Risques et bénéfices d'une approche interventionnelle face aux corps étrangers digestifs [Digestive foreign body management].

Foreign body (FB) ingestion is a frequent reason for gastroenterology consulting. Eighty percent of these ingestions are accidental and observed among paediatric subjects. However, intentional repetitive ingestions are also observed, especially amongst prisoners or psychiatric patients. Most FBs pass throughout the digestive tract without any complication and without any need for surgical or endoscopic intervention. Nevertheless, around 10-20% of cases require an endoscopy examination and 1% will lead to a surgical intervention. Management approaches should favor inter-disciplinarity, balance benefits and risks of FB removal based on its location, and integrate psychiatric comorbidities into the decision process.

Antifungal activity against planktonic and biofilm Candida albicans in an experimental model of foreign-body infection.

OBJECTIVES: The treatment of Candida implant-associated infections remains challenging. We investigated the antifungal activity against planktonic and biofilm Candida albicans in a foreign-body infection model. METHODS: Teflon cages were subcutaneously implanted in guinea pigs, infected with C. albicans (ATCC 90028). Animals were treated intraperitoneally 12 h after infection for 4 days once daily with saline, fluconazole (16 mg/kg), amphotericin B (2.5 mg/kg), caspofungin (2.5 mg/kg) or anidulafungin (20 mg/kg). Planktonic Candida was quantified, the clearance rate and cure rate determined. RESULTS: In untreated animals, planktonic Candida was cleared from cage fluid in 25% (infected with 4.5 × 10(3) CFU/cage), 8% (infected with 4.8 × 10(4) CFU/cage) and 0% (infected with 6.2 × 10(5) CFU/cage). Candida biofilm persisted on all explanted cages. Compared to untreated controls, caspofungin reduced the number of planktonic C. albicans to 0.22 and 0.0 CFU/ml, respectively, and anidulafungin to 0.11 and 0.13 CFU/ml, respectively. Fluconazole cured 2/12 cages (17%), amphotericin B and anidulafungin 1/12 cages (8%) and caspofungin 3/12 cages (25%). CONCLUSION: Echinocandins showed superior activity against planktonic C. albicans. Caspofungin showed the highest cure rate of C. albicans biofilm. However, no antifungal exceeded 25% cure rate, demonstrating the difficulty of eradicating Candida biofilms from implants.

Congenital lobar emphysema presenting as an airway foreign body.

We report here the case of a 15 months old girl presenting with clinical signs and radiological exams highly suggestive of a foreign body (FB) aspiration. Diagnostic endoscopy revealed an overlooked bronchial malformation responsible for a congenital lobar emphysema (CLE). CLE presenting after one year of age is rare and can easily be misdiagnosed. Therefore, the possibility of an overlooked CLE needs to be known and evoked as an alternative diagnosis when dealing with children presenting with suspected FB aspirations. We report on this unexpected, yet misleading presentation of CLE and review the available literature on the subject.

Multidetector-row computed tomography in the preoperative diagnosis of intestinal complications caused by clinically unsuspected ingested dietary foreign bodies: a case series emphasizing the use of volume rendering techniques

Objective The present study was aimed at describing a case series where a preoperative diagnosis of intestinal complications secondary to accidentally ingested dietary foreign bodies was made by multidetector-row computed tomography (MDCT), with emphasis on complementary findings yielded by volume rendering techniques (VRT) and curved multiplanar reconstructions (MPR). Materials and Methods The authors retrospectively assessed five patients with surgically confirmed intestinal complications (perforation and /or obstruction) secondary to unsuspected ingested dietary foreign bodies, consecutively assisted in their institution between 2010 and 2012. Demographic, clinical, laboratory and radiological data were analyzed. VRT and curved MPR were subsequently performed. Results Preoperative diagnosis of intestinal complications was originally performed in all cases. In one case the presence of a foreign body was not initially identified as the causal factor, and the use of complementary techniques facilitated its retrospective identification. In all cases these tools allowed a better depiction of the entire foreign bodies on a single image section, contributing to the assessment of their morphology. Conclusion Although the use of complementary techniques has not had a direct impact on diagnostic performance in most cases of this series, they may provide a better depiction of foreign bodies' morphology on a single image section.

The Connectivity of Musical Aptitude and Foreign Language Learning Skills: Neural and Behavioural Evidence

Given the structural and acoustical similarities between speech and music, and possible overlapping cerebral structures in speech and music processing, a possible relationship between musical aptitude and linguistic abilities, especially in terms of second language pronunciation skills, was investigated. Moreover, the laterality effect of the mother tongue was examined with both adults and children by means of dichotic listening scores. Finally, two event-related potential studies sought to reveal whether children with advanced second language pronunciation skills and higher general musical aptitude differed from children with less-advanced pronunciation skills and less musical aptitude in accuracy when preattentively processing mistuned triads and music / speech sound durations. The results showed a significant relationship between musical aptitude, English language pronunciation skills, chord discrimination ability, and sound-change-evoked brain activation in response to musical stimuli (durational differences and triad contrasts). Regular music practice may also have a modulatory effect on the brain’s linguistic organization and cause altered hemispheric functioning in those who have regularly practised music for years. Based on the present results, it is proposed that language skills, both in production and discrimination, are interconnected with perceptual musical skills.

Project owner’s and outside engineering consultant’s role in power plant implementation projects

The purpose of this study was to investigate the nature of co-operation between a project owner and an outside engineering consultant in combined heat and power plant implementation projects. Moreover, as another focal subject of the study was to familiarize the purchasing behavior of the energy producer and how an outside engineering consultant participated into different stages of the purchasing process. The study was carried out as a multiple case study including altogether six Finnish power plant implementation projects that had been taken into commercial use during 1995 – 2015. By adjusting the findings of empirical interview data and comparing those to the theoretical framework concerning, among others, Finnish energy production, engineering consulting businesses, delivery methods of construction project and finally the purchasing process, it can be concluded that especially in the power plant implementation projects in the past have a great influence to decisions made during the project. The role of the main engineering consultant is to act as an assistant, who helps to achieve the project goals successfully rather than an advisor who only knows how the project should be conducted. At least in these five project cases this was the case, meaning that the final decision power always remaining with project owner.

Effects of Foreign Direct Investment inflows on growth in Central and Eastern European transition countries

The aim of this master’s thesis is to analyze the effects of Foreign Direct Investments on growth in selected Central and Eastern European transition countries. The theoretical part of this thesis, introduces growth theories and how FDI is covered in those theories. In addition, the results from previous studies, which have studied FDI’s effect on growth, are presented in this master’s thesis. This work introduces also the economical progress during the transition period in selected countries. In the empirical part’s regression model, it will be searched for the direct effect of FDI on growth with panel data collected from nine transition countries.

A long way to the rainbow country : understanding the foreign market expansion process of Finnish corporations into the Republic of South Africa between 1999 and 2005

De afrikanska ekonomierna växer med nära fyra procent per år och detta är en god indikation på kontinentens växande betydelse. Under kalla kriget hade afrikanska regeringar haft ett begränsat utrymme för opportunistisk köpslående, och därmed även en marginal att positionera sig strategiskt. Alltför ofta uppmuntrade och beskyddade stormakterna diktatorer och små lokala eliter som främst ville berika sig själv. I och med att globaliseringen tog fart och USA allt mera kom att dominera globalt, började en ny era i fråga om förändringar. Trots dessa förändringar på den globala arenan, har Afrika som kontinent hamnat i bakgrunden och jämfört med andra utvecklingsländer har Afrika attraherat ett fåtal utländska investeringar. Fortfarande, speciellt i Norden, finns det lite kunskap om hur utländska företag expanderar sin affärsverksamhet på den afrikanska kontinenten. Det råder brist på empiriska undersökningar om vilken inverkan afrikanska institutionella förändringar och lokala affärsmiljöer har på internationaliseringen och på de utländska företagens affärsutvecklingsstrategier på den afrikanska kontinenten. Med denna avhandling vill jag lyfta fram ett exempel på ett land (Sydafrika), som har lyckat dra nytta av de förändringar som 1990-talet förde med sig. I denna avhandling har jag intervjuat olika personer i ledande positioner inom olika finländska företag i Finland och i Sydafrika. Avhandlingen skapar en referensram för att öka förståelse och fördjupa analys av hur en kombination av olika interna och externa resurser ökar företagens konkurrenskraft och på det sättet bidrar till en framgångsrik affärsutveckling i Afrika. De politiska och sociala aktörerna samt aktörerna inom affärslivet besitter resurser som ambitiösa företag kan dra nytta av i sin strävan att erövra de nya framgångsrika marknaderna i Afrika. Gradvis ökar finländska företag sina insatser på den afrikanska kontinenten i strävan att skapa mervärde för sina kunder. Den värdeskapande processen gör att parterna måste närma sig varandra utgående från sina egna strategiska målsättningar. Hittills har finländska företag varit intresserad att sälja till Afrika men inte intresserad att köpa därifrån. Förutom de praktiska råden till olika företag, föreslår avhandlingen hur den finska staten och den sydafrikanska staten kunde agera tillsammans för att främja ömsesidigt handelsutbyte.

Jäänmurtopalveluiden kilpailutus palvelua tarjoavan yrityksen näkökulmasta

Jäänmurtajien ja jäänmurtopalveluiden kehittymisen myötä Suomen teollisuus ja ulkomaankauppa on voinut tukeutua ympärivuotisiin merikuljetuksiin. Vuodesta 1889 lähtien, yli sadan vuoden ajan, jäänmurto oli valtion virkamiesten hoitamaa palvelua. Viimeisen seitsemän vuoden aikana jäänmurtajat ja palveluntuotanto on siirtynyt liikelaitoksen kautta valtion omistamalle osakeyhtiölle. Tarkoituksena on ollut monien muiden palveluiden tapaan saada myös jäänmurto kilpailutuksen piiriin. Tämän diplomityön tarkoituksena oli selvittää jäänmurto -liiketoiminnan kannattavuutta kilpailuun mahdollisesti osallistuvien yritysten näkökulmasta. Kannattavuutta selvitettiin kolmen tutkimuskokonaisuuden avulla. Tutkittavat osa-alueet olivat jäänmurron sopimukset, kustannusrakenne sekä muu mahdollinen jäänmurtajalla avovesikaudella suoritettava liiketoiminta. Tutkimus toteutettiin haastattelututkimuksena. Haastateltavina oli sekä jäänmurrossa mukana olevia ja siitä kiinnostuneita varustamoita että muita merenkulun sidosryhmiä, joiden toiminta vaikuttaa liiketoiminnan kannattavuuteen. Lisäksi tehtiin laskelmia kilpailutekijöiden selventämiseksi. Työn tuloksena ei pyritty saamaan ehdotonta tulosta kannattavuudesta, vaan tuloksina esiteltiin yritysten ja sidosryhmien näkemyksiä siitä, miten jäänmurron kilpailutusta voisi kehittää. Erityisesti haluttiin tuoda esille ne seikat, mitkä varustamot näkivät tärkeänä ja mitkä tukisivat heidän osallistumistaan mahdolliseen kilpailuun.