Hématome des muscles ilio-psoas: rappel des éléments diagnostiques

Introduction: La survenue d'une hémorragie dans les muscles iliopsoasconstitue une pathologie grave, dont le diagnostic est souventtardif et grevé d'une morbidité importante. Sa présentation cliniquedoit être reconnue précocement, en particulier par les médecins depremier recours.Cas clinique: Un patient de 65 ans est admis aux urgences en raisonde douleurs invalidantes de la jambe droite, prédominant sur la faceantérieure de la cuisse. Les douleurs irradient dans le pli inguinal, leflanc, la région lombaire, ainsi que la hanche droite. Elles sont associéesà une parésie du quadriceps droit. Le patient a bénéficié en2006 d'un remplacement de valve aortique, avec implantation d'unevalve mécanique motivant une anticoagulation par acenocoumarol.Il présente par ailleurs une parésie sur le territoire du nerf sciatiquedroit, après fracture du bassin en 1970. Le diagnostic est évoqué auvu d'une antioagulation supra-thérapeutique (INR 5).Un CT-scan de l'abdomen confirmera un important hématome(11 x 7 cm) du muscle iliaque droit (fig. 1) qui sera drainé chirurgicalement,après réversion partielle de la crase, permettant une évolutionfavorable.Discussion: Les hématomes des muscles ilio-psoas surviennentclassiquement de manière spontanée. Les symptômes sont peu spécifiques,à type de douleurs diffuses abdominales, lombaires ou crurales,de paresthésies, de limitation fonctionnelle ou de chute isoléede l'hémoglobine (Hb). Les patients sous anticoagulants (héparine,acenocoumarol) ou présentant des troubles de la coagulation (hémophilie,thrombopathie, maladie de von Willebrand) sont particulièrementà risque. Les complications sont fréquentes: compressions dunerf fémoral (avec hypoesthésie, parésie du quadriceps ou abolitiondu réflexe rotulien), anémie, état de choc. Le traitement implique lacorrection des troubles de la coagulation, ainsi qu'un suivi clinique,radiologique et biologique (Hb) régulier. Le traitement conservateurest proposé lors d'hématome de petite taille, si le patient est stable etpeu symptomatique. Dans les autres cas, un drainage chirurgical parvoie ouverte ou par voie percutanée est recommandé. L'embolisationartérielle s'affiche comme une future option thérapeutique.Conclusions: Ce cas illustre les différents éléments cliniques etbiologiques qui orientent précocement vers le diagnostic d'hématomedes muscles ilio-psoas. Il devrait favoriser l'évocation d'une pathologierare, permettant de garantir un diagnostic précoce.

Desempenho agronômico de genótipos de maracujazeiro-azedo cultivados no Distrito Federal

O presente trabalho teve como objetivo avaliar a produtividade de 14 genótipos cultivados no Distrito Federal. Utilizou-se o delineamento de blocos casualizados, com quatro repetições, 14 tratamentos (genótipos), 8 plantas úteis por parcela. Foram avaliados os 14 genótipos: [PCF-2, EC-RAM, MAR 20#03, MAR 20#09, MAR 20#23, MAR 20#36, MAR 20#46, AR-01, AR-02, Yellow Master FB-200, FP-01, RC-3, GA2, AP-1], totalizando 1.111 plantas por hectare. Após vinte colheitas (período de 9 meses), foram avaliadas as seguintes características: produtividade (kg/ha), massa média de frutos (g), número de frutos e coloração da casca. Na avaliação geral, houve maior rendimento dos genótipos, PCF-2 com 15,8 t/ha, EC-RAM 13,9 t/ ha, FP-01 12,4 t/ha e o AR-01 com 12,3 t/ha. Dos 14 genótipos avaliados, 2 produziram mais que a média nacional de 13 t/ha/ano em 2008 (Banco de dados do IBGE, 2008). A massa média dos frutos variou de 105g para o PCF-2 a 192g para o genótipo AR-01. O número de frutos variou de 33.666 frutos/ha, no genótipo RC 3, a 142.791 frutos/ha no genótipo PCF-2. Todos os genótipos apresentaram maior produção de frutos amarelos, seguido de frutos de cor rosa e de cor roxa.

ErbB Ligands in Angiogenesis

The formation of new blood vessels, i.e. angiogenesis, is an important phenomenon during normal development and wound repair, as well as during various pathological processes, such as tumor growth and metastasis. Specific growth factors regulate angiogenesis by modulating the different cellular functions of endothelial cells (EC), and periendothelial cells, such as pericytes (PC) and smooth muscle cells (SMC), which interact with ECs in a paracrine manner. ErbB receptors form a subgroup of transmembrane receptor tyrosine kinases that interact with growth factors of the epidermal growth factor (EGF) family. ErbB receptors regulate behaviour of a variety of normal as well as tumor cell types. Cancer drugs that target epidermal growth factor receptor (EGFR, ErbB1) or ErbB2 receptor have been approved for clinical use. It has been speculated that part of the antitumor activity of ErbB inhibitor compounds result from an antiangiogenic mechanism. The results presented here indicate a role for endothelial-derived EGF-like growth factors heparin binding EGF-like growth factor (HB-EGF) and neuregulin-1 (NRG-1) in the paracrine regulation of angiogenesis. HB-EGF, EGFR and ErbB2 are shown to mediate interaction between ECs and SMCs in vitro, and gefitinib, an inhibitor of EGFR kinase activity, suppresses recruitment of PCs/SMCs in vivo. NRG-1 is shown to regulate EC functions in vitro and angiogenesis in vivo by indirect mechanisms involving vascular endothelial growth factor-A (VEGF-A) and VEGF receptor-2 (VEGFR-2). Furthermore, EGFR activity is demonstrated to regulate recruitment of bone marrow-derived perivascular cells during tumor neovascularization in vivo. These results indicate that ErbB signaling is involved in the cellular processes of new blood vessel formation. This study gives new information about the role of ErbB ligands and receptors in angiogenesis and vasculogenesis and about the mechanisms by which ErbB inhibitor drugs such as gefitinib affect tumor growth.

Repetibilidade e número mínimo de medições para caracteres de cacho de bacabi (Oenocarpus mapora)

A bacabi (Oenocarpus mapora H. Karsten) é uma palmeira perene nativa da Amazônia, que produz cachos com centenas de frutos que apresentam grande potencialidade à agroindústria de polpa, mas tem sido pouco estudada. Os objetivos deste trabalho foram estimar os coeficientes de repetibilidade e determinar a previsibilidade e o número de medições necessárias para caracteres de cacho dessa palmeira. Foram avaliados 27 indivíduos de bacabi pertencentes ao Banco de Germoplasma de Oenocarpus/Jessenia da Embrapa Amazônia Oriental, em Belém-PA. De cada planta, foram colhidos três cachos em maturação completa para a mensuração de seis caracteres: peso total do cacho (PTC) e de frutos por cacho (PFC), número de ráquilas por cacho (NRC), comprimento da ráquis por cacho (CRC), peso de 100 frutos (PCF) e rendimento de frutos por cacho (RFC). As estimativas de repetibilidade foram obtidas pelos métodos estatísticos da análise de variância, componentes principais e análise estrutural. Em todos os caracteres, as estimativas de repetibilidade apresentaram valores muito semelhantes nos três métodos. As estimativas dos coeficientes de repetibilidade e as previsibilidades foram relativamente altas (r 0,60 e R² 81,7%) para os caracteres número de ráquilas e rendimento de frutos por cacho, demonstrando regularidade dos genótipos nas várias medições (cachos), em todos os métodos. Para esses caracteres, o número mínimo de cachos necessários para a avaliação do real valor dos genótipos foi de treze (RFC) e cinco (NRC) cachos com confiabilidade de 95%, tornando-os factíveis no uso de inferências genéticas para as condições do estudo. Os demais caracteres exibiram repetibilidades e coeficientes de determinação de médias a baixas magnitudes, indicando necessidade de maior controle ambiental para suas mensurações.

Caracterização morfoagronômica de germoplasma de açaizeiro no nordeste paraense

A caracterização morfológica de germoplasma é requisito básico para determinar e quantificar a variabilidade genética de germoplasma. A eliminação de descritores redundantes reduz o trabalho de tomada de dados, sem ocasionar redução na precisão da caracterização. Neste trabalho, objetivou-se analisar e quantificar a variabilidade fenotípica de matrizes de açaizeiro no nordeste paraense, analisando a importância relativa de diferentes características morfológicas para variância fenotípica. Foram analisados 22 caracteres morfométricos, sendo cinco da planta (NEP, AE, NF, CAP e CEN), seis dos frutos (DLF, DTF, PF, PS, PP e RPF) e onze agronômicos (PC, PFC, RFC, NRC, NFR, NFC, NCP, PCF, CIC, CC e PTF). Utilizou-se a análise de componentes principais e os critérios de Jolliffe, Mardia e Cury para descarte de variáveis redundantes assistidos pelas correlações de Pearson. Necessitou-se de oito caracteres para explicar 80% da variação fenotípica. Sugeriram-se para descarte os caracteres PF, PFC, NFC, RPF, PCF, PTF, DTF e NFR. A dispersão gráfica 3D formou um grupo homogêneo e parcialmente disperso, permitindo detectar os genótipos EO-018 e EO-035 como os mais divergentes. Concluiu-se que há variabilidade para discriminar todas as matrizes, com 83,84% da variância fenotípica total, sendo 14 caracteres utilizados para este objetivo. Os critérios de descarte indicaram que se podem utilizar apenas os caracteres NEP, AE, CAP, CEN, NF, DLF, PS, PP, PC, RFC, NRC, CC, CIC e NCP para discriminar as matrizes, com perda mínima de informação. Pela análise gráfica 3D, observam-se matrizes divergentes, importantes para aumentar a variabilidade genética da coleção e o desenvolvimento de genótipos superiores.

Antibiotic susceptibility and molecular epidemiology of Panton-Valentine leukocidin-positive meticillin-resistant Staphylococcus aureus: An international survey

The antibiotic susceptibility and molecular epidemiology of Panton-Valentine leukocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA) isolates reported from 17 countries in the Americas, Europe and, Australia-Asia were analysed. Among a total of 3236 non-duplicate isolates, the lowest susceptibility was observed to erythromycin in all regions. Susceptibility to ciprofloxacin showed large variation (25%, 75% and 84% in the Americas, Europe and Australia-Asia, respectively). Two vancomycin-intermediate PVL-positive MRSA isolates were reported, one from Hong Kong and the other from The Netherlands. Resistance to trimethoprim/sulfamethoxazole and linezolid was <1%. Among 1798 MRSA isolates from 13 countries that were tested for the requested 10 non-β-lactam antibiotics, 49.4% were multisusceptible. However, multiresistant isolates (resistant to at least three classes of non-β-lactam antibiotics) were reported from all regions. Sequence type 30 (ST30) was reported worldwide, whereas ST80 and ST93 were exclusive to Europe and Australia, respectively. USA300 and related clones (ST8) are progressively replacing the ST80 clone in several European countries. Eight major clusters were discriminated by multilocus variable-number tandem repeat assay (MLVA), showing a certain geographic specificity. PVL-positive MRSA isolates frequently remain multisusceptible to non-β-lactam agents, but multiresistance is already prevalent in all regions. Surveillance of MRSA susceptibility patterns should be monitored to provide clinicians with the most current information regarding changes in resistance patterns.

La perspectiva de los profesionales en la evaluación de un programa de intervención socioeducativa en familias

RESUMEN: El programa de competencia familiar (PCF, adaptación española del Strengthening Families Program) es evaluado a partir de la perspectiva de los profesionales responsables de la implementación (formadores y coordinadores). Se trata de un programa dirigido a diversos colectivos con dificultades sociales. El programa tiene como objetivos la reducción de los factores de riesgo, el refuerzo de los factores de protección en los hijos e hijas y la mejora de las relaciones paterno-filiales. El objetivo del estudio es recoger la valoración que hacen los profesionales responsables de la implementación del programa sobre los cambios observados en las familias, la idoneidad del programa, y la adecuación del perfil seleccionado de familias. Igualmente, se valoran los recursos personales y profesionales que han facilitado la tarea de los equipos de implementación (coordinadores y formadores) y las dificultades existentes. La evaluación de los formadores y coordinadores aporta información básica para conocer cómo se ha desarrollado la implementación. Para ello hemos sumado a los instrumentos de evaluación ya existentes, la aplicación de un cuestionario que combina preguntas de respuesta abierta y cerrada y nos permite ahondar en el análisis cuantitativo y cualitativo del proceso y resultados de implementación. Los principales resultados apuntan transformaciones positivas en las familias, la idoneidad del PCF como instrumento y la mejora en la relación entre los profesionales y las familias. Las evaluaciones de los profesionales son fundamentales para conocer mejor el desarrollo del programa, constituyendo un instrumento de comunicación y legitimación del rol de los formadores y coordinadores.

Effect of heating oxyhemoglobin and methemoglobin on microsomes oxidation.

Hemoglobin (Hb) has been proposed to be a major pro-oxidant in raw and cooked meats. To understand the mechanisms and differentiate between the pro-oxidant and antioxidant potential of oxyhemoglobin (OxyHb) and methemoglobin (MetHb), their pro-oxidant activity, protein solubility, radical scavenging capacity, iron content and contribution of non-chelatable iron on lipid oxidation were determined as a function of thermal treatments. The ability of native OxyHb and MetHb to promote lipid oxidation was similar and higher than their corresponding OxyHb or MetHb heated at 68 and 90 degrees C but not different from those at 45 degrees C. The pro-oxidant activity of MetHb heated at 68 and 90 degrees C were similar whereas the pro-oxidant activity of OxyHb heated at 68 degrees C was higher than that heated at 90 degrees C. The decreased pro-oxidant activity of heat-denatured Hb was associated with a decrease in the solubility of heme iron while free iron showed little impact on the lipid oxidation.

Erikoiskokoelma

Erikoiskokoelma on rypäs kirjaston keskeisten tieteenalojen erikoiskokoelmia (Metsä, Maatalous, Luonnontieteet, Eläinlääketieteet ja Farmasia), joihin on koottu vanhoja teoksia: neuvonta- ja kansanvalistustyyppistä kirjallisuutta, farmakopeioita, almanakkoja, Turun akatemian väitöskirjoja ja vanhoja tieteellisiä sarjoja yms. Aineisto on pääasiassa julkaistu ennen v. 1900 ja puolet on julkaistu Suomessa. 40 % aineistosta on luetteloitu Helkaan, josta ne on löydettävissä signumilla "Hb Erikoiskokoelma".

Association of Hematological Variables with Team-Sport Specific Fitness Performance.

PURPOSE: We investigated association of hematological variables with specific fitness performance in elite team-sport players. METHODS: Hemoglobin mass (Hbmass) was measured in 25 elite field hockey players using the optimized (2 min) CO-rebreathing method. Hemoglobin concentration ([Hb]), hematocrit and mean corpuscular hemoglobin concentration (MCHC) were analyzed in venous blood. Fitness performance evaluation included a repeated-sprint ability (RSA) test (8 x 20 m sprints, 20 s of rest) and the Yo-Yo intermittent recovery level 2 (YYIR2). RESULTS: Hbmass was largely correlated (r = 0.62, P<0.01) with YYIR2 total distance covered (YYIR2TD) but not with any RSA-derived parameters (r ranging from -0.06 to -0.32; all P>0.05). [Hb] and MCHC displayed moderate correlations with both YYIR2TD (r = 0.44 and 0.41; both P<0.01) and RSA sprint decrement score (r = -0.41 and -0.44; both P<0.05). YYIR2TD correlated with RSA best and total sprint times (r = -0.46, P<0.05 and -0.60, P<0.01; respectively), but not with RSA sprint decrement score (r = -0.19, P>0.05). CONCLUSION: Hbmass is positively correlated with specific aerobic fitness, but not with RSA, in elite team-sport players. Additionally, the negative relationships between YYIR2 and RSA tests performance imply that different hematological mechanisms may be at play. Overall, these results indicate that these two fitness tests should not be used interchangeably as they reflect different hematological mechanisms.

Final results of the SAKK 16/00 trial: a randomized phase III trial comparing neoadjuvant chemoradiation to chemotherapy alone in stage IIIA/N2 non-small cell lung cancer (NSCLC).

Aim: One standard option in the treatment of stage IIIA/N2 NSCLC is neoadjuvant chemotherapy followed by surgery. We investigated in a randomized trial whether the addition of neoadjuvant radiotherapy would improve the outcome. Here we present the final results of this study. Methods: Patients (pts.) with pathologically proven, resectable stage IIIA/N2 NSCLC, performance status 0-1, and adequate organ function were randomized 1:1 to chemoradiation (CRT) with 3 cycles of neoadjuvant chemotherapy (cisplatin 100 mg/m2 and docetaxel 85 mg/m2 d1, q3weeks) followed by accelerated concomitant boost radiotherapy (RT) with 44 Gy in 22 fractions in 3 weeks, or neoadjuvant chemotherapy alone (CT), with subsequent surgery for all pts. The primary endpoint was event-free survival (EFS). Results: 232 pts. were randomized in 23 centers, the median follow-up was 53 months. Two thirds were men, median age was 60 years (range 37-76). Histology was squamous cell in 33%, adenocarcinoma in 43%. Response rate to CRT was 61% vs. 44% with CT. 85% of all pts. underwent surgery, 30-day postoperative mortality was 1%. The rate of complete resection was 91% (CRT) vs. 81% (CT) and the pathological complete remission (pCR) rate was 16% vs. 12%. The median EFS was 13.1 months (95% CI 9.9 - 23.5) for the CRT group vs. 11.8 months (95% CI 8.4 - 15.2) in the CT arm (p 0.665). The median overall survival (OS) with CRT was 37.1 months (95% CI 22.6 -50), with CT 26.1 months ( 95% CI 26.1 - 52.1, p 0.938). The local failure rate was 23% in both arms. In the CT arm 12 pts. were given postoperative radiotherapy (PORT) for R1 resection, 6 pts. received PORT in violation of the protocol. Pts. with a pCR, mediastinal downstaging to ypN0/1 and complete resection had a better outcome. Toxicity of chemotherapy was substantial, especially febrile neutropenia was common, whereas RT was well tolerated. Conclusions: This is the first completed phase III trial to evaluate the role of induction chemoradiotherapy and surgery, in comparison to neoadjuvant CT alone followed by surgery. RT was active, it increased response, complete resection and pCR rates. However, this failed to translate into an improvement of local control, EFS or OS. Notably, surgery after induction treatment was safe, including pneumonectomy. The overall survival rates of our neoadjuvant regimen are very encouraging, especially for a multicenter setting. Disclosure: M. Pless: Advisory Board for Sanofi; R. Cathomas: Advisory Board Sanofi D.C. Betticher: Advisory Board Sanofi. All other authors have declared no conflicts of interest.

Barnbokssamlingen

Samlingen med signum HB Barnbokssaml. finns vid huvudbiblioteket och innehåller uteslutande utländsk barnlitteratur i original och i översättning till finska. Barnbokssamlingen presenteras närmare i Marita Rajalins publikation Barnbokssamlingen i Åbo Akademis bibliotek. Böcker, samlingar, bibliotekarier utgiven i serien Skrifter utgivna av Åbo Akademis bibliotek 14, Åbo 1979, s. 39-56. En förkortad och omarbetad version av publikationen finns under adressen http://bibbild.abo.fi/barnbok/index.htm

Biografica, släktforskning

Den biografiska litteraturen vid huvudbiblioteket är till och med år 1999 samlad under signum HB Vc i tre klasser, HB Vc1 personhistoria, HB Vc2 historiker över flere personer och HB Vc3 släktforskning. Samlingen med signum HB Vc3 omfattar litteratur om släktforskning i form av böcker, adelskalendrar och släktforskningssamfunds årsböcker. Ett stort antal särtryck och småskrifter ingår i samlingen. Släktforskningsmaterial har ingått i talrika bokdonationer såväl från hemlandet som från Sverige. Friexemplar har erhållits från år 1919. Utgivningen har följts med kontinuerligt och genom inköp har samlingen kompletterats. Litteraturen i samlingen söks i databasen Alma med sökfunktionen Signum och söktermen HB Vc3. En del litteratur tryckt före 1980 skall sökas manuellt i huvudbibliotekets realkatalog eller systematiska katalog, men retroaktiv inmatning i Alma av litteratur tryckt mellan 1830 och 1979 pågår. Genealogisk litteratur efter år 1999 vid hela akademibiblioteket söks i Alma med släktnamn som sökterm vid ämnesordssökning (fritext).

Biografier och memoarer, enskilda personer

Den biografiska litteraturen vid huvudbiblioteket är till och med år 1999 samlad under signum HB Vc i tre klasser, HB Vc1 personhistoria, HB Vc2 historiker över flere personer och HB Vc3 släktforskning. Samlingen med signum HB Vc1 personhistoria omfattar memoarer och biografier om enskilda personer. Dessutom finns ett stort antal biografiska särtryck och småskrifter som är ordnade i tre kapselsamlingar. Kapselsamling HB Vc1 A omfattar material om finlandssvenskar från svenska tiden, dvs intill år 1810. Kapselsamling HB Vc1 B omfattar material om finländare från och med år 1810. Kapselsamling HB Vc1 C omfattar s.k. personskrifter om utlänningar. Memoarer och biografiska arbeten har ingått i talrika bokdonationer såväl från hemlandet som från Sverige. Friexemplar har erhållits från år 1919. Utgivningen har kontinuerligt följts med och genom inköp har samlingen kompletterats. Litteraturen i samlingen söks i databasen Alma med sökfunktionen Signum och söktermen HB Vc1. En del litteratur tryckt före 1980 skall sökas manuellt i huvudbibliotekets realkatalog eller systematiska katalog, men retroaktiv inmatning i Alma av litteratur tryckt mellan 1830 och 1979 pågår. Litteratur vid hela akademibiblioteket från och med år 2000 söks i Alma med personens namn som sökterm vid ämnesordssökning (fritext).

Biografier om flere personer, matriklar

Den biografiska litteraturen vid huvudbiblioteket är till och med år 1999 samlad under signum HB Vc i tre klasser, HB Vc1 personhistoria, HB Vc2 historiker över flere personer och HB Vc3 släktforskning. Samlingen med signum HB Vc2 omfattar biografier om flere personer och biografiska förteckningar såsom matriklar. Biografiska arbeten har ingått i talrika bokdonationer såväl från hemlandet som från Sverige. Friexemplar har erhållits från år 1919. Utgivningen har kontinuerligt följts med och genom inköp har samlingen kompletterats. Litteraturen i samlingen söks i Alma med sökfunktionen Signum och söktermen HB Vc2. En del litteratur tryckt före 1980 skall sökas manuellt i huvudbibliotekets realkatalog eller systematiska katalog, men retroaktiv inmatning i Alma av litteratur tryckt mellan 1830 och 1979 pågår. Litteratur från och med år 2000 vid hela akademibiblioteket söks i Alma med namn som sökterm vid ämnesordssökning (fritext).