559 resultados para Gallbladder stones


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This series of posts will consider the acting techniques required for this style of performance with reference to four productions from the 1990s in which two actors took on multiple roles: Frank Pig Says Hello (1992), Co-Motion’s stage adaptation of Pat McCabe’s novel; The Butcher Boy, Corca Dorca’s production of Disco Pigs (1996) by Enda Walsh; DubbleJoint’s production of Stones in his Pockets by Marie Jones (1996) and its subsequent award-winning revival which I produced at Belfast’s Lyric Theatre in 1999; and Kabosh’s production of Mojo Mickybo by Owen McCafferty (1998). The discussion will focus primarily on my own empirical exploration of the demands multi-roling places on an actor through the direction of recent revivals of Mojo Mickybo for Belfast’s Chatterbox Theatre Company (2013) and Bedlam Productions (2015).

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A patient with loin pain haematuria syndrome suffering chronic throbbing pulsing pain overlaid with prolonged periods of incapacitating colic and overnight vomiting was presented 10 months following diagnosis. Ultrasound was normal. No renal or ureteral stones, or filling defects were seen on CT. At cytoscopy, bladder and urethra were normal, and bloody urine effluxed from the left ureteric orifice. The ureters were normal at diagnosis, and developed new abutting non‐penetrating calcifications by 8 months. Pain episodes of complete incapacitating intensity of 2–4 h duration were reduced to 10 min with 5 mg crushed tadalafil administered at onset. If tadalafil was delayed to after onset, the original course of agony resulted. Daily tadalafil reduced loin pain intensity, but not the exacerbations. Tadalafil efficacy may indicate that the pain exacerbations are due to spasm of ureter smooth muscle. 5 mg tadalafil taken at onset alleviated severe loin pain exacerbations in this case of loin pain haematuria syndrome.

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G.H. Mead (1863-1931) oriented much of his intellectual efforts around three unavoidable questions for anyone living in a modern society: how are selfhood, knowledge, and politics understood and organized in such a society? Modern individuals continually seek answers to questions although nobody has ever come up with a definitive answer to them. Modernity, in other words, confronts us with inevitable problematics that fundamentally shape the way in which we think about certain topics. For the purposes of my discussion of Mead, I focus upon three of these modern problematics: science, selfhood, and democratic politics. But before I discuss Mead’s treatment of these problem areas, allow me to briefly situate Mead as a pragmatist in relation to Dewey and James within pragmatism.

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As Tennyson's “little Hamlet ,” Maud (1855) posits a speaker who, like Hamlet, confronts the ignominious fate of dead remains. Maud's speaker contemplates such remains as bone, hair, shell, and he experiences his world as one composed of hard inorganic matter, such things as rocks, gems, flint, stone, coal, and gold. While Maud's imagery of “stones, and hard substances” has been read as signifying the speaker's desire “unnaturally to harden himself into insensibility” (Killham 231, 235), I argue that these substances benefit from being read in the context of Tennyson's wider understanding of geological processes. Along with highlighting these materials, the text's imagery focuses on processes of fossilisation, while Maud's characters appear to be in the grip of an insidious petrification. Despite the preoccupation with geological materials and processes, the poem has received little critical attention in these terms. Dennis R. Dean, for example, whose Tennyson and Geology (1985) is still the most rigorous study of the sources of Tennyson's knowledge of geology, does not detect a geological register in the poem, arguing that by the time Tennyson began to write Maud, he was “relatively at ease with the geological world” (Dean 21). I argue, however, that Maud reveals that Tennyson was anything but “at ease” with geology. While In Memoriam (1851) wrestles with religious doubt that is both initiated, and, to some extent, alleviated by geological theories, it finally affirms the transcendence of spirit over matter. Maud, conversely, gravitates towards the ground, concerning itself with the corporal remains of life and with the agents of change that operate on all matter. Influenced by his reading of geology, and particularly Charles Lyell's provocative writings on the embedding and fossilisation of organic material in strata in his Principles of Geology (1830–33) volume 2, Tennyson's poem probes the taphonomic processes that result in the incorporation of dead remains and even living flesh into the geological system.

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Journal of Human Evolution, V. 55, pp. 148-163

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Dissertação de Mestrado Apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Empreendedorismo e Internacionalização, sob orientação do Mestre Adalmiro Álvaro Malheiro de Castro Andrade Pereira

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RESUMO - A obesidade constitui um importante problema de saúde pública com consequências económicas de grande dimensão. Os obesos têm um risco acrescido de contrair doenças e de sofrer morte prematura devido a problemas como a diabetes, hipertensão arterial, AVC, insuficiência cardíaca e algumas neoplasias malignas. O presente estudo tem como objectivo estimar o custo económico indirecto (valor da produção perdida) associado à obesidade em Portugal no ano de 2002. O estudo adopta uma abordagem tipo custos da doença baseada na prevalência. Os dados são retirados do Inquérito Nacional de Saúde e estatísticas de rotina publicadas pelo INE e por outros organismos oficiais. Consideram-se como obesas pessoas com índice de massa corporal (IMC) ≥ 30 kg/m2 e estabelecem-se como limites etários para participação em actividades económicas produtivas as idades compreendidas entre os 15 e os 64 anos. A estratégia de imputação de custos ao factor de risco obesidade caracteriza- se por estimar, para a população portuguesa, as proporções de doença e morte prematura atribuíveis à obesidade e em multiplicar as estimativas populacionais encontradas pelo valor da produtividade económica potencial das pessoas afectadas. O custo indirecto total da obesidade em Portugal no ano de 2002 foi estimado em 199,8 milhões de euros. A mortalidade contribuiu com 58,4% deste valor (117 milhões de euros) e a morbilidade com 41,6% (83 milhões de euros). Os custos da morbilidade advêm de mais de 1,6 milhões de dias de incapacidade anuais, principalmente por faltas ao trabalho associadas a doenças do sistema circulatório e diabetes tipo II. Os custos da mortalidade são o resultado de 18 733 potenciais anos de vida activa perdidos, numa razão de 3 mortes masculinas por cada morte feminina. Os resultados indicam que a obesidade acarreta consideráveis perdas económicas para o país. Comparando os resultados com um estudo complementar que calculou os custos directos (em cuidados de saúde) da obesidade, verifica-se que a componente indirecta representa 40,2% do total dos custos da obesidade. A implementação de estratégias que prevenissem ou reduzissem a incidência e prevalência de obesidade em Portugal poderia gerar ganhos de produtividade elevados. Para conhecer a dimensão destes ganhos é necessária mais investigação sobre os benefícios clínicos e relação custo-efectividade de estratégias para a redução da obesidade.

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In liver, the glyoxylate cycle contributes to two metabolic functions, urea and glucose synthesis. One of the key enzymes in this pathway is glyoxylate reductase/hydroxypyruvate reductase (GRHPR) whose dysfunction in human causes primary hyperoxaluria type 2, a disease resulting in oxalate accumulation and formation of kidney stones. In this study, we provide evidence for a transcriptional regulation by the peroxisome proliferator-activated receptor alpha (PPARalpha) of the mouse GRHPR gene in liver. Mice fed with a PPARalpha ligand or in which PPARalpha activity is enhanced by fasting increase their GRHPR gene expression via a peroxisome proliferator response element located in the promoter region of the gene. Consistent with these observations, mice deficient in PPARalpha present higher plasma levels of oxalate in comparison with their wild type counterparts. As expected, the administration of a PPARalpha ligand (Wy-14,643) reduces the plasma oxalate levels. Surprisingly, this effect is also observed in null mice, suggesting a PPARalpha-independent action of the compound. Despite a high degree of similarity between the transcribed region of the human and mouse GRHPR gene, the human promoter has been dramatically reorganized, which has resulted in a loss of PPARalpha regulation. Overall, these data indicate a species-specific regulation by PPARalpha of GRHPR, a key gene of the glyoxylate cycle.

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Si le passage d'un calcul rénal est souvent considéré comme un événement médical mineur, quoique très douloureux, de plus en plus d'études indiquent qu'il doit être pris au sérieux puisqu'il peut indiquer un risque cardiovasculaire augmenté. Nous revoyons ici les études qui associent risque cardiovasculaire et calcul rénal et les liens physiopathologiques qui les unissent. Nous montrons que la lithiase est un événement intervenant tôt dans la vie d'un individu à risque de développer des complications cardiovasculaires. Ainsi, la lithiase ne doit pas être banalisée, mais doit être considérée comme une première alerte devant inciter le médecin traitant à recenser précocement les facteurs de risque cardiovasculaires et à mettre en place une stratégie de prévention. Cette approche pourrait permettre de diminuer l'incidence d'événements cardiovasculaires chez les patients formeurs de lithiases. Most of the time, kidney stones are considered as minor, but painful events. However, several studies have recently shown an association between kidney stone and an increased cardio-vascular risk. We review here these studies and explore the underlying pathophysiological hypotheses. At the end, we propose that lithiasis should be considered as a red flag intervening early during life-time and allowing a check of cardiovascular risk factors and early preventive intervention. Such approach may be successful in reducing the incidence of cardio-vascular events in stone formers.

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Bank stabilization structures are used to prevent the loss of valuable land within the urban environment and the decision for the type of structure used depends on the properties of the stream. In the urban areas of Southern Ontario there is a preference for the use of armourstone blocks as bank stabilization. The armourstone revetment is a free standing stone structure with large blocks of stone layered vertically and offset from one another. During fieldwork at Forty Mile Creek in Grimsby, Ontario armourstone failure was identified by the removal of two stones within one column from the wall. Since the footer stones were still in place, toe scour was eliminated as a cause of failure. Through theoretical, field, and experimental work the process of suction has been identified as a mode of failure for the armourstone wall and the process of suction works similarly to quarrying large blocks of rock off bedrock streambeds. The theory of lateral suction has previously not been taken into consideration for the design of these walls. The physical and hydraulic evidence found in the field and studied during experimental work indicate that the armourstone wall is vulnerable to the process of suction. The forces exerted by the flow and the resistance of the block determine the stability of the armourstone block within the wall. The design of the armourstone wall, high surface velocities, and short pulses of faster flowing water within the profile could contribute to armourstone failure by providing the forces needed for suction to occur, therefore adjustments to the design of the wall should be made in order to limit the effect.

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Survey map of the Second Welland Canal created by the Welland Canal Company showing the Grantham Township between the Town of St. Catharines and Merritton. Identified structures associated with the Canal include Locks 8, 9, and 10, waste weirs, the towing path, and several floating bridges. The surveyors' measurements and notes can be seen in red and black ink and pencil. Several stones and tree stumps likely used in the measurements are identified on the map. Local area landmarks are also identified and include streets and roads(ex. Macadamized Road to Thorold), J. Hamilton's Hotel, a school house, McCoy's Farm House, Bradley's House, O. Phelps Saw Mill, Disher and Hait's Woolen Mill, Centreville Mills, a bridge, several barns, and a number of structures (possibly houses, cabins, or shops) belonging to: P. McCoy, E. McLachlan, T. Wilson, W. Wilson, M. Bradley, S. Bradley, P. Boyle, J. Bradley, E. Grant, and W. Church. Lock 12 and 15 of the original canal are also identified. Properties and property owners of note are: Concession 8 Lots 12, 13 and 14, O. J. Phelps, P. McCoy, A. Bradley, C. Bradley, T. Reed, O. Clifford, J. Bradley, W. C. Loan Company, Duffin, and T. Towers Mill Lot.

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Survey map of the Second Welland Canal created by the Welland Canal Company showing the Grantham Township along the outskirts of Merritton. Identified structures associated with the Canal include Locks 11, 12, 13, 14, and 15, Lock House Lot, and the towing path. The surveyors' measurements and notes can be seen in red and black ink and pencil. Several stones likely used in the measurements are identified on the map. Local area landmarks are also identified and include streets and roads(ex. Hartzel Road and Macadamized Road), the Great Western Railroad, Swing Bridge, Thorold Station and its structures (ex. freight house, office, water tank, and wood house), Gordon and Mackay Houses, Gordon and Mackay's Cotton Mill, hydraulic race, a wharf, pond, and an unnamed bridge. Properties and property owners of note are: Concession 9 Lots 12 and 13, A. Bradley, John O'Coner, G. Grant, J. Bradley, J. Vanderburgh, O. Clifford and a parcel of land leased Gordon and Mackay.

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Copies (these items were copied from the internet) of Samuel DeVeaux's attestation paper, casualty details and a copy of a photo of Wailly Orchard Cemetery in which the old wooden crosses have been replaced by stones.

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Receipts from the Park Lawn Cemetery Co. Ltd., Bloor St. West, Toronto. Receipt no. 851 for payment in full for a Lot no.91 in section H received from Percy C. Bands [Band]. Receipt no. 852 for payment for corner stones for Lot no.91 in section H received from Percy C. Bands [Band]. The unnumbered receipt is for opening an adult grave for Sarah Lawrence. Payment was received from Percy C. Bands [Band], Feb. 23, 1926.

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Cette thèse traite de l’impact de l’économie congolaise sur la pastorale du diocèse d’Idiofa, de la gestion de ce diocèse et de leurs répercussions sur le ministère des prêtres. Après plusieurs années de son érection, le diocèse d’Idiofa subit présentement les conséquences de la crise économique congolaise. Sa pastorale est malade, en panne et même bloquée. Partout, il n’y pas d’argent, les caisses sont vides, on ne peut ni manger ni célébrer l’Eucharistie. On assiste à la démotivation presque généralisée des prêtres : refus des obédiences ou contestation des affectations, séjours prolongés et études à l’étranger, absence, ignorance ou mystère des finances. Les gens et les prêtres sont de plus en plus pauvres. Cela contraste avec la croissance numérique des prêtres dans le diocèse d’Idiofa. À y regarder de près, cette croissance masque mal une énigme. Avec la pauvreté grandissante, on aurait dû s’attendre à une diminution du nombre des prêtres. Or, tel n’est pas le cas. On assiste à un phénomène inverse dans le diocèse d’Idiofa. À quoi est dû cet état de chose? Promotion sociale, recherche du bien être matériel? Hausse des vocations? Le problème paraît banal, mais c’est une question pratique qui nous conduit à une prise de conscience de notre agir et de notre identité ecclésiaux. Cette thèse aidera à saisir les enjeux en cause et leurs conséquences sur le ministère des prêtres et sur la population. Elle nous éclairera sur l’incapacité de notre Église locale à s’assumer et à réagir de façon réaliste dans notre contexte propre. L’écart est énorme entre sa théorie et sa pratique. Cette thèse vise une Église locale nouvelle qui se veut active, pratique et qui n’a pas le droit de méconnaître les problèmes des prêtres et des gens en situation difficile. S’il est vrai que le modèle ecclésial actuel est élaboré en fonction des défis et des aspirations des communautés diocésaines, comment expliquer que la même Église puisse reléguer aux oubliettes les problèmes économiques qui conditionnent la vie réelle des prêtres et des gens? La communauté diocésaine peut-elle se bâtir en négligeant l’aspect économique? Malgré la vitalité actuelle de l’Église du diocèse en termes numériques, liturgiques et sacramentaires, de graves insuffisances témoignent de sa paralysie actuelle et rendent l’avenir incertain : misère croissante des masses, mauvaise gestion, dépendance accrue, etc. Cette thèse veut que notre Église locale se sente interpellée dans son agir pastoral par ce problème économique. Une nouvelle orientation ou organisation pastorale s’avère donc nécessaire pour la subsistance et la croissance de notre Église et de son milieu. Notre thèse comprend sept chapitres. Le premier dresse un portrait économique de la République Démocratique du Congo avec ses immenses richesses et la crise qu’elle traverse tant au plan politique que économique. Le deuxième analyse l’écart entre les prises de position audacieuses de l’Église congolaise dans ce contexte et sa pratique cléricale et institutionnelle plus conservatrice. Le troisième décrit la situation pastorale du diocèse d’Idiofa, du ministère de brousse jusqu’à la gestion diocésaine en passant par ses diverses pastorales sectorielles. On y trouve l’exposé des faiblesses et des forces de ce diocèse. Le quatrième analyse la situation économique du diocèse tant en rapport avec la crise congolaise qu’avec les dynamiques internes du diocèse. On y voit émerger par exemple, la dépendance envers Rome, le favoritisme et le tribalisme financiers, la perte de moyens de production propres au diocèse, la pauvreté du clergé et, évidemment, des fidèles et des gens du diocèse. Le cinquième chapitre réévalue les progrès théologiques (adaptation, pierres d’attente, inculturation, reconstruction, libération et contextuelle) et des pratiques pastorales du diocèse en regard de sa réalité actuelle. Le sixième propose une interprétation théologique de la crise économique du diocèse d’Idiofa en fonction de l’Évangile, du salut considéré comme salut global concernant la transformation des structures historiques, de la mission de l’Église d’annoncer ce salut en paroles et en actes. Le septième et dernier chapitre propose une analyse des implications éthiques et ecclésiales. Il présente aussi quelques voies pastorales susceptibles de favoriser la prise en mains des communautés par elles-mêmes et l’assainissement des finances du diocèse : pastorales du grenier, des mains sales et du jardin partagé. La conclusion générale de la thèse rappelle les idées-forces et propose des pistes de solution.