Safety of oral glutamine in the abbreviation of preoperative fasting; a double-blind, controlled, randomized clinical trial

Introduction: No study so far has tested a beverage containing glutamine 2 h before anesthesia in patients undergoing surgery. Objectives: The aim of the study was to investigate: 1) the safety of the abbreviation of preoperative fasting to 2 h with a carbohydrate-L-glutamine-rich drink; and 2) the residual gastric volume (RGV) measured after the induction of anesthesia for laparoscopic cholecystectomies. Methods: Randomized controlled trial with 56 women (42 (17-65) years-old) submitted to elective laparoscopic cholecystectomy. Patients were randomized to receive either conventional preoperative fasting of 8 hours (fasted group, n = 12) or one of three different beverages drunk in the evening before surgery (400 mL) and 2 hours before the initiation of anesthesia (200 mL). The beverages were water (placebo group, n = 12), 12.5% (240 mOsm/L) maltodextrine (carbohydrate group, n = 12) or the latter in addition to 50 g (40 g in the evening drink and 10g in the morning drink) of L-glutamine (glutamine group, n = 14). A 20 F nasogastric tube was inserted immediately after the induction of general anesthesia to aspirate and measure the RGV. Results: Fifty patients completed the study. None of the patients had either regurgitation during the induction of anesthesia or postoperative complications. The median (range) of RGV was 6 (0-80) mL. The RGV was similar (p = 0.29) between glutamine group (4.5 [0-15] mL), carbohydrate group (7.0 [0-80] mL), placebo group (8.5 [0-50] mL), and fasted group (5.0 [0-50] mL). Conclusion: The abbreviation of preoperative fasting to 2 h with carbohydrate and L-glutamine is safe and does not increase the RGV during induction of anesthesia. (Nutr Hosp. 2011;26:86-90) DOI:10.3305/nh.2011.26.1.4993

Historicity in development : abbreviation in mother-infant communications. 'Historicidad y desarrollo : abreviación en la comunicación madre-infante'.

Monográfico con el título: 'Los mecanismos del cambio cognitivo'. Resumen basado en el de la publicación

Notae latinae; an account of abbreviation in Latin mss. of the early minuscule period (c. 700-850)

"List of mss used": p. [444]-494.

Suggestions to medical authors and A. M. A. style book, with a guide to abbreviation of bibliographic references

Mode of access: Internet.

Suggestions to medical authors and A. M. A. style book, with a guide to abbreviation of bibliographic references;

Mode of access: Internet.

Pes no chão e a dança no coração : um olhar fenomenologico da linguagem do movimento

Universidade Estadual de Campinas . Faculdade de Educação Física

Life cycle evolution in the Digenea: a new perspective from phylogeny

We use a new molecular phylogeny, developed from small and large subunit ribosomal RNA genes, to explore evolution of the digenean life cycle. Our approach is to map character states on the phylogeny and then use parsimony to infer how the character evolved. We conclude that, plesiomorphically, digenean miracidia hatched from eggs and penetrated gastropod first intermediate hosts externally. Fork-tailed cercariae were produced in rediae and emerged from the snail to be eaten directly by the teleost definitive host. These plesiomorphic characters are seen in extant Bivesiculidae. We infer that external encystment and the use of second intermediate hosts are derived from this behaviour and that second intermediate hosts have been adopted repeatedly. Tetrapod definitive hosts have also been adopted repeatedly. The new phylogeny proposes a basal dichotomy between 'Diplostomida' (Diplostomoidea, Schistosomatoidea and Brachylaimoidea) and 'Plagiorchiida' (all other digeneans). There is no evidence for coevolution between these clades and groups of gastropods. The most primitive life cycles are seen in basal Plagiorchiida. Basal Diplostomida have three-host life cycles and are associated with tetrapods. The blood flukes (Schistosomatoidea) are inferred to have derived their two-host life cycles by abbreviating three-host cycles. Diplostomida have no adult stages in fishes except by life cycle abbreviation. We present and test a radical hypothesis that the blood-fluke cycle is plesiomorphic within the Diplostomida.

Análisis, Diseño e implementación de un sistema B2E en una administración pública.

Es pretén implementar un sistema B2E (abreviatura de l'expressió business to employee, de l'Empresa a empleat) que permeti a través d'un client lWeb, de forma àgil, ràpida, segura i sezcilla, realitzar els processos de comunicació més habituals entre un organisme públic i els seus professionals específicament en l'àmbit de tramitació administrativa.

Treatment rationale and study design for a phase III, double-blind, placebo-controlled study of maintenance pemetrexed plus best supportive care versus best supportive care immediately following induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small cell lung cancer.

BACKGROUND: To improve the efficacy of first-line therapy for advanced non-small cell lung cancer (NSCLC), additional maintenance chemotherapy may be given after initial induction chemotherapy in patients who did not progress during the initial treatment, rather than waiting for disease progression to administer second-line treatment. Maintenance therapy may consist of an agent that either was or was not present in the induction regimen. The antifolate pemetrexed is efficacious in combination with cisplatin for first-line treatment of advanced NSCLC and has shown efficacy as a maintenance agent in studies in which it was not included in the induction regimen. We designed a phase III study to determine if pemetrexed maintenance therapy improves progression-free survival (PFS) and overall survival (OS) after cisplatin/pemetrexed induction therapy in patients with advanced nonsquamous NSCLC. Furthermore, since evidence suggests expression levels of thymidylate synthase, the primary target of pemetrexed, may be associated with responsiveness to pemetrexed, translational research will address whether thymidylate synthase expression correlates with efficacy outcomes of pemetrexed. METHODS/DESIGN: Approximately 900 patients will receive four cycles of induction chemotherapy consisting of pemetrexed (500 mg/m2) and cisplatin (75 mg/m2) on day 1 of a 21-day cycle. Patients with an Eastern Cooperative Oncology Group performance status of 0 or 1 who have not progressed during induction therapy will randomly receive (in a 2:1 ratio) one of two double-blind maintenance regimens: pemetrexed (500 mg/m2 on day 1 of a 21-day cycle) plus best supportive care (BSC) or placebo plus BSC. The primary objective is to compare PFS between treatment arms. Secondary objectives include a fully powered analysis of OS, objective tumor response rate, patient-reported outcomes, resource utilization, and toxicity. Tumor specimens for translational research will be obtained from consenting patients before induction treatment, with a second biopsy performed in eligible patients following the induction phase. DISCUSSION: Although using a drug as maintenance therapy that was not used in the induction regimen exposes patients to an agent with a different mechanism of action, evidence suggests that continued use of an agent present in the induction regimen as maintenance therapy enables the identification of patients most likely to benefit from maintenance treatment.

El ocio terapéutico y educativo en los centros penitenciarios. Aprenentatge i Servei en el Centre Penitenciari de Lledoners

El Aprendizaje y Servicio (APS) es una propuesta educativa que combina procesos de aprendizaje y de servicio a la comunidad en un solo proyecto. El Aprenentatge i Servei en el Centre Penitenciari de Lledoners nace de la voluntad de estudiantes y docentes de la Facultad de Educación Social y Trabajo Social Pere Tarrés (URL) y del Grupo 33, una Plataforma Ciudadana de Sensibilización y Movilización, formada por más de 7.000 personas de todos los sectores de la sociedad civil, que trabaja para conseguir la reinserción real de las personas privadas de libertad. El proyecto pretende hacer frente al actual modelo de prisiones de Cataluña y promover cambios hacia un modelo rehabilitador.

Nelitietrukin ohjausjärjestelmän suunnittelu QFD-laatutyökalua hyväksikäyttäen

Tämä työ käsittelee tuotekehitysprojektia, jonka tarkoituksena on suunnitella uusi nelitietyöntömastotrukki asiakaslähtöisesti QFD-laatutyökalua hyväksi käyttäen. Työ esittelee QFD-laatutyökalun, sekä varsinkin sen nelivaiheisen ASI:n toimintamallin. Työ antaa myös perusvalmiudet ASI:n toimintamallin käyttöön tuotekehitysprojektissa. Työssä keskitytään tarkastelemaan uuden ohjausjärjestelmän mekaanista kehittelyä. Suunnittelutyössä käytetään hyväksi ASI:n (American Supplier Institute) nelivaiheista QFD-laatutyökalua, joka on autoteollisuuden toimintatapoihin perustuva QFD-tekniikka. QFD tulee sanoista Quality Funcktion Deployment ja vapaasti suomennettuna se merkitsee asiakaslähtöinen tuotesuunnittelu. Nelivaiheinen QFD-malli koostuu seuraavista matriiseista: 1. Tuotteen suunnittelu, 2. osien suunnittelu ja kehittäminen, 3. prosessin suunnittelu sekä 4. tuotannon suunnittelu. Matriisin tulokset muodostavat aina seuraavan matriisin lähtökohdat. Ensimmäisen matriisin lähtökohdat muodostuvat asiakastarvekuvauksesta, joka saadaan haastatteluista, tutkimuksista yms. Tuotekehitysprojektissa kehitetty TEM-monitietrukki, jossa rajattomasti ympäripyöriviä tukipyöriä ohjataan CAN-väylän kautta älykkäällä ohjauslogiikalla, on markkinoilla erittäin kilpailukykyinen sekä ominaisuuksiensa että hintansa puolesta. QFD yhdessä huolellisesti analysoidun asiakastarvekuvauksen kanssa selkeyttää ja priorisoi tuotteen spesifikaation määrittelyä sekä ohjaa tuotteen kehittelyä ja tuotannollistamista. Tuotekehitysprojekti pysyy aikataulussaan ja tuotannollistamisen kynnyksellä tehtävät muutokset vähenevät selkeän jäsentelyn ansiosta.

Kemikaaliasetuksen ja REACH-järjestelmän vaikutus maahantuontiyritykseen - case PCC SE

Tutkielmassa käsitellään Euroopan unionin kemikaaliasetusta 1907/2006, joka astui voimaan 1.6.2007 ja sen vaikutuksia maahantuontiyrityksen toimintaan. Kemikaaliasetusta toteutetaan soveltamalla REACH-järjestelmää. REACH tulee sanoista Registration (rekisteröinti), Evaluation (arviointi), Authorisation (lupamenettely) Chemicals (koskee kemikaaleja). Tutkielman kirjallisuusosassa käsitellään pääosin kemikaaliasetusta. Empiirisessä osassa käsitellään asetuksen tuomia haasteita ja peilataan niitä maahantuontiyrityksen tähänastisiin kokemuksiin ja vaikutelmiin. Kohdeyrityksenä on kemian alan yritys PCC SE. Tutkielmassa selvitetään myös, miten REACH on vaikuttanut tarkastus- ja testauslaitokseen. Lisäksi REACH-järjestelmää peilataan olemassa olevaan kasvinsuojelu-ainedirektiiviin ja käytännön kokemuksia saaneeseen kasvinsuojeluaine-teollisuuteen. Lyhyesti käsitellään myös joidenkin EU:n ulkopuolisten maiden kokemuksia. Johtopäätöksenä voitaneen todeta, että kemikaaliasetuksen tavoitteet, terveyttä ja ympäristöä suojelevat toimenpiteet, koetaan positiivisina asioina. Asioiden selvittely, valtava työmäärä ja korkeat kustannukset koettiin negatiivisiksi asioiksi. Markkinoiden uskotaan jakautuvan harvempien ja suurempien yritysten kesken, ja PK-yritysten toiminta-mahdollisuudet vähenevät oleellisesti. Tarkastus- ja testaus-asiantuntijoiden vähäinen määrä vaikuttaa jo nyt testausaikatauluihin ja tulee yhä enemmän vaikuttamaan tulevaisuudessa.

Enhanced muscle strength with carbohydrate supplement two hours before open cholecystectomy: a randomized, double-blind study

Objective: to investigate the effects of preoperative fasting abbreviation with oral supplementation with carbohydrate in the evolution of grip strength in patients undergoing cholecystectomy by laparotomy. Methods : we conducted a clinical, randomizeddouble blind study with adult female patients, aged 18-60 years. Patients were divided into two groups: Control Group, with fasting prescription 6-8h until the time of operation; and Intervention Group, which received prescription of fasting for solids 6-8h before surgery, but ingested an oral supplement containing 12.5% carbohydrate, six (400ml) and two (200ml) hours before theprocedure. The handgrip strength was measured in both hands in both groups, at patient's admission (6h before surgery), the immediate pre-operative time (1h before surgery) and 12-18h postoperatively. Results : we analyzed 27 patients, 14 in the intervention group and 13 in the control group. There was no mortality. The handgrip strength (mean [standard deviation]) was significantly higher in the intervention group in the three periods studied, in at least one hand: preoperatively in the dominant hand (27.8 [2.6] vs 24.1 [3.7] kg; p=0.04), in the immediate preoperative in both hands, and postoperatively in the non-dominant hand (28.5 [3.0] vs 21.3 [5.9] kg; p=0.01). Conclusion : the abbreviation of preoperative fasting to two hours with drink containing carbohydrate improves muscle function in the perioperative period.

Français 2018

Contient : 1° « Apertorium artis », par « RAYMUNDUS LULLIUS » ; 2° « L'Epistre de l'abbreviation de la pierre benoiste, de maistre RAYMOND LULLIER » ; 3° « Ung Traicté responsif envoyé à maistre Thomas de Boulongne, phisicien du roy de France, tres saige Phelippe, et conte palatin, par BERNARD DE TREVES, en l'an 1385 » ; 4° « Clavicula RAYMUNDI LULLII »

Donald Ziraldo Fonds, 1968-2012, n.d.

Donald J. P. Ziraldo, C.M., BSc., LLD was born in St. Catharines, Ontario on October 13, 1948 to Fredrick and Irma (Schiratti) Ziraldo. He graduated Denis Morris High School in St. Catharines in 1967, and received his B.Sc. in Agriculture at the University of Guelph in 1971. In 1974, Ziraldo was running Ziraldo Nurseries when he met Austrian born schoolteacher, chemist and winemaker Karl J. Kaiser. They realized that there was a gap in the premium varietal wine market and decided to plant a premium traditional European variety of grape vine species, the Vitis vinifera. This was an innovation in the Niagara region because the current wine producers were not using premium European grapes at the time. Ziraldo and Kaiser founded and then formally incorporated Inniskillin Wines Inc. in Niagara-on-the-Lake, Ontario on July 31, 1975. Ziraldo successfully lobbied General George Kitching, CEO of the LCBO, for a winery license. In 1975, Kitching granted him a winery license, the first in Ontario since Prohibition ended. From the beginning, there was a division of labour where Kaiser focused on the winemaking and Ziraldo focused on the marketing and promotion of the wines. Ziraldo also became president of the company. Ziraldo and Kaiser worked on improving their winemaking techniques and promoting their products and company. Ziraldo has been called ‘one of the founding fathers of the Canadian wine industry’, and it is widely acknowledged that both men played a large role in the success and growth of the Canadian wine industry. Together they pioneered the estate winery movement in Canada. A major turning point Inniskillin came in 1984 when Karl Kaiser successfully harvested the first Icewine crop from frozen grapes on the vine and bottled Eiswein Vidal (Icewine). In 1990, Inniskillin received worldwide recognition for this Icewine when their 1989 Vidal Icewine won the most prestigious award in the wine world, the Grand Prix d’Honneur, given at Vinexpo in France. This victory has been called ‘the award heard round the world’ and it launched Inniskillin into the international wine arena. At the same time, this helped lift the profile of Canadian wines in general. Inniskillin not only became Canada’s leading producer of Icewine, but it also became known for producing ‘one of the world’s great wines’. After the 1990 award, Ziraldo began a major public relations campaign to promote Inniskillin and build Icewine into a worldwide brand. He travelled broadly every year to promote the brand and products and networked extensively with politicians, celebrities, chefs, sommeliers, etc. To ensure worldwide and long-term success, Ziraldo introduced Icewine to Asia and the United States which were new markets. He developed a new Icewine glass with George Riedel. Tony Aspler has called Ziraldo ‘Canada’s Wine Ambassador’. Ziraldo was President of Inniskillin Wines Inc. (Niagara) from 1975 to 2006. In 1992, Inniskillin merged with Cartier Wines, and in 1993 Cartier Inniskillin Vintners Inc. merged with T.G. Bright & Co. Limited, forming the new company Vincor International Inc. Inniskillin wines was now a subsidiary of Vincor. Ziraldo became a Director at Vincor International Inc. from 1993 to 2004. From 1989 to the mid 1990s, Ziraldo also became President of Inniskillin Napa, in Napa Valley, California. Inniskillin purchased Napa Valley vineyards and produced wines under the Terra label. In 1994, Ziraldo set up a subsidiary estate winery of Inniskillin in Oliver, British Columbia which was called Inniskillin Okanagan Vineyards Inc. He became President of the winery. This started as a partnership between Inniskillin and the local Inkameep Indian Band in the Okanagan. In 2006, Ziraldo left Inniskillin and since that time he has been involved in other Icewine related ventures such as running Ziraldo Estate Winery and producing Ziraldo Riesling Icewine 2007. He also is in partnership with the Niagara based Equifera Estate Winery to produce Equifera Icewine. His most recent projects include planting Picolit grapes in his parent’s hometown, in a project called Picolit Di Fagagna and becoming Managing Director of the Senhora Do Convento Port Winery in Portugal. Donald Ziraldo was instrumental in the creation of the Vintners Quality Alliance (VQA) in Ontario and was its founding Chair from 1988-1995. The VQA was established as a regulatory and appellation system which secured the quality and origin of Canadian wines made under this system. The VQA designation and bottle label gave the consumer confidence that the wines they were purchasing were 100% local products. The VQA system was set up first in Ontario and then in British Columbia.