased receptor mRNA levels through unclear mechanisms. Phosphorylation of the receptor by GPCR kinases (GRKs) and the recruitment of β-arrestins is critical to both these short- and long-term desensitization mechanisms. In addition to phosphorylation, both the GPCR and β-arrestins are modified post-translationally in several ways, including by ubiquitination. For many GPCRs, receptor ubiquitination promotes degradation of agonist-activated receptors in the lysosomes. Other proteins also play important roles in desensitization, including phosphodiesterases, RGS family proteins and A-kinase-anchoring proteins. Together, this intricate network of kinases, ubiquitin ligases, and adaptor proteins orchestrate the acute and prolonged desensitization of GPCRs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. [A case of prolonged paroxysmal sympathetic hyperactivity].

    Science.gov (United States)

    Yamamoto, Akiko; Ide, Shuhei; Iwasaki, Yuji; Kaga, Makiko; Arima, Masataka

    2016-03-01

    We report the case of a 4-year-old girl who presented with paroxysmal sympathetic hyperactivity (PSH), after developing severe hypoxic-ischemic-encephalopathy because of cardiopulmonary arrest. She showed dramatic paroxysmal sympathetic activity with dystonia. She was treated with wide variety of medications against PSH, which were found to be effective in previous studies. Among them, morphine, bromocriptine, propranolol, and clonidine were effective in reducing the frequency of her attacks while gabapentin, baclofen, dantrolene, and benzodiazepine were ineffective. Though the paroxysms decreased markedly after the treatment, they could not be completely controlled beyond 500 days. Following the treatment, levels of plasma catecholamines and their urinary metabolites decreased to normal during inter- paroxysms. However, once a paroxysm had recurred, these levels were again very high. This case study is considered significant for two rea- sons. One is that PSH among children have been rarely reported, and the other is that this case of prolonged PSH delineated the transition of plasma catecholamines during the treatment. The excitatory: inhibitory ratio (EIR) model proposed by Baguley was considered while dis- cussing drug sensitivity in this case. Accumulation of similar case studies will help establish more effective treatment strategies and elucidate the pathophysiology of PSH.

  2. STRESS PROLONGS WOUND HEALING POST CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Ah. Yusuf

    2017-07-01

    Full Text Available Introduction: Decision for cesarean section may lead to the stress for women in delivery. Stress response requires longer recovery time in post cesarean section patients. Most of patients who experience stress before and after surgical is associated with wound healing delay. When this condition continues, the wound will have a higher risk of infection. The objective of this study was to analyze correlation between stress and wound healing phase in post cesarean section patients. Method: A cross sectional design was used in this study. The population were women with cesarean section, both elective or emergency, in Delivery Room I RSU Dr. Soetomo Surabaya. Samples were recruited by using purposive sampling, with 28 samples who met to the inclusion criterias. The observed variables were stress and wound healing phase in post cesarean section patient. Stress data were collected by interview and wound healing measurement done by observation on the 3rd day post cesarean section. Result: The result showed that women with stress experience wound healing delay. The characteristic of wound healing delay was prolonged on inflammation phase, nevertheless there was presence of granulation tissue. Spearman’s rho correlation showed that correlation value r=0.675 with p=0.000. Discussion: It can be concluded that there was strong significant correlation between stress and wound healing phase in post cesarean section patients. It is important to give this information to the patients with cesarean section in order to prevent stress and delay in wound healing phase.

  3. Bulletin #109 | CRDI - Le Centre de recherches pour le ...

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

    ... offres d'emploi. Appel à propositions de recherche sur les villes résilientes en Amérique latine. Date butoir : 13 juin 2016. Programme de recherche sur le virus Zika Canada-Amérique latine et Caraïbes Date butoir : 12 juillet 2016. POSSIBILITÉS D'EMPLOIS Agent de ressources humaines · Analyste des opérations de TI.

  4. Le cosmos et le lotus confessions d'un astrophysicien

    CERN Document Server

    Trinh, Xuan Thuan

    2011-01-01

    Que nous dit vraiment la science sur la nature de l'univers, sur son origine et son avenir ? Par quel mystère le langage mathématique, pure création de l'esprit humain, se révèle-t-il aussi performant pour nous décrire les phénomènes physiques, de l'infiniment petit à l'infiniment grand ? S'il existe un ordre du monde, ce que nous en disent la physique quantique et la théorie de la relativité est-il compatible avec ce qu'enseigne le bouddhisme ? Et que peut-on en conclure concernant notre propre vie ? A ces questions passionnantes et à beaucoup d'autres, le célèbre astrophysicien Trinh Xuan Thuan répond ici d'une façon personnelle, en s'appuyant sur son expérience. Son itinéraire l'a placé d'emblée à la confluence de trois cultures : issu d'une famille de lettrés vietnamiens imprégnée de traditions bouddhiste et confucéenne, il a reçu une éducation à la française puis une formation scientifique à l'américaine. Une telle richesse de points de vue lui permet d'apporter, non pas de...

  5. Le futur du travail | CRDI - Centre de recherches pour le ...

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

    12 juin 2017 ... Une base de données probantes est nécessaire afin de trouver des solutions stratégiques et sociales appropriées aux divers défis que posent ces nouveaux modes de travail. La recherche sur l'innovation en matière d'éducation et le renforcement des capacités seront également essentiels pour assurer la ...

  6. Management of children with prolonged diarrhea [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Antonietta Giannattasio

    2016-02-01

    Full Text Available Prolonged diarrhea is usually defined as acute-onset diarrhea lasting 7 days or more, but less than 14 days. Its trend has been declining in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. The pathogenesis of prolonged diarrhea is multifactorial and essentially based on persistent mucosal damage due to specific infections or sequential infections with different pathogens, host-related factors including micronutrient and/or vitamin deficiency, undernutrition and immunodeficiency, high mucosal permeability due to previous infectious processes and nutrient deficiency with consequential malabsorption, and microbiota disruption. Infections seem to play a major role in causing prolonged diarrhea in both developing and developed areas. However, single etiologic pathogens have not been identified, and the pattern of agents varies according to settings, host risk factors, and previous use of antibiotics and other drugs. The management of prolonged diarrhea is complex. Because of the wide etiologic spectrum, diagnostic algorithms should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Often, expensive laboratory evaluations are of little benefit in guiding therapy, and an empirical approach may be effective in the majority of cases. The presence or absence of weight loss is crucial for driving the initial management of prolonged diarrhea. If there is no weight loss, generally there is no need for further evaluation. If weight loss is present, empiric anti-infectious therapy or elimination diet may be considered once specific etiologies have been excluded.

  7. Study of contamination by 100 {mu}Ci of Sr 90 in the rat: clinical, hematological and osseous effects (appearance of osteosarcomas); Etude d'une contamination par 100 {mu}Ci de Sr 90 chez le rat: consequences cliniques, hematologiques et osseuses (apparition d'osteosarcomes)

    Energy Technology Data Exchange (ETDEWEB)

    Graf, B.; Lafuma, J.; Parmentier, C.; Parmentier, N. [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1968-07-01

    Clinical, hematological and osseous effects following an intramuscular injection of 100 {mu}Ci 90 Sr were studied in the rat. In spite of the magnitude of the injection and the resulting damage, the elimination of strontium could compare with what occurs after an injection at tracer doses. Comparing with the controls at the outcoming time, clinical monitoring mainly brought out a loss of body weight. Fairly early (20. - 30. day) there occurred severe hematological damage, especially on lymphocyte line, which subsided spontaneously. As foreseen, the anatomo-pathological survey of the early period showed bone and medullar lesions in the areas of enchondral ossification. In the late period, bone sarcomas occurred in nine animals out of ten. The outstanding histological type was osteogenic osteosarcomas; besides, two animals experienced bilateral tumors. (authors) [French] Les auteurs etudient les consequences cliniques, hematologiques et osseuses d'une contamination par 100 microcuries de Sr 90 injectes par voie intramusculaire chez le rat. Malgre l'importance de la contamination et les lesions consequentes, l'elimination du Sr 90 est comparable a celle que l'on observe apres injection de doses traceuses. La surveillance clinique ne met essentiellement en evidence, a la periode terminale, qu'une diminution du poids par rapport aux temoins. Les lesions hematologiques sont importantes, predominant sur la lignee lymphocytaire. Elles sont relativement precoces (20e - 30e jours) et regressent spontanement. La surveillance anatomo-pathologique de la periode precoce a montre, comme il etait previsible, des lesions osseuses et medullaires dans les zones d'ossification enchondrale. A la periode tardive, la survenue de sarcomes osseux a ete observee chez neuf animaux sur dix. Le type histologique predominant est l'osteosarcome osteogenique et il faut signaler egalement les tumeurs bilaterales observees chez deux animaux. (auteurs)

  8. Drug-induced QT interval prolongation: does ethnicity of the thorough QT study population matter?

    Science.gov (United States)

    Shah, Rashmi R

    2013-02-01

    Inter-ethnic differences in drug responses have been well documented. Drug-induced QT interval prolongation is a major safety concern and therefore, regulatory authorities recommend a clinical thorough QT study (TQT) to investigate new drugs for their QT-prolonging potential. A positive study, determined by breach of a preset regulatory threshold, significantly influences late phase clinical trials by requiring intense ECG monitoring. A few studies that are currently available, although not statistically conclusive at present, question the assumption that ethnicity of the study population may not influence the outcome of a TQT study. Collective consideration of available pharmacogenetic and clinical information suggests that there may be inter-ethnic differences in QT-prolonging effects of drugs and that Caucasians may be more sensitive than other populations. The information also suggest s that (a) these differences may depend on the QT-prolonging potency of the drug and (b) exposure-response (E-R) analysis may be more sensitive than simple changes in QT(c) interval in unmasking this difference. If the QT response in Caucasians is generally found to be more intense than in non-Caucasians, there may be significant regulatory implications for domestic acceptance of data from a TQT study conducted in foreign populations. However, each drug will warrant an individual consideration when extrapolating the results of a TQT study from one ethnic population to another and the ultimate clinical relevance of any difference. Further adequately designed and powered studies, investigating the pharmacologic properties and E-R relationships of additional drugs with different potencies, are needed in Caucasians, Oriental/Asian and African populations before firm conclusions can be drawn. © 2012 The Author. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  9. Incidence and risk of QTc interval prolongation among cancer patients treated with vandetanib: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jiajie Zang

    Full Text Available Vandetanib is a multikinase inhibitor that is under assessment for the treatment of various cancers. QTc interval prolongation is one of the major adverse effects of this drug, but the reported incidence varies substantially among clinical trials. We performed a systematic review and meta-analysis to obtain a better understanding in the risk of QTc interval prolongation among cancer patients administered vandetanib.Eligible studies were phase II and III prospective clinical trials that involved cancer patients who were prescribed vandetanib 300 mg/d and that included data on QTc interval prolongation. The overall incidence and risk of QTc interval prolongation were calculated using random-effects or fixed-effects models, depending on the heterogeneity of the included studies. Nine trials with 2,188 patients were included for the meta-analysis. The overall incidence of all-grade and high-grade QTc interval prolongation was 16.4% (95% CI, 8.1-30.4% and 3.7% (8.1-30.4%, respectively, among non-thyroid cancer patients, and 18.0% (10.7-28.6% and 12.0% (4.5-28.0%, respectively, among thyroid cancer patients. Patients with thyroid cancer who had longer treatment duration also had a higher incidence of high-grade events, with a relative risk of 3.24 (1.57-6.71, than patients who had non-thyroid cancer. Vandetanib was associated with a significantly increased risk of all-grade QTc interval prolongation with overall Peto odds ratios of 7.26 (4.36-12.09 and 5.70 (3.09-10.53 among patients with non-thyroid cancer and thyroid cancer, respectively, compared to the controls.Treatment with vandetanib is associated with a significant increase in the overall incidence and risk of QTc interval prolongation. Different cancer types and treatment durations may affect the risk of developing high-grade QTc interval prolongation.

  10. Le glaive de la parole

    Directory of Open Access Journals (Sweden)

    Luce Marchal-Albert

    2006-09-01

    Full Text Available Chacun sait, selon le mot de Pierre Viret, « en quelle confusion est la Chrestienté » au xvie siècle en Europe. C’est le deuxième quart du siècle qui nous intéressera ici, et en particulier l’année 1545, qui constitue une année charnière qui voit vaciller l’Église romaine, flamber et culminer la chasse aux hérétiques en même temps qu’elle voit la jeune Église réformée se renforcer et se positionner avec succès dans un champ religieux plus que chaotique. Les ouvrages polémiques réformés écrits...

  11. Prendre le pli des techniques

    OpenAIRE

    Latour, Bruno

    1983-01-01

    À partir de la notion de mode d’existence développée par Gilbert Simondon et surtout par Etienne Souriau, il est possible d’aborder la question de la technique sans se laisser arrêter par la présence excessive de l’un de ses résultats : les objets techniques. On peut alors essayer de définir le mode propre de la technique comme un mouvement, un projet, un plissage, une forme très particulière de transcendance, qui n’a pas reçu en philosophie le traitement que mérite son importance et son ubiq...

  12. Le sette meraviglie del cosmo

    CERN Document Server

    Narlikar, Jayant V

    2004-01-01

    Tra giganti, "nane" e stelle che esplodono in cielo, un vademecum per scoprire il cosmo e i misteri che lo abitano. Lasciati alle spalle i confini sicuri della Terra e del Sistema solare, assistiamo a un'esplosione continua di fenomeni inaspettati. L'universo si svela nel suo continuo mutamento, cresce in fascino e complessità via via che ci addentriamo nei suoi spazi profondi. Tramite esempi semplici, aneddoti umoristici e una prosa cristallina, Vishnu Narkilar racconta l'emozione di fronte alle sorprese del cosmo. Le "sette meraviglie" sono i fenomeni misteriosi che si nascondono dietro le stelle che punteggiano il cielo, una schiera di eventi spettacolari che per secoli hanno sfidato la curiosità umana ed eluso ogni spiegazione.

  13. Le CRDI au Sri Lanka

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

    Le CRDI appuie la recherche au Sri. Lanka depuis 1973. Il s'est d'abord concentré sur l'amélioration des pratiques agricoles. Par exemple, grâce à la mise au point d'un système de rizi - culture permettant d'exploiter les pluies de mousson, les riziculteurs ont triplé leurs rendements en quatre ans. Ils ont été nombreux à ...

  14. Le jumelage de journalistes scientifiques

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

    Cathy Egan

    Les questions scientifiques suscitent de plus en plus de doutes, d'angoisse et de discorde chez le grand public. Les profanes, peut-être plus encore que les scientifiques, s'interrogent et s'obstinent sur les causes du réchauffement planétaire, l'innocuité des organismes génétiquement modifiés (OGM) dans les aliments ou ...

  15. Leg fluid accumulation during prolonged sitting.

    Science.gov (United States)

    Vena, Daniel; Rubianto, Jonathan; Popovic, Milos; Yadollahi, Azadeh

    2016-08-01

    The accumulation of fluid in the legs due to sedentariness can be a health risk in extreme cases. Negative health impacts associated with leg fluid accumulation include leg edema and risk of blood clots. Furthermore, fluid accumulating in the legs is accompanied by fluid shift into the upper body which is also associated with health risks such as: increased blood pressure when lying down, respiratory problems in people with heart failure, and increased sleep apnea. Understanding the pattern by which fluid accumulates in the legs can aid in the development of devices for reducing leg fluid accumulation. The purpose of this study was to characterize the time course of fluid accumulation over a two-and-half-hour seated period. Non-obese participants with sleep apnea and no other co-morbidities were included in the sample as part of a larger study. Leg fluid was measured continuously using a method of bioelectrical impedance. Participants were first asked to lie supine for 30 minutes as a washout, and then sat with their legs still for two and a half hours. The main finding of this study is that the pattern of leg fluid accumulation differed in the first 45 minutes compared to the latter 105 minutes. In the first 45 minutes, fluid accumulated according to first order exponential function. In the latter period, fluid accumulated according to a linear function. The initial exponential accumulation is likely due to the large increase in capillary pressure caused by rapid blood flow into the legs due to gravity, leading to substantial filtration of blood plasma into the tissue spaces. The latter linear portion likely represents continued slow filtration of fluid out of the vasculature and into the tissue spaces. This is the first study to show that fluid accumulation in the legs is a combination of an exponential and linear functions. The linear increase identifies that there is no foreseeable point in which leg fluid stops accumulating while sitting for prolonged periods.

  16. Encephalitis with Prolonged but Reversible Splenial Lesion

    Directory of Open Access Journals (Sweden)

    Alena Meleková

    2015-12-01

    Full Text Available Introduction: The splenium of the corpus callosum has a specific structure of blood supply with a tendency towards blood-brain barrier breakdown, intramyelinic edema, and damage due to hypoxia or toxins. Signs and symptoms of reversible syndrome of the splenium of the corpus callosum typically include disorientation, confusion, impaired consciousness, and epileptic seizures. Case report: A previously healthy 32-year-old man suffered from weakness, headache, and fever. Subsequently, he developed apathy, ataxia, and inability to walk, and therefore was admitted to the hospital. Cerebrospinal fluid showed protein elevation (0.9 g/l and pleocytosis (232/1 ul. A brain MRI showed hyperintense lesions in the middle of the corpus callosum. The patient was treated with antibiotics, and subsequently, in combination with steroids. Two months later, the hyperintense lesions in the splenium and the basal ganglia had disappeared. Almost seven months since his hospitalization in the Department of Neurology, the patient has returned to his previous employment. He now does not exhibit any mental changes, an optic edema and urological problems have improved. In addition, he is now actively engaged in sports. Conclusion: We have described a case of a 32-year-old man with confusion, ataxia, and inability to stand and walk. The man developed a febrile meningeal syndrome and a hyperintense lesion of the splenium, which lasted for two months. Neurological changes, optic nerve edema, and urinary retention have resolved over the course of seven months. We think that the prolonged but transient lesion of the splenium may have been caused by encephalitis of viral origin.

  17. Fluids and hydration in prolonged endurance performance.

    Science.gov (United States)

    Von Duvillard, Serge P; Braun, William A; Markofski, Melissa; Beneke, Ralph; Leithäuser, Renate

    2004-01-01

    Numerous studies have confirmed that performance can be impaired when athletes are dehydrated. Endurance athletes should drink beverages containing carbohydrate and electrolyte during and after training or competition. Carbohydrates (sugars) favor consumption and Na(+) favors retention of water. Drinking during competition is desirable compared with fluid ingestion after or before training or competition only. Athletes seldom replace fluids fully due to sweat loss. Proper hydration during training or competition will enhance performance, avoid ensuing thermal stress, maintain plasma volume, delay fatigue, and prevent injuries associated with dehydration and sweat loss. In contrast, hyperhydration or overdrinking before, during, and after endurance events may cause Na(+) depletion and may lead to hyponatremia. It is imperative that endurance athletes replace sweat loss via fluid intake containing about 4% to 8% of carbohydrate solution and electrolytes during training or competition. It is recommended that athletes drink about 500 mL of fluid solution 1 to 2 h before an event and continue to consume cool or cold drinks in regular intervals to replace fluid loss due to sweat. For intense prolonged exercise lasting longer than 1 h, athletes should consume between 30 and 60 g/h and drink between 600 and 1200 mL/h of a solution containing carbohydrate and Na(+) (0.5 to 0.7 g/L of fluid). Maintaining proper hydration before, during, and after training and competition will help reduce fluid loss, maintain performance, lower submaximal exercise heart rate, maintain plasma volume, and reduce heat stress, heat exhaustion, and possibly heat stroke.

  18. Predictors of prolonged fluoroscopy time in diagnostic coronary angiography.

    Science.gov (United States)

    Adachi, Yusuke; Sakakura, Kenichi; Wada, Hiroshi; Funayama, Hiroshi; Umemoto, Tomio; Momomura, Shin-Ichi; Fujita, Hideo

    2016-07-01

    Prolonged fluoroscopy time during coronary angiography is a major concern for interventional cardiologists as well as for patients. It is unknown which factors affect the prolonged fluoroscopy time. A total of 458 patients who underwent diagnostic coronary angiography were included. The patients who had the highest decile of fluoroscopy time were assigned to the prolonged fluoroscopy group (fluoroscopy time ≥15.7min), while the other patients were assigned to the non-prolonged fluoroscopy group (fluoroscopy time fluoroscopy time. Mean fluoroscopy time in 458 patients was 8.5±5.8min. Median and ranges of fluoroscopy time were 19.0 [15.7-47.0]min in the prolonged fluoroscopy group and 6.0 [2.0-15.3]min in the non-prolonged fluoroscopy group, respectively. The multivariate logistic regression analysis showed that significant predictors of prolonged fluoroscopy time were prior surgery of ascending aorta replacement [odds ratios (OR) 11.46, 95% confidence intervals (CI) 1.53-85.74, p=0.02] and the prevalence of moderate to severe aortic regurgitation (OR 2.83, 95% CI 1.20-6.66, p=0.02). The prior surgery of ascending aorta replacement and moderate to severe aortic regurgitation were significant predictors of the prolonged fluoroscopy time. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  19. Quality of drug label information on QT interval prolongation

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Holtkamp, Frank A; Rutten, Frans H

    2014-01-01

    BACKGROUND: Information regarding QT-prolongation in the drug label may vary between products. This could lead to suboptimal risk minimization strategies. OBJECTIVE: To systematically assess the variation in the extent and content of information on QT prolongation in the summary of product...

  20. Georges et le big bang

    CERN Document Server

    Hawking, Lucy; Parsons, Gary

    2011-01-01

    Georges et Annie, sa meilleure amie, sont sur le point d'assister à l'une des plus importantes expériences scientifiques de tous les temps : explorer les premiers instants de l'Univers, le Big Bang ! Grâce à Cosmos, leur super ordinateur, et au Grand Collisionneur de hadrons créé par Éric, le père d'Annie, ils vont enfin pouvoir répondre à cette question essentielle : pourquoi existons nous ? Mais Georges et Annie découvrent qu'un complot diabolique se trame. Pire, c'est toute la recherche scientifique qui est en péril ! Entraîné dans d'incroyables aventures, Georges ira jusqu'aux confins de la galaxie pour sauver ses amis...Une plongée passionnante au coeur du Big Bang. Les toutes dernières théories de Stephen Hawking et des plus grands scientifiques actuels.

  1. [Management of prolonged convulsive seizures in the community: results of the PERFECT™ study in Spain].

    Science.gov (United States)

    Raspall-Chaure, M; Martínez-Bermejo, A; Pantoja-Martínez, J; Paredes-Carmona, F; Sánchez-Carpintero, R; Wait, S

    2014-08-01

    The Practices in Emergency and Rescue medication For Epilepsy managed with Community administered Therapy (PERFECT™) Initiative was set up in 2011 to gain a better understanding of how prolonged convulsive seizures are managed, and rescue medication is administered, in out-of-hospital settings across Europe. This paper explores the initial research findings for Spain. A review was made of existing clinical guidelines, guidance to schools, and relevant policy and legal frameworks, as well as a survey of 20 healthcare professionals who treat children with prolonged convulsive seizures in Spain. Existing clinical guidelines pertain mainly to the hospital setting, and contain very little information on how prolonged seizures should be managed outside of the hospital. Guidance for schools is unclear as to whether teachers are allowed to administer rescue medication to children, and there is no legal obligation for school staff to administer medication to children under their care. As a result of such uncertainty, whether or not children who experience prolonged seizures receive their rescue medication during school hours depends mostly on the resources and training available in each school. There is a need for more explicit guidance covering educational and healthcare settings, clearer information to parents and schools, and more systematic training to be made available to caregivers. This is to ensure that all children at risk of a prolonged convulsive seizure receive rescue medication in a timely manner, regardless of where their seizure occurs. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  2. Risk Factors for Prolonged Hospitalization in Pediatric Appendicitis Patients with Medical Treatment.

    Science.gov (United States)

    Chen, Ching-Lun; Chao, Hsun-Chin; Kong, Man-Shan; Chen, Shih-Yen

    2017-06-01

    With effective antibiotics against enteric flora and computed tomography-guided drainage for abscesses, the initial use of nonoperative therapy for children with appendicitis has increased both in recent reports and at our hospital. However, it has been reported that these patients have a relatively longer hospital stay and that their treatment is more expensive than those who undergo aggressive surgical intervention. This was a retrospective cohort study based in a single medical center. A systemic chart review was conducted to identify risk factors for prolonged hospitalization in pediatric appendicitis patients not initially undergoing surgical treatment. Patient demographics, clinical symptoms, duration of symptoms, laboratory findings, imaging findings, complications, and length of hospital stay were analyzed. Logistic regression analysis was used to identify significant predictors of prolonged hospitalization (≥15 days) and readmission. One hundred and twenty-five patients were recruited in this study, of whom 53 (42.4%) had prolonged hospitalization. The values of serum C-reactive protein (CRP) were significantly higher in patients with prolonged hospitalization compared with those without prolonged hospitalization (203 ± 108.6 mg/L vs. 140 ± 93.0 mg/L, p = 0.001). Risk factors of prolonged hospitalization were serum CRP >150 mg/L (35/53 vs. 28/72, p = 0.001), abscess formation (38/53 vs. 35/72, p = 0.008), and multiple abscesses (10/53 vs. 1/72, p = 0.001). Under multivariate analysis, CRP >150 mg/L (odds ratio=1.004, p = 0.0334) and multiple abscesses (odds ratio = 8.788, p = 0.044) were two independent predictors for prolonged hospitalization. Marked elevation of serum CRP (>150 mg/L) and multiple abscesses are two independent risk factors for prolonged hospitalization in children with appendicitis who are initially treated nonoperatively. Copyright © 2016. Published by Elsevier B.V.

  3. Urètrocèle post-traumatique chez l'homme: A propos de 2 cas

    African Journals Online (AJOL)

    Y. Sow

    d'épithélium et de couche musculaire lisse [2]. Il peut être secon- daire à une effraction de la paroi urétrale par un traumatisme pelvien ou périnéal [1] (c'est le cas de nos observations) ou à un traumatisme iatrogène: sondage vésical prolongé surtout chez les paraplégiques ou traumatique, urètrotomie endoscopique [3].

  4. Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report

    Directory of Open Access Journals (Sweden)

    Laura Pratchett

    2010-12-01

    Full Text Available Rationale: Prolonged exposure (PE therapy has been found to reduce symptoms of posttraumatic stress disorder (PTSD; however, it is difficult for many patients to engage fully in the obligatory retelling of their traumatic experiences. This problem is compounded by the fact that habituation and cognitive restructuring – the main mechanisms through which PE is hypothesized to work – are not instantaneous processes, and often require several weeks before the distress associated with imaginal exposure abates. Case reports: Two cases are described that respectively illustrate the use of hydrocortisone and placebo, in combination with PE, for the treatment of combat-related PTSD. Based on known effects of glucocorticoids on learning and memory performance, we hypothesized that augmentation with hydrocortisone would improve the therapeutic effects of PE by hastening “new” learning and facilitating decreases in the emotional impact of fear memories during the course of treatment. The veteran receiving hydrocortisone augmentation of PE displayed an accelerated and ultimately greater decline in PTSD symptoms than the veteran receiving placebo. Conclusions: While no general conclusion can be derived from comparison of two patients, the findings are consistent with the rationale for augmentation. These case reports support the potential for an appropriately designed and powered clinical trial to examine the efficacy of glucocorticoids in augmenting the effects of psychotherapy for PTSD.

  5. Le principe non bis in idem et le droit communautaire

    OpenAIRE

    Hedabou, Aziz

    2018-01-01

    Le principe non bis in idem est une garantie fondamentale qui interdit que les mêmes faits soit poursuivi et puni deux fois. Il est reconnu par tous les droits internes et “appartient aux droit universel des nations”. Dès lors, sa lettre et son esprit ne sont plus cantonnés au droit interne et ont tendance à s’internationaliser. En droit communautaire, l’étude du principe non bis in idem peut être envisagée sous trois angles différents. D’abord en droit pénal international unilatéral où chaqu...

  6. Contester le mariage forcé : mettre en place la ligne de défense et le ...

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

    Le droit civil en matière de mariage est la Loi spéciale sur le mariage, qui permet aux parties de différentes religions de se marier sans changer de religion. Elle exige le consentement explicite des deux partenaires pour que le mariage soit possible. Le consentement demeure le point central de la loi sur le mariage; ...

  7. Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum.

    Science.gov (United States)

    Mullin, Patrick M; Ching, ChunYu; Schoenberg, Frederic; MacGibbon, Kimber; Romero, Roberto; Goodwin, T Murphy; Fejzo, Marlena S

    2012-06-01

    To identify factors associated with prolonged Hyperemesis Gravidarum (HG). About 395 women completed a survey regarding pre-existing conditions, treatments and outcomes. Responses were compared using two-sided t-tests or the F-test. Participants with prolonged HG are slightly younger and weigh more. Pre-existing factors associated with prolonged HG include allergies and a restrictive diet. Prolonged HG is associated with hematemesis, dizziness, fainting and antiemetic treatment. Following pregnancy, those with prolonged HG reported more posttraumatic stress, motion sickness, muscle weakness and infants with irritability, severe colic and growth restriction. Multiple pre-existing conditions and poor maternal and infant outcomes were associated with prolonged HG. The most significant condition prior to pregnancy was allergies suggesting a possible autoimmune component affecting duration of HG. In addition, the most significant lifestyle choice linked to prolonged HG was a restrictive diet. Future research is needed to determine whether a change in diet prior to pregnancy may lead to a shorter duration of HG and its associated outcomes.

  8. [Prolonged fever: specific issues in the young adult population].

    Science.gov (United States)

    Carmoi, T; Grateau, G; Billhot, M; Dumas, G; Biale, L; Perrot, G; Algayres, J-P

    2010-12-01

    Early studies on prolonged fever date back to the 1960s. Fifty years later, prolonged unexplained fever remains a diagnostic challenge to the general internists. Although the aetiologies of prolonged fevers have not changed much in the general population, the distribution between the various causes is not the same anymore. A regular decrease in infectious and neoplastic causes is noticed whatever the age. Prolonged fevers related to inflammatory disorders and fevers that remain of unknown origin still represent approximately 30 to 50% of the cases. In the young adult population, as in the older patients, prolonged fevers can be attributed to four groups: infection, inflammation, neoplasic and other aetiologies (including drug-related fevers). In the young adult population, the management of prolonged fever presents some specific issues that are the purpose of this review coupled with our own experience. The prognosis of undiagnosed prolonged fever is usually favourable, as a life-threatening aetiology is exceptionally diagnosed during the follow-up if the initial management was complete and accurate. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  9. Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum

    Science.gov (United States)

    Mullin, PM; Ching, CY; Shoenberg, F; MacGibbon, K; Romero, R; Goodwin, TM; Fejzo, MS

    2013-01-01

    Objective To identify factors associated with prolonged Hyperemesis Gravidarum (HG). Study Design About 395 women completed a survey regarding pre-existing conditions, treatments and outcomes. Responses were compared using two-sided t-test or the F-test. Results Participants with prolongs HG are slightly younger and weight more. Pre-existing factors associated with prolonged HG include allergies and a restrictive diet. Prolonged HG is associated with hematemesis, dizziness, fainting and antiemetic treatment. Following pregnancy, those with prolonged HG reported more posttraumatic stress, motion sickness, muscle weakness and infants with irritability, severe colic and growth restriction. Conclusion Multiple pre-existing conditions and poor maternal and infant outcomes were associated with prolonged HG. The most significant condition prior to pregnancy was allergies suggesting a possible autoimmune component affecting duration of HG. In addition, the most significant lifestyle choice linked to prolonged HG was a restrictive diet. Future research is needed to determine whether a change in diet prior to pregnancy may lead to a shorter duration of HG and its associated outcomes. PMID:21916750

  10. LE SECTEUR INFORMEL EN ALGERIE : APPROCHES, ACTEURS ...

    African Journals Online (AJOL)

    du respect des lois et des règlements et de l'Etat de droit de façon générale. 1.4. L'approche du secteur informel selon le Bureau International du Travail (BIT) ... qui ne tiennent pas une comptabilité complète et dont la person- l'importation…) mais également dans le secteur immobilier dont le fonctionnement est informel.

  11. Peut-on voyager dans le temps ?

    CERN Multimedia

    CERN. Geneva

    2008-01-01

    La possibilité de voyager dans le temps est régulièrement évoquée par les magazines scientifiques (et parfois même par les scientifiques). Elle est également le sujet de nombreux romans de science-fiction. Nous discuterons d’abord du sens qu’on peut donner à l’expression « voyager dans le temps », puis nous expliciterons ce que la physique contemporaine dit à ce propos.

  12. Télécharger le PDF

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

    Le CRDI finance la recherche dans les pays en développement afin de réduire la pauvreté, soutenant ainsi l'objectif des activités de dévelop- pement international du Canada. Le Centre favorise la croissance et le développement et encourage la communication des connaissances aux responsables des politiques, aux ...

  13. Le CRDI en Égypte

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

    afin d'y favoriser la croissance et le développement. Il en résulte des solutions locales, novatrices et durables, qui offrent des choix aux personnes qui en ont le plus besoin et font changer les choses. Centre de recherches pour le développement international. CP 8500, Ottawa (Ontario) Canada K1G 3H9. 1012 alexandrie.

  14. Le CRDI en Éthiopie

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

    'une crise. À long terme, toutefois, elle peut entraîner la dépendance et saper le système local de production de semences. Dans le cadre d'une étude menée de 2005 à 2008, des chercheurs s ubventionnés par le CRDI ont constaté que l'on ...

  15. Le corps dans l'Antiquité

    Directory of Open Access Journals (Sweden)

    Sophie Lalanne

    2008-06-01

    Full Text Available Ouvrages générauxLaqueur Thomas, La fabrique du sexe. Essai sur le corps et le genre en Occident, trad. fr., Paris, Gallimard, 1992.Feher Michel, Naddaff Ramona, Tazi Nadia, Fragments for a History of the Human Body, 3 volumes, New York, Zone Books, 1989.Le Corps dans l’AntiquitéBodiou Lydie, Frère Dominique, Mehl Véronique dir., L’expression des corps. Gestes, attitudes, regards dans l’iconographie antique, Rennes, Presses Universitaires de Rennes, 2006.Bonnard Jean-Baptiste, Le complexe de ...

  16. Le marketing : quelle contribution au bien commun ?

    OpenAIRE

    Béji-Bécheur, Amina

    2015-01-01

    National audience; Partons d'un constat : le marketing est né pour servir l'entreprise capitaliste et le développement de ses marchés. Le but ultime étant la création de richesses et par ricochet le bien-être des populations. Un ensemble d'outils marketing ont été créés pour accompagner les enjeux de performance économique des entreprises. Reprenant les travaux de Jean-Claude Moisdon (Du mode d'existence des outils de gestion, les instruments de gestion à l'épreuve de l'organisation 1), ces o...

  17. Le marketing cherche ses marques

    OpenAIRE

    Hentschel, Dieter

    2018-01-01

    Voici maintenant dix ans que, dans le cadre d’une politique continue de diversification des formations offertes aux germanistes, l’IAA a mis en place un enseignement de marketing. Cette innovation n’est pas restée sans suite, puisqu’elle a abouti au repositionnement du DESS « économie et Société dans les pays de langue allemande » qui s’appelle désormais « Gestion et marketing franco-allemands ». L’objectif a été de proposer aux étudiants une formation professionnalisante qui corresponde aux ...

  18. Le CRDI et la lutte contre le paludisme | CRDI - Centre de ...

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

    22 juil. 2011 ... D'autres interventions luttent également contre le paludisme, notamment les moustiquaires imprégnées d'insecticide et les médicaments visant à prévenir le ... Le CRDI appuie le GCRAI depuis les années 1970 et participe avec SIMA au financement de la recherche sur les interactions complexes entre ...

  19. Lele du langage de programmation dans la réalisation de code ...

    African Journals Online (AJOL)

    Lele du langage de programmation dans la réalisation de code de qualité, les cas de Delphi et C++ Nous discutons dans ce papier lele du langage de programmation dans la production d'un code de qualité. La qualité d'un code peut être atteinte en respectant certains critères simples au niveau de la programmation ...

  20. Le

    NARCIS (Netherlands)

    de Beer, P.T.; Luttikhuizen, R.; Barbier, J.C.; Gautii, J.

    1998-01-01

    Interventions ` visie ` la fois iconomique et sociale, les politiques publiques de l'emploi (PPE) de chaque pays trouvent leur logique dans une relation itroite avec chacun des systhmes nationaux de protection sociale. La premihre partie de cet ouvrage est consacrie ` la prisentation de cas

  1. The impact of prolonged violent video-gaming on adolescent sleep: an experimental study.

    Science.gov (United States)

    King, Daniel L; Gradisar, Michael; Drummond, Aaron; Lovato, Nicole; Wessel, Jason; Micic, Gorica; Douglas, Paul; Delfabbro, Paul

    2013-04-01

    Video-gaming is an increasingly prevalent activity among children and adolescents that is known to influence several areas of emotional, cognitive and behavioural functioning. Currently there is insufficient experimental evidence about how extended video-game play may affect adolescents' sleep. The aim of this study was to investigate the short-term impact of adolescents' prolonged exposure to violent video-gaming on sleep. Seventeen male adolescents (mean age = 16 ± 1 years) with no current sleep difficulties played a novel, fast-paced, violent video-game (50 or 150 min) before their usual bedtime on two different testing nights in a sleep laboratory. Objective (polysomnography-measured sleep and heart rate) and subjective (single-night sleep diary) measures were obtained to assess the arousing effects of prolonged gaming. Compared with regular gaming, prolonged gaming produced decreases in objective sleep efficiency (by 7 ± 2%, falling below 85%) and total sleep time (by 27 ± 12 min) that was contributed by a near-moderate reduction in rapid eye movement sleep (Cohen's d = 0.48). Subjective sleep-onset latency significantly increased by 17 ± 8 min, and there was a moderate reduction in self-reported sleep quality after prolonged gaming (Cohen's d = 0.53). Heart rate did not differ significantly between video-gaming conditions during pre-sleep game-play or the sleep-onset phase. Results provide evidence that prolonged video-gaming may cause clinically significant disruption to adolescent sleep, even when sleep after video-gaming is initiated at normal bedtime. However, physiological arousal may not necessarily be the mechanism by which technology use affects sleep. © 2012 European Sleep Research Society.

  2. Inconclusive evidence for allergic rhinitis to predict a prolonged or chronic course of acute rhinosinusitis.

    Science.gov (United States)

    Frerichs, Kristine A; Nigten, Gea; Romeijn, Kalynda; Kaper, Nina M; Grolman, Wilko; van der Heijden, Geert J M G

    2014-01-01

    To systematically review the evidence on allergic rhinitis as a predictor for a prolonged or chronic course in adult patients with acute rhinosinusitis. Pubmed, EMBASE, and the Cochrane library. A systematic literature search was performed on March 15, 2013. During screening of title and abstract, 3 authors independently selected studies on allergic rhinitis as a predictor for the course of acute rhinosinusitis in adults. The reported study design was assessed for directness of evidence and risk of bias. We aimed to extract prior and posterior probabilities for a prolonged or chronic course of acute rhinosinusitis. Of 13,202 retrieved articles, 2 articles were eligible for study assessment. They provided a high directness of evidence but carried a high risk of bias. The studies showed an incidence of a prolonged and chronic course of, respectively, .19 (95% confidence interval [CI] .16-.23) and .05 (95% CI, .02-.13). In patients with allergic rhinitis, the incidence was .25 (95% CI, .18-.35) and .14 (95% CI, .04-.34), so the added value of allergic rhinitis to predict a prolonged course is 6% and to predict a chronic course 8%. While the 2 included studies suggest that allergic rhinitis adds little to the prediction of a prolonged or chronic course in patients with acute rhinosinusitis, they carry a high risk of bias. As the available evidence does not provide grounds for different management of patients with and without allergic rhinitis, namely, according to clinical practice guidelines, both can be managed with expectant observation and symptomatic treatment.

  3. Le CRDI participe à la lutte mondiale contre le VIH/sida | CRDI ...

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

    15 juil. 2014 ... Le Centre de recherches pour le développement international (CRDI), organisme canadien, a été l'un des premiers bailleurs de fonds à vocation internationale à reconnaître que le VIH/sida constituait un problème de développement important.

  4. Le CRDI participe à la lutte mondiale contre le VIH/sida | IDRC ...

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

    15 juil. 2014 ... Le Centre de recherches pour le développement international (CRDI), organisme canadien, a été l'un des premiers bailleurs de fonds à vocation internationale à reconnaître que le VIH/sida constituait un problème de développement important.

  5. Politisation de la pensée deleuzienne, position de minorité dans le marxisme

    Directory of Open Access Journals (Sweden)

    Blan Sibertan Gijom

    2009-01-01

    Full Text Available (francuski Repartant de la première courbe d'élaboration du concept de 'devenir- Mineur' de Deleuze et Guattari (de Kafka Pour une littérature mineure à Mille plateaux, nous interrogeons le rapport entre les deux lignes de problématisation de ce concept: une analyse des antagonismes historiques dont les minorités sociales sont aujourd'hui le lieu 'surdéterminé' l'identification d'un type de position au sein des modes collectifs d'énonciation. Par là, nous soulevons également le problème de ce que peut signifier politiquement occuper une position de minorité dans le discours (théorique, littéraire, philosophique…. C'est en ce sens que nous confrontons les luttes de minorités au schème de la lutte des classes, que nous examinons certains liens (liens de prolongement, d'intégration, mais aussi de différenciation entre les processus de 'prolétarisation' et de 'minoration', et que nous reposons sur cette base la question d'un nouvel internationalisme.

  6. Význam ,clinical guidelines´ pro určení náležité odborné úrovně poskytování zdravotních služeb

    Czech Academy of Sciences Publication Activity Database

    Smrž, Ivo

    2017-01-01

    Roč. 7, č. 1 (2017), s. 13-27 ISSN 1804-8137 Institutional support: RVO:68378122 Keywords : clinical guidelines * medical negligence * liability Subject RIV: AG - Legal Sciences OBOR OECD: Law http://www.ilaw.cas.cz/medlawjournal/index.php/medlawjournal/article/view/133/121

  7. L'analyse des semences d'arachide fermières pour le contrôle de ...

    African Journals Online (AJOL)

    Le manque de semences sélectionnées en qualité satisfaisante et en quantités suffisantes est une contrainte majeure à la production de l'arachide (Arachis hypogea L.) en Afrique centrale. La multiplication de semences en milieu paysan est le moyen de propagation le plus rapide, le moins cher et le plus durable.

  8. Role of FDG-PET and PET/CT in the diagnosis of prolonged febrile states

    Energy Technology Data Exchange (ETDEWEB)

    Jaruskova, M.; Belohlavek, O. [Na Homolce Hospital, PET Center, Prague 5 (Czech Republic)

    2006-08-15

    The role of FDG-PET and PET/CT in patients whose main symptom is prolonged fever has not yet been defined. We addressed this topic in a retrospective study. A total of 124 patients (referred between May 2001 and December 2004) with fever of unknown origin or prolonged fever due to a suspected infection of a joint or vascular prosthesis were included in the study. The patients underwent either FDG-PET or FDG-PET/CT scanning. Sixty-seven patients had a negative focal FDG-PET finding; in this group the method was regarded as unhelpful in determining a diagnosis, and no further investigation was pursued. We tried to obtain clinical confirmation for all patients with positive PET findings. Fifty-seven (46%) patients had positive FDG-PET findings. In six of them no further clinical information was available. Fifty-one patients with positive PET findings and 118 patients in total were subsequently evaluated. Systemic connective tissue disease was confirmed in 17 patients, lymphoma in three patients, inflammatory bowel disease in two patients, vascular prosthesis infection in seven patients, infection of a hip or knee replacement in seven patients, mycotic aneurysm in two patients, abscess in four patients and AIDS in one patient. In eight (16%) patients the finding was falsely positive. FDG-PET or PET/CT contributed to establishing a final diagnosis in 84% of the 51 patients with positive PET findings and in 36% of all 118 evaluated patients with prolonged fever. (orig.)

  9. Aharon Appelfeld et Philip Roth : le réel, l’imaginaire, le double et le fantastique

    OpenAIRE

    Toren, Orly

    2014-01-01

    C’est la marge étroite entre « le réel et l’imaginaire » selon le titre de l’essai de Masha Itzhaki sur Appelfeld que nous souhaiterions explorer à partir de la relation entre Le Temps des prodiges d’Appelfeld et Opération Shylock de Philip Roth. Si la vrai/fausse « confession » de Roth se présente comme le détournement vertigineux des codes du fantastique, de l’autobiographie et de l’autofiction, le roman d’Appelfeld pousse les limites du réalisme par l’interrogation que suscite son titre én...

  10. L’Association du personnel, le TREF, le Comité des Finances et le Conseil du CERN

    CERN Multimedia

    Staff Association

    2016-01-01

    L’Association du personnel, forte de son approche participative et consensuelle, recherche toujours le meilleur accord possible pour l’Organisation et son personnel. Pour ce faire, discussions et concertation avec la Direction, travail d’explication et de persuasion au TREF et ailleurs auprès des délégués des États membres sont nos principaux atouts. TREF (Tripartite Employment Conditions Forum), un Forum d’échanges, de discussions « L’objectif du Forum est d’améliorer le processus de prise de décision  en donnant aux personnes concernées la possibilité et le temps de comprendre pleinement la position de tous les participants. » (CERN/RTG/8) Le Forum tripartite sur les conditions d’emploi (TREF), créé par le Conseil du CERN en juin 1994, est composé de r...

  11. A prolonged case of Mycobacterium marinum flexor tenosynovitis: radiographic and histological correlation, and review of the literature

    International Nuclear Information System (INIS)

    Wongworawat, M.D.; Holtom, P.; Learch, T.J.; Fedenko, A.; Stevanovic, M.V.

    2003-01-01

    We report on a 30-year-old man with prolonged Mycobacterium marinum flexor tenosynovitis. Due to low clinical suspicion, diagnosis was not made until 8 years after initial presentation. The history and magnetic resonance and tissue examination findings are consistent with mycobacterial tenosynovitis. These findings are presented, together with a review of the literature. (orig.)

  12. A prolonged case of Mycobacterium marinum flexor tenosynovitis: radiographic and histological correlation, and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Wongworawat, M.D. [Dept. of Orthopaedic Surgery, Loma Linda Univ. Medical Center, Loma Linda, CA (United States); USC Univ. Hospital, Los Angeles, CA (United States); Holtom, P.; Learch, T.J.; Fedenko, A.; Stevanovic, M.V. [USC Univ. Hospital, Los Angeles, CA (United States)

    2003-09-01

    We report on a 30-year-old man with prolonged Mycobacterium marinum flexor tenosynovitis. Due to low clinical suspicion, diagnosis was not made until 8 years after initial presentation. The history and magnetic resonance and tissue examination findings are consistent with mycobacterial tenosynovitis. These findings are presented, together with a review of the literature. (orig.)

  13. Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice? : The example of haloperidol

    NARCIS (Netherlands)

    Warnier, Miriam Jacoba; Souverein, Patrick Cyriel; de Boer, Anthonius; Hoes, Arno Wilhelmus; De Bruin, Marie Louise; Rutten, Frans H

    PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed the

  14. Are ECG monitoring recommendations before prescription of QT prolonging drugs applied in daily practice? The example of haloperidol

    NARCIS (Netherlands)

    Warnier, Miriam; Rutten, Frans; Souverein, Patrick; Hoes, Arno; De Boer, Anthonius; De Bruin, Marie

    2014-01-01

    Background: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT prolonging drugs. It is, however, unknown how often these risk minimisation measures are being adhered to by general practitioners in daily clinical practice.

  15. Dexamethasone prolongs local analgesia after subcutaneous infiltration of bupivacaine microcapsules in human volunteers

    DEFF Research Database (Denmark)

    Holte, Kathrine; Werner, Mads U; Lacouture, Peter G

    2002-01-01

    BACKGROUND: The addition of small amounts of dexamethasone to extended-release formulations of bupivacaine in microcapsules has been found to prolong local analgesia in experimental studies, but no clinical data are available. METHODS: In a double-blinded study, 12 healthy male volunteers were...... randomized to receive simultaneous subcutaneous injections of bupivacaine microcapsules with dexamethasone and bupivacaine microcapsules without dexamethasone in each calf. Local analgesia was assessed with a validated human pain model; main parameters evaluated were thermal, mechanical, and pain detection...... curve [AUC]) were considered best estimate of analgesia. Safety evaluations were performed daily for the first week and at 2 weeks, 6 weeks, and 6 months after injection. RESULTS: The addition of dexamethasone significantly prolonged local analgesia of bupivacaine microcapsules without influence...

  16. Liver failure caused by prolonged state of malnutrition following bariatric surgery.

    Science.gov (United States)

    Lammers, Willem J; van Tilburg, Antonie Jp; Apers, Jan A; Wiebolt, Janneke

    2018-03-27

    Bariatric surgery is an effective tool in the treatment of patients with morbid obesity. In these case reports we describe 2 patients who developed liver failure after currently-practiced types of bariatric surgery, caused by a prolonged state of malnutrition provoked by psychiatric problems. Despite intensive guidance of a psychologist and dieticians after surgery, our patients deteriorated psychologically, resulting in a prolonged state of severe malnutrition and anorexia. Finally, a state of starvation was reached, passing a critical level of the liver capacity. Patients who present with signs of severe protein malnutrition after bariatric surgery should be closely monitored and checked for nutritional status. Specific attention should be given to patients who develop psychiatric problems post-bariatric surgery. If refeeding does not result in clinical improvement, reversal surgery should be considered in a timely manner.

  17. Rhabdomyolysis After Prolonged Surgery: Report of 2 Cases and Review of Literature.

    Science.gov (United States)

    Grammer, Rebecca; Wang, Jingping; Lahey, Edward

    2018-02-02

    Rhabdomyolysis is a condition in which damaged muscle tissue breaks down and intracellular contents, including myoglobin, are released into the circulation. This produces a nonspecific clinical syndrome including electrolyte disturbances, hypovolemia, metabolic acidosis, coagulopathies, and risk of acute kidney injury. Rhabdomyolysis has been reported as a complication of prolonged surgical procedures but has rarely been reported in the oral and maxillofacial surgery literature. Early diagnosis and treatment of rhabdomyolysis are important to avoid long-term complications such as renal failure. We present 2 cases of postoperative rhabdomyolysis after prolonged maxillofacial surgical procedures in which the patients were managed without long-term sequelae. The pathophysiology, risk factors, diagnosis, and treatment of postoperative rhabdomyolysis are discussed, with a brief review of the literature. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Le contrôle de gestion environnementale d'une entreprise

    OpenAIRE

    Marquet-Pondeville, Sophie

    2001-01-01

    Dans cette recherche, nous étudions comment s’opère le contrôle de gestion environnementale. Cette problématique est abordée dans une perspective contingente et nous proposons un modèle théorique qui met en évidence l’impact de certaines variables sur les systèmes de contrôle de la gestion environnementale. Certains liens présents dans ce modèle sont discutés à travers une étude de cas.

  19. Le facteur humain et la sûreté de fonctionnement dans le ...

    African Journals Online (AJOL)

    Notre contribution porte sur lele fondamental du facteur humain dans le management intégré des risques d'une part et du rôle déterminant qu'il peut avoir à jouer pour que la sûreté de fonctionnement réponde à sa propriété d'autre part. Un rôle illustré à travers une analyse de risque dans un complexe de Gaz Naturel ...

  20. Le Hodler d'Iéna

    OpenAIRE

    2017-01-01

    Suites de la protestation contre le bombardement de la cathédrale de Reims. Nouvelle proposition de M. Gunsburger pour le rachat du tableau de Hodler "Départ des étudiants d'Iéna pour la guerre de libération contre Napoléon en 1813".

  1. L'astronomie dans le monde

    Science.gov (United States)

    Manfroid, J.

    2008-09-01

    Fragmentation et astéroïdes binaires; Astéroïde géocroiseur triple; Rosetta sort de son hibernation; Messenger; Transit lunaire vu par Deep Impact; Titan; Phobos; Phoenix; Einstein avait raison; Le ballet des taches rouges; Le poids des lentilles;

  2. Le barrage des trois Gorges (Chine

    Directory of Open Access Journals (Sweden)

    Luc Merchez

    1999-09-01

    Full Text Available Le barrage des Trois Gorges, en construction sur le Yangzijiang, sera le plus grand barrage au monde. Le gigantisme du projet et sa médiatisation croissante en Occident permettent d'en saisir les enjeux environnementaux et humains. On analyse les grandes caractéristiques du projet et ses conséquences premières avant d'aborder le travail de recherche de l'équipe SIG de l'IGA de Grenoble qui vise à préparer la relocalisation de plus d'un million d'habitants, et à modéliser les impacts démographiques et sociaux.

  3. Le Premier Amendement : un mythe

    Directory of Open Access Journals (Sweden)

    Claude‑Jean Bertrand

    2006-03-01

    Full Text Available Ce papier, plein de verve, d’humeur et d’humour, pose, comme sait si bien le faire l’auteur, des questions profondes sous une apparence paradoxale. Il a été présenté lors d’un colloque sur le Premier amendement organisé à l’Université Lumière-Lyon 2 les 17 et 18 janvier 2003. Certaines communications ont été publiées dans le volume XXIV, n°1 (2003, « Le premier amendement : un modèle américain des libertés » (sous la direction de Vincent Michelot de la Revue Tocqueville.

  4. Cisjordanie et Gaza | CRDI - Centre de recherches pour le ...

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

    Le conflit qui perdure et la violence politique ont aggravé le stress chez les adolescents, qui constituent près de la moitié de la population de la Cisjordanie. La violence politique et le conflit qui perdure ont aggravé le stress chez les adolescents. Le problème a été analysé dans le cadre de travaux menés en collaboration ...

  5. A Conceptual Framework for Understanding Unintended Prolonged Opioid Use.

    Science.gov (United States)

    Hooten, W Michael; Brummett, Chad M; Sullivan, Mark D; Goesling, Jenna; Tilburt, Jon C; Merlin, Jessica S; St Sauver, Jennifer L; Wasan, Ajay D; Clauw, Daniel J; Warner, David O

    2017-12-01

    An urgent need exists to better understand the transition from short-term opioid use to unintended prolonged opioid use (UPOU). The purpose of this work is to propose a conceptual framework for understanding UPOU that posits the influence of 3 principal domains that include the characteristics of (1) individual patients, (2) the practice environment, and (3) opioid prescribers. Although no standardized method exists for developing a conceptual framework, the process often involves identifying corroborative evidence, leveraging expert opinion to identify factors for inclusion in the framework, and developing a graphic depiction of the relationships between the various factors and the clinical problem of interest. Key patient characteristics potentially associated with UPOU include (1) medical and mental health conditions; (2) pain etiology; (3) individual affective, behavioral, and neurophysiologic reactions to pain and opioids; and (4) sociodemographic factors. Also, UPOU could be influenced by structural and health care policy factors: (1) the practice environment, including the roles of prescribing clinicians, adoption of relevant practice guidelines, and clinician incentives or disincentives, and (2) the regulatory environment. Finally, characteristics inherent to clinicians that could influence prescribing practices include (1) training in pain management and opioid use; (2) personal attitudes, knowledge, and beliefs regarding the risks and benefits of opioids; and (3) professionalism. As the gatekeeper to opioid access, the behavior of prescribing clinicians directly mediates UPOU, with the 3 domains interacting to determine this behavior. This proposed conceptual framework could guide future research on the topic and allow plausible hypothesis-based interventions to reduce UPOU. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  6. Pediatric Prolonged Mechanical Ventilation: Considerations for Definitional Criteria.

    Science.gov (United States)

    Sauthier, Michaël; Rose, Louise; Jouvet, Philippe

    2017-01-01

    A 2005 consensus conference led by the National Association for Medical Direction of Respiratory Care (NAMDRC) defined prolonged mechanical ventilation (PMV) for adults as invasive and/or noninvasive mechanical ventilation (NIV) for ≥ 21 consecutive days for ≥ 6 h/d. In children, no such consensus definition exists. This results in substantial variability in definitional criteria, making study of the impact and outcomes of PMV across and within settings problematic. The objective of this work was to identify how PMV for children and neonates is described in the literature and to outline pediatric/neonatal considerations related to PMV, with the goal of proposing a pediatric/neonatal adaptation to the NAMDRC definition. We searched electronic databases for studies describing PMV in children. We extracted definitional criteria and developed recommendations based on the literature review and our clinical experience. Of the 416 citations obtained, 87 met inclusion criteria, totaling 34,255 subjects. Identified criteria for the pediatric PMV definition included: number of consecutive days of mechanical ventilation (ranging from 6 h to 3 months), inclusion of NIV, time spent off the ventilator during weaning (considered as same ventilation episode), and importance of chronological age (term neonates) and postmenstrual age for preterm neonates. We considered high-flow nasal cannula; however, we determined that its current role as a weaning adjunct is unclear. Therefore, we developed the following recommendations for the pediatric PMV definition: ≥ 21 consecutive days (after 37 weeks postmenstrual age) of ventilation for ≥ 6 h/d considering invasive ventilation and NIV and including short interruptions (ventilation during the weaning process as the same episode of ventilation. We propose a definition of pediatric PMV that incorporates the number of consecutive days of mechanical ventilation while taking into account use of NIV and lung maturity and including short

  7. Le lien retrouvé

    Directory of Open Access Journals (Sweden)

    Luis Antonio Bittar Venturi

    2009-06-01

    Full Text Available Les ressources naturelles sont les principales médiatrices de la relation homme-nature, se situant à l´interface entre les dimensions sociale et naturelle. Cette thématique favorise donc la ré-intégration entre la géographie physique et humaine, dans la mesure où elle amène le chercheur à une vraie analyse géographique, celle qui considère, en même temps, les aspects humains et naturels pour la compréhension du territoire ou, si l’on préfère, de l´espace géographique. C´est dans ce contexte i...

  8. Comprendre le territoire de Venise

    Directory of Open Access Journals (Sweden)

    Lorena Rocca

    2013-05-01

    Full Text Available Le projet de recherche PANDORA - PArticipatory Networks and Databases fOr sustainable Research and Assessment (www.feempandora.it – de la Fondation Eni Enrico Mattei repose sur une démarche innovante de recherche action invitant à la participation de tous grâce aux Nouvelles Technologies de l’Information et de la Communication (TIC. A partir de l’analyse des pratiques collaboratives sur Internet, un espace en ligne a été créé afin de diffuser des informations et des données sur la ville mais surtout, de recueillir des avis, des idées et des solutions alternatives permettant d’atteindre les objectifs d’un développement urbain durable et co-construit.

  9. Le Point sur... Astronomie IV

    Science.gov (United States)

    Pecker, J.-C.

    Cet ouvrage regroupe des articles de mise au point sollicités par le rédacteur en chef de la rubrique Astronomie des Comptes rendus de l'Académie des sciences. Les textes se proposent de faire découvrir aux lecteurs, dans les principales disciplines de l'astronomie, les résultats les plus remarquables des dernières années.Leurs auteurs sont des spécialistes participant activement à l'accroissement des connaissances dans des domaines faisant l'objet de recherches intensives. Ces mises au point sur des questions particulièrement importantes de l'astronomie sont rédigées soit en français, soit en anglais et accompagnées d'une bibliographie détaillée.

  10. Le Point sur... Astronomie III

    Science.gov (United States)

    Pecker, J.-C.

    Ce fascicule contient l'ensemble des textes du débat sur la cosmologie du big-bang entre Joseph Silk, Jayant V. Narlikar, arbitrés par Jean-Claude Pecker. Il regroupe également des articles de mise au point sollicités par le rédacteur en chef de la rubrique Astronomie des Comptes rendus de l'Académie des sciences. Les textes se proposent de faire découvrir aux lecteurs, dans les principales disciplines de l'astronomie, les résultats les plus remarquables des dernières années. Ces mises au point sur des questions particulièrement importantes de l'astronomie sont rédigées soit en francais, soit en anglais et accompagnèes d'une bibliographie dètaillèe.

  11. Two Paired "Le Chatelier" Reactions

    Science.gov (United States)

    Cawley, John J.

    1995-07-01

    We have created a two-week, two hour-per-week cyclic experiment, which pairs two reactions. These reactions, the acid catalyzed esterification to yield n-amyl acetate and the base catalyzed hydrolysis of n-amyl acetate are intended to serve as a first and last experiment respectively, of the second-semester laboratory for liberal arts students. Because of time constraints, we have modified these experiments so that no distillation is performed as a purification step. The notion of achieving yields beyond the equilibrium value is discussed in terms of the pragmatics of removing one of the products of an equilibrium. Because of this "Le Chatelier" aspect of each reaction, each of them may be pushed in practicality to completion, which is well beyond the equilibrium value expectation. Because of the cycle, the chemistry may be done on a scale well beyond the microscale approach with little loss of material.

  12. Le Squatteur, le Gentrifieur et le Promoteur. Une leçon de la géographie

    Directory of Open Access Journals (Sweden)

    Laurent Matthey

    2005-03-01

    Full Text Available Posées sur mon bureau : deux photos. Je les regarde. Silencieusement, je les décris et les commente. La première a été prise en novembre 1997. Angle rue Jean-Violette, rue Prévost-Martin, à Genève. On y voit un immeuble, ancien, des échafaudages. Entre cet immeuble et celui qui lui fait face, on a tendu des fanions verts, bleus, orange. Son rez-de-chaussée a été repeint dans une teinte un peu brique. La seconde date d’avril 2005. C’est le même immeuble, presque dix ans plus tard, rénové. Jaun...

  13. Des maux pour le taire

    OpenAIRE

    Dussy, Dorothée; Caisne, Léonore Le

    2011-01-01

    Cette enquête ethnographique effectuée dans une association parisienne d’entraide aux victimes d’inceste montre que les enfants sexuellement abusés par un familier doivent se construire sur une double approche de la réalité sociale : d’un côté un discours dominant qui prône l’interdit de l’inceste et le respect des valeurs ordinaires, de l’autre l’expérience quotidienne des viols perpétrés par un de ceux qui transmettent ces valeurs. Grâce à un annonciateur, l’inceste perd son caractère anomi...

  14. Pharmacometabolomic Approach to Predict QT Prolongation in Guinea Pigs

    Science.gov (United States)

    Lee, Hae Won; Lim, Mi-sun; Seong, Sook Jin; Seo, Jeong Ju; Kim, Eun-Jung; Kang, Wonku; Yoon, Young-Ran

    2013-01-01

    Drug-induced torsades de pointes (TdP), a life-threatening arrhythmia associated with prolongation of the QT interval, has been a significant reason for withdrawal of several medicines from the market. Prolongation of the QT interval is considered as the best biomarker for predicting the torsadogenic risk of a new chemical entity. Because of the difficulty assessing the risk for TdP during drug development, we evaluated the metabolic phenotype for predicting QT prolongation induced by sparfloxacin, and elucidated the metabolic pathway related to the QT prolongation. We performed electrocardiography analysis and liquid chromatography–mass spectroscopy-based metabolic profiling of plasma samples obtained from 15 guinea pigs after administration of sparfloxacin at doses of 33.3, 100, and 300 mg/kg. Principal component analysis and partial least squares modelling were conducted to select the metabolites that substantially contributed to the prediction of QT prolongation. QTc increased significantly with increasing dose (r = 0.93). From the PLS analysis, the key metabolites that showed the highest variable importance in the projection values (>1.5) were selected, identified, and used to determine the metabolic network. In particular, cytidine-5′-diphosphate (CDP), deoxycorticosterone, L-aspartic acid and stearic acid were found to be final metabolomic phenotypes for the prediction of QT prolongation. Metabolomic phenotypes for predicting drug-induced QT prolongation of sparfloxacin were developed and can be applied to cardiac toxicity screening of other drugs. In addition, this integrative pharmacometabolomic approach would serve as a good tool for predicting pharmacodynamic or toxicological effects caused by changes in dose. PMID:23593245

  15. Le surpoids, l'obésité et le contrôle glycémique chez les diabétiques ...

    African Journals Online (AJOL)

    utilisation et du stockage des sucres apportés par l'alimentation, sa prise en charge est assurée par le suivi du surpoids et l'obésité et le contrôle glycémique régulier. L'objectif de ce travail était l'étude du surpoids, l'obésité et le contrôle glycémique ...

  16. Influence of a prolonged fasting and mild activity on routine laboratory tests.

    Science.gov (United States)

    Šupak-Smolčić, Vesna; Antončić, Dragana; Ožanić, Doris; Vladilo, Ivana; Bilić-Zulle, Lidija

    2015-01-01

    Despite the standardization of the phlebotomy procedure, blood analysis is occasionally requested after recommended hours with the excuse that the patient is still fasting. We aimed to examine the influence of prolonged fasting and mild physical activity on routine laboratory tests. The study was conducted on 30 volunteers (27 female) median age 40y (20-59). Blood samples were taken in the morning (7:00-8:00a.m.) and early afternoon (1:00-2:00p.m.) after prolonged fasting and usual daily activities. Serum glucose (GLU), urea, creatinine, triglyceride, uric acid (UA), iron and electrolytes were analyzed on Roche cobas 6000 c501 and complete blood count on Siemens ADVIA 2120i. Statistical significance between the two measurements was tested using paired t-test or Wilcoxon test according to data distribution. Clinical significance was judged against calculated reference change values (RCV). A statistically significant decrease was found for red blood cell count, hemoglobin, hematocrit, mean corpuscular volume (MCV), GLU, urea, creatinine, triglycerides and electrolytes, whereas white blood cell count and iron were significantly increased. Judging against desirable bias derived from biological variation, a significant change was found for all the analytes except MCV, platelet count, UA and triglycerides. A clinically significant change was not found for any of the tested analytes when compared to RCV. Prolonged fasting and mild activity will not influence the medical decision for healthy subjects with normal results. Despite the present statistically significant change, the clinically significant change was not shown. However, the study did not include pathological results which have to be interpreted more carefully. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  17. Correcting magnesium deficiencies may prolong life

    Directory of Open Access Journals (Sweden)

    Rowe WJ

    2012-02-01

    Full Text Available William J RoweFormer Assistant Clinical Professor of Medicine, Medical University of Ohio at Toledo, Ohio, USAAbstract: The International Space Station provides an extraordinary facility to study the accelerated aging process in microgravity, which could be triggered by significant reductions in magnesium (Mg ion levels with, in turn, elevations of catecholamines and vicious cycles between the two. With space flight there are significant reductions of serum Mg (P < 0.0001 that have been shown in large studies of astronauts and cosmonauts. The loss of the functional capacity of the cardiovascular system with space flight is over ten times faster than the course of aging on Earth. Mg is an antioxidant and calcium blocker and in space there is oxidative stress, insulin resistance, and inflammatory conditions with evidence in experimental animals of significant endothelial injuries and damage to mitochondria. The aging process is associated with progressive shortening of telomeres, repetitive DNA sequences, and proteins that cap and protect the ends of chromosomes. Telomerase can elongate pre-existing telomeres to maintain length and chromosome stability. Low telomerase triggers increased catecholamines while the sensitivity of telomere synthesis to Mg ions is primarily seen for the longer elongation products. Mg stabilizes DNA and promotes DNA replication and transcription, whereas low Mg might accelerate cellular senescence by reducing DNA stability, protein synthesis, and function of mitochondria. Telomerase, in binding to short DNAs, is Mg dependent. On Earth, in humans, a year might be required to detect changes in telomeres, but in space there is a predictably much shorter duration required for detection, which is therefore more reasonable in time and cost. Before and after a space mission, telomere lengths and telomerase enzyme activity can be determined and compared with age-matched control rats on Earth. The effect of Mg supplementation

  18. Le Mahdi dans le Maghreb médiéval

    Directory of Open Access Journals (Sweden)

    Michael Brett

    2009-05-01

    Full Text Available Dans le monde islamique médiéval, l'Afrique du Nord fut le centre principal du mahdisme, qui y inspira deux des trois grandes révolutions qui unifièrent le Maghreb entre le IV/Xe et le Vl/XIIe siècles : celle des Fatimides au Xe et celle des Almohades au XIIe siècle. La forme islamique du messianisme judéo-chrétien, le mahdisme, attendait l'arrivée d'un second Muhammad pour inaugurer un âge d'or ; mais il souffrait aussi d'une hésitation entre un royaume de ce monde ou du monde à venir, entre un homme envoyé par Dieu ou un être divin. Son succès au Maghreb était le fruit de son appel aux fidèles à conquérir le monde, moyennant une prédication militante adressée à des populations tribales pour les persuader de se soumettre à la discipline militaire imposée par un prophète. Dans les deux cas, néanmoins, la prédication et son accomplissement se divisèrent entre un annonciateur comparable à Saint Jean-Baptiste et « l'homme né pour être roi ». Dans le cas des Fatimides, le roi fut le mahdi lui-même ; mais dans le cas des Almohades, le mahdi fut le prophète qui ouvrit la voie à son calife, destiné au gouvernement du monde. Après la désintégration de l'empire almohade au XIIIe siècle, le mahdisme se réduisit au Maghreb à un millénarisme inefficace, mais revint au pouvoir au XVIe avec la dynastie saadienne au Maroc. Ici encore, comme dans le cas d'Abdelkader en Algérie au XIXe siècle, le mahdisme se fonda sur la même distinction entre prophète et roi ; mais, au cours du XXe siècle, il a été remplacé par le nationalisme comme force politique efficace.

  19. Pediatric nasopharyngeal carcinoma: Anatomo-clinic aspects, therapeutic results and progressive particularities;Le cancer du cavum de l'enfant et l'adulte jeune: aspects anatomocliniques, therapeutiques et particularites evolutives

    Energy Technology Data Exchange (ETDEWEB)

    Frikha, M.; Toumi, N. [Service de carcinologie medicale, CHU Habib-Bourguiba, Sfax (Tunisia); Ghorbel, L.; Ben Salah, H.; Daoud, J. [Service de carcinologie radiotherapie, CHU Habib-Bourguiba, Sfax, (Tunisia); Khabir, A.; Boudawara, T. [Service d' anatomopathologie, CHU Habib-Bourguiba, Sfax (Tunisia); Karray, H. [Service de virologie, CHU Habib-Bourguiba, Sfax (Tunisia); Gargouri, R. [Centre de biotechnologie, Sfax (Tunisia); Ghorbel, A. [Service d' ORL, CHU Habib-Bourguiba, Sfax (Tunisia)

    2010-06-15

    Purpose We retrospectively analyzed anatomo-clinic, therapeutic and progressive particularities of 74 young patients (= 20 years) with nasopharyngeal carcinoma treated between 1993 and 2005. Patients and methods Initial work-up included a fiberoptic naso-fiberscopy with biopsy, computed tomography and/or MRI of nasopharynx and neck, chest X-ray, abdominal ultrasonography and bone scan. Patients were treated with either primary chemotherapy (epirubicin and cisplatin) followed by radiotherapy or concomitant radio chemotherapy (five fluorouracil and cisplatin). Radiotherapy was delivered to a total dose of 70 to 75 Gy to nasopharynx and involved cervical lymph nodes and 50 Gy to the remainder cervical areas. Results The median age was 16 years. Sixty-three percent of patients had undifferentiated tumors. Sixty-six percent had locally advanced tumor. With a median follow-up of 107 months, one patient presented a local relapse, 24 patients developed distant metastases with a median delay of 7 months. The 5 years overall survival and disease-free survival were 66 and 65 %. Late complications were dominated by dry mouth and endocrine disorders. Comments Pediatric nasopharyngeal carcinoma is characterized by an early metastatic diffusion. Local control is excellent but with severe late toxicities. New techniques of radiotherapy and new molecules of chemotherapy could improve these results. (authors)

  20. : Le Goff, Annales and National Historical Traditions:

    OpenAIRE

    Rucquoi, Adeline

    1994-01-01

    Version originale de l'article traduit en anglais (mal) et publié sous le titre (dû à l'éditeur) "Spanish Medieval History and the Annales: Between Franco and Marx"; International audience; Influencia ejercida por las obras de Jacques Le Goff y la llamada "escuela de los Annales" sobre la historiografía española (1950-1990); Influence des travaux de Jacques Le Goff et de l'"école" des Annales sur l'historiographie espagnole (1950-1990)

  1. Le Corbusier, Alfred Roth y el color

    Directory of Open Access Journals (Sweden)

    Angelica Fernández-Morales

    2014-07-01

    Full Text Available This article discusses the relationship between Le Corbusier and Alfred Roth, a member of the Paris office between 1927 and 1928. It also deals with the influence that this period had with reference to an important factor in Roth’s professional development, as in Le Corbusier’s later works: the use of colour in his architecture. This article takes the position that Roth, given his close friendship with Mondrian, was an important figure in turning Le Corbusier’s work towards greater use of primary colours and aesthetic neoplasticism.

  2. QT interval prolongation after sertraline overdose: a case report

    Directory of Open Access Journals (Sweden)

    Holman Nicole D

    2005-07-01

    Full Text Available Abstract Background Selective serotonin reuptake inhibitors (SSRIs are the most common antidepressants used in first-world countries and are generally well tolerated. Specifically, less cardiovascular toxicity has been reported in comparison with tricyclic antidepressants. Here we report QT interval prolongation after an overdose of the SSRI sertraline. Case presentation A previously healthy female patient presented with an attempted suicide with overdoses sertraline (2250 mg, diazepam (200 mg, and temazepam (400 mg. Routine laboratory studies were normal and her ECG upon admission showed a normal QT interval. The next day, her ECG showed prolongation of the QTc interval up to 525 ms. After discontinuation of sertraline the QT interval normalized. Echocardiography and exercise electrocardiography were normal. After hospitalization, the patient resumed sertraline in the normally recommended dose and QT interval remained within normal ranges. Conclusion It seems that the SSRI sertraline in overdose may cause QT interval prolongation.

  3. Prolonged social withdrawal disorder: a hikikomori case in Spain.

    Science.gov (United States)

    Ovejero, Santiago; Caro-Cañizares, Irene; de León-Martínez, Victoria; Baca-Garcia, Enrique

    2014-09-01

    The Japanese term hikikomori means literally 'to be confined'. Social withdrawal can be present in severe psychiatric disorders; however, in Japan, hikikomori is a defined nosologic entity. There have been only a few reported cases in occidental culture. We present a case report of a Spanish man with prolonged social withdrawal lasting for 4 years. This is a case of prolonged social withdrawal not bound to culture, as well as the second case of hikikomori reported in Spain. We propose prolonged social withdrawal disorder as a disorder not linked to culture, in contrast to hikikomori. Further documentation of this disorder is still needed to encompass all cases reported in Japan and around the world. © The Author(s) 2013.

  4. A propos d'un cas de grossesse abdominale très prolongée

    Science.gov (United States)

    Kangulu, Ignace Bwana; Umba, Elie Kilolo Ngoy; Cibuabua, Deddy Kalonji; Ilunga, Clovis Mwamba; Ndolo, Adellard Umba; Nzaji, Michel Kabamba; Kayamba, Prosper Kalenga Mwenze

    2013-01-01

    Un cas de grossesse abdominale prolongée d'environ 18 mois avec mort fœtale, vécu à l'hôpital général de référence de Mulongo dans la province du Katanga, en République Démocratique du Congo, est rapporté dans ce papier. Ce cas clinique d’évolution étonnante permet de faire la revue de la littérature, de rappeler l'importance d'un bon suivi clinique et échographique de la grossesse et de s'interroger sur le niveau d’éducation de la femme ainsi que la qualité des soins prénataux en milieu rural congolais. PMID:24570787

  5. Le Great Limpopo Transfrontier Park

    Directory of Open Access Journals (Sweden)

    Nadia Belaidi

    2008-10-01

    Full Text Available Cet article a pour objet de présenter quelques problématiques d'une recherche sur la construction d’un mécanisme de valorisation sociale de la protection de l’environnement : l’ordre public écologique. Cette étude s’appuie sur une expérience récente et originale en Afrique australe : la création de Parcs pour la Paix dont relève le Great Limpopo Transfrontier Park. Ces parcs sont officiellement consacrés à la protection et à la conservation de la diversité biologique, des ressources naturelles et culturelles qui y sont associées, ainsi qu’à la promotion de la coopération et de la Paix qu’elle soit civile, sociale, économique ou culturelle. La logique de construction de ces parcs repose sur l’idée que l’articulation des zones de conservation facilite la résolution de conflits territoriaux – de toutes sortes – en transformant les préoccupations environnementales en objet de coopération entre des juridictions politiques diverses. C’est précisément le schéma du concept juridique objet de nos travaux : l’ordre public écologique. Aussi peut-on se demander si le GLTP, en particulier, (peut constitue(r une illustration concrète de ce mécanisme et permettre d’atteindre la Paix recherchée, favorisant ainsi les processus de développement ?This article aims to present some problems of researches on the construction of a mechanism of social valorisation of the environmental protection: ecological public order. This study leans on a recent and original experience in southern Africa: the creation of Peace Park like the Great Limpopo Transfrontier Park (GLTP. These parks are officially dedicated to the protection and to the preservation of biological diversity, natural and cultural resources which are associated with it, as well as in the promotion of the cooperation and the peace. The peace looked for in these parks is not only the opposite of the war but it is also social, economic and cultural peace

  6. Connexin-purinergic signaling in enteric glia mediates the prolonged effect of morphine on constipation.

    Science.gov (United States)

    Bhave, Sukhada; Gade, Aravind; Kang, Minho; Hauser, Kurt F; Dewey, William L; Akbarali, Hamid I

    2017-06-01

    Morphine is one of the most widely used drugs for the treatment of pain. However, side effects, including persistent constipation and antinociceptive tolerance, limit its clinical efficacy. Prolonged morphine treatment results in a "leaky" gut, predisposing to colonic inflammation that is facilitated by microbial dysbiosis and associated bacterial translocation. In this study, we examined the role of enteric glia in mediating this secondary inflammatory response to prolonged treatment with morphine. We found that purinergic P2X receptor activity was significantly enhanced in enteric glia that were isolated from mice with long-term morphine treatment ( in vivo ) but not upon direct exposure of glia to morphine ( in vitro ). LPS, a major bacterial product, also increased ATP-induced currents, as well as expression of P2X4, P2X7, IL6, IL-1β mRNA in enteric glia. LPS increased connexin43 (Cx43) expression and enhanced ATP release from enteric glia cells. LPS-induced P2X currents and proinflammatory cytokine mRNA expression were blocked by the Cx43 blockers Gap26 and carbenoxolone. Likewise, colonic inflammation related to prolonged exposure to morphine was significantly attenuated by carbenoxolone (25 mg/kg). Carbenoxolone also prevented gut wall disruption and significantly reduced morphine-induced constipation. These findings imply that enteric glia activation is a significant modulator of morphine-related inflammation and constipation.-Bhave, S., Gade, A., Kang, M., Hauser, K. F., Dewey, W. L., Akbarali, H. I. Connexin-purinergic signaling in enteric glia mediates the prolonged effect of morphine on constipation. © FASEB.

  7. Post-traumatic stress disorder after weaning from prolonged mechanical ventilation.

    Science.gov (United States)

    Jubran, Amal; Lawm, Gerald; Duffner, Lisa A; Collins, Eileen G; Lanuza, Dorothy M; Hoffman, Leslie A; Tobin, Martin J

    2010-12-01

    Weaning from prolonged mechanical ventilation may be associated with mental discomfort. It is not known whether such discomfort is linked with the development of post-traumatic stress disorder (PTSD). Accordingly, we investigated whether PTSD occurs in patients after weaning from prolonged ventilation. We also determined whether administering a questionnaire would identify patients at risk for developing PTSD. A prospective longitudinal study of patients transferred to a long-term acute-care hospital for weaning from prolonged ventilation was undertaken: 72 patients were studied 1 week after weaning, and 41 patients were studied again 3 months later. An experienced psychologist conducted a structured clinical interview 3 months after weaning to establish a diagnosis of PTSD. To assess for the presence of PTSD-related symptoms, the post-traumatic stress syndrome (PTSS-10) questionnaire was administered 1 week after weaning and 3 months later. The psychologist diagnosed PTSD in 12% of patients 3 months after ventilator weaning. Patients who developed PTSD were more likely to have a previous history of psychiatric disorders (P 20 one week after weaning reliably identified patients who were diagnosed with PTSD 3 months later: sensitivity 1.0; specificity 0.76; area under the receiver-operating characteristic curve 0.91. PTSD was diagnosed in 12% of patients who were weaned from prolonged ventilation. A PTSS-10 score >20 one week after weaning identified patients diagnosed with PTSD 3 months later. This finding suggests that a simple questionnaire administered before hospital discharge can identify patients at risk for developing PTSD.

  8. Discontinuous insurance coverage predicts prolonged hospital stay after pediatric adenotonsillectomy.

    Science.gov (United States)

    Tumin, Dmitry; King, Adele; Walia, Hina; Tobias, Joseph D; Raman, Vidya T

    2017-10-01

    Changes in health insurance coverage have been implicated in limiting access to care and increasing morbidity risk. The consequences of insurance discontinuity for surgical outcomes are unclear. In this study, we explored whether recent insurance discontinuity was associated with prolonged inpatient hospitalization after adenotonsillectomy in children. We retrospectively evaluated single-center data on children aged 2-18 y undergoing adenotonsillectomy with overnight stay in 2009-2014. Insurance coverage at surgery and over the preceding year was categorized as (1) continuous private, (2) continuous Medicaid, or (3) discontinuous (changes or gaps in coverage). The association between insurance discontinuity and prolonged hospitalization (≥2 d) was evaluated using multivariable logistic regression. The study included 1013 girls and 983 boys (aged 4.5 ± 2.9 y), of whom 205 (10%) required prolonged hospitalization. Insurance was continuous private for 749 patients (38%), continuous Medicaid for 1121 patients (56%), and discontinuous for 126 patients (6%). Prolonged stay was most common with discontinuous insurance (23/126, 18%), followed by continuous Medicaid (117/1,121, 10%), and continuous private insurance (65/749, 9%; P = 0.004). In multivariable analysis, discontinuous insurance remained associated with prolonged hospital stay, compared with continuous private insurance (odds ratio = 1.88; 95% confidence interval: 1.06-3.33; P = 0.031), and compared with continuous Medicaid (odds ratio = 1.86; 95% confidence interval: 1.09-3.19; P = 0.023). This study demonstrates greater odds of prolonged hospitalization after adenotonsillectomy among children with recent gaps or changes in insurance coverage and illustrates the feasibility of studying influences of health insurance change on surgical outcomes using existing data in hospital electronic records. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Clinical and anatomical guidelines in pelvic cancer contouring for radiotherapy treatment planning; Definition de regles simples anatomocliniques dans la determination du volume cible des tumeurs pelviennes pour le planning radiotherapeutique

    Energy Technology Data Exchange (ETDEWEB)

    Portaluri, M.; Bambace, S.; Giuliano, G.; Pili, G.; Didonna, V. [General Hospital Di Summa-Perrino, Dept. of Radiation Oncology, Medical Physics, Brindisi (Italy); Perez, C.; Angone, G.; Alloro, E. [General Hospital Di Summa-Perrino, Dept. of Radiology, Medical Physics, Brindisi (Italy); Scialpi, M. [General Hospital SS. Annunziata, Dept. of Radiology, Taranto (Italy)

    2004-08-01

    Background and purpose. Many observations on potential inadequate coverage of tumour volume at risk in advanced cervical cancer (CC) when conventional radiation fields are used, have further substantiated by investigators using MRI, CT or lymph-angiographic imaging. This work tries to obtain three dimensional margins by observing enlarged nodes in CT scans in order to improve pelvic nodal chains clinical target volumes (CTVs) drawing, and by looking for corroborative evidence in the literature for a better delineation of tumour CTV. Method. Eleven consecutive patients (seven males, four females, mean age 62 years, range 43 8) with CT diagnosis of nodal involvement caused by pathologically proved carcinoma of the cervix (n = 2), carcinoma of the rectum (n = 2), carcinoma of the prostate (n = 2), non-Hodgkin lymphoma (n 2), Hodgkin lymphoma (n = 1), carcinoma of the penis (n = 1) and carcinoma of the corpus uteri (n = 1) were retrospectively reviewed. Sixty CT scans with 67 enlarged pelvic nodes were reviewed in order to record the more proximal structures (muscle, bone, vessels, cutis or sub-cutis and other organs) to each enlarged node or group of nodes according to the four surfaces (anterior, lateral, posterior and medial) in a clockwise direction. Results. summary of the observations of each nodal chain and the number of occurrences of every marginal structure on axial CT slices is presented. Finally, simple guidelines are proposed. Conclusions. Tumour CTV should be based on individual tumour anatomy mainly for lateral beams as it results from sagittal T2 weighted MRI images. Boundaries of pelvic nodes CTVs can be derived from observations of enlarged lymph nodes in CT scans. (author)

  10. Le soleil devient un mythe

    Directory of Open Access Journals (Sweden)

    Ildikó Lőrinszky

    2009-01-01

    Full Text Available Partant d’une phrase énigmatique datant de 1858 et puisée dans la Correspondance de Flaubert, cet article s’interroge sur la relation entre soleil et mythe, qui constituera l’un des éléments clefs de la dimension mythologique de Salammbô. Il se propose d’examiner la façon dont cette question apparaît dans deux ouvrages représentatifs des études mythographiques : d’une part, L’Origine de tous les cultes de Charles-François Dupuis, d’autre part, Les Religions de l’Antiquité..., publié sous les noms de Frédéric Creuzer et de son adaptateur français, Joseph-Daniel Guigniault. La version française de la grande synthèse de Creuzer, assortie d’une série importante de planches, a été richement exploitée par Flaubert au cours de la genèse du roman carthaginois. Dans Salammbô, le mythe apparaît sous de multiples formes. L’analyse de ce texte peut nous amener à réfléchir sur le « bon usage » du mythe auquel chaque créateur (et chaque lecteur se trouve nécessairement confronté.Starting from an enigmatic phrase in Flaubert’s correspondence, dating from 1858, this article examines the relation between the Sun and myth, which constitutes one of the key elements of the mythological dimension of Salammbô. It especially focuses on the treatment of this question in two representative works of mythographic studies, The Origin of All Religious Worship by Charles-François Dupuis, and Les Religions de l’Antiquité..., the French adaptation of Frédéric Creuzer’s Symbolik und Mythologie der alten Völker by Joseph-Daniel Guigniault. The French version of Creuzer’s great synthesis, supplied with a remarkable set of prints, was abundantly consulted by Flaubert when writing his Carthaginian novel. In Salammbô, myth takes on various forms. Analyzing this text might lead one to reconsider “the right way” to use myths — a problem all writers (and readers find themselves confronted with.

  11. Les ERP changent-ils le contrôle de gestion ?

    OpenAIRE

    Meyssonnier, François; Pourtier, Frédéric

    2005-01-01

    L'intégration de l'information de gestion dans le cadre d'ERP se généralise et le contrôle de gestion s'effectue maintenant la plupart du temps en environnement ERP dans les grandes entreprises. Un état de l'art est effectué relativement à l'impact des ERP aussi bien sur les concepts et les outils du contrôle de gestion que sur la fonction et lele des contrôleurs de gestion. La démarche de recherche, fondée sur dix études de cas dans une approche intermédiaire entre les monographies qualit...

  12. Prolonged job strain and subsequent risk of cancer in women

    DEFF Research Database (Denmark)

    Vesterlund, Gitte K.; Høeg, Beverley L.; Johansen, Christoffer

    2017-01-01

    across six years and subsequent cancer risk. Methods and materials: We used data from 6571 cancer-free women from the Danish Nurse Cohort aged 45–70 years at inclusion, and self-reported questionnaires on job strain at baseline in 1993 and again in 1999. Prolonged job strain was defined as high job......-related, digestive and lung cancers according to level of prolonged job strain. The women were followed from 1 January 2000 until cancer diagnosis, emigration, death or 31 December 2013 (mean follow-up 13 years) and models were adjusted for potential confounders. Effect modification was examined according to working...

  13. Cerebral ammonia uptake and accumulation during prolonged exercise in humans

    DEFF Research Database (Denmark)

    Nybo, Lars; Dalsgaard, Mads K.; Steensberg, Adam

    2005-01-01

    We evaluated whether peripheral ammonia production during prolonged exercise enhances the uptake and subsequent accumulation of ammonia within the brain. Two studies determined the cerebral uptake of ammonia (arterial and jugular venous blood sampling combined with Kety-Schmidt-determined cerebral...... blood flow; n = 5) and the ammonia concentration in the cerebrospinal fluid (CSF; n = 8) at rest and immediately following prolonged exercise either with or without glucose supplementation. There was a net balance of ammonia across the brain at rest and at 30 min of exercise, whereas 3 h of exercise...... exercise with glucose, and further to 16.1 ± 3.3 µM after the placebo trial (P

  14. Vers une plus grande collaboration régionale — le CRDI appuie le ...

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

    26 janv. 2011 ... Bien qu'ils aient souvent de la difficulté à se démarquer face à la véritable dynamo économique qu'est la Chine, des pays tels que le Laos, le Cambodge et le Vietnam, qui tentaient d'échapper à la guerre il y a à peine 25 ans, connaissent une croissance explosive encore plus remarquable. Renaissance ...

  15. Démocratie et le développement dans le monde arabe | CRDI ...

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

    Extrants. Rapports. Democracy and development in the Arab world : final technical report, Sep. 15, 2006 - Sep. 15, 2009. Téléchargez le PDF. Contenus connexes. Le CRDI « analyse l'autonomisation des femmes » lors d'une conférence à l'Université McGill. Les conclusions d'un programme financé par le CRDI au ...

  16. ÉTUDE DE CAS — Cuba : Le logement et le capital humain à Cuba ...

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

    10 janv. 2011 ... ÉTUDE DE CAS — Cuba : Le logement et le capital humain à Cuba .... Elle reconnaît qu'il existe des liens inéluctables entre les humains et les milieux biophysique, social et économique qui ont des répercussions sur la santé des gens », explique le Dr Mariano Bonet, l'un des chercheurs de l'équipe et ...

  17. pour le trimestre qui a pris fin le 30 juin 2014

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

    Office 2004 Test Drive User

    30 juin 2014 ... d'information financière (normes IFRS). Toutes les sommes sont exprimées en dollars canadiens. Le CRDI recommande de lire ce rapport en parallèle avec les états financiers intermédiaires résumés, non audités (qui débutent à la page 11). L'information et les divulgations contenues dans le Rapport ...

  18. pour le trimestre qui a pris fin le 30 septembre 2014

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

    Office 2004 Test Drive User

    30 sept. 2014 ... d'information financière (normes IFRS). Toutes les sommes sont exprimées en dollars canadiens. Le CRDI recommande de lire ce rapport en parallèle avec les états financiers intermédiaires résumés, non audités (qui débutent à la page 11). L'information et les divulgations contenues dans le Rapport ...

  19. pour le trimestre qui a pris fin le 30 juin 2012

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

    Office 2004 Test Drive User

    30 juin 2012 ... dans le Rapport annuel 2011-2012 du CRDI s'appliquent au trimestre sur lequel porte le présent rapport trimestriel à moins d'une mise à jour fournie aux présentes. Résultats. Aperçu de la situation financière. (pour la période de trois mois qui a pris fin le 30 juin 2012). 0. 10. 20. 30. 40. 50. 60. 70. Produits.

  20. Rapport financier trimestriel pour le trimestre qui a pris fin le 31 ...

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

    Sophie Comeau

    31 déc. 2011 ... Le Centre de recherches pour le développement international. CRDI , qui est un élément clé de l'aide internationale du. Canada depuis 1970, appuie des travaux de recherche dans les pays en développement afin d'y favoriser la croissance et le développement. Il veille aussi à promouvoir la diffusion.

  1. Le « modèle germanique » Français

    OpenAIRE

    Lefebvre , Armelle

    2009-01-01

    Resume Le concept d?Allemagne permet de reveler, selon une approche , l?ampleur des desaccords ayant preside a la definition du concept d?Etat en France. De ce dernier, l?on aborde divers emplois qu?illustrent des modeles d?Etat. Le opere ainsi dans un debat qui est le creuset de la connaissance politique moderne, avec ses apories: celles de la souverainete externe, de l?ordre interetatique, de la confederation. L?article expose alo...

  2. 205 Le Role de la Litterature dans le Developpement de la Nation ...

    African Journals Online (AJOL)

    Ike Odimegwu

    du plaisir en même temps qu'il le moralise. Elle fait naître dans ses lecteurs ou dans son audience des .... développement de l'esprit>>(319)Par cette définition nous comprenons que le développement signale qu'il du progrès ... qu'elle est une œuvre de l'imagination qui aide l'homme à transcender le monde physique.

  3. Prolonged Barium-Impaction Ileus in Two Lung Transplant Recipients With Systemic Sclerosis: Case Report.

    Science.gov (United States)

    Tokman, S; Hays, S R; Leard, L E; Bush, E L; Kukreja, J; Kleinhenz, M E; Golden, J A; Singer, J P

    2015-12-01

    Lung transplantation can be a life-saving measure for people with end-stage lung disease from systemic sclerosis. However, outcomes of lung transplantation may be compromised by gastrointestinal manifestations of systemic sclerosis, which can involve any part of the gastrointestinal tract. Esophageal and gastric disease can be managed by enteral feeding with the use of a gastrojejunal feeding tube. In this report, we describe the clinical courses of 2 lung transplant recipients with systemic sclerosis who experienced severe and prolonged barium-impaction ileus after insertion of a percutaneous gastrojejunal feeding tube. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve

    DEFF Research Database (Denmark)

    Kofoed, Klaus F; Bangsgaard, Regitze; Carstensen, Steen

    2002-01-01

    OBJECTIVE: A major effect of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and impaired left ventricular (LV) contractile function is believed to be an improvement in LV function due to recovery of dysfunctional, but viable myocardium. However, recent studies have...... indicated a time limit for such a recovery. We therefore investigated the extent of viable myocardium in patients with impaired LV function due to ischemic heart disease after a prolonged strategy of medical treatment and its relation to changes in clinical variables after CABG. METHODS: Forty......-five consecutive patients with a mean duration of ischemic heart symptoms of 9 years and LV ejection fraction (EF) stress...

  5. Droits d'auteur | CRDI - Centre de recherches pour le ...

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

    Droits d'auteur détenus par le CRDI Sauf indication contraire, les droits d'auteur relatifs aux documents mis en ligne sur le présent site Web sont détenus par le Centre de recherches pour le développement international (CRDI).

  6. Publications | Page 200 | CRDI - Centre de recherches pour le ...

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

    Le CRDI collabore avec les chercheurs et les établissements des pays en développement au renforcement des capacités locales par le truchement du financement, de la mise en commun des connaissances et de la ... Le partage de l''information et des techniques de la communication favorise le développement durable.

  7. Publications | Page 103 | CRDI - Centre de recherches pour le ...

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

    Le FIE 2008 fait avancer le cadre écobiosocial de l'OMS. Le Programme spécial de recherche et de formation concernant les maladies tropicales (TDR) de l'OMS a élaboré le concept du champ « écobiosocial », qui combine les perspectives écologiques, biologiques et sociales « pour mieux.

  8. Publications | Page 17 | CRDI - Centre de recherches pour le ...

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

    Publication du rapport de BSR sur le travail des enfants en Birmanie. Le CRDI finance plusieurs projets de recherche sur les facteurs expliquant le travail des enfants, incluant le rapport intitulé 'Child labor in Myanmar's Garment Sector' écrit récemment par l'organisme Business for Social Responsibility (BSR).

  9. Causes of prolonged jaundice in infancy: 3-year experience in a tertiary paediatric centre.

    Science.gov (United States)

    Andre, Margaret; Day, Andrew S

    2016-01-29

    Although prolonged jaundice (PJ) commonly occurs in infancy, there is not yet agreement as to the appropriate extent of investigations, particularly in otherwise well children. Significant pathologies may present with PJ in this age group and need to be considered. The aim of this retrospective study was to ascertain the causes of PJ in infants referred to a single tertiary paediatric centre. Infants referred with PJ over a 3-year period were identified. Clinical documentation, electronic notes and results of investigations performed prior to and after referral were reviewed. One hundred and sixty-seven infants with PJ were seen. Fifty-eight percent were over 28 days of age. Four patients had conjugated hyperbilirubinaemia. Eighteen percent of patients were found to have a specific medical diagnosis causing or contributing to PJ, almost half of whom had normal clinical examination. The single most common pathological cause for PJ was hypothyroidism found in six patients. This study demonstrates that normal clinical examination and exclusion of conjugated hyperbilirubinaemia are insufficient to exclude pathological causes of PJ. Overall, these children were referred late. Guidelines, in conjunction with education initiatives, are required to optimise the management of prolonged jaundice in infancy.

  10. Jan Potocki et le "Gothic Novel"

    Science.gov (United States)

    Finne, Jacques

    1970-01-01

    Establishes a parallel between the supernatural and fantastic qualities of Le Comte Jan Potocki's literary works, and the English gothic novels by comparing the elements of terror, mysterious atmosphere, and the supernatural beings involved. (DS)

  11. Savoir gérer le mal

    Directory of Open Access Journals (Sweden)

    Michel Maffesoli

    2015-09-01

    Full Text Available Le sens commun, conservatoire immémorial de la sagesse humaine « sait », de savoir incorporé, que le mal, l’ombre, la mort, la douleur sont des caractéristiques essentielles de l’existence en son entièreté. Dès lors les créatures quelles qu’elles soient, sont des manifestations de la vie et, dès lors, méritent une attitude « compassionnelle », fraternelle, parce qu’ensemble elles constituent le flux vital. C’est ainsi que l’on peut comprendre l’utilité sociale de ces divers « mondes intermédiaires » que sont les croyances, religieuses ou philosophiques, au « double », au « daimon », aux esprits et autres figures tutélaires ou effrayantes. Elles aident à vivre, au jour le jour, la souffrance en la communalisant.

  12. Nuevo León

    Directory of Open Access Journals (Sweden)

    Laura Nelly Medellín Mendoza

    2006-01-01

    Full Text Available El ensayo analiza la transición política nuevoleonesa a partir de un contexto de liberalización política. En Nuevo León el régimen político autoritario fue cediendo en el plano electoral, dada la presión que conjuntamente la sociedad política y la sociedad civil ejercieron por lograr reglas democráticas. Este avance gradual permitió garantizar un organismo electoral confiable y que determinó en buena medida la garantía de la alternancia en 1997. El pan fue el partido que capitalizó el bono democrático, pero una vez en la responsabilidad de gobierno, no pudo ampliar el proceso de liberalización política al mediatizar las reformas electorales y no comprometerse para sacar del atolladero legislativo las iniciativas que garantizaban mecanismos de participación ciudadana: referéndum y plebiscito.

  13. le des universités dans le renforcement des technologies de l ...

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

    le des universités dans le renforcement des technologies de l'information et de la communication au service du développement (TIC-D) en Asie. Jusqu'à maintenant, les efforts déployés dans le secteur de l'enseignement supérieur ont surtout été axés sur le téléapprentissage, l'apprentissage électronique et différentes ...

  14. Rapport financier trimestriel pour le trimestre qui a pris fin le 31 ...

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

    Office 2004 Test Drive User

    31 déc. 2015 ... Budget 2015-2016 révisé. Le Conseil a approuvé le budget 2015-2016 avant le début de lʼexercice. Cʼest sur ce budget que sont fondées les sommes budgétaires qui ont été présentés dans le Rapport annuel. 2014-2015. En octobre, on a revu les prévisions budgétaires initiales en tenant compte des.

  15. Le modèle de l’erreur humaine de James Reason

    OpenAIRE

    Larouzée, Justin; Guarnieri, Franck; Besnard, Denis

    2014-01-01

    Ce papier de recherche a pour objet de revenir en détail sur les travaux de recherche du psychologue anglais James Reason, mondialement célèbre pour sa taxonomie de l’erreur humaine et son modèle étiologique de l’accident immensément connu sous le nom de Swiss Cheese Model (SCM) ou Modèle du Fromage Suisse. Ce papier de recherche est une synthèse du parcours scientifique de Reason, il revient aussi sur la conception du modèle et ses évolutions, il traite de ses usages, apports et limites. Il ...

  16. la lutte contre le SIDA au Cameroun

    African Journals Online (AJOL)

    Chantel

    à une action efficace et courageuse, à la mesure de l'enjeu. De nombreuses ..... des médicaments à un niveau toujours prohibitif. Tableau 2 indique les ... Les femmes et les jeunes paient le plus lourd tribut à l'épidémie (Kuate Defo, 1998). En effet, les 3/5 des personnes infectées sont des femmes et le tiers des personnes ...

  17. Le déficit de filles

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

    qui veulent former un couple idéal. D'autre part, les chercheuses indiquent que le céli- bat des femmes est perçu comme une « aberration totale ». Tous les répondants ont fait, à ce sujet, des remarques semblables : même la personne la plus riche du monde, disent-ils, ne peut assumer le far- deau financier qu'impose une ...

  18. Quand la musique donne le ton

    DEFF Research Database (Denmark)

    Reeh, Henrik

    2017-01-01

    Le lycée Sainte-Anne de Copenhague est un établissement réputé pour les résultats de ses élèves et pour être le foyer d’une intense tradition chorale et musicologique. L’article interroge les parcours de 32 élèves d’une même classe, tous reçus au baccalauréat 2014 avec une option musique et...

  19. Le désordre du monde

    African Journals Online (AJOL)

    sulaiman.adebowale

    interfère dans le désordre du monde. Globalement, une négligence des aspects collectifs planétaires par rap- port à des intérêts nationaux toujours surdéterminés conduit à l'entropie. Cela débouche sur le désordre, au regard des questions qui nécessitent un consensus, un accord et une démarche collective sans (auto) ...

  20. Le Chatelier principle in replicator dynamics

    OpenAIRE

    Allahverdyan, Armen E.; Galstyan, Aram

    2011-01-01

    The Le Chatelier principle states that physical equilibria are not only stable, but they also resist external perturbations via short-time negative-feedback mechanisms: a perturbation induces processes tending to diminish its results. The principle has deep roots, e.g., in thermodynamics it is closely related to the second law and the positivity of the entropy production. Here we study the applicability of the Le Chatelier principle to evolutionary game theory, i.e., to perturbations of a Nas...

  1. Le CRDI au Népal

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

    Les chercheurs ont aidé les agriculteurs de Kulekhani à adopter la pisciculture en cage. CRDI. Centre De reCherChes pour le Développement internAtionAl. Le CRDI au Népal. Grâce à l'appui du CRDI. □ les collectivités s'adaptent aux changements climatiques. □ les agriculteurs de l'Himalaya améliorent leurs moyens.

  2. Le cas du Brésil

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

    pwust

    de biocarburants (particulièrement l'éthanol et le biodiesel). Les tendances actuelles donnent à croire que les projets reliés à l'énergie et aux biocarburants deviendront particulièrement importants sous peu. Outre ces domaines traditionnels, les projets en Afrique ont ciblé l'éducation, le développement des entreprises, les ...

  3. Transparence | CRDI - Centre de recherches pour le ...

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

    La transparence est un élément clé de l'engagement du gouvernement du Canada envers le gouvernement ouvert, dont l'objectif est d'améliorer l'accès aux données, aux renseignements et aux échanges. Le CRDI s'emploie à la transparence en fournissant des renseignements sur son site Web, dans ses publications, ...

  4. Le CRDI en Cisjordanie et à Gaza

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

    Stress des adolescents et conflit qui perdure. En Cisjordanie, la violence politique et le conflit qui perdure ont aggravé le stress chez les adolescents, qui constituent près de la moitié de la population. À Ramallah, plus de 3 000 adolescents de 15 à 17 ans ont été interrogés par des chercheurs de l'Université de Birzeit et de ...

  5. Le cas de l'Inde

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

    pwust

    le développement, l'Inde doit réduire la proportion de personnes vivant en deçà du seuil de pauvreté de 37,5 %, en. 1990, à 18,75 % ... exemple, à la suite du tsunami en Asie, en 2004, c'est le premier ministre qui a décidé de porter assistance. Pour ces types d'opérations, les forces militaires et paramilitaires indiennes.

  6. dynamiques migratoires et rapport avec le

    African Journals Online (AJOL)

    qui s'était illustré sur le campus par sa violence, notamment l'agression des étudiants au restaurant et en cité universitaires (sans aucune réaction de ... venant de l'extérieur), dans des actions de parrainage (le président du Tocsin a été choisi comme parrain par la promotion 2002 de l'École nationale du service social de ...

  7. Le juge administratif et le sens des images. Les mutations des techniques contentieuses du contrôle des visas d’exploitation

    OpenAIRE

    Mercier, Jérémy

    2017-01-01

    A la suite des affaires Nymphomaniac, La Vie d'Adèle, Antichrist, Love, SAW 3D Chapitre final, Cinquante Nuances de Grey, Bang Gang : une histoire d'amour moderne, Les Huit Salopards et Salafistes, l'affaire Sausage Party a mis en évidence un élément central dans le raisonnement du juge administratif : l'argumentation sur les images et sur le sens de leur contenu, impliquant un affinement progressif de son contrôle théorique de l'effet produit sur le spectateur. Le contentieux relatif au syst...

  8. INFLUENCE DES TEMPERATURES OPERATIONNELLES SUR LA PERFORMANCE D’UN REFRIGERATEUR SOLAIRE A ADSORPTION QUI FONCTIONNE AVEC LE COUPLE CHARBON ACTIF-METHANOL

    Directory of Open Access Journals (Sweden)

    H SOUALMI

    2014-12-01

    Full Text Available Le séchage des produits alimentaires au soleil est un moyen efficace, facile et économique pour conserver les aliments, en particulier les fruits. Le séchoir solaire est l'équipement le plus populaire pour le séchage des fruits. En raison de la nature intermittente de l'énergie solaire, le stockage de l'énergie thermique est nécessaire pour assurer un fonctionnement prolongé du séchoir. L'objectif principal de cette étude est d'évaluer l'efficacité du séchoir solaire intégré avec un lit en gravier comme stockage thermique. L’air dans ce séchoir est sucé naturellement grâce à la cheminé solaire le séchage. Le cabinet de séchage est envisagé théoriquement (CFD.La distribution de la vitesse et de la température de l'air à travers le séchoir solaire ont été présentés durant une journée d’Août et sous les conditions climatiques de Tlemcen (Algérie. L’effet de la présence d'un stockage thermique sur la distribution de la vitesse et de la température du flux d'air et de la température des figues ont été analysés. Les résultats montrent que la conception du séchoir solaire, comportant un stockage thermique augmente les capacités et le rendement du séchoir solaire, par l’augmentation du temps de séchage.

  9. Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study.

    Science.gov (United States)

    Kertai, Miklos D; Ji, Yunqi; Li, Yi-Ju; Mathew, Joseph P; Daubert, James P; Podgoreanu, Mihai V

    2016-04-01

    We characterized cardiac surgery-induced dynamic changes of the corrected QT (QTc) interval and tested the hypothesis that genetic factors are associated with perioperative QTc prolongation independent of clinical and procedural factors. All study subjects were ascertained from a prospective study of patients who underwent elective cardiac surgery during August 1999 to April 2002. We defined a prolonged QTc interval as > 440 msec, measured from 24-hr pre- and postoperative 12-lead electrocardiograms. The association of 37 single nucleotide polymorphisms (SNPs) in 21 candidate genes -involved in modulating arrhythmia susceptibility pathways with postoperative QTc changes- was investigated in a two-stage design with a stage I cohort (n = 497) nested within a stage II cohort (n = 957). Empirical P values (Pemp) were obtained by permutation tests with 10,000 repeats. After adjusting for clinical and procedural risk factors, we selected four SNPs (P value range, 0.03-0.1) in stage I, which we then tested in the stage II cohort. Two functional SNPs in the pro-inflammatory cytokine interleukin-1β (IL1β), rs1143633 (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.53 to 0.95; Pemp = 0.02) and rs16944 (OR, 1.31; 95% CI, 1.01 to 1.70; Pemp = 0.04), remained independent predictors of postoperative QTc prolongation. The ability of a clinico-genetic model incorporating the two IL1B polymorphisms to classify patients at risk for developing prolonged postoperative QTc was superior to a clinical model alone, with a net reclassification improvement of 0.308 (P = 0.0003) and an integrated discrimination improvement of 0.02 (P = 0.000024). The results suggest a contribution of IL1β in modulating susceptibility to postoperative QTc prolongation after cardiac surgery.

  10. Causes of Death Associated With Prolonged TV Viewing

    Science.gov (United States)

    Keadle, Sarah K.; Moore, Steven C.; Sampson, Joshua N.; Xiao, Qian; Albanes, Demetrius; Matthews, Charles E.

    2015-01-01

    Introduction TV viewing is the most prevalent sedentary behavior and is associated with increased risk of cardiovascular disease and cancer mortality, but the association with other leading causes of death is unknown. This study examined the association between TV viewing and leading causes of death in the U.S. Methods A prospective cohort of 221,426 individuals (57% male) aged 50–71 years who were free of chronic disease at baseline (1995–1996), 93% white, with an average BMI of 26.7 (SD=4.4) kg/m2 were included. Participants self-reported TV viewing at baseline and were followed until death or December 31, 2011. Hazard ratios (HRs) and 95% CIs for TV viewing and cause-specific mortality were estimated using Cox proportional hazards regression. Analyses were conducted in 2014–2015. Results After an average follow-up of 14.1 years, adjusted mortality risk for a 2-hour/day increase in TV viewing was significantly higher for the following causes of death (HR [95% CI]): cancer (1.07 [1.03, 1.11); heart disease (1.23 [1.17, 1.29]); chronic obstructive pulmonary disease (1.28 [1.14, 1.43]); diabetes (1.56 [1.33, 1.83]); influenza/pneumonia (1.24 [1.02, 1.50]); Parkinson disease (1.35 [1.11, 1.65]); liver disease (1.33 [1.05, 1.67]); and suicide (1.43 [1.10, 1.85]. Mortality associations persisted in stratified analyses with important potential confounders, reducing causation concerns. Conclusions This study shows the breadth of mortality outcomes associated with prolonged TV viewing, and identifies novel associations for several leading causes of death. TV viewing is a prevalent discretionary behavior that may be a more important target for public health intervention than previously recognized. Trial Registration ClinicalTrials.gov number, NCT00340015 PMID:26215832

  11. Le patrimoine et ses outils de gestion

    CERN Document Server

    Garcin, J

    2001-01-01

    Les principale taches de gestion du Patrimoine immobilier du CERN sont la saisie des données, leur mise à jour, l'archivage et la mise à disposition des informations. Les outils de gestion actuels : Le Système de Gestion de Base de Données Relationnelles alphanumérique ORACLE permet de gérer toutes les informations du Patrimoine, sur le réseau du CERN. Le logiciel de dessin Graphique MICROSTATION (Bentley) a été installé dans la division ST depuis fin 1991. Les plans de situation des sites, des bâtiments et locaux, des espaces confinés ont été réalisés avec ce logiciel. Les outils de demain : La mise en place du SIG (Système d'Information Graphique) STAR a été réalisée en 1993. Le transfert des plans de locaux de MICROSTATION vers STAR est en cours depuis une année environ. Le dessin de la cartographie des réseaux de canalisations Eaux Usées et Eaux Pluviales est en cours de réalisation. Le Web est l'outil de consultation de l'information par les utilisateurs.

  12. Dans le grand collisionneur du CERN

    CERN Document Server

    AUTHOR|(CDS)2051256

    2014-01-01

    Ce livre fait pénétrer le lecteur non initié dans l’instrument scientifique le plus grand du monde. D’ailleurs, le web fut précisément inventé à Genève en vue d’une collaboration aussi gigantesque. Résultat de vingt ans de recherche, le LHC, Grand collisionneur de hadrons, est l’anneau de 26,7 km creusé sous la frontière francosuisse, où sont accélérés, en sens opposés, des paquets de particules jusqu’à des vitesses et des énergies extrêmes. Ainsi la physique s’est-elle engagée dans une étape nouvelle de nos connaissances. Après les grandes découvertes de l’univers et de la réalité microscopique du siècle dernier, le collisionneur nous fait progresser aujourd’hui dans un «nuage de probabilités» aux frontières de l’antimatière. Dans une bousculade de particules, voici le champ convoité du boson de Higgs. Mario Campanelli, professeur associé à l’Université de Londres et collaborateur au projet ATLAS du LHC, propose, dans cet ouvrage, de s’introduire pas �...

  13. Activité antérieure – Le Kenya nomme le titulaire de sa première ...

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

    14 avr. 2016 ... De concert avec le CRDI, la National Commission for Science, Technology and Innovation (NACOSTI) du Kenya a inauguré sa première chaire de recherche à Nairobi, le 31 mars 2015. Le professeur Fabian Omoding Esamai, qui dirige actuellement le College of Health Sciences de la Moi University, a été ...

  14. Physiological response of rabbit bucks to prolonged feeding of ...

    African Journals Online (AJOL)

    Sixty-four (64) weanling rabbit bucks, 5 to 6 weeks old, were involved in a 2 x 4 factorial experiment to evaluate the effects of prolonged feeding of cottonseed cake (CSC) – based diets with or without vitamin E supplementation on the physiological response of the bucks. There were eight treatment combinations comprising ...

  15. The Prolonged Neonatal Admission: Implications for our National Children's Hospital

    LENUS (Irish Health Repository)

    McGlacken-Byrne, SM

    2016-06-01

    A significant number of neonates are admitted to tertiary paediatric units for prolonged stays annually, despite limited availability of neonatal beds. As the three Dublin paediatric hospitals merge, this pressure will be transferred to our new National Children’s Hospital.\\r\

  16. Prognostic Significance Of QT Interval Prolongation In Adult ...

    African Journals Online (AJOL)

    Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. Ninety-six ...

  17. QTc-prolonging drugs and hospitalizations for cardiac arrhythmias

    NARCIS (Netherlands)

    De Bruin, ML; Hoes, AW; Leufkens, HGM

    2003-01-01

    Cardiac arrhythmia as an adverse effect of noncardiac drugs has been an issue of growing importance during the past few years. In this population-based study, we evaluated the risk for serious cardiac arrhythmias during the use of several noncardiac QTc-prolonging drugs in day-to-day practice, and

  18. QTc prolongation in Black diabetic subjects with cardiac autonomic ...

    African Journals Online (AJOL)

    This finding is in keeping with other related works.1,16,17. In this study, the prevalence of prolonged QTc in diabet- ic subjects with CAN was 12%. The prevalence of pro- longed QTc in diabetics with CAN showed a wide range of 6% to 70.5% in Caucasian studies. Tentolouris et al17 and Ewing and Clarke19 reported 6%.

  19. Prolonged multifocal electroretinographic implicit times in the ocular ischemic syndrome

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Munch, Inger Christine; Sander, Birgit

    2010-01-01

    .4 +/- 1.7 mm Hg, respectively. Summed mfERG implicit times (N1, P1, N2) were prolonged in eyes with OIS, by 7.6%, 6.2%, and 7.5%, respectively, compared with fellow eyes (P macula, whereas the assessment of responses from...

  20. The basis for prolonged contractions in molluscan muscles.

    Science.gov (United States)

    JOHNSON, W H; TWAROG, B M

    1960-05-01

    Two basically different hypotheses have been advanced to explain the behavior of molluscan muscles in cases in which relaxation of the muscle is extraordinarily prolonged. In one hypothesis, tetanic activation due to prolonged activity in an intrinsic ganglion network is postulated; in the other, changes in the mechanical properties of the muscle capable of maintaining tension generated by the contractile system are proposed. Experiments reported here were designed to test these hypotheses. Recordings were made of electrical activity in a number of circumstances in which the muscle relaxes slowly, and this activity was absent in some cases and in others was not found to correlate well with rate of relaxation. Quick release of the muscle during and after a stimulus which induced slow relaxation showed disappearance of the active state long before decay of tension. Contractile tension decreases with length below rest length whereas passive tension due to stretch following D. C. stimuli remains approximately independent of length. The latter has the same mechanical basis as prolonged relaxation following D. C. stimuli. Thus initial contractile tension and the tension remainder during prolonged relaxation appear to originate through different mechanisms. These results lead us to favor the second hypothesis above. A means by which this could be achieved in vivo is discussed.

  1. Brain activity and fatigue during prolonged exercise in the heat

    DEFF Research Database (Denmark)

    Nielsen, Bodil; Hyldig, Tino; Bidstrup, F.

    2001-01-01

    We hypothesized that fatigue due to hyperthermia during prolonged exercise in the heat is in part related to alterations in frontal cortical brain activity. The electroencephalographic activity (EEG) of the frontal cortex of the brain was measured in seven cyclists [maximal O2 uptake (VO2max) 4...... min of exercise; P

  2. Efficacy of an Emotion-Focused Treatment for Prolonged Fatigue

    Science.gov (United States)

    Schutte, Nicola S.; Malouff, John M.; Brown, Rhonda F.

    2008-01-01

    Previous research findings have suggested a relationship between less adaptive emotional functioning and fatigue. The present study used a research design involving multiple baselines across participants to evaluate the efficacy of a new emotion-focused treatment for prolonged fatigue delivered in a cognitive behavioral therapy framework. The 13…

  3. Preparation and assessment of ketamine hydrogels for prolonged ...

    African Journals Online (AJOL)

    Purpose: To formulate and assess thermoresponsive ketamine hydrogels for prolonged transdermal analgesia/anaesthesia. Methods: Thermoresponsive ketamine hydrogels were prepared from chitosan (CTS) and poloxamer 407. Four different formulations (2 formulations of ketamine with 1 and 2 % w/w CTS and 2 ...

  4. Prolonged Intrauterine Retention of Foetal Bones after Midtrimester ...

    African Journals Online (AJOL)

    Prolonged retention of foetal bones in the uterus is a rare complication of induced abortion. We present the case of a 37 year old nullipara with retained foetal bones following a second trimester induced abortion. Accurate diagnosis and removal of the bony fragments led to restoration of fertility and subsequent delivery of a ...

  5. Intrathecal Delivery of Ketorolac Loaded In Situ Gels for Prolonged ...

    African Journals Online (AJOL)

    erosion for prolonged period of time [23]. Moreover, the method used for fabrication of alginate-based in situ gels in the present study was simple and reproducible. Only those formulations were selected that demonstrated satisfactory attributes in terms of gelling capacity in the pre-formulation studies. The initial drug release ...

  6. Competing for Consciousness: Prolonged Mask Exposure Reduces Object Substitution Masking

    Science.gov (United States)

    Goodhew, Stephanie C.; Visser, Troy A. W.; Lipp, Ottmar V.; Dux, Paul E.

    2011-01-01

    In object substitution masking (OSM) a sparse, temporally trailing 4-dot mask impairs target identification, even though it has different contours from, and does not spatially overlap with the target. Here, we demonstrate a previously unknown characteristic of OSM: Observers show reduced masking at prolonged (e.g., 640 ms) relative to intermediate…

  7. Prolonged use of indwelling urinary catheter following acute urinary ...

    African Journals Online (AJOL)

    J.O. Bello

    duration of catheter use and median out-of-pocket payment per catheter change was 65 years (range 20–90 years), 12 months (range .... pocket payments per catheter change and reasons for prolonged catheter use was collected. ... ing almost half (44.7%) of the average annual income of an adult in the study region of ...

  8. Inclusion rate and physiological effects of prolonged feeding of ...

    African Journals Online (AJOL)

    The effect of incluusion of cocoa bean cake (CBC) on productive performance and physiological response of Isa Brown pullets to prolonged feeding of CBC were investigated. Dietary Inclusions or CBC (0, 50, 100 and 200g/ kg-1 diet) were monitored in typical poultry diets from day old to 51 weeks of age. Sexual maturity ...

  9. Public stigma of prolonged grief disorder : An experimental study

    NARCIS (Netherlands)

    Eisma, Maarten C.

    Prolonged grief disorder (PGD), characterized by severe, persistent and disabling grief, is being considered for inclusion in the International Classification of Diseases’ 11 (ICD-11) and a related disorder, Persistent Complex Bereavement Disorder (PCBD), is included for further investigation in the

  10. Diet-consumer nitrogen isotope fractionation for prolonged fasting arthropods.

    Science.gov (United States)

    Mizota, Chitoshi; Yamanaka, Toshiro

    2011-12-01

    Nitrogen acquisition for cellular metabolism during diapause is a primary concern for herbivorous arthropods. Analyses of naturally occurring stable isotopes of nitrogen help elucidate the mechanism. Relevant articles have cited (58 times up to mid-June 2011) anomalously elevated δ(15)N (per mil deviation of (15)N/(14)N, relative to atmospheric nitrogen=0 ‰) values (diet-consumer nitrogen isotope fractionation; up to 12 ‰) for a prolonged fasting raspberry beetle (Byturus tomentosus Degeer (Coleoptera: Byturidae)), which feeds on red raspberries (Rubus idaeus: δ(15)N= ~ +2 ‰). Biologists have hypothesised that extensive recycling of amino acid nitrogen is responsible for the prolonged fasting. Since this hypothesis was proposed in 1995, scientists have integrated biochemical and molecular knowledge to support the mechanism of prolonged diapausing of animals. To test the validity of the recycling hypothesis, we analysed tissue nitrogen isotope ratios for four Japanese arthropods: the shield bug Parastrachia japonensis Scott (Hemiptera: Cydnidae), the burrower bug Canthophorus niveimarginatus Scott (Hemiptera: Cydnidae), leaf beetle Gastrophysa atrocyanea Motschulsky (Coleoptera: Chrysomelidae) and the Japanese oak silkworm Antheraea yamamai (Lepidoptera: Saturniidae), all of which fast for more than 6 months as part of their life-history strategy. Resulting diet-consumer nitrogen isotope discrimination during fasting ranged from 0 to 7‰, as in many commonly known terrestrial arthropods. We conclude that prolonged fasting of arthropods does not always result in anomalous diet-consumer nitrogen isotope fractionation, since the recycling process is closed or nearly closed with respect to nitrogen isotopes.

  11. Metabolic and Cardiovascular Responses of Children during Prolonged Physical Activity.

    Science.gov (United States)

    Chausow, Sharon A.; And Others

    1984-01-01

    Metabolic and cardiovascular responses during 45 minutes of continuous moderate intensity exercise were investigated in 11 children, 8-11 years of age. Results indicate that children exhibit metabolic and cardiovascular adjustments similar to those noted in adults during prolonged exercise. (Author/JMK)

  12. Effect of prolonged birth spacing on maternal and perinatal outcome ...

    African Journals Online (AJOL)

    The commonest reason adduced for prolonged birth spacing is failed contraception (56%), followed by secondary infertility (24%) and to a lesser extent re-marriage, improved income and sheer desire. Conclusion: There was no significant difference in maternal and perinatal outcome in pregnancy between women with ...

  13. A non-Archimedean approach to prolongation theory

    NARCIS (Netherlands)

    van Eck, H.N.

    1986-01-01

    Some evolution equations possess infinite-dimensional prolongation Lie algebras which can be made finite-dimensional by using a bigger (non-Archimedean) field. The advantage of this is that convergence problems hardly exist in such a field. Besides that, the accompanying Lie groups can be easily

  14. The carotid baroreflex is reset following prolonged exercise in humans

    DEFF Research Database (Denmark)

    Hart, E C; Rasmussen, P; Secher, N H

    2010-01-01

    Alterations in the carotid baroreflex (CBR) control of arterial pressure may explain the reduction in arterial pressure and left ventricular (LV) function after prolonged exercise. We examined the CBR control of heart rate (HR) and mean arterial pressure (MAP), in addition to changes in LV function...

  15. Livres | Page 21 | CRDI - Centre de recherches pour le ...

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

    ISBN: 190239142X. Le débat des semences volume 2 : Solutions pour les lois nationales régissant le contrôle des ressources génétiques et des innovations biologiques. Le Débat des semences met les lecteurs au courant de ce qui a changé — sur le plan scientifique, politique et environnemental — depuis la publication ...

  16. Le Projet d’Ole Lando sur les Contrats

    DEFF Research Database (Denmark)

    Holle, Marie-Louise

    2017-01-01

    En 2016 le projet de recherche le plus important jusqu’à présent sur le droit nordique des contrats a pris fin et un livre, de presque 400 pages, en a marqué l’aboutissement. Le résultat du projet est un « restatement » tel qu’il existe aux États-Unis. Le Restatement porte sur les règles et les...

  17. La prolongation de la vie humaine selon Francis Bacon. Ou : quel Tithon voulons-nous être ?

    Directory of Open Access Journals (Sweden)

    Dominique Weber

    2011-07-01

    Full Text Available Afin de comprendre avec exactitude la manière dont Francis Bacon envisage la question de la prolongation de la vie humaine, il faut impérativement examiner l’assise théologique de la réflexion du philosophe à ce sujet. Il convient aussi de restituer l’intégration de cette réflexion dans les objectifs plus amples de la philosophie naturelle nouvelle. Enfin, il est nécessaire de comprendre les dimensions proprement morales de la question. Car la prolongation de la vie humaine n’est pas seulement, au sein de la philosophie naturelle nouvelle, un cas parmi d’autres des recherches qu’il faut désormais effectuer : en réalité, c’est elle qui lui donne et qui lui fixe son sens ; avec elle se joue l’effectivité de l’identité espérée entre science et puissance. Mais il faut encore préciser qu’il ne s’agit aucunement pour l’homme de vieillir pour vieillir : il s’agit pour lui de pouvoir vieillir bien. Les leçons que Bacon tire de la fable de Tithon sont ici véritablement décisives.

  18. New developments in the treatment of primary insomnia in elderly patients: focus on prolonged-release melatonin

    Directory of Open Access Journals (Sweden)

    Vigo DE

    2012-10-01

    , and was associated with significantly less impairment on many of these tasks relative to zolpidem alone or in combination with prolonged-release melatonin. In 3-week and 6-month randomized, double-blind, clinical trials in patients with primary insomnia aged ≥55 years, prolonged-release melatonin was associated with improvements relative to placebo in many sleep and daytime parameters, including sleep quality and latency, morning alertness, and quality of life. Prolonged-release melatonin was very well tolerated in clinical trials in older patients, with a tolerability profile similar to that of placebo. Short-term or longer-term treatment with prolonged-release melatonin was not associated with dependence, tolerance, rebound insomnia, or withdrawal symptoms.Keywords: insomnia, melatonin, Circadin®, clinical trials

  19. Contribution de l'échographie dans le dépistage et le diagnostic des ...

    African Journals Online (AJOL)

    échographie dans le dépistage et le diagnostic des lésions mammaires à Yaoundé, Cameroun. Il s'agissait de décrire les anomalies cliniques, échogra- phiques, éventuellement anatomopathologiques pour des lésions suspectes et les confronter.

  20. Le point sur le sida, l'alimentation et la nutrition | CRDI - Centre de ...

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

    agriculture et l'alimentation ( FAO ), Stuart Gillespie a passé six mois à étudier le lien entre le VIH/sida et la sécurité alimentaire. Il a vite compris que l'épidémie risquait d'avoir, à long terme, des répercussions désastreuses sur la ...

  1. Pour que brûle le feu du changement | IDRC - International ...

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

    7 déc. 2010 ... Le programme Recherche pour la lutte mondiale contre le tabac (RMCT) du CRDI aide des chercheurs des pays en développement à contrer l'influence des géants de l'industrie du tabac aux ressources financières colossales.

  2. Le FIE 2008 fait avancer le cadre écobiosocial de l'OMS | CRDI ...

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

    10 mai 2011 ... Le Programme spécial de recherche et de formation concernant les maladies tropicales (TDR) de l'OMS a élaboré le concept du champ « écobiosocial », qui combine les perspectives écologiques, biologiques et sociales « pour mieux comprendre la dynamique des maladies infectieuses à transmission ...

  3. Contribution de l'échographie dans le dépistage et le diagnostic des ...

    African Journals Online (AJOL)

    Contribution de l'échographie dans le dépistage et le diagnostic des cancers du sein : une expérience de Yaoundé, Cameroun. GE Guegang, TI Sandjong, PM Tebeu, BA Temgoua, Z Sando, JR Moulion, A Atem, E Mboudou, J Yomi, A Doh, FJ Gonsu ...

  4. Changer le travail des animaux, pour changer le travail des humains

    OpenAIRE

    Porcher, Jocelyne

    2016-01-01

    Animaux et hommes construisent des liens par le travail, explique l’auteure de cette tribune. Il existe même un « travailler » de l’animal, où celui-ci s’investit et recherche du sens. Réfléchir au travail des animaux, c’est aussi s’interroger sur le travail humain.

  5. Le SRAS, le sida, et la santé publique | IDRC - International ...

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

    22 juil. 2011 ... Certaines de ces leçons portent sur les interactions complexes entre la biologie, la culture et le pouvoir. D'autres traitent des moyens de .... HIV prevention policy in China. IDRC-funded research is using mathematical modelling to influence local and national policies in China to reduce HIV transmission.

  6. Juan Goytisolo: Le soi, le monde et la création littéraire

    Directory of Open Access Journals (Sweden)

    Pablo Romero Alegría

    2010-01-01

    Full Text Available Reseña de la obra: Yannick Llored. Le soi, le monde et la création littéraire. Presses Universitaires du Septentrion. Villeneuve d’Ascq (Francia. 2009. 421 págs. ISBN: 978-2-75740-0089-0

  7. Pertussis may be the cause of prolonged cough in adolescents and adults in the interepidemic period.

    Science.gov (United States)

    Pimentel, Analíria Moraes; Baptista, Paulo Neves; Ximenes, Ricardo Arraes de Alencar; Rodrigues, Laura Cunha; Magalhães, Vera; Silva, Andrea Rosane Sousa; Souza, Nadjla Ferreira; Matos, Deize Gomes Cavalcanti de; Pessoa, Ana Kelly Lins

    2015-01-01

    This study was aimed to evaluate the prevalence of pertussis in adolescents and adults with cough lasting more than 14 days and less than 30 days. This is a prospective observational study in interepidemic period of pertusis. Ten public health outpatient clinics in the city of Recife, Brazil, were randomly selected for the study. The study population consisted of individuals aged 10 years and over with cough that had lasted between 14 and 30 days. Nasopharyngeal swabs were collected for culture and PCR in order to identify Bordetella pertussis. We adopted the Centers for Disease Control and Prevention in the US (CDC) definition of cases of pertussis. A total of 192 individuals were identified as suspected cases. Their mean age was 40.7 years. Pertussis was confirmed in 10 of the 192 suspected cases, with an estimated prevalence of 5.21% (95% confidence interval 2.03-8.38). All cases met the clinical case definition for pertussis; one suspect had both culture and PCR positive. PCR confirmed 100% of the cases, 7/10 by PCR and 3/10 by epidemiological linkage with a case confirmed by PCR. During an interepidemic period, 1 in 20 cases of prolonged cough had pertussis, suggesting this is an important cause of prolonged cough in adolescents and adults. Copyright © 2014. Published by Elsevier Editora Ltda.

  8. LE LIEN ENTRE FINANCE ET ECONOMIE ISLAMIQUES VIA LE MODELE PRINCIPIEL "ZR"

    OpenAIRE

    BELABES, ABDERRAZAK

    2010-01-01

    A l'heure où certains évoquent l'intégration de la finance islamique à la finance globale, et d'autres rattachent la finance islamique à des thèmes en vogue telles que la finance éthique, la finance participative ou la finance socialement responsable, le présent papier explore le lien entre finance et économie islamiques à partir du modèle principiel "ZR", c’est-à-dire "Zakât" et "Ribâ". Ce modèle montre que les principes invariants de Zakât et Ribâ jouent un rôle central dans l’établissement...

  9. Le patrimoine astronomique provençal

    Science.gov (United States)

    Rous, M.; Figon, P.; Guyot, S.

    2012-12-01

    L'OSU OAMP/Institut Pythéas porte les missions de conservation, inventaire et valorisation du patrimoine. Suite à la fusion de l'Observatoire de Marseille et du Laboratoire d'Astronomie Spatiale en 2000 pour créer le Laboratoire d'Astrophysique de Marseille, le déménagement des équipes sur le site de Château-Gombert en 2008 a soulevé le problème du devenir des collections des deux sites d'origine. Nous ferons le bilan des actions passées en matière de conservation et de valorisation de ce riche patrimoine : versement à l'inventaire général du Ministère de la Culture, classement de 22 instruments au titre des Monuments Historiques, inventaire et numérisation des archives anciennes, montage d'expositions et réalisation du catalogue Telescopium, 400 ans de lunettes et de télescopes. Nous présenterons les actions en cours: mesures de conservation préventive, inventaire des archives et des instruments. Nous parlerons enfin des projets: création d'un espace d'exposition permanente, participation à des expositions temporaires.

  10. Smoking prolongs the infectivity of patients with tuberculosis.

    LENUS (Irish Health Repository)

    Siddiqui, U A

    2010-10-01

    We sought to establish if smokers on anti-tuberculosis treatment are more likely to have a prolonged period of infectivity, compared to non-smoking tuberculosis patients, in a low tuberculosis prevalence country. We conducted a cross-sectional, retrospective study in Ireland that recruited 53 microbiologically confirmed cases of pulmonary tuberculosis (PTB). The age-sex adjusted odds ratios (AOR) suggest that the infectivity status of PTB on treatment was four times more likely to be prolonged beyond 6-8 weeks, if the cases had a smoking history (AOR: 4.42; 95% CI: 1.23; 15.9). Smoking was associated with delayed sputum smear conversion in PTB patients on treatment.

  11. Infection prevention and control during prolonged human space travel.

    Science.gov (United States)

    Mermel, Leonard A

    2013-01-01

    Prolonged human spaceflight to another planet or an asteroid will introduce unique challenges of mitigating the risk of infection. During space travel, exposure to microgravity, radiation, and stress alter human immunoregulatory responses, which can in turn impact an astronaut's ability to prevent acquisition of infectious agents or reactivation of latent infection. In addition, microgravity affects virulence, growth kinetics, and biofilm formation of potential microbial pathogens. These interactions occur in a confined space in microgravity, providing ample opportunity for heavy microbial contamination of the environment. In addition, there is the persistence of aerosolized, microbe-containing particles. Any mission involving prolonged human spaceflight must be carefully planned to minimize vulnerabilities and maximize the likelihood of success.

  12. QTc-prolonging drugs and hospitalizations for cardiac arrhythmias

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Hoes, Arno W; Leufkens, Hubert G M

    2003-01-01

    Cardiac arrhythmia as an adverse effect of noncardiac drugs has been an issue of growing importance during the past few years. In this population-based study, we evaluated the risk for serious cardiac arrhythmias during the use of several noncardiac QTc-prolonging drugs in day-to-day practice......, and subsequently focused on several specific groups of patients who could be extremely vulnerable for drug-induced arrhythmias. We performed a case-control study in which patients (cases), hospitalized for nonatrial cardiac arrhythmias from 1987 to 1998, were compared with their matched controls regarding current...... use of QTc-prolonging drugs. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariate conditional logistic regression, adjusting for potential confounding factors. Data were obtained from the PHARMO record linkage system. We identified 501 cases, 39 of whom used QTc...

  13. Effect of prolonged chemical challenges on selected properties of silorane

    DEFF Research Database (Denmark)

    de Jesus, Vivian CBR; Martinelli, Natan Luiz; Pascotto, Renata Corrêa

    Objectives: The purpose of this study was to investigate the effect of prolonged chemical challenges on water sorption, solubility, and roughness of a silorane-based material when compared to methacrylate-based composites. Methods: Initial roughness and mass were registered for specimens (n=24...... phosphoric acid, 75% ethanol or distilled water for 7, 14, 21, and 180 days, when new measurements were performed. Subsequently, specimens were dehydrated until a constant mass was obtained. Water sorption and solubility were calculated after 180 days of immersion in the different solutions. Data were...... differences in water sorption and solubility were detected amongst the investigated composites (pwater sorption (with similar values to Filtek Z250 and Filtek Z350XT) and low solubility (with similar values to Filtek Z250) after prolonged immersion...

  14. Prolonged and tunable residence time using reversible covalent kinase inhibitors.

    Science.gov (United States)

    Bradshaw, J Michael; McFarland, Jesse M; Paavilainen, Ville O; Bisconte, Angelina; Tam, Danny; Phan, Vernon T; Romanov, Sergei; Finkle, David; Shu, Jin; Patel, Vaishali; Ton, Tony; Li, Xiaoyan; Loughhead, David G; Nunn, Philip A; Karr, Dane E; Gerritsen, Mary E; Funk, Jens Oliver; Owens, Timothy D; Verner, Erik; Brameld, Ken A; Hill, Ronald J; Goldstein, David M; Taunton, Jack

    2015-07-01

    Drugs with prolonged on-target residence times often show superior efficacy, yet general strategies for optimizing drug-target residence time are lacking. Here we made progress toward this elusive goal by targeting a noncatalytic cysteine in Bruton's tyrosine kinase (BTK) with reversible covalent inhibitors. Using an inverted orientation of the cysteine-reactive cyanoacrylamide electrophile, we identified potent and selective BTK inhibitors that demonstrated biochemical residence times spanning from minutes to 7 d. An inverted cyanoacrylamide with prolonged residence time in vivo remained bound to BTK for more than 18 h after clearance from the circulation. The inverted cyanoacrylamide strategy was further used to discover fibroblast growth factor receptor (FGFR) kinase inhibitors with residence times of several days, demonstrating the generalizability of the approach. Targeting of noncatalytic cysteines with inverted cyanoacrylamides may serve as a broadly applicable platform that facilitates 'residence time by design', the ability to modulate and improve the duration of target engagement in vivo.

  15. Prolonged urinary leakage in the postoperative period of renal hydatic cyst treatment with oral desmopressin: a case report

    Directory of Open Access Journals (Sweden)

    Ceylan Cavit

    2012-10-01

    Full Text Available Abstract Introduction Prolonged extravasation after renal and ureter surgeries is a bothersome situation for both the patient and the doctor. It is usually related to the suture line not being watertight. The contact between urine and the edges of the wound also delay healing of the wound. In this situation, the first thing to do is to break the contact between the wound and the urine by inserting an adequate stent. Sometimes, this process is not enough. We approached this problem with a different treatment method for a case involving prolonged drainage. Case presentation A 52-year-old Caucasian woman who presented at our clinic with right flank pain was operated on due to a renal hydatic cyst, and cyst removal was performed. On follow-up, prolonged urinary leakage was observed and a desmopressin treatment was started on the patient. Drainage was greatly reduced after desmopressin was started and there was no drainage on the fifth day. Conclusion Prolonged extravasation is a bothersome situation and there can be many reasons for this. Whenever traditional approaches are not enough, oral desmopressin therapy can be started reliably if there are no contraindications for the patient. Eventually, contact between urine and the suture site will cease and therefore the fever and healing time will be shortened.

  16. Anesthetic Management for Prolonged Incidental Surgery in Advanced Liver Disease

    OpenAIRE

    Kundu, Riddhi; Subramaniam, Rajeshwari; Sardar, Arijit

    2017-01-01

    In spite of advances in perioperative management, operative procedures in patients with chronic liver disease pose a significant challenge for the anesthesiologist due to multisystem involvement, high risk of postoperative hepatic decompensation, and mortality. We describe the anesthetic management of an elderly patient with advanced liver disease (model for end-stage liver disease 16) for prolonged abdominal surgery. The use of invasive hemodynamic monitoring, point-of-care biochemical, and ...

  17. Diclofenac Prolongs Repolarization in Ventricular Muscle with Impaired Repolarization Reserve

    Science.gov (United States)

    Kristóf, Attila; Husti, Zoltán; Koncz, István; Kohajda, Zsófia; Szél, Tamás; Juhász, Viktor; Biliczki, Péter; Jost, Norbert; Baczkó, István; Papp, Julius Gy; Varró, András; Virág, László

    2012-01-01

    Background The aim of the present work was to characterize the electrophysiological effects of the non-steroidal anti-inflammatory drug diclofenac and to study the possible proarrhythmic potency of the drug in ventricular muscle. Methods Ion currents were recorded using voltage clamp technique in canine single ventricular cells and action potentials were obtained from canine ventricular preparations using microelectrodes. The proarrhythmic potency of the drug was investigated in an anaesthetized rabbit proarrhythmia model. Results Action potentials were slightly lengthened in ventricular muscle but were shortened in Purkinje fibers by diclofenac (20 µM). The maximum upstroke velocity was decreased in both preparations. Larger repolarization prolongation was observed when repolarization reserve was impaired by previous BaCl2 application. Diclofenac (3 mg/kg) did not prolong while dofetilide (25 µg/kg) significantly lengthened the QTc interval in anaesthetized rabbits. The addition of diclofenac following reduction of repolarization reserve by dofetilide further prolonged QTc. Diclofenac alone did not induce Torsades de Pointes ventricular tachycardia (TdP) while TdP incidence following dofetilide was 20%. However, the combination of diclofenac and dofetilide significantly increased TdP incidence (62%). In single ventricular cells diclofenac (30 µM) decreased the amplitude of rapid (IKr) and slow (IKs) delayed rectifier currents thereby attenuating repolarization reserve. L-type calcium current (ICa) was slightly diminished, but the transient outward (Ito) and inward rectifier (IK1) potassium currents were not influenced. Conclusions Diclofenac at therapeutic concentrations and even at high dose does not prolong repolarization markedly and does not increase the risk of arrhythmia in normal heart. However, high dose diclofenac treatment may lengthen repolarization and enhance proarrhythmic risk in hearts with reduced repolarization reserve. PMID:23300901

  18. Risk Factors of Prolonged Hospitalization in Patients with Hyperemesis Gravidarum

    Directory of Open Access Journals (Sweden)

    Hasan Onur Topcu

    2015-03-01

    Conclusion: Number of vomiting per day and maternal serum TSH levels could help physicians to estimate the risk of prolonged hospitalization; however further investigations are needed in large population studies. Identifying the high risk patients is important both for prevention of HEG and beginning appropriate antiemetic treatment to avoid complications to reduce the economic costs. [Cukurova Med J 2015; 40(1.000: 113-118

  19. The effects of sodium bicarbonate during prolonged cardiopulmonary resuscitation.

    Science.gov (United States)

    Weng, Yi-Ming; Wu, Shih-Hao; Li, Wen-Cheng; Kuo, Chan-Wei; Chen, Shou-Yen; Chen, Jih-Chang

    2013-03-01

    This study was performed to determine the effects of sodium bicarbonate injection during prolonged cardiopulmonary resuscitation (for >15 minutes). The retrospective cohort study consisted of adult patients who presented to the emergency department (ED) with the diagnosis of cardiac arrest in 2009. Data were retrieved from the institutional database. A total of 92 patients were enrolled in the study. Patients were divided into 2 groups based on whether they were treated (group1, n = 30) or not treated (group 2, n = 62) with sodium bicarbonate. There were no significant differences in demographic characteristics between groups. The median time interval between the administration of CPR and sodium bicarbonate injection was 36.0 minutes (IQR: 30.5-41.8 minutes). The median amount of bicarbonate injection was 100.2 mEq (IQR: 66.8-104.4). Patients who received a sodium bicarbonate injection during prolonged CPR had a higher percentage of return of spontaneous circulation, but not statistical significant (ROSC, 40.0% vs. 32.3%; P = .465). Sustained ROSC was achieved by 2 (6.7%) patients in the sodium bicarbonate treatment group, with no survival to discharge. No significant differences in vital signs after ROSC were detected between the 2 groups (heart rate, P = .124; systolic blood pressure, P = .094). Sodium bicarbonate injection during prolonged CPR was not associated with ROSC after adjust for variables by regression analysis (Table 3; P = .615; odds ratio, 1.270; 95% confidence interval: 0.501-3.219) The administration of sodium bicarbonate during prolonged CPR did not significantly improve the rate of ROSC in out-of-hospital cardiac arrest. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Metabolic response to human growth hormone during prolonged starvation.

    Science.gov (United States)

    Felig, P; Marliss, E B; Cahill, G F

    1971-02-01

    The metabolic response to human growth hormone (HGH) was studied in five obese subjects in the fed state and during prolonged (5-6 wk) starvation. In the fed state (three subjects), HGH induced an elevation in basal serum insulin concentration, a minimal increase in blood and urine ketone levels, and a marked reduction in urinary nitrogen and potassium excretion resulting in positive nitrogen and potassium balance. In prolonged fasting (four subjects), HGH administration resulted in a 2- to 3-fold increase in serum insulin which preceded a 50% elevation in blood glucose. Persistence of the lipolytic effects of HGH was indicated by a rise in free fatty acids and glycerol. The response differed markedly from the fed state in that blood beta-hydroxybutyrate and acetoacetate levels rose by 20-40%, resulting in total blood ketone acid concentrations of 10-12 mmoles/liter, ketonuria of 150-320 mmoles/day, and increased urinary potassium loss. The subjects complained of nausea, vomiting, weakness, and myalgias. Despite a 50% reduction in urea excretion during HGH administration, total nitrogen loss remained unchanged as urinary ammonia excretion rose by 50% and correlated directly with the degree of ketonuria. It is concluded that in prolonged starvation (a) HGH may have a direct insulinotropic effect on the beta cell independent of alterations in blood glucose concentration, (b) persistence of the lipolytic action of HGH results in severe exaggeration of starvation ketosis and interferes with its anticatabolic action by necessitating increased urinary ammonia loss, and (c) failure of HGH to reduce net protein catabolism in starvation suggests that this hormone does not have a prime regulatory role in conserving body protein stores during prolonged fasting.

  1. Aristides Leão: a birth centennial homage with comments on his spreading depression

    Directory of Open Access Journals (Sweden)

    Eliasz Engelhardt

    2015-06-01

    Full Text Available The year of 2014 is the birth centenary of Aristides Azevedo Pacheco Leão (1914-1993, and also marks seventy years of the publication of his discovery of the novel electrophysiological phenomenon, named by him “spreading depression” (SD, soon designated “Leão’s wave” or “Leão’s spreading depression”. This was a remarkable scientific milestone, and the author must be celebrated for this achievement, as the studies he triggered proceeded worldwide, with new concepts, as spreading depolarization, until the present days. Robust experimental and clinical evidence emerged to suggest that these and related electrophysiological phenomena are involved in the mechanisms of migraine aura, acute cerebrovascular diseases, traumatic brain injury, transient global amnesia, epileptic seizures, and their pathophysiological characteristics come to offer new therapeutic perspectives. He was a remarkable and complex personality, and the authors remit the readers to a paper where his personal life is contemplated.

  2. Predicting QRS and PR interval prolongations in humans using nonclinical data.

    Science.gov (United States)

    Bergenholm, L; Parkinson, J; Mettetal, J; Evans, N D; Chappell, M J; Collins, T

    2017-10-01

    Risk of cardiac conduction slowing (QRS/PR prolongations) is assessed prior to clinical trials using in vitro and in vivo studies. Understanding the quantitative translation of these studies to the clinical situation enables improved risk assessment in the nonclinical phase. Four compounds that prolong QRS and/or PR (AZD1305, flecainide, quinidine and verapamil) were characterized using in vitro (sodium/calcium channels), in vivo (guinea pigs/dogs) and clinical data. Concentration-matched translational relationships were developed based on in vitro and in vivo modelling, and the in vitro to clinical translation of AZD1305 was quantified using an in vitro model. Meaningful (10%) human QRS/PR effects correlated with low levels of in vitro Na v 1.5 block (3-7%) and Ca v 1.2 binding (13-21%) for all compounds. The in vitro model developed using AZD1305 successfully predicted QRS/PR effects for the remaining drugs. Meaningful QRS/PR changes in humans correlated with small effects in guinea pigs and dogs (QRS 2.3-4.6% and PR 2.3-10%), suggesting that worst-case human effects can be predicted by assuming four times greater effects at the same concentration from dog/guinea pig data. Small changes in vitro and in vivo consistently translated to meaningful PR/QRS changes in humans across compounds. Assuming broad applicability of these approaches to assess cardiovascular safety risk for non-arrhythmic drugs, this study provides a means of predicting human QRS/PR effects of new drugs from effects observed in nonclinical studies. © 2017 The British Pharmacological Society.

  3. Prolonged Exposure Therapy For Post Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Levent SÜTÇÝGÝL

    2012-08-01

    Full Text Available Post-traumatic Stress Disorder (PTSD is a psychiatric illness that usually develops after an event that threatens one’s life and body integrity and it affects quality of life and impairs social functioning significantly. Many studies have shown therapeutic effect of cognitive behavioral therapies on posttraumatic stress disorder, so that these therapies take part in the first step of treatment guides. Exposure is a practice that is generally used to reduce pathological fear and related emotions common in posttraumatic stress disorder (PTSD and other anxiety disorders. During exposure, patients intentionally confront with feared objects, situations, thoughts and similar stimuli in order to reduce anxiety level. Exposure can be divided into two main techniques as in vivo exposure and imaginal exposure. Prolonged exposure therapy is a specialized treatment program configured for the treatment of posttraumatic stress disorder and it is based on emotional processing theory. Program is comprised of four main components: (a Psycho-education about trauma and posttraumatic disorders, (b Training for breathing exercises, (c repeated facing with objects, persons, situations and thoughts which causes re-experience about trauma, (d Patient are instructed for telling repeatedly and loudly about traumatic experiences . Prolonged exposure usually involves 9 to 12 sessions, each lasting about 60-90 minutes, administered once or twice a week. Prolonged exposure therapy was started to be implemented since the 1980s, during this period the effectiveness of the therapy has been shown in various empirical studies. [JCBPR 2012; 1(2.000: 98-104

  4. Prolonged Exposure Therapy For Post Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Levent SÜTÇİGİL

    2012-07-01

    Full Text Available Post-traumatic Stress Disorder (PTSD is a psychiatric illness that usually develops after an event that threatens one’s life and body integrity and it affects quality of life and impairs social functioning significantly. Many studies have shown therapeutic effect of cognitive behavioral therapies on posttraumatic stress disorder, so that these therapies take part in the first step of treatment guides. Exposure is a practice that is generally used to reduce pathological fear and related emotions common in posttraumatic stress disorder (PTSD and other anxiety disorders. During exposure, patients intentionally confront with feared objects, situations, thoughts and similar stimuli in order to reduce anxiety level. Exposure can be divided into two main techniques as in vivo exposure and imaginal exposure. Prolonged exposure therapy is a specialized treatment program configured for the treatment of posttraumatic stress disorder and it is based on emotional processing theory. Program is comprised of four main components: (a Psycho-education about trauma and posttraumatic disorders, (b Training for breathing exercises, (c repeated facing with objects, persons, situations and thoughts which causes re-experience about trauma, (d Patient are instructed for telling repeatedly and loudly about traumatic experiences . Prolonged exposure usually involves 9 to 12 sessions, each lasting about 60-90 minutes, administered once or twice a week. Prolonged exposure therapy was started to be implemented since the 1980s, during this period the effectiveness of the therapy has been shown in various empirical studies.

  5. Diagnostic performance of placental alpha-microglobulin-1 test in women with prolonged pre-labour rupture of membranes.

    Science.gov (United States)

    Eleje, George Uchenna; Ezugwu, Euzebus Chinonye; Eke, Ahizechukwu Chigoziem; Eleje, Lydia Ijeoma; Ikechebelu, Joseph Ifeanyichukwu; Afiadigwe, Evaristus Anthony; Ezugwu, Frank O; Udigwe, Gerald Okanandu; Okafor, Charles I; Ezeama, Chukwuemeka Okwudili

    2016-01-01

    To determine diagnostic performance of placental alpha-microglobulin-1 (PAMG-1) test compared to conventional clinical assessment (CCA) in women with prolonged pre-labour rupture of membranes (PROM). A double-blind study of women with symptoms and signs of PROM in Nnamdi Azikiwe University Teaching Hospital, Nnewi and University of Nigeria Teaching Hospital, Enugu, in south-east Nigeria using CCA for PROM and PAMG-1 test was done. Women were included if their symptoms, signs or complaints suggestive of PROM was more than 24 h duration. PROM was diagnosed if two out of three methods from CCA (pooling, positive nitrazine test or ferning) were present. Confirmation of PROM was done after delivery using any two of these clinical criteria: delivery in 48 h to 7 days, evidence of chorioamnionitis, membranes obviously ruptured at delivery and adverse perinatal outcomes strongly correlated with prolonged PROM. Accuracy, specificity and sensitivity value for CCA were 72.5, 36.8 and 86.0% lower than for PAMG-1 test which were 95.7, 94.1 and 96.2%. In equivocal cases, PAMG-1 was significantly more accurate than CCA (92.3% versus 38.5%; p < 0.001). This study in women with prolonged PROM, confirms that PAMG-1 test has high diagnostic accuracy irrespective of the duration of PROM before clinical evaluation.

  6. Le mal et ses complots imaginaires

    OpenAIRE

    Frankfurter, David

    2012-01-01

    Les récits d’abus rituels sataniques que les médias ont largement diffusés, aux États-Unis et au Royaume-Uni, entre le début des années 1980 et la fin des années 1990, soutenaient le parallèle avec les allégations avancées, durant l’Antiquité et au début des Temps modernes, contre les chrétiens, les hérétiques, les juifs ou les sorcières. Quelle est la nature de ces parallèles ? Cet article examine plusieurs types de modèles convoqués lors de diverses occurrences historiques des peurs panique...

  7. Le catch, la domestication du risque

    Directory of Open Access Journals (Sweden)

    Jeremy Lacoste

    2015-09-01

    Full Text Available Cet article vise à questionner les logiques de gestion, réappropriation et détournement du risque à travers le catch. Il s’appuie sur la monographie d’un club de la région parisienne observée durant huit mois. Parce que la discipline est à mi-chemin entre la sportivité théâtrale et la scénarisation pugilistique, elle pioche dans le registre de la représentation. Ainsi, art de la surenchère et du pastiche, le catch constitue un terreau majeur pour déconstruire les figures du risque.

  8. Le littoral face aux changements climatiques

    OpenAIRE

    Mulot, Vanessa; Vigneron, Anne-Laure; Lambert-Hadid, Marie-Laure

    2011-01-01

    Le changement climatique et l’anthropisation du littoral accentuent le risque de submersion marine sur l’ensemble des côtes. Malgré l’élévation en cours du niveau des mers, l’attractivité du littoral ne décroît pas malgré la connaissance du risque. Ce risque aggravera dans les années à venir les enjeux liés à la submersion marine, parmi lesquels le danger pour les vies humaines, comme l’a malheureusement illustré l’actualité (Xynhia), mais aussi la question de la propriété des biens et des te...

  9. Les Brulures Chimiques Par Le Laurier Rose

    OpenAIRE

    Bakkali, H.; Ababou, M.; Nassim Sabah, T.; Moussaoui, A.; Ennouhi, A.; Fouadi, F.Z.; Siah, S.; Ihrai, H.

    2010-01-01

    Le laurier rose ou Nerium oleander est un arbuste qui pousse naturellement dans les régions méditerranéennes. Au Maroc on le trouve dans les lieux humides. Il est réputé par ses risques de toxicité systémique en cas d'empoisonnement à cause de la présence de deux alcaloïdes, surtout l'oléandrine. La littérature illustre des cas d'utilisation locale des feuilles de cette plante contre la gale, les hémorroïdes et les furoncles. Nous rapportons deux cas de brûlures chimiques par le laurier rose ...

  10. Influence du soleil sur le climat

    OpenAIRE

    Bard, Édouard

    2013-01-01

    Variations du forçage radiatif solaire Il a fallu attendre la fin des années 70 pour obtenir les premières données précises sur l’irradiance solaire mesurée à partir des satellites. La « constante solaire », introduite par le physicien français Claude Pouillet en 1838, fluctue à court terme et son cycle de 11 ans se caractérise par une variation de l’irradiance totale d’environ 0,1 %. Paradoxalement, l’éclairement augmente avec le nombre de taches solaires : les taches assombrissent le Soleil...

  11. Farid Ameur, Le Ku Klux Klan

    OpenAIRE

    Laberge, Yves

    2018-01-01

    S’il existe de nombreuses études en anglais sur le Ku Klux Klan, et notamment celles — percutantes — de Stetson Kennedy (1916-2011), qui avait réussi à infiltrer cette organisation, on en trouve relativement peu en langue française. De ce fait, la réédition de cette monographie de l’historien Farid Ameur tombe à point nommé. Mouvement social d’extrême-droite prônant le racisme et la suprématie blanche, le KKK a une histoire secrète qui est de ce fait difficile à raconter de manière exhaustive...

  12. Le jeu de la création : Le mangeur (2005 de Ying Chen

    Directory of Open Access Journals (Sweden)

    Nicole Dunham

    2013-11-01

    Full Text Available Le théoricien James Hans définit le jeu comme une déconstruction structurante, un processus de perpétuelle remise en question. Dans Le Mangeur (2005 de Ying Chen, la narratrice revit un épisode d’une de ses vies passées où elle meurt mangée, avalée, par son père, descendant dans le « tunnel » du ventre de ce dernier. Cependant, suite à cet événement, elle se retrouve dans un autre espace-temps où elle rencontre son mari, A.. Une équivalence s’établit dans le roman entre les éléments suivants : le ventre du père, les tableaux peints par ce dernier et l’espace-temps de A., et la fenêtre. Ces éléments deviennent des aires de jeu, remettant en question les concepts de l’intérieur et de l’extérieur et du créateur et de l’œuvre. En nous servant du texte « Le Tunnel » écrit par Ying Chen, nous démontrerons que cette notion du jeu s’applique également à l’ensemble de son œuvre.

  13. O labor secreto de Le Corbusier

    OpenAIRE

    Alexandre Hector Benoit

    2014-01-01

    Após iniciar sua trajetória como pintor junto às vanguardas parisienses do cubismo e do purismo, Le Corbusier cessa em 1923, aos olhos do público, tal atividade, mantendo-a regular e sistemática como um trabalho exclusivo seu. Afora algumas poucas exposições menores e discretas, Le Corbusier permanece cerca de 30 anos pintando sem expor até que, em 1948, inicia o redescobrimento do que veio a chamar de seu \\"labor secreto\\". Esse processo de retomada da pintura como a \\"virtude profunda\\" de ...

  14. LE MARCHE FINANCIER EN ALGERIE : SITUATION ET ...

    African Journals Online (AJOL)

    Administrateur

    Dans les pays en transition, la performance du marché financier apparaît loin des espérances suscitées. Le marché financier dont le début de la mise en place en Algérie remonte à 1995, peut-il se construire dans une économie dominée par la rente pétro- lière et par un système bancaire public sclérosé, omniprésent et ...

  15. Le language des masques burkinabè

    African Journals Online (AJOL)

    hond

    2 juil. 2007 ... Les masques, dont le côté festif, esthétique et touristique retient encore l'attention des jeunes, tendent à « s'épurer » de leur ésotérisme qui leur donnait une âme grave. Ainsi « allégés », les masques risquent de tomber dans le folklore ; ils risquent même. 23 Millogo_F 03.pmd. 2/7/2007, 1:40 PM. 330 ...

  16. Le continu contre l'espace

    Science.gov (United States)

    Salanskis, Jean-Michel

    Disons pour conclure que, en tout état de cause, la façon de concevoir philosophiquement le conflit du continu et de l'espace que nous avons trouvée chez Hegel n'est pas homogène avec le style et les modalités de la pensée mathématique: 1) d'une part, le lien classique, le lien de référence entre continu et espace en mathématiques n'est pas que l'espace serait premier et privé de pensée, et le continu second, venant dissoudre l'espace en apportant la qualité, l'infini et la pensée, mais tout au contraire, il consiste en ce que l'espace est fondé sur l'abîme infinitaire du continu ; 2) d'autre part, l'éventuel divorce entre l'espace et le continu dans l'aire mathématique n'est pas celui d'une réflexivité purement conceptuelle du continu avec un positivisme géométrique, n'équivaut pas à une rupture disciplinaire ; il est plutôt le symptôme de la dérive d'une herméneutique à l'égard d'une autre, au sein d'un continent juridique commun définissant la discipline (la mathématique ensembliste), cette dérive pouvant, à la limite, induire une refonte de ce sol juridique, sans que jamais il soit question pour autant de nier l'unité des mathématiques, à comprendre ici comme l'unité ultime de responsabilité de la communauté mathématique à l'égard des trois questions Qu'est-ce que l'espace?”, “Qu'est-ce que le continu?” et “Qu'est-ce que l'infini?”.

  17. et le développement La

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

    été réalisée, le service postal venait de mettre en place un système automatisé de transferts monétaires par voie élec- tronique à l'intérieur du pays, mais il offrait un service international restreint. À la fin de 2007, l'Uzbekistan. Pochtasi a intégré officiellement le système financier inter- national de l'Union postale universelle, ...

  18. L'astronomie dans le monde

    OpenAIRE

    Manfroid, Jean

    2004-01-01

    comètes en pagaille; Recherche d'astéroïdes; Voisinage galactique; Titan en X; Titan à haute résolution; Alignement parfait dans le Sagittaire; Où est la lune de Sedna; SgrA*; Première image d'une planète extrasolaire?; Deux Jupiter chauds; Cycles stellaires; Le trou noir de M87; Un nouveau bras pour la Voie LactÃée; L'étoile la plus massive jamais observée!

  19. Particularites des accidents vasculaires cerebraux chez le ...

    African Journals Online (AJOL)

    Une revue de la littérature nous a permis de relever les particularités des AVC chez le diabétique. Résultats L'AVC peut être révélateur du diabète dans 20% des cas, ... Le dépistage du diabète doit être systématique chez tout patient présentant un AVC. A la phase aiguë, l'hyperglycémie doit être traitée énergiquement.

  20. Maternal anti-M induced hemolytic disease of newborn followed by prolonged anemia in newborn twins.

    Science.gov (United States)

    Arora, Satyam; Doda, Veena; Maria, Arti; Kotwal, Urvershi; Goyal, Saurabh

    2015-01-01

    Allo-anti-M often has an immunoglobulin G (IgG) component but is rarely clinically significant. We report a case of hemolytic disease of the fetus and newborn along with prolonged anemia in newborn twins that persisted for up to 70 days postbirth. The aim was to diagnose and successfully manage hemolytic disease of newborn (HDN) due to maternal alloimmunization. Direct antiglobulin test (DAT), antigen typing, irregular antibody screening and identification were done by polyspecific antihuman globulin cards and standard tube method. At presentation, the newborn twins (T1, T2) had HDN with resultant low reticulocyte count and prolonged anemia, which continued for up to 70 days of life. Blood group of the twins and the mother was O RhD positive. DAT of the both newborns at birth was negative. Anti-M was detected in mothers as well as newborns. Type of antibody in mother was IgG and IgM type whereas in twins it was IgG type only. M antigen negative blood was transfused thrice to twin-1 and twice to twin-2. Recurring reduction of the hematocrit along with low reticulocyte count and normal other cell line indicated a pure red cell aplastic state. Anti-M is capable of causing HDN as well as prolonged anemia (red cell aplasia) due to its ability to destroy the erythroid precursor cells. Newborns with anemia should be evaluated for all the possible causes to establish a diagnosis and its efficient management. Mother should be closely monitored for future pregnancies as well.

  1. Maternal anti-M induced hemolytic disease of newborn followed by prolonged anemia in newborn twins

    Directory of Open Access Journals (Sweden)

    Satyam Arora

    2015-01-01

    Full Text Available Allo-anti-M often has an immunoglobulin G (IgG component but is rarely clinically significant. We report a case of hemolytic disease of the fetus and newborn along with prolonged anemia in newborn twins that persisted for up to 70 days postbirth. The aim was to diagnose and successfully manage hemolytic disease of newborn (HDN due to maternal alloimmunization. Direct antiglobulin test (DAT, antigen typing, irregular antibody screening and identification were done by polyspecific antihuman globulin cards and standard tube method. At presentation, the newborn twins (T1, T2 had HDN with resultant low reticulocyte count and prolonged anemia, which continued for up to 70 days of life. Blood group of the twins and the mother was O RhD positive. DAT of the both newborns at birth was negative. Anti-M was detected in mothers as well as newborns. Type of antibody in mother was IgG and IgM type whereas in twins it was IgG type only. M antigen negative blood was transfused thrice to twin-1 and twice to twin-2. Recurring reduction of the hematocrit along with low reticulocyte count and normal other cell line indicated a pure red cell aplastic state. Anti-M is capable of causing HDN as well as prolonged anemia (red cell aplasia due to its ability to destroy the erythroid precursor cells. Newborns with anemia should be evaluated for all the possible causes to establish a diagnosis and its efficient management. Mother should be closely monitored for future pregnancies as well.

  2. Le stéréotype dans le roman policier

    Directory of Open Access Journals (Sweden)

    Marion François

    2009-12-01

    Full Text Available Le roman policier offre à l’étude du stéréotype une grande variété de redondances, lexicales et structurelles, qui permettent d’éclairer le concept même de genre, en fait issu du constat de stéréotypie. Il est également manifeste que contrairement aux idées reçues, les clichés font du texte policier un texte littéraire, parce qu’ils naissent d’images associées, distinctes de la réalité, qui révèlent d’ailleurs le cheminement même de l’écriture. Par ailleurs ces images jouent un rôle fondamental dans le plaisir du lecteur, comme dans les contes de fées de notre enfance. Les clichés ouvrent la porte des fantasmes : le stéréotype rejoignant l’archétype, les clichés policiers réactivent de nombreux mythes, le texte évoquant l’Autre Scène. Le constat de stéréotypie provoque l’écriture, en particulier parodique, et stimule le renouvellement et l’essaimage des clichés dans toutes sortes de textes, qui bénéficieront de la présence du déjà-lu, laquelle donne au lecteur une assise pour affronter l’inconnu et une expérience pour apprécier la nouveauté.

  3. Le Peer to Peer: Vers un Nouveau Modèle de Civilization

    Directory of Open Access Journals (Sweden)

    Michel Bauwens

    2006-06-01

    Full Text Available Le « peer to peer » est la dynamique intersubjective caractéristique des réseaux distribués. Le but de cet essai est de montrer qu'il s'agit d'une véritable nouvelle forme d’organisation sociale, apte à produire et échanger des biens, à créer de la valeur. Celle-ci est la conséquence d'un nouvel imaginaire social, et possède le potentiel de devenir le pilier d'un nouveau mode d'économie politique, voire d'un nouveau type de civilisation. Pour cela, nous allons d'abord définir le P2P, décrire en bref ces manifestations, et le différencier d'autres modalités d'échange intersubjectif tel que le marché, la hiérarchie, l'économie du don.Comme principale modalité P2P nous distinguons: Les processus de production P2P, comme troisième mode de production, qui n'est ni géré par un mode hiérarchique ou par l'état, ni répondant à des impératifs de profit ou qui sont modulés par le biais des prix. Les processus de gouvernance P2P, qui gouverne ces processus de production. Les formes de propriété P2P, qui sont destine a empecher l’appropriation prive de cette production pour le commun.Afin d’examiner les characteristiques de cette nouvelle dynamique sociale, nous utilisons la typologie intersubjective de l’anthropologue Alan Page Fisque, qui distingue: 1. l'échange égalitaire (Equality Matching, c..a.d l’economie du don. 2. La relation d’autorité (Authority Ranking tel qu’elle s’exprime dans le mode hierarchique. 3. le marché (Market Pricing. 4. la participation commune (Communal Shareholding.En conclusion, nous examinons les possibilites d’expansion de ce nouveau mode sociale et son insertion dans l’economie capitaliste, en nous nous posons la question: le P2P peut-il etre concu comme alternative sociale et economique aux modeles existants.

  4. L'Inde : où est le milieu ? | CRDI - Centre de recherches pour le ...

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

    1 avr. 2011 ... Mais ils n'ont pas créé les emplois « fiables » dont l'Inde a désespérément besoin. Le travail peu rémunéré demeure un problème de taille sur le marché du travail indien. Pourtant, l'étude réalisée par M. Mazumdar sur la pauvreté, la croissance et l'inégalité montre que le nombre d'Indiens vivant dans la ...

  5. La science, la littérature, le rituel: le vrai dire et le plus que mentir

    Directory of Open Access Journals (Sweden)

    Panagiotis Christias

    2005-03-01

    Full Text Available Le scientifique promet la vérité sans être en mesure d'accomplir sa promesse tandis que l'écrivain promet de mentir mais par son mensonge, il fait plus que mentir. Il ne dit certainement pas la vérité, car la vérité n'est pas sa préoccupation première. Voilà comment nous pouvons résumer les deux attitudes, condamnées à un antagonisme stérile par l'attitude positiviste moderne. Compte tenu donc de l'intention fondatrice de la science, de sa promesse donc originaire et fondatrice, la science doit dire la vérité et rien que la vérité. Ce qui, de l'aveu même de cette même science, est impossible. [...] La littérature se permet de reconstruire des mondes par-delà le vrai et le faux. [...] Un récit littéraire ne demande pas la consécration de la vérité, ne demande pas à être suivi parce que vrai, n'impose rien et n'attend rien. Sa vraie destinée est l'errance et sa vraie conscience est celle de sa dissémination. Celui qui renonce à la prétention de vérité renonce en même temps à la volonté de dominer. Dominer signifie créer un espace de vérité dans lequel celui qui énonce la vérité est le maître légitime de ceux qui sont dans le champ de la conception du monde dont cette vérité est la pierre angulaire.

  6. Perspectives | Page 3 | CRDI - Centre de recherches pour le ...

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

    Des experts du CRDI examinent les questions et les approches sur lesquelles se penchent les acteurs du développement international, ainsi que lele de la recherche dans la mise au point de solutions.

  7. Pronto chi parla. Cesare e le intercettazioni telefoniche

    Directory of Open Access Journals (Sweden)

    Paolo Caponi

    2010-03-01

    Full Text Available Pronto chi parla. Cesare e le intercettazioni telefoniche (Ugo Guspini, L’orecchio del regime. Le intercettazioni telefoniche al tempo del fascismo, Milano, Mursia, 1973, pp. 262 di Paolo Caponi

  8. Are salt loading and prolonging infusion period effective in prevention of amphotericin B-induced nephrotoxicity?

    Science.gov (United States)

    Karimzadeh, Iman; Farsaei, Shadi; Khalili, Hossein; Dashti-Khavidaki, Simin

    2012-11-01

    Nephrotoxicity is generally considered as the most clinically significant adverse reaction of amphotericin B, and has been reported in up to 80% of amphotericin B recipients during the first 2 weeks of treatment. Numerous experimental and clinical investigations have been performed over the past 4 decades, to find appropriate interventions for preventing or minimizing the nephrotoxic effects of amphotericin B. The aim of this literature review was to collect available clinical data regarding interventions to prevent amphotericin B-induced nephrotoxicity in human populations. A literature search was performed in the following databases: Scopus, Medline, Embase, Cochrane central register of controlled trials, and Cochrane database systematic reviews. The key words used as search terms were 'amphotericin', 'amphotericin B', 'nephrotoxicity', 'renal failure', 'renal damage', 'renal dysfunction', 'renal impairment', 'prevention', 'preventive measures', and 'preventive interventions'. Studies in humans have clearly demonstrated that salt loading can prevent or alleviate an amphotericin B-induced rise in serum creatinine, or decrease in glomerular filtration rate, without beneficial effects on tubular toxicity of amphotericin B. Current clinical data regarding the prolongation of amphotericin B duration of infusion in the prevention of nephrotoxicity is controversial and associated with several clinical and practical drawbacks.

  9. Outcomes of octogenarians discharged from the hospital after prolonged intensive care unit length of stay after cardiac surgery.

    Science.gov (United States)

    Arora, Rakesh C; Manji, Rizwan A; Singal, Rohit K; Hiebert, Brett; Menkis, Alan H

    2017-11-01

    Octogenarians offered complex cardiac surgery frequently experience a prolonged intensive care unit length of stay; however, minimal data exist on the outcomes of these patients. We sought to determine the rates and predictors of 1-year noninstitutionalized survival ("functional survival") and rehospitalization for octogenarian patients with prolonged intensive care unit length of stay after cardiac surgery and who were discharged from hospital. The outcomes of discharged patients aged 80 years or more who underwent cardiac surgery with prolonged intensive care unit length of stay (≥5 consecutive days) from January 1, 2000, to December 31, 2011, were examined retrospectively from linked clinical and administrative provincial databases. Regression analysis was used to determine predictors of 1-year functional survival and rehospitalization after discharge from the hospital. A total of 80 of 683 (11.7%) discharged octogenarian patients had prolonged intensive care unit length of stay. Functional survival at 1 year was 92% and 81% for those with nonprolonged and prolonged intensive care unit lengths of stay, respectively (P intensive care unit lengths of stay, respectively, with 41% of all rehospitalizations occurring within 30 days of initial discharge. A rural residence (hazard ratio, 1.82; P intensive care unit length of stay have acceptable functional survival at 1 year but have high rates of early rehospitalization. Access to health services may influence functional survival and early rehospitalizations. These data suggest that close follow-up of these vulnerable patients after hospital discharge is warranted. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  10. Availability of human induced pluripotent stem cell-derived cardiomyocytes in assessment of drug potential for QT prolongation

    Energy Technology Data Exchange (ETDEWEB)

    Nozaki, Yumiko, E-mail: yumiko-nozaki@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Honda, Yayoi, E-mail: yayoi-honda@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Tsujimoto, Shinji, E-mail: shinji-tsujimoto@ds-pharma.co.jp [Regenerative and Cellular Medicine Office, Dainippon Sumitomo Pharma. Co., Ltd., Chuo-ku, Tokyo 104-0031 (Japan); Watanabe, Hitoshi, E-mail: hitoshi-1-watanabe@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Kunimatsu, Takeshi, E-mail: takeshi-kunimatsu@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Funabashi, Hitoshi, E-mail: hitoshi-funabashi@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan)

    2014-07-01

    Field potential duration (FPD) in human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs), which can express QT interval in an electrocardiogram, is reported to be a useful tool to predict K{sup +} channel and Ca{sup 2+} channel blocker effects on QT interval. However, there is no report showing that this technique can be used to predict multichannel blocker potential for QT prolongation. The aim of this study is to show that FPD from MEA (Multielectrode array) of hiPS-CMs can detect QT prolongation induced by multichannel blockers. hiPS-CMs were seeded onto MEA and FPD was measured for 2 min every 10 min for 30 min after drug exposure for the vehicle and each drug concentration. I{sub Kr} and I{sub Ks} blockers concentration-dependently prolonged corrected FPD (FPDc), whereas Ca{sup 2+} channel blockers concentration-dependently shortened FPDc. Also, the multichannel blockers Amiodarone, Paroxetine, Terfenadine and Citalopram prolonged FPDc in a concentration dependent manner. Finally, the I{sub Kr} blockers, Terfenadine and Citalopram, which are reported to cause Torsade de Pointes (TdP) in clinical practice, produced early afterdepolarization (EAD). hiPS-CMs using MEA system and FPDc can predict the effects of drug candidates on QT interval. This study also shows that this assay can help detect EAD for drugs with TdP potential. - Highlights: • We focused on hiPS-CMs to replace in vitro assays in preclinical screening studies. • hiPS-CMs FPD is useful as an indicator to predict drug potential for QT prolongation. • MEA assay can help detect EAD for drugs with TdP potentials. • MEA assay in hiPS-CMs is useful for accurately predicting drug TdP risk in humans.

  11. An unusual case of prolonged post-endoscopic retrograde cholangiopancreatography jaundice.

    Science.gov (United States)

    Tziatzios, Georgios; Gkolfakis, Paraskevas; Papanikolaou, Ioannis S; Dimitriadis, George; Triantafyllou, Konstantinos

    2016-04-01

    Despite the effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of choledocholithiasis, various complications have been described. We herein report the first case of prolonged post-ERCP jaundice due to toxicity of the contrast agent Iobitridol (®XENETIX, Guerbet, Roissy CdG Cedex, France) in a patient who underwent ERCP with sphincterectomy and common bile duct stone removal. While clinical improvement and normalization of aminotransferases and cholestatic enzymes after the procedure, an unexplained increase of direct bilirubin was noticed. A second ERCP was performed one week later, excluding possible remaining choledocholithiasis. Nevertheless, serum direct bilirubin increased further up to 15 mg/dL. Other potential causes of direct hyperbilirubinemia were ruled out and patient's liver biopsy was compatible with drug-induced liver toxicity. Additionally, the cause-result time connection between the use of Iobitridol and bilirubin increase indicated the possibility of a toxic effect related to the repeated use of the particular contrast agent. Iobitridol, a contrast agent, can induce prolonged direct hyperbilirubinemia.

  12. C-Med 100, a hot water extract of Uncaria tomentosa, prolongs lymphocyte survival in vivo.

    Science.gov (United States)

    Akesson, Ch; Pero, R W; Ivars, F

    2003-01-01

    Water extracts of the bark of Uncaria tomentosa, a vine indigenous to South America, has been used for generations as an "immuno modulator". To understand the basis of this immuno modulatory effect we fed mice in their drinking water with C-Med 100, which is a commercially available water extract from Uncaria tomentosa. We found a dose-dependent increase in spleen cell numbers in the supplemented mice, but the proportions of B cells, T cells, NK cells, granulocytes, and memory lymphocytes were normal. However, there were no detectable changes of the lymphoid architecture of the spleen even after long-term treatment. Further, when C-Med 100 treatment was interrupted the cellularity returned to normal level within four weeks. The increased number of lymphocytes was most likely not due to increased production because C-Med 100 did not have any significant effect on precursor cells nor on the accumulation of recent thymic emigrants in the spleen. We conclude that accumulation is most likely due to prolonged cell survival, because adoptive transfer experiments demonstrated that C-Med 100 treatment significantly prolonged lymphocyte survival in peripheral lymphoid organs, without increasing their proliferation rate. Since the accumulation was reversible and without detectable pathological effects, these results suggest the use of C-Med 100 as a potential agent for clinically accelerating the recovery of patients from leukopenia.

  13. Life-threatening asthma attack during prolonged fingolimod treatment: case report

    Directory of Open Access Journals (Sweden)

    Zecca C

    2014-07-01

    Full Text Available Chiara Zecca,1,* Matteo Caporro,1,* Sandor Györik,2 Claudio Gobbi11Neurocenter of Southern Switzerland, Department of Neurology, Ospedale Regionale di Lugano, Lugano, Switzerland; 2Department of Internal Medicine, Ospedale Regionale di Bellinzona, Bellinzona, Switzerland*These authors contributed equally to this workBackground: Fingolimod (FTY mediates bronchoconstriction by interacting with sphingosine-1-phosphate receptors. The majority of the reported adverse respiratory events occur during the first weeks of treatment.Case presentation: A 49-year-old woman developed a life-threatening asthma attack after 6 months of continuous FTY treatment. The adverse event required prolonged hospitalization, and the patient recovered without sequelae after FTY interruption. A history of previous airway hyperreactivity and a concurrent viral respiratory infection possibly acted as predisposing factors.Conclusion: This first description of a severe, life-threatening asthma attack during prolonged FTY treatment suggests the need for long-term clinical surveillance, especially in patients with known predisposing factors.Keywords: multiple sclerosis, bronchial hyper-reactivity

  14. Features of Prolonged Grief Symptoms in Chinese and Swiss Bereaved Parents.

    Science.gov (United States)

    Xiu, Daiming; Maercker, Andreas; Woynar, Stefanie; Geirhofer, Bettina; Yang, Yuting; Jia, Xiaoming

    2016-09-01

    This study investigates clinical expressions of prolonged grief in samples of 32 Chinese and 33 Swiss bereaved parents, according to the proposed International Classification of Diseases, 11th Revision model of prolonged grief disorder (PGD). Sex differences and predictors (cultural attitudes, sense of coherence, and posttraumatic growth) of PGD were analyzed. In result, after controlling for sociodemographic and loss-related sample differences, both samples showed similar PGD symptom profiles, with Swiss parents exhibiting more severe grief-related preoccupation and Chinese parents exhibiting some accessory symptoms and functional impairment to a greater extent. Multivariate analyses revealed for the Chinese sample primary predictions of PGD by life satisfaction, general health and one's world view (social cynicism) and for the Swiss sample by female sex, sense of coherence, and life satisfaction. The findings substantiate the basic appropriateness of the International Classification of Diseases, 11th Revision PGD in distinct cultural groups and may contribute to a better understanding of grief expression and its potential predictors across different cultures.

  15. Total knee arthroplasty for treatment of osteoarthritis with prolonged patellar dislocation

    Directory of Open Access Journals (Sweden)

    Kosuke Kumagai, MD, PhD

    2017-03-01

    Full Text Available Prolonged dislocation of the patella is a rare condition and is often related to severe osteoarthritis (OA of the femorotibial (FT joint. For this condition's treatment, numerous surgical techniques using total knee arthroplasty (TKA have been published. To the best of our knowledge, this case report is the first description of the use of lateral release alone to treat recurrent patellar subluxation with TKA. An interesting point in this case is that the patient had a good recovery after TKA in spite of quite a long-term (a duration of almost 55 years dislocation of her patella and development of secondary OA. We describe a case that we treated by TKA for FT-OA with a prolonged patellar dislocation. We were able to obtain good patellar reduction without additional surgery by performing adequate lateral release of the patellar retinaculum. This clinical case indicates the usefulness of lateral patellar retinaculum release for obtaining stable patellar tracking in TKA for FT-OA with remaining lateral patellar dislocation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/.

  16. Disulfide bond-conjugated dual PEGylated siRNAs for prolonged multiple gene silencing.

    Science.gov (United States)

    Liao, Zi-Xian; Hsiao, Chun-Wen; Ho, Yi-Cheng; Chen, Hsin-Lung; Sung, Hsing-Wen

    2013-09-01

    Many human diseases carry at least two independent gene mutations, further exacerbating clinical disorders. In this work, disulfide bond-conjugated dual PEGylated siRNAs were synthesized, capable of specifically targeting and silencing two genes simultaneously. To achieve efficient delivery, the conjugated siRNAs were formulated with the cationic chitosan together with an anionic polymer, poly(γ-glutamic acid) (γPGA), to form a ternary complex. Experimental results indicate that the incorporated γPGA could significantly enhance their intracellular delivery efficiency, allowing for reduction of the disulfide bond-conjugated PEGylated siRNAs delivered to the PEGylated siRNAs in the reductive cytoplasmic environment. The PEGylated siRNAs could more significantly increase their enzymatic tolerability, effectively silence multiple genes, and prolong the duration of their gene silencing capability than the unmodified siRNAs could. Silencing of different genes simultaneously significantly contributes to the efforts to treat multiple gene disorders, and prolonged duration of gene silencing can reduce the need for frequent administrations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Tolerance and withdrawal from prolonged opioid use in critically ill children.

    Science.gov (United States)

    Anand, Kanwaljeet J S; Willson, Douglas F; Berger, John; Harrison, Rick; Meert, Kathleen L; Zimmerman, Jerry; Carcillo, Joseph; Newth, Christopher J L; Prodhan, Parthak; Dean, J Michael; Nicholson, Carol

    2010-05-01

    After prolonged opioid exposure, children develop opioid-induced hyperalgesia, tolerance, and withdrawal. Strategies for prevention and management should be based on the mechanisms of opioid tolerance and withdrawal. Relevant manuscripts published in the English language were searched in Medline by using search terms "opioid," "opiate," "sedation," "analgesia," "child," "infant-newborn," "tolerance," "dependency," "withdrawal," "analgesic," "receptor," and "individual opioid drugs." Clinical and preclinical studies were reviewed for data synthesis. Mechanisms of opioid-induced hyperalgesia and tolerance suggest important drug- and patient-related risk factors that lead to tolerance and withdrawal. Opioid tolerance occurs earlier in the younger age groups, develops commonly during critical illness, and results more frequently from prolonged intravenous infusions of short-acting opioids. Treatment options include slowly tapering opioid doses, switching to longer-acting opioids, or specifically treating the symptoms of opioid withdrawal. Novel therapies may also include blocking the mechanisms of opioid tolerance, which would enhance the safety and effectiveness of opioid analgesia. Opioid tolerance and withdrawal occur frequently in critically ill children. Novel insights into opioid receptor physiology and cellular biochemical changes will inform scientific approaches for the use of opioid analgesia and the prevention of opioid tolerance and withdrawal.

  18. Overdose with modified-release paracetamol results in delayed and prolonged absorption of paracetamol.

    Science.gov (United States)

    Graudins, A; Chiew, A; Chan, B

    2010-01-01

    A modified-release formulation of paracetamol is currently available in Australasia and marketed under a number of different trade names. These include: Panadol Osteo, Panadol Extend Tablets, and Duatrol SR. We report four cases of intentional overdose with this formulation resulting in delay to peak plasma paracetamol concentrations and prolonged paracetamol absorption. Physicians must be aware that a single plasma paracetamol estimation four or more hours post-ingestion may not be adequate in the risk assessment of patients requiring treatment with N-acetylcysteine (NAC). Current Australasian guidelines for the management of modified-release paracetamol overdose advise empiric commencement of NAC if the suspected ingested dose is greater than 10 grams or 200 mg/kg (whichever is the least), an initial plasma paracetamol concentration should be assayed four or more hours post-ingestion and a second assay should be estimated four hours after the first. Treatment with NAC should continue if either concentration falls above the paracetamol treatment nomogram line. With massive ingestions of this paracetamol formulation (>50 grams) plasma concentrations may be elevated for several days and prolonged treatment with NAC is recommended. When modified-release paracetamol overdose is suspected a clinical toxicologist or Poisons Information Centre should be consulted to help guide management decisions.

  19. Le Corbusier, Pierre Chareau and two masterpieces of modern architecture

    Directory of Open Access Journals (Sweden)

    Sílvia Amaral Palazzi Zakia

    2015-06-01

    Full Text Available Le Corbusier and Pierre Chareau are famously responsible for two projects considered iconic of modern architecture: Villa Savoye and Maison de Verre. Both are coeval and commissioned by clients with the same socioeconomic profile – the French haute bourgeoisie –, and with similar needs. Villa Savoye is a single family home, while Maison de Verre houses both residential and medical clinic functions in the same building structure. However, this difference does not interfere in our intended analysis. By comparing the client-architect relationships in both projects – Le Corbusier/Savoye and Chareau/Dalsace – we raise  questions regarding the professional behavior that modern architects have arrogated to themselves: to revolutionize customs and practices. The projects are modern and diverse responses to similar requests. In both cases, the role of women is indicative of their influence in that particular historical context as opinion setters. The house is the locus of the female dominium, and as such expresses women’s tastes and habits.

  20. Publications | Page 102 | CRDI - Centre de recherches pour le ...

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

    En mars 2004, le ministre ougandais de l'Éducation et des sports, Kiddhu Makubuya, et le... Biodiversité et santé : Tuons-nous les plantes qui peuvent nous guérir ? Enrhumé ? Vite, de l'échinacée. Le stress vous tenaille ? Prenez un peu de ginseng. Vous êtes inquiet et déprimé ? Le millepertuis devrait vous requinquer.

  1. Mexico : tous les projets | CRDI - Centre de recherches pour le ...

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

    Au cours des 15 dernières années, des efforts ont été déployés par le gouvernement, la société civile, le secteur privé et les organisations internationales dans le but de relever les défis auxquels sont confrontés les peuples autochtones, et tout particulièrement les femmes dans certains cas, dans le système ...

  2. Publications | Page 179 | CRDI - Centre de recherches pour le ...

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

    Lele de l'énergie dans le développement rural. Hisham Zerriffi n'a aucun mal à énumérer les bienfaits de l'électrification des zones rurales : une ... Enterrer la hache de guerre : le CRDI appuie un processus de paix inédit. La plupart des gens pensent que la paix est un état dans lequel soit il « ne se produit rien de ...

  3. Publications | Page 177 | CRDI - Centre de recherches pour le ...

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

    Lele de l'énergie dans le développement rural. Hisham Zerriffi n'a aucun mal à énumérer les bienfaits de l'électrification des zones rurales : une ... Enterrer la hache de guerre : le CRDI appuie un processus de paix inédit. La plupart des gens pensent que la paix est un état dans lequel soit il « ne se produit rien de ...

  4. Plaidoyer pour le lavage de nez dans les pathologies naso ...

    African Journals Online (AJOL)

    Le lavage de nez permet l'humidification des muqueuses partant favorise le nettoyage mucociliaire en enlevant voire diminuant les croutes favorise leur élimination et ainsi la guérison en réduisant le recours aux antibiotiques [4-10]. Sans danger, le lavage de nez est bien tolérée tant chez les enfants que chez les adultes.

  5. La nouvelle politique concernant le salaire minimum au Myanmar ...

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

    20 avr. 2016 ... Au cours de la dernière décennie, le marché du travail asiatique a été marqué par des augmentations du salaire minimum. Alors que la Chine et le Vietnam ont augmenté leur salaire minimum au cours des 10 dernières années, le Bangladesh et le Cambodge ont adopté un salaire minimum dans les deux ...

  6. Publications | Page 59 | CRDI - Centre de recherches pour le ...

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

    Le rapport régional de 2012 du projet Global Entrepreneurship Monitor (GEM), qui porte sur l'Afrique subsaharienne, est le premier à examiner les dynamiques d'entrepreneuriat dans la région. Il a été lancé à Lusaka, en Zambie, le 19 novembre 2013. Les données recueillies par le Zimbabwe sur la pauvreté : un apport ...

  7. Gestion du Centre | CRDI - Centre de recherches pour le ...

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

    Le Comité de gestion du Centre (CGC) est composé des membres de la haute direction du CRDI, notamment les directeurs de nos quatre bureaux régionaux et de nos principaux secteurs de programme. Le CGC travaille en collaboration avec le président afin de soutenir la recherche pour le développement, lui fournissant ...

  8. Le stockage thermique par chaleur latente

    OpenAIRE

    Martin, F.; Nicolas, Jacques

    1988-01-01

    L'article présente le principe du stockage d'énergie par transformation de phase ainsi que les matériaux employés (composés organiques, sels hydratés et matériaux à transformation solide-solide) et les différents types d'échangeurs. Peer reviewed

  9. Le Chatelier's principle in replicator dynamics.

    Science.gov (United States)

    Allahverdyan, Armen E; Galstyan, Aram

    2011-10-01

    The Le Chatelier principle states that physical equilibria are not only stable, but they also resist external perturbations via short-time negative-feedback mechanisms: a perturbation induces processes tending to diminish its results. The principle has deep roots, e.g., in thermodynamics it is closely related to the second law and the positivity of the entropy production. Here we study the applicability of the Le Chatelier principle to evolutionary game theory, i.e., to perturbations of a Nash equilibrium within the replicator dynamics. We show that the principle can be reformulated as a majorization relation. This defines a stability notion that generalizes the concept of evolutionary stability. We determine criteria for a Nash equilibrium to satisfy the Le Chatelier principle and relate them to mutualistic interactions (game-theoretical anticoordination) showing in which sense mutualistic replicators can be more stable than (say) competing ones. There are globally stable Nash equilibria, where the Le Chatelier principle is violated even locally: in contrast to the thermodynamic equilibrium a Nash equilibrium can amplify small perturbations, though both types of equilibria satisfy the detailed balance condition.

  10. Le Francais Moderne: Part I, French.

    Science.gov (United States)

    Dade County Public Schools, Miami, FL.

    Instructional objectives of the Dade County Public Schools Quinmester Program in French for use with "Le Francais Moderne: Part 1" focus on the development of vocabulary and mastery of grammatical structures. The formation of the passe compose with "avoir," object pronouns, the present tense of regular "-ir" verbs,…

  11. ON THE LE CHATELIER-SAMUELSON PRINCIPLE

    OpenAIRE

    ANDERSON, Richard K.; TAKAYAMA, Akira

    1992-01-01

    This paper obtains a method to derive the Le Chatelier-Samuelson Principle. Not only is it simpler and more straightforward than other methods in the literature, but also it enables us to obtain important results which are not readily accessible otherwise.

  12. Le Chatelier's Principle, Temperature Effects, and Entropy.

    Science.gov (United States)

    Campbell, J. Arthur

    1985-01-01

    One of the most useful methods of understanding chemical equilibria is provided by Le Chatelier's principle. The relationships between this principle, temperature, and entropy are discussed. Tables with thermodynamic data for some net reactions commonly used to illustrate the principle and for reactions involving gases are included. (JN)

  13. Le Chatelier--Right or Wrong?

    Science.gov (United States)

    Helfferich, Friedrich G.

    1985-01-01

    Presents a class exercise designed to find out how well students understand the nature and consequences of the mass action law and Le Chatelier's principle as applied to chemical equilibria. The exercise relates to a practical situation and provides simple relations for maximizing equilibrium quantities not found in standard textbooks. (JN)

  14. Le Chatelier's principle in replicator dynamics

    Science.gov (United States)

    Allahverdyan, Armen E.; Galstyan, Aram

    2011-10-01

    The Le Chatelier principle states that physical equilibria are not only stable, but they also resist external perturbations via short-time negative-feedback mechanisms: a perturbation induces processes tending to diminish its results. The principle has deep roots, e.g., in thermodynamics it is closely related to the second law and the positivity of the entropy production. Here we study the applicability of the Le Chatelier principle to evolutionary game theory, i.e., to perturbations of a Nash equilibrium within the replicator dynamics. We show that the principle can be reformulated as a majorization relation. This defines a stability notion that generalizes the concept of evolutionary stability. We determine criteria for a Nash equilibrium to satisfy the Le Chatelier principle and relate them to mutualistic interactions (game-theoretical anticoordination) showing in which sense mutualistic replicators can be more stable than (say) competing ones. There are globally stable Nash equilibria, where the Le Chatelier principle is violated even locally: in contrast to the thermodynamic equilibrium a Nash equilibrium can amplify small perturbations, though both types of equilibria satisfy the detailed balance condition.

  15. Microscopic Description of Le Chatelier's Principle

    Science.gov (United States)

    Novak, Igor

    2005-01-01

    A simple approach that "demystifies" Le Chatelier's principle (LCP) and simulates students to think about fundamental physical background behind the well-known principles is presented. The approach uses microscopic descriptors of matter like energy levels and populations and does not require any assumption about the fixed amount of substance being…

  16. (Mycosphaerella fijiensis Morelet) chez le bananier plantain

    African Journals Online (AJOL)

    SARAH

    31 mars 2014 ... Aguirre MC, Castano- zapata J, Valencia JA, Zuluaga. LE, Arce C, 1988 a. Interaccion de. Mycosphaerella fijiensis Morelet y M. musicola. Leach en siete genotipos de la Sigatoka negra en la zonacafetera colombiana. Pp. 192-220 in. Memorias del Seminaio Internacional sobre P roduction de Platano.

  17. Le rêve dans la psychanalyse

    Czech Academy of Sciences Publication Activity Database

    Pechar, Jiří

    2016-01-01

    Roč. 12, č. 3 (2016), s. 1-5 ISSN 1336-6556 Institutional support: RVO:67985955 Keywords : psychoanalysis * dream-work * condensation * displacement * screen-memory * Freud Subject RIV: AA - Philosophy ; Religion http://www.ostium.sk/sk/le-r%c8%87ve-dans-la-psychanalyse/

  18. Le recueil littéraire

    OpenAIRE

    Alduy, Cécile; Asselin, Isabelle; Audet, René; Baetens, Jan; Beaudet, Marie-Andrée; Bissonnette, Thierry; Bonenfant, Luc; Bouchet, André du; Brault, Jacques; Brouillette, Marc André; Clément, Anne-Marie; Denis, Benoît; Doucet, Isabelle; Dumont, François; Dupont, Frances Fortier et Caroline

    2016-01-01

    Architecte d'une œuvre plurielle, le recueil est de toutes nos lectures. Puzzle ou série, cycle ou mélange, il se feuillette, se reprend, se quadrille ou se picore. Mais qu'est-ce donc qu'un recueil ?

  19. "Le CERN restera un grand employeur"

    CERN Multimedia

    Monin, V

    2002-01-01

    "Pour le porte-parole du CERN, la suppression de 600 postes d'ici 2007 était prévue depuis bien longtemps. Il s'agit de départs en retraite qui ne sont en aucun cas liés au dépassement du budget du LHC" (1 page).

  20. Intelligence artificielle et agents collectifs : le modèle EUROSIM

    Directory of Open Access Journals (Sweden)

    Denise Pumain

    2007-07-01

    Full Text Available EUROSIM est un modèle multi-agents conçu pour simuler l’évolution à moyen terme du système des villes européennes. Les agents sont des entités collectives, les grandes villes caractérisées par leur taille et leur fonction dans le système des villes, et dont les interactions (échanges modulés par des relations de proximité ou de réseau déterminent la dynamique relative, tandis que la croissance d’ensemble dépend de l’innovation. Des outils d’analyse multiscalaire ont été développés afin d’interpréter les sorties du modèle et faciliter le calibrage.

  1. Luther contre le protocole de Kyoto ou le retour des « indulgences ».

    Directory of Open Access Journals (Sweden)

    Bernard Jouve

    2005-05-01

    Full Text Available Le 16 février 2005 a marqué la mise en œuvre du Protocole de Kyoto. En fait, depuis l’annonce par la Russie, le 25 octobre 2004, de sa décision de ratifier ce protocole, l’affaire était entendue. Menacé depuis le refus des États-Unis, l’un des plus grands pollueurs de la planète, de ne pas le ratifier pour des raisons purement économiques alors que ce pays produit à lui seul 40 % des gaz à effet de serre ( ges , l’accord survenu à Kyoto en 1997 est enfin entériné et ...

  2. Le détroit de Gibraltar

    Directory of Open Access Journals (Sweden)

    Guillaume Le Boedec

    2008-02-01

    Full Text Available Les assauts sur les grillages de Ceuta et Melilla à l’automne 2005 et le flux continu de migrants vers les îles Canaries en 2006 (+574% par rapport à 2005 ont, par leur surmédiatisation, défini une nouvelle perception du phénomène migratoire. Depuis le début des années 1990, le détroit de Gibraltar, marge naturelle de l’Europe, s’était affirmé comme le point nodal, la centralité, de l’immigration clandestine transméditerranéenne. Il capte et diffuse, depuis l’apparition de la frontière commune de l’Europe Schengen, toutes les évolutions juridiques et techniques mises en place par l’Union européenne pour lutter contre les migrations illégales. Véritable laboratoire de l’externalisation de la politique migratoire européenne et de la coopération maghrébine, le détroit de Gibraltar s’est imposé comme l’espace modèle de la « frontièrisation » de l’espace Schengen, mais aussi le symbole de son inefficacité. La réactivité des migrants et leur capacité à contourner les dispositifs européens soulignent l’impuissance d’une politique de fermeture menée sans projet de développement des pays émetteurs.As they received much media coverage, the assaults on the fences at Ceuta and Melilla in autumn 2005 and the continuous flow of migrants to the Canary Islands in 2006 defined a new perception of migratory phenomena. Since the beginning of the 90’s, the Strait of Gibraltar, the natural limit of Europe, had become the nodal point, the very centre, of transmediterranean illegal immigration. Since the apparition of the common frontier of Schengen, it has caught and spread all legal and technical evolutions set by the European Union to fight illegal migrations. A real testing laboratory for the outsourcing of European migratory policy and of Maghreb cooperation, the Strait of Gibraltar has emerged as a model «frontier-setting» in the Schengen zone, but also as the symbol of its lack of efficiency

  3. Publications | Page 13 | CRDI - Centre de recherches pour le ...

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

    Bien que la recherche a largement montré que les adolescents ont besoin de réseaux sociaux positifs et de connexions interpersonnelles – capital social positif – pour devenir des adultes productifs et socialement responsables, le capital social, son fonctionnement et lele essentiel qu'il joue pour diminuer la délinquance ...

  4. Publications | Page 227 | CRDI - Centre de recherches pour le ...

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

    ... au Togo" (open access). Le projet Savoirs locaux et gestion de la biodiversité : Habitudes alimentaires et utilisation des plantes alimentaires mineures ou menacées de disparition au Togo est financé par le Centre de Recherche et de Développement International (CRDI) et exécuté par le Laboratoire de Botanique et.

  5. Tabagisme et dysfonction erectile chez les personnes vivant avec le ...

    African Journals Online (AJOL)

    La dysfonction erectile (DE) est un probleme de sante publique qui altere la qualite de vie des patients. Chez les personnes infectees par le VIH, le tabagisme en association ii d'autres facteurs pourrait accroitre le risque de survenue de ce trouble. L'objectif de cette etude est de determiner la prevalence de laDE, les ...

  6. Publications | Page 86 | CRDI - Centre de recherches pour le ...

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

    Des visages connus de l'étranger : le tourisme de la diaspora dans les Caraïbes. Afin de stimuler le tourisme, les pays des Caraïbes ciblent une clientèle plus proche d'eux, soit les familles et les amis de la diaspora caribéenne. Nombre de pays des Caraïbes.

  7. Publications | Page 87 | CRDI - Centre de recherches pour le ...

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

    Des visages connus de l'étranger : le tourisme de la diaspora dans les Caraïbes. Afin de stimuler le tourisme, les pays des Caraïbes ciblent une clientèle plus proche d'eux, soit les familles et les amis de la diaspora caribéenne. Nombre de pays des Caraïbes.

  8. On Leśniewski’s Characteristica Universalis

    NARCIS (Netherlands)

    Betti, A.

    2010-01-01

    Leśniewski's systems deviate greatly from standard logic in some basic features. The deviant aspects are rather well known, and often cited among the reasons why Leśniewski's work enjoys little recognition. This paper is an attempt to explain why those aspects should be there at all. Leśniewski

  9. Publications | Page 119 | CRDI - Centre de recherches pour le ...

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

    Le CRDI collabore avec les chercheurs et les établissements des pays en développement au renforcement des capacités locales par le truchement du financement, de la mise en ... Renforcement des capacités et transfert des connaissances : le Programme de partenariat Teasdale-Corti de recherche en santé mondiale.

  10. Publications | Page 33 | CRDI - Centre de recherches pour le ...

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

    Le Centre de recherches pour le développement international (CRDI) appuie le projet Research into Open Educational Resources for Development ou ROER4D (Recherche sur les ressources éducatives libres au service du développement), dont l'objectif est d'améliorer les politiques, les pratiques et la recherche en ...

  11. Publications | Page 34 | CRDI - Centre de recherches pour le ...

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

    Le Centre de recherches pour le développement international (CRDI) appuie le projet Research into Open Educational Resources for Development ou ROER4D (Recherche sur les ressources éducatives libres au service du développement), dont l'objectif est d'améliorer les politiques, les pratiques et la recherche en ...

  12. Publications | Page 162 | CRDI - Centre de recherches pour le ...

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

    africain. Il y a deux ans, le Centre de recherches pour le développement international a créé CIME, un programme de communication pour le développement, afin de témoigner de l'importance des interrelations entre la Communication à la base, l'.

  13. Initiative Think tank | CRDI - Centre de recherches pour le ...

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

    L'ITT est le fruit d'un partenariat regroupant cinq bailleurs de fonds. Lancée en 2008, l'ITT est administrée par le Centre de Recherches pour le Développement International (CRDI), un organisme canadien.

  14. Eau, terre et vie : Communication participative pour le ...

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

    6 févr. 2007 ... Eau, terre et vie : Communication participative pour le développement et gestion des ressources naturelles ... Le CRDI investit dans des solutions locales aux problèmes auxquels l'Inde est confrontée, comme le stress thermique, la gestion de l'eau et les migrations liées aux changements climatiques.

  15. Recherche | Page 5 | CRDI - Centre de recherches pour le ...

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

    Gestion des risques climatiques pour la planification de l'agriculture ... La province du Cap-Occidental est le secteur le plus rentable sur le plan de l' agriculture en Afrique du Sud et contribue de manière importante à la balance des .

  16. Gestion communautaire des ressources naturelles dans le Parc ...

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

    En 2002, le Mozambique, l'Afrique du Sud et le Zimbabwe ont signé un accord établissant le Parc transfrontalier du Grand Limpopo (Greater Limpopo Trans Frontier Conservation Area), qui relie entre eux des parcs nationaux des trois pays et un ensemble de terres relevant pour la plupart de régimes fonciers communaux.

  17. Publications | Page 172 | CRDI - Centre de recherches pour le ...

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

    E-Commerce in the Asian Context : Selected Case Studies. Le commerce électronique en Asie retient beaucoup l'attention en raison de la prolifération des connexions Internet et des technologies connexes dans la région. Face à cette tendance, le Centre de recherches pour le développement international (.

  18. Publications | Page 173 | CRDI - Centre de recherches pour le ...

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

    E-Commerce in the Asian Context : Selected Case Studies. Le commerce électronique en Asie retient beaucoup l'attention en raison de la prolifération des connexions Internet et des technologies connexes dans la région. Face à cette tendance, le Centre de recherches pour le développement international (.

  19. Maternal frustration, emotional and behavioural responses to prolonged infant crying.

    Science.gov (United States)

    Barr, Ronald G; Fairbrother, Nicole; Pauwels, Julie; Green, James; Chen, Mandy; Brant, Rollin

    2014-11-01

    Prolonged inconsolable crying bouts in the first months of life are frustrating to parents and may lead to abuse. There is no empirical description of frustration trajectories during prolonged crying, nor of their emotional predictors or emotional and behavioural sequelae. Frustration responses and their relationships were explored in an analogue cry listening paradigm. Without knowing how long it would last, 111 postpartum mothers were randomized to listen to a 10-min audiotape of infant crying or cooing while continuously recording frustration on a visual analogue 'slider' scale. The listening bout was preceded by questionnaires on negative mood, trait anger and empathy and followed by questionnaires on the reality of the cry sound, positive and negative emotions, soothing strategies, coping strategies and urges to comfort and flee. Individual frustration trajectories were modelled parametrically and characterized by frustration maximum, rate of rise, inflections and harmonicity parameters. As hypothesized, the modal response was of gradually increasing frustration throughout. However, there were marked individual differences in frustration trajectories. Negative mood, trait anger and empathy did not predict modal or modelled individual trajectories. However, frustration responses were significantly related to post-listening emotions and behavioural ratings. In particular, prolonged crying generated highly ambivalent positive and negative emotional responses. In summary, maternal frustration generally increased as the crying bout progressed; however, frustration trajectories were highly individual and emotional responses were highly ambivalent in terms of positive and negative emotions generated. Some emotional and behavioural responses were associated with specific trajectory parameters of frustration responses. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. PR Interval Prolongation and Cryptogenic Stroke: A Multicenter Retrospective Study.

    Science.gov (United States)

    Montalvo, Mayra; Tadi, Prasanna; Merkler, Alexander; Gialdini, Gino; Martin-Schild, Sheryl; Navalkele, Digvijaya; Samai, Alyana; Nouh, Amre; Hussain, Mohammad; Goldblatt, Steven; Hemendinger, Morgan; Chu, Antony; Song, Christopher; Kamel, Hooman; Furie, Karen L; Yaghi, Shadi

    2017-10-01

    Atrial dysfunction or "cardiopathy" has been recently proposed as a mechanism in cryptogenic stroke. A prolonged PR interval may reflect impaired atrial conduction and thus may be a biomarker of atrial cardiopathy. We aim to compare the prevalence of PR interval prolongation in patients with cryptogenic stroke (CS) when compared with known non-cryptogenic non-cardioembolic stroke (NCNCS) subtypes. We used prospective ischemic stroke databases of 3 comprehensive stroke centers to identify patients 18 years or older with a discharge diagnosis of ischemic non-cardioembolic stroke between December 1, 2013 and August 31, 2015. The main outcome was ischemic stroke subtype (CS versus NCNCS). We compared PR intervals as a continuous and categorical variable (PR interval prolongation and CS. We identified 644 patients with ischemic non-cardioembolic stroke (224 CS and 420 NCNCS). Patients with CS were more likely to have a PR of 200 milliseconds or greater when compared with those with NCNCS (23.2% versus 13.8%, P = .009). After adjusting for factors that were significant in univariate analyses, a PR of 200 milliseconds or greater was independently associated with CS (odds ratio [OR] 1.70, 95% CI 1.08-2.70). The association was more pronounced when excluding patients on atrioventricular nodal blocking agents (OR 2.64, 95% CI 1.44-4.83). A PR of 200 milliseconds or greater is associated with CS and may be a biomarker of atrial cardiopathy in the absence of atrial fibrillation. Prospective studies are needed to confirm this association. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.