Non-invasive ventilation for cystic fibrosis.

Non-invasive ventilation may be a means to temporarily reverse or slow the progression of respiratory failure in cystic fibrosis. To compare the effect of non-invasive ventilation versus no non-invasive ventilation in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings. We searched the reference lists of each trial for additional publications possibly containing other trials.Most recent search: 22 February 2013. Randomised controlled trials comparing a form of pressure preset or volume preset non-invasive ventilation to no non-invasive ventilation in people with acute or chronic respiratory failure in cystic fibrosis. Three reviewers independently assessed trials for inclusion criteria and methodological quality, and extracted data. Fifteen trials were identified; seven trials met the inclusion criteria with a total of 106 participants. Six trials evaluated single treatment sessions and one evaluated a six-week intervention.Four trials (79 participants) evaluated non-invasive ventilation for airway clearance compared with an alternative chest physiotherapy method and showed that airway clearance may be easier with non-invasive ventilation and people with cystic fibrosis may prefer it. We were unable to find any evidence that NIV increases sputum expectoration, but it did improve some lung function parameters.Three trials (27 participants) evaluated non-invasive ventilation for overnight ventilatory support, measuring lung function, validated quality of life scores and nocturnal transcutaneous carbon dioxide. Due to the small numbers of participants and statistical issues, there were discrepancies in the results between the RevMan and the original trial analyses. No clear differences were found between non-invasive ventilation compared with oxygen or room air except for exercise performance, which significantly improved with non-invasive ventilation compared to room air over six weeks. Non-invasive ventilation may be a useful adjunct to other airway clearance techniques, particularly in people with cystic fibrosis who have difficulty expectorating sputum. Non-invasive ventilation, used in addition to oxygen, may improve gas exchange during sleep to a greater extent than oxygen therapy alone in moderate to severe disease. These benefits of non-invasive ventilation have largely been demonstrated in single treatment sessions with small numbers of participants. The impact of this therapy on pulmonary exacerbations and disease progression remain unclear. There is a need for long-term randomised controlled trials which are adequately powered to determine the clinical effects of non-invasive ventilation in cystic fibrosis airway clearance and exercise.

Using genomics for drug discovery in medulloblastoma

Tese de doutoramento, Medicina (Neurocirurgia), Universidade de Lisboa, Faculdade de Medicina, 2014

A mass spectrometric study of some pesticides /|nK. S. Subramanian. -- 260 St. Catharines, Ont. : [s. n.],

The fragmentation processes in the mass spectra of a series of organophosphorus, organochlorine, thio and dithiocarbamate as well as a number of miscellaneous pesticides have been studied i n detail by using the Bendix timeof- flight, MS-12 single-focussing and MS-30 double-focussing mass spectrometers. Interpretation of all the spectra have been presented; their mode s of dissociation elucidated, aided by metastable transitions wherever possible and the structures of the various f ragmentation species postulated wherever f easible. The fragmentation mechanisms are based on the concepts of inductive, resonance and steric ef~ects. Multiple bond cleavages accompanied by simultaneous bond formation and rearrangement reactions involving cycli c t r ansition states have clarified t he formation of various ions . Due emphasis has been placed on the effect of the functional groups or substituents in altering the mass spectral behaviour of the pesticides as they form the basis for the identifi cation of the otherwise identical pesticides. The organophosphorus pesticides which have been studied include i) the phosphates (eg: DDVP and Phosdrin ); ii) phosphorothionates (eg: Parathion, 0-2, 4 dichloro phenyl 0, O-diethyl thionophosphate); iii) phosphorothioites (eg: Tributyl phosphorotrithioite); i V) phosphorothioates (eg: Ethion) and v) phosphorodithioates (eg: Carbophenolthion). Cleavages and rearrangements of the ester moiety dominate the spectrum of phosdrin while that of DDVP is + dominated by t he fragmentation modes of the (OH30)2P=0 + moiety. Fragmentation §f the (CH30)2P=S characterises the spectrum of (OH30)2"P -Cl while cleavages of the + (C2H50 )2P=S species mark the spectra of parathion and 0-2, 4- di chlorophenyl O, O-diethyl thiophosphate. The 0(, cl eavages of the thioether f unction rather than + cleavages of the (C2H50)2P=S signify the spectrum of carbophenolthion. Tributyl phosphorotrithioite behaves more like an aliphatic hydrocarbon than like the corresponding phosphites. The isopropyl and butyl esters of 2, 4 dichlorophenoxy acetic acid show cleavage and rearrangement ions typical of an ester. In spite of its structural similari ty to pp' - DDT and pp' - DDD, Kalthane has a completely different mass spectral behaviour due to the influence of its hydroxyl function. The thiocarbamate pesticides studied include Eptam and Perbulate. Both are structurally similar but having different alkyl substituents on nitrogen and sulphur. This structurQlsimilarity leads to similar types of (N-C), (O-S) and (S-alkyl cleavages). However, perbulate differs from Eptam in showing a rearrangement ion at mle 161 and in forming an isocyanate ion as the base peak. In Eptam the base peak i s the alkyl ion. The dithiocarbamate, Vegadex, resembles the thiocarbamates in undergoing simple cleavages but it differs from them in having a weak parent ion; in the formation of its base peak and in undergoing a series of rearrangement reactions. The miscellaneous pesticides studied include 1-Naphthalene acetic aCid- methyl ester, Fiperonyl butoxide and Allethrin. The ester i s stable to electron impact and shows only fewer ions. Piper onyl butoxide, a polyether, shows characteristics of an et her, alcohol and aldehyde . Allethrin is regarded as an ester of the type R-C-O-R1 with n R being a substituted cyclopr opane moiety and o Rt, a substituted cyclopentenone mOiety. Accordingly it shows cleavage ions typical of an aliphatic ester and undergoes bond ruptures of the cyclic moieties to give unusual ions. Its base peak is an odd electron ion, quite contrary to expectations.

Photograph - Dorothy Rungeling's Second Airplane

A photograph of Dorothy Rungeling's second airplane. The airplane is described as a Piper PA20, 4 seats, 125 h.p. Lycoming engine.

Sport moderne et spiritualité évangélique : une étude interdisciplinaire des concepts de plaisir et de motivation en lien avec l’action humaine

Dans le contexte pastoral évangélique, il est très difficile de s’expliquer qu’un croyant puisse aimer et servir Dieu avec passion pour constater, quelques années plus tard, que la motivation qui le pousse vers Dieu a été étouffée. Bien qu’ils utilisent des termes différents, les entraineurs sportifs posent essentiellement la même question : comment inciter les personnes sous leur charge à fournir un rendement correspondant à leur potentiel. Si la motivation est le moteur du comportement, pour bien des personnes, les émotions en constituent le volant. Il semble que par nature l’humain oriente son comportement vers les émotions agréables et s’éloigne des émotions désagréables. C’est aussi vrai pour le sportif que pour le croyant. Cette étude propose une réflexion interdisciplinaire entre la théologie et la psychologie au sujet du plaisir, de la motivation et de l’action humaine, à la fois dans le sport moderne et dans la spiritualité, qui permette d’aborder notre problématique sous un nouvel éclairage. Les premiers chapitres ont pour objectifs d’identifier la rencontre entre le sport et la spiritualité (chapitre 1), de situer la problématique dans son contexte anthropologique à partir de la compréhension psychologique contemporaine de l’émotion (chapitre 2) et de la motivation (chapitre 3). Les chapitres qui suivent examinent la motivation humaine chez les sportifs à partir de la psychologie du sport (chapitre 4), avant de consulter deux théologiens protestants Jürgen Moltmann du courant libéral et John Piper, évangélique conservateur (chapitre 5) pour introduire la discussion théologique. Bien que la psychologie contemporaine ait été une discipline longtemps figée dans un paradigme darwinien ou humaniste, décriant l’empiètement de la théologie sur sa compréhension de l’humain, le chapitre 6 présente des exemples où une discussion théologique de l’humain, dépourvue de toute validité empirique, peut apporter une vision complémentaire à la psychologie contemporaine et contribuer au bien-être du sportif comme à celui du croyant. Ainsi, la contribution de la psychologie, qui est acceptable à une interprétation évangélique, peut apporter un éclaircissement sur les raisons possibles d’un changement de motivation chez le croyant dans son amour et son service envers Dieu. Le dernier chapitre se veut le prolongement de cette étude dans d’autres domaines, comme les études bibliques et le counseling auprès des croyants et des sportifs et dans le cadre de l’aumônerie militaire.