Role of Chlamydia trachomatis and emerging Chlamydia-related bacteria in ectopic pregnancy in Vietnam.

In this case-control study, we investigated the seroprevalence and molecular evidence of Chlamydia trachomatis and Waddlia chondrophila in ectopic pregnancies (EP) and uneventful control pregnancies in 343 women from Vietnam. Whereas presence of C. trachomatis IgG was strongly associated with EP [adjusted odds ratio (aOR) 5·41, 95% confidence interval (CI) 2·58-11·32], its DNA remained undetected in all tubal lesions. We confirmed an independent association between antibodies against Waddlia and previous miscarriage (aOR 1·87, 95% CI 1·02-3·42). Further investigations are needed to understand the clinical significance of Waddlia's high seroprevalence (25·9% in control pregnancies) in this urban population.

Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes.

Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomarkers of systemic and bronchial inflammation, sputum microbiology, CT of the thorax and echocardiography were assessed. COPD groups were identified by partitioning cluster analysis and validated prospectively against cause-specific hospitalisations and all-cause mortality during a 4 year follow-up. Results Three COPD groups were identified: group 1 (n ¼ 126, 67 years) was characterised by severe airflow limitation (postbronchodilator forced expiratory volume in 1 s (FEV 1 ) 38% predicted) and worse performance in most of the respiratory domains of the disease; group 2 (n ¼ 125, 69 years) showed milder airflow limitation (FEV 1 63% predicted); and group 3 (n ¼ 91, 67 years) combined a similarly milder airflow limitation (FEV 1 58% predicted) with a high proportion of obesity, cardiovascular disorders, iabetes and systemic inflammation. During follow-up, group 1 had more frequent hospitalisations due to COPD (HR 3.28, p < 0.001) and higher all-cause mortality (HR 2.36, p ¼ 0.018) than the other two groups, whereas group 3 had more admissions due to cardiovascular disease (HR 2.87, p ¼ 0.014). Conclusions In patients with COPD recruited at their first hospitalisation, three different COPD subtypes were identified and prospectively validated:"severe respiratory COPD","moderate respiratory COPD", and"systemic COPD'

Hoitotyön opettajan osaaminen

The purpose of this study was to evaluate the competence of nurse teachers, who are teaching nursing at polytechnic level in Finland. The following research questions were framed for the study: What kind of evaluation nurse teachers of their nursing competence, teaching skills, evaluation skills, personality factors and relationships with students. The data were collected by a questionnaire (A Tool for Evaluation of Requirements of Nurse Teacher, ERNT). The questionnaire regarded background factors and 20 statements divided in five categories. The five competence categories were: Nursing competence, Teaching skills, Evaluation skills, Personality factors and Relationships with students. The evaluation scale was a 5-point Likert-scale. The respondents were nurse teachers, teacher for emergency nursing, public health nurse and midwifery teachers from all polytechnics in Finland. Response rate to the questionnaire was 46 % (n=342). The data were analysed by using descriptive statistics. Mean scores and standard deviations for each item were calculated. Category scores were obtained by summing scores of all items within a category. The results of this study showed that nurse teacher evaluated their competence on a high level. Concerning the category Relationships with students (mean 4.61, standard deviation 0.71) they got the highest averages. The lowest scores were gained regarding the requirements associated with teaching skills (mean 4.30, standard deviation 0.82). Concerning a single question, the best score was achieved in ability to take students seriously (mean 4.66, standard deviation 0.71) and the lowest score was achieved for their guidance of students to advance in decision making (mean 4.15, Std 0.69). The nurse teachers evaluated themselves with relatively high scores concerning competence categories as a hole. In future it is important to study nurse teacher competence with students or authorities of health service.

Oxidative stress in gastric mucosa of asymptomatic humans infected with Helicobacter pylori: effect of bacterial eradication.

BACKGROUND: Inducible nitric oxide synthase (iNOS) and interleukin 8 (IL-8) are positive in approximately 50% of Helicobacter pylori-related diseases but it is not clear whether oxidative stress is also present in H. pylori asymptomatic humans. Our aim was to study the expression of iNOS, superoxide dismutase, catalase and IL-8 production in H. pylori-infected asymptomatic humans, and to investigate the effect of eradication of H. pylori. MATERIALS AND METHODS: Biopsies of corpus and antrum of asymptomatic H. pylori positive and negative humans served for determination of the gastritis score and H. pylori status; iNOS was measured by reverse transcriptase polymerase chain reaction and immunohistochemistry and superoxide dismutase and catalase by immunohistochemistry. IL-8 in biopsies was assessed by enzyme-linked immunosorbent assay. RESULTS: Immunostaining of iNOS, catalase and superoxide dismutase was significantly associated with H. pylori infection and was localized to inflammatory cells. IL-8 concentrations were greater in the H. pylori positive than H. pylori negative group and decreased after bacterial eradication. A decrease in staining for iNOS and catalase was observed after H. pylori eradication. CONCLUSIONS: INOS and antioxidant enzymes are present in gastric biopsies of asymptomatic H. pylori positive humans. Eradication caused a significant decrease in staining for iNOS and catalase. These results indicate that oxidative stress occurs in asymptomatic patients and can be modulated by H. pylori eradication.

Impact of a cis-associated gene expression SNP on chromosome 20q11.22 on bipolar disorder susceptibility, hippocampal structure and cognitive performance.

BackgroundBipolar disorder is a highly heritable polygenic disorder. Recent enrichment analyses suggest that there may be true risk variants for bipolar disorder in the expression quantitative trait loci (eQTL) in the brain.AimsWe sought to assess the impact of eQTL variants on bipolar disorder risk by combining data from both bipolar disorder genome-wide association studies (GWAS) and brain eQTL.MethodTo detect single nucleotide polymorphisms (SNPs) that influence expression levels of genes associated with bipolar disorder, we jointly analysed data from a bipolar disorder GWAS (7481 cases and 9250 controls) and a genome-wide brain (cortical) eQTL (193 healthy controls) using a Bayesian statistical method, with independent follow-up replications. The identified risk SNP was then further tested for association with hippocampal volume (n = 5775) and cognitive performance (n = 342) among healthy individuals.ResultsIntegrative analysis revealed a significant association between a brain eQTL rs6088662 on chromosome 20q11.22 and bipolar disorder (log Bayes factor = 5.48; bipolar disorder P = 5.85×10(-5)). Follow-up studies across multiple independent samples confirmed the association of the risk SNP (rs6088662) with gene expression and bipolar disorder susceptibility (P = 3.54×10(-8)). Further exploratory analysis revealed that rs6088662 is also associated with hippocampal volume and cognitive performance in healthy individuals.ConclusionsOur findings suggest that 20q11.22 is likely a risk region for bipolar disorder; they also highlight the informative value of integrating functional annotation of genetic variants for gene expression in advancing our understanding of the biological basis underlying complex disorders, such as bipolar disorder.

Postoperative Adjuvant Lapatinib and Concurrent Chemoradiotherapy Followed by Maintenance Lapatinib Monotherapy in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck: A Phase III, Randomized, Double-Blind, Placebo-Controlled Study.

PURPOSE: This multicenter phase III study evaluated the efficacy and safety of lapatinib, an epidermal growth factor receptor/ErbB2 inhibitor, administered concomitantly with chemoradiotherapy and as maintenance monotherapy in patients with high-risk surgically treated squamous cell carcinoma of the head and neck (SCCHN). PATIENTS AND METHODS: Patients with resected stage II to IVA SCCHN, with a surgical margin ≤ 5 mm and/or extracapsular extension, were randomly assigned to chemoradiotherapy (66 Gy total radiation dose and cisplatin 100 mg/m(2) per day administered on days 1, 22, and 43) plus placebo or lapatinib (1,500 mg per day) before and during chemoradiotherapy, followed by 12 months of maintenance monotherapy. RESULTS: Six hundred eighty-eight patients were enrolled (lapatinib, n = 346; placebo, n = 342). With a median follow-up time of 35.3 months, the study ended early because of the apparent plateauing of disease-free survival (DFS) events. Median DFS assessed by an independent review committee was 53.6 months and not reached for lapatinib and placebo, respectively (hazard ratio, 1.10; 95% CI, 0.85 to 1.43). Investigator-assessed results confirmed the independent review committee assessment. No significant differences in DFS by human papillomavirus status or overall survival were observed between treatment arms. Similar numbers of patients in both treatment arms experienced adverse events (AEs), with more patients in the lapatinib arm than the placebo arm experiencing serious AEs (48% v 40%, respectively). The most commonly observed treatment-related AEs were diarrhea and rash, both predominantly in the lapatinib arm. CONCLUSION: Addition of lapatinib to chemoradiotherapy and its use as long-term maintenance therapy does not offer any efficacy benefits and had additional toxicity compared with placebo in patients with surgically treated high-risk SCCHN.

Hoitotyön opettajan yhteiskunnallinen toiminta – osa opettajuutta

The social activity of nurse teacher – a part of teacherhood Every nurse teacher must know the current health policy in order to use it in teaching. The conception of the role of health policy in curriculum and the concrete teaching of social activity are quite unclear. The purpose of this study was to describe the social activity of nurse teachers. The data were collected by a structured questionnaire (Paltta 1998) via E-mail. The questionnaire included background factors and nine items for society activities. The respondents were nurse teachers, teachers for emergency nursing, public health nurse and midwifery teachers from all polytechnics in Finland. Response rate was 46 % (n = 342). The data were analysed by using descriptive statistics. The results of this study showed that 36 % of nurse teachers evaluated themselves quite active in society activities and 43 % of them evaluated themselves inactive. 32 % of nurse teachers was member and involved to working in general organisations. 28 % of nurse teachers worked or have been worked in local commission or trustees. Nurse teachers evaluated their knowledge about health policy quite good (mean 3.75, Std 0.99). Their knowledge about education policy was also quite good (mean 3.57, Std 1.04). Nurse teachers updated their knowledge about health policy and education policy by reading professional journals, newspapers, internet and following television and radio. According to results nurse teachers are quite active in society activities even tough almost half of them evaluated themselves quite inactive. Although nurse teachers’ knowledge about health policy was quite good by their opinion, they must update and improve the knowledge. In the future it is important to study how nurse teachers use health policy in their teaching and how nurse students’ participation in society activities can be improved.

Apokalypt

Soitinnus: piano.

Hypomnemata guaedam in Chronicon episcoporum Aboensium a Paulo Justen consignatum

Invocatio: I.N.J.C.

Estudi del condicionament d’una vivenda prefabricada amb criteris de sostenibilitat i d’autosuficiència

Partint del projecte bàsic d’un habitatge unifamiliar aïllat, projectat amb sistema prefabricat, onhi ha definida l’arquitectura i de forma molt bàsica el sistema estructural, els tancaments, lesinstal•lacions i els acabats, es pretén realitzar un estudi que es basi en la millora de l’envoltantespaial i de les instal•lacions per tal d’aconseguir un habitatge energèticament més eficientrespecte a la proposada inicialment.Concretament, es tracta d’un habitatge unifamiliar aïllat, del model tipus “CUBIC EVOLUTION”,dissenyat pels arquitectes Joaquin Torres i Rafael Llamazares de l’estudi d’arquitectura A-Cero.Aquest model, presenta una superfície de 290,91m2 útils i de 342,76m2 construïts, distribuïtsd’una manera molt raonable al seu ús.Per tant, l’objectiu principal d’aquest projecte final de grau, és projectar el condicionament del’envoltant, de totes les instal•lacions amb sistemes renovables i sostenibles necessàries en lavivenda i de diferents sistemes passius d’estalvi energètic de la vivenda prefabricada de l’estildescrit anteriorment, tenint presents criteris de sostenibilitat i autosuficiència, sense deixar debanda la condició estètica de la vivenda proposada en el projecte bàsic, de manera que aquestaes pugui autosubministrar la major part de l’energia i aigua que necessita, i complint sempre lanormativa actual.També es tindran en compte aspectes bioclimàtics, tals com ubicació, orientació, il•luminaciónatural, ventilació natural, pluja, etc., per tal d’adaptar-se a les condicions climàtiques i de l’entornon està situada i permetre a l’edifici estalviar la major quantitat d’energia possible

Le Constitutionnel : journal politique et littéraire

1816/12/07 (Numéro 342).

Kansainvälisen valuuttarahaston (IMF) julkaisut

International Monetary Fund (IMF) eli Kansainvälinen valuuttarahasto perustettiin v. 1945 valvomaan 187 jäsenmaansa rahoitusjärjestelmiä ja edistämään rahoitusmarkkinoiden vakautta ja kansainvälistä kauppaa. IMF julkaisee kansainvälisiä maksutasetilastoja n. 200 maasta, ulkomaankaupan tilastotietoa, aikasarjoja v. 1948 lähtien ja valtiontalouden rahoitustilastoja sekä maakohtaisia raportteja. Painettuun kokoelmaan kuuluu vuosikertomuksia, kausijulkaisuja, tilastoja ja monografioita. Ne käsittelevät makrotaloutta, taloudellista kehitystä, rahoitusmarkkinoita, kansainvälistä taloutta ja valuuttamarkkinoita. Kokoelmassa on yhteensä n. 4342 nimekettä ja se karttuu jatkuvasti. Kokoelman vanhin julkaisu on vuodelta 1944. Suurin osa kokoelman julkaisuista on ilmestynyt v. 1995 - 2011. Sitä uudempia ei ole enää hankittu painettuina. Kokoelmaan kuuluu erilaisia vuosikirjoja pitkältä ajanjaksolta, kuten Annual report (1948 -), Annual Report on Exchange Arrangements (1990 -), Balance of payments statistics yearbook (1938 - ), Direction of trade statistics yearbook (1958 - ), Government finance statistics yearbook (1952 - ) ja International financial statistics yearbook (1991 - ). Kokoelma sisältää myös kausijulkaisuja kuten Economic review (1951 - ), IMF staff papers (1951 -) ja International financial statistics (1948 -). Kokoelmaan kuuluvat myös elektronisia julkaisuja sisältävät IMF E-Library ja AREAER -tietokannat. AREAR-tietokannassa on Annual Report on Exchange Arrangements -julkaisut sähköisessä muodossa. Tietokannassa on dataa mm. IMF:n jäsenmaiden valuutta- ja kauppajärjestelyistä. IMF E-Library, sisältää elektronisia julkaisuja sekä tilastotietokannat: International financial statistics (IFS), Balance of payments statistics (BOP), Direction of trade statistics (DOT) ja Government finance statistics (GFS). Julkaisuja on yhteensä n. 11 806. Kokoelman uudempaa osaa säilytetään Suomen Pankin kirjaston avokokoelmassa ja vanhempaa varastokokoelmassa. Painetut julkaisut ovat käytettävissä kirjastossa ja lainattavissa lukuun ottamatta tilastojulkaisuja, kausijulkaisuja ja vuosikirjoja. Elektronisia tietokantoja voi käyttää vain organisaation henkilökunta.

Edistys ja idylli

Kirjallisuusarvostelu

Hipertensão portal esquistossomótica avaliação do fluxo sangüíneo portal antes e após tratamento cirúrgico

OBJETIVO: Avaliar o fluxo sangüíneo portal na esquistossomose hepato-esplênica e o efeito tardio do tratamento cirúrgico na hemodinâmica portal. MÉTODO: Foram estudados 64 pacientes por Doppler dúplex: grupo I (pacientes com hipertensão portal esquistossomótica); grupo II (pacientes submetidos a desconexão ázigo-portal com esplenectomia) e grupo III (pacientes submetidos derivação esplenorrenal distal). RESULTADOS: O fluxo da veia porta foi maior no grupo I (1954,46 ± 693,73ml/min) e foi menor no grupo III (639,55 ± 285,86ml/min), neste correlacionou-se com o tempo pós-operatório (r=-0,67, p=0,0005). O fluxo sangüíneo portal do grupo II (1097,18 ± 342,12ml/min) foi semelhante ao de indivíduos normais. As mesmas alterações foram verificadas com relação ao diâmetro da veia porta nos grupos I, II, e III (cm): 1,46 ± 0,23; 1,12 ± 0,22; 0,93 ± 0,20, respectivamente. CONCLUSÕES: Estes dados sugerem que: 1) Existe hiperfluxo portal na fisiopatologia da hipertensão portal esquistossomótica; 2) o tratamento cirúrgico interferiu na hemodinâmica portal, diminuindo o fluxo sangüíneo da veia porta; 3) Esta redução do fluxo sangüíneo portal correlacionou-se com o tempo de seguimento pós-operatório no grupo III mas não no grupo II.