52 resultados para main characters

em Université de Lausanne, Switzerland


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Résumé Les mousses sont la plus ancienne lignée de plantes terrestres et leur longue évolution a été accompagnée par des tendances à la simplification des caractères morphologiques. Ce phénomène a quelque peu compliqué les reconstructions phylogénétiques basées sur la morphologie. Les analyses génétiques ont permis de donner de nouvelles informations dans le cadre des analyses phylogénétiques et une réévaluation de certains caractères morphologiques. La plupart des études combinant les données morphologiques et moléculaires ne concernent que des niveaux systématiques élevés comme l'ordre ou la famille et très peu considèrent le niveau du genre. La présente étude tend à tester les relations phylogénétiques du genre Grimmia à l'aide d'une combinaison de caractères morphologiques et moléculaires. Les 40 espèces de Grimmia utilisées dans la première partie de cette étude représentent la majorité des espèces trouvées en Eurasie, un des centres de diversification du genre. Lors de l'analyse morphologique, 52 caractères morphologiques/anatomiques (33 du gamétophyte et 19 du sporophyte) ont été numérisés. Malgré le peu de support statistique des arbres, la topologie des arbres est stable. Les Grimmia, comme décrit précédemment, sont paraphylétiques. Trois clades, correspondant respectivement aux sous-genres Rhabdogrimmia Limpr, Litoneuron I.Hagen et Gasterogrimmia Schimp. sont présents, tandis que le restant des taxons appartenant aux Grimmia forment un groupe non-résolu et indistinct des autres Grimmiaceae. Les séquences chloroplastiques trnL-trnF et rps4 combinés à la morphologie ont été ensuite utilisés pour reconstruire la phylogénie des Grimmia. Les arbres obtenus soutiennent la monophylie des Grimmiaceae tandis que les Grimmia, sont paraphylétiques. Deux clades principaux correspondant aux "Rhabdogrimmia" et aux "Grimmia" se détachent. Seules les espèces de "Rhabdogrimmia" produisent des gemmules foliaires (reproduction asexuée). Dans une étude considèrant 91 séquences trrIL-trnF les espèces appartenant aux "Rhabdogrimrnia" (reproduction asexuée essentiellement) ont des variabilités intraspécifique très faible et interspécifique relativement élevée tandis que les "Grimmia" possèdent la tendance inverse (plus de reproduction sexuée). Summary The mosses are a very old land plant lineage and their long evolutionary history has been accompanied by a trend of morphological character simplifications. This phenomenon has somewhat complicated morphological based phylogenetic reconstructions. Genetic analyses have provided new insights for phylogenetic studies, and have allowed morphological data to be re¬evaluated. Most of the studies combining morphological and molecular data have concerned the higher systematic levels of order and family and only have few considered the genus. The present study aims to test the phylogenetic relationships of the genus Grimmia using a combination of morphological and molecular characters. The 40 chosen Grimmia species represent the majority of those found in Eurasia, one diversification centers of the genus. For the morphological analysis, 52 morphological/anatomical characters (33 gametophyte and 19 sporophyte characters) were numerized. Although the internal statistical support was relatively low, the tree topologies were stable. Grimmia as currently defined was found to be paraphyletic. Three subclades, corresponding to the subgenera Rhabdogrimmia Limpr., Litoneuron I.Hagen, and Gasterogrimmia Schimp. were observed in the trees, while the reminder of the Grimmia species formed an unresolved group indistinct from other Grimmiaceae. Chloroplast (trnL-trnF and rps4) DNA sequences combined with morphology were used to reconstruct the phylogeny of Grimmia. The resulting trees supported the monophyly of Grimmiaceae and that the genus Grimmia, as currently defined, as paraphyletic. Two main clades were resolved corresponding to "Rhabdogrimmia" and "Grimmia". The species belonging to "Rhabdogrimmia" produce foliar-gemmae (asexual reproduction). In a study using 91 sequences of trnL-trnF,"Rhabdogrimmia" species (mainly asexual reproduction) have very low intraspecific variability and high interspecific variability whereas the "Grimmia" species possess the inverse tendency.

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In cases of highly inflammatory dermatophytosis in humans, it is important to identify the possible source of animal transmission in order to prevent recurrence, family outbreaks or rapidly progressing epidemics. A survey of dermatophytes in pets during a 14-month period in Switzerland revealed, in addition to Microsporum canis, two different species of the Trichophyton mentagrophytes complex, Arthroderma benhamiae and Arthroderma vanbreuseghemii, all causing inflammatory dermatophytoses. Arthroderma benhamiae was only and frequently isolated from guinea pigs. Arthroderma vanbreuseghemii was isolated mainly from European short hair cats, but also from dogs and in one case from a pure-bred cat. Ninety-three percent of the cats carrying A. vanbreuseghemii were hunters and all had skin lesions. In contrast, cats with skin lesions that were strictly indoors were found to be almost exclusively infected by M. canis. Therefore, it can be suspected that infection with A. vanbreuseghemii occurred during hunting and that the natural source of this dermatophyte is either soil or an animal other than the cat, most probably a rodent.

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[Contents] 1. Executive summary. 2. Introduction. 3. Methods. 4. Main results. 4.1. Participants. 4.2. Estimation of dietary salt intake using 24-hour urine collection. 4.3. Blood pressure and hypertension. 4.4. Anthropometric data (Body weight, height and body mass index BMI; prevalence of overweight and obesity; waist circumference;...). 4.5. Knowledge and behaviors towards salt. 5. Discussion.

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A coimmunosuppression with azathioprine or methotrexate in addition to infliximab does not improve the therapeutic efficacy in Crohn's disease but increase the risks of infectious complications and neoplasia.

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Introduction : Population aging leads to a considerable increase in the prevalence of specific diseases. We aimed to assess if those changes were already reflected in an Internal Medicine ward. Methods : Anonymous data was obtained from the administrative database of the department of internal medicine of the Lausanne University Hospital (CHUV). All hospitalizations of adult (>=18 years) patients occurring between 2003 and 2011 were included. Infections, cancers and diseases according to body system (heart, lung...) were defined by the first letter of the ICD-10 code for the main cause of hospitalization. Specific diseases (myocardial infarction, heart failure...) were defined by the first three letters of the ICD-10 codes for the main cause of hospitalization. Results : Data from 32,741 hospitalizations occurring between 2003 and 2011 was analyzed. Cardiovascular (ICD-10 code I) and respiratory (ICD-10 code J) diseases ranked first and second, respectively, and their ranks did not change during the study period (figure). Digestive and endocrine diseases decreased while psychiatric diseases increased from rank 9 in 2003 to rank 6 in 2011 (figure). Among specific diseases, pneumonia (organism unspecified, code J18) ranked first in 2003 and second in 2011. Acute myocardial infarction (code I21) ranked second in 2003 and third in 2011. Chronic obstructive pulmonary disease with acute lower respiratory infection (code J44) ranked third in 2003 and decreased to rank 8 in 2011. Conversely, heart failure (code I50) increased from rank 8 in 2003 to rank 1 in 2011 and delirium (not induced by alcohol and other psychoactive substances, code F05) increased from below rank 20 in 2003 to rank 4 in 2011. For more details, see table. Conclusion : In less than 10 years, considerable changes occurred in the presentation of patients attending an Internal Medicine ward. The changes in diseases call for adaptations in hospital staff and logistics.

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OBJECTIVES: This study sought to assess outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI) for unprotected left main (LM) disease. BACKGROUND: Limited data are available on outcomes in patients with ST-segment elevation myocardial infarction undergoing LM PCI. METHODS: Of 9,075 patients with ST-segment elevation myocardial infarction enrolled in the AMIS (Acute Myocardial Infarction in Switzerland) Plus registry between 2005 and June 30, 2010, 6,666 underwent primary PCI. Of them, 348 (5.2%; mean age: 63.5 ± 12.6 years) underwent LM PCI, either isolated (n = 208) or concomitant to PCI for other vessel segments (n = 140). They were compared with 6,318 patients (94.8%; mean age: 61.9 ± 12.5 years) undergoing PCI of non-LM vessel segments only. RESULTS: The LM patients had higher rates of cardiogenic shock (12.2% vs. 3.5%; p < 0.001), cardiac arrest (10.6% vs. 6.3%; p < 0.01), in-hospital mortality (10.9% vs. 3.8%; p < 0.001), and major adverse cardiac and cerebrovascular events (12.4% vs. 5.0%; p < 0.001) than non-LM PCI. Rates of mortality and major adverse cardiac and cerebrovascular events were highest for concurrent LM and non-LM PCI (17.9% and 18.6%, respectively), intermediate for isolated LM PCI (6.3% and 8.3%, respectively), and lowest for non-LM PCI (3.8% and 5.0%, respectively). Rates of mortality and major adverse cardiac and cerebrovascular events for LM PCI were higher than for non-LM multivessel PCI (10.9% vs. 4.9%, p < 0.001, and 12.4% vs. 6.4%, p < 0.001, respectively). LM disease independently predicted in-hospital death (odds ratio: 2.36; 95% confidence interval: 1.34 to 4.17; p = 0.003). CONCLUSIONS: Emergent LM PCI in the context of acute myocardial infarction, even including 12% cardiogenic shock, appears to have a remarkably high (89%) in-hospital survival. Concurrent LM and non-LM PCI has worse outcomes than isolated LM PCI.

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AIM: To review the various pharmacological approaches currently proposed for the treatment of hypertension. RESULTS: With the evolution of pharmacological treatment of hypertension, various classes of agent (diuretics, beta-blockers, angiotensin converting enzyme inhibitors, calcium antagonists and alpha 1-blockers) have become available for the initiation of antihypertensive therapy. As monotherapy, each type of agent will normalize blood pressure in about half of all hypertensive patients. Replacing one drug with another that acts through a different mechanism improves the probability of controlling blood pressure. Another way to increase the number of responders is to increase the dose; however, this often results in more side effects. A preferable way of improving efficacy is to combine low doses of drugs that have different impacts on the cardiovascular system, thus opposing the compensatory responses that tend to limit the blood pressure drop. CONCLUSION: Low-dose drug combinations are generally well tolerated and the treatment of hypertension can be simplified by using fixed-dose combinations. These combinations have the potential to become a valuable alternative in the initiation of antihypertensive therapy.

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Sponsored by the Health Administrations of nine cantons, this study was conducted by the University Institute of Social and Preventive Medicine in Lausanne in order to assess how DRGs could be used within the Swiss context. A data base mainly provided by the Swiss VESKA statistics was used. The first step provided the transformation of Swiss diagnostic and intervention codes into US codes, allowing direct use of the Yale Grouper for DRG. The second step showed that the overall performance of DRG in terms of variability reduction of the length of stay was similar to the one observed in US; there are, however, problems when the homogeneity of medicotechnical procedures for DRG is considered. The third steps showed how DRG could be used as an account unit in hospital, and how costs per DRG could be estimated. Other examples of applications of DRG were examined, for example comparison of Casemix or length of stay between hospitals.

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