Cost-effective utilization of a private facility to perform outpatient surgery in public hospital waiting list patients.

Background: Public hospitals' long waiting lists make outpatient surgery in private facilities very attractive provided a standardized protocol is applied. The aim of this study was to assess this kind of innovative collaboration in abdominal surgery from a clinical and economical perspective. Methods: All consecutive patients operated on in an outpatient basis in a private facility by a public hospital abdominal surgeon and an assistant over a 5-year period (2004-2009) were included. Clinical assessment was carried out from patients' charts and satisfaction questionnaire, and economic assessment from the comparison between the surgeons' charges paid by the private facility and the surgeons' hospital salaries during the days devoted to surgery at the private facility. Results: Over the 5 years, 602 operative procedures were carried out during 190 operative days. All patients could be discharged the same day and only 1% of minor complications occurred. The patients' satisfaction was 98%. The balance between the surgeons' charges paid by the private facility and their hospital salary costs was positive by 25.8% for the senior surgeon and 12.6% for the assistant or, on average, 21.9% for both. Conclusion: Collaboration between an overloaded university hospital surgery department and a private surgical facility was successful, effective, safe, and cost-effective. It could be extended to other surgical specialities. Copyright (C) 2011 S. Karger AG, Basel

Role of substrate utilization and thermogenesis on body-weight control with particular reference to alcohol.

Alcohol (ethanol; EtOH) provides fuel energy to the body (29.7 kJ (7. 1 kcal)/g, 23.4 kJ (5.6 kcal)/ml), as do other macronutrients, but no associated essential nutrients. The thermogenic effect of EtOH (on average 15 % of its metabolizable value) is much greater than that of the main substrates utilized by the body, i.e. fat and carbohydrates (CHO), suggesting a lower net efficiency of energy utilization for EtOH than for fat and CHO. EtOH cannot be stored in the body and is toxic, so that there is an obligatory continuous oxidation of EtOH and it becomes the priority fuel to be metabolized. In contrast to CHO, its rate of oxidation does not depend on the dose ingested. As with CHO intake, it engenders a shift in postprandial substrate utilization (decrease in fat oxidation), but by a non-insulin-mediated mechanism. A limited amount of EtOH can be converted to fatty acids by hepatic de novo lipogenesis (as occurs with high levels of CHO feeding) from acetate production, which inhibits lipolysis in peripheral tissues. There is no evidence that EtOH consumed under normoenergetic conditions (i.e. isoenergetically replacing CHO or fat) leads to greater body fat storage than fat or CHO. However, there is still a lack of experimental studies on the influence of EtOH on the level of spontaneous physical activity in man. This effect may well depend on the dose of EtOH consumed as well as other intrinsic factors.

Traité de la noblesse des offices d'armes, et du blason.

Contient : « Comment on doit faire l'Empereur,... roy,... duc, ... », etc ; « De gaige de bataille » ; « Des neuf Preux... — Les noms, armes et diz de neuf... Preuses » ; « Les armes du roy et doze pers de France » ; « Le vergier de France » ; « Les armes de pluseurs roys crestiens... » ; « Les armes du duc, des barons et autres grans seigneurs de Bretaigne » ; « La maniere coment on doit faire lettres et rescripcions » ; « Libelle de paix, » d'Alain Chartier ; incomplet des quatorze premiers vers ; « Louange de Paris, » par Alain Chartier (?). Début : « Paris sans per, receptable des Dieux... » ; « La geanologie des roys, ducs et princes de Bretaingne, » par « Pierre Le Baud, historien de la royne Anne, » d'après une note signée : « Pontglas ». — Incomplet de la fin

Traité de la noblesse des offices d'armes, et du blason.

Contient : « Comment on doit faire l'Empereur,... roy,... duc, ... », etc ; « De gaige de bataille » ; « Des neuf Preux... — Les noms, armes et diz de neuf... Preuses » ; « Les armes du roy et doze pers de France » ; « Le vergier de France » ; « Les armes de pluseurs roys crestiens... » ; « Les armes du duc, des barons et autres grans seigneurs de Bretaigne » ; « La maniere coment on doit faire lettres et rescripcions » ; « Libelle de paix, » d'Alain Chartier ; incomplet des quatorze premiers vers ; « Louange de Paris, » par Alain Chartier (?). Début : « Paris sans per, receptable des Dieux... » ; « La geanologie des roys, ducs et princes de Bretaingne, » par « Pierre Le Baud, historien de la royne Anne, » d'après une note signée : « Pontglas ». — Incomplet de la fin

Determinants of brain cell metabolic phenotypes and energy substrate utilization unraveled with a modeling approach.

Although all brain cells bear in principle a comparable potential in terms of energetics, in reality they exhibit different metabolic profiles. The specific biochemical characteristics explaining such disparities and their relative importance are largely unknown. Using a modeling approach, we show that modifying the kinetic parameters of pyruvate dehydrogenase and mitochondrial NADH shuttling within a realistic interval can yield a striking switch in lactate flux direction. In this context, cells having essentially an oxidative profile exhibit pronounced extracellular lactate uptake and consumption. However, they can be turned into cells with prominent aerobic glycolysis by selectively reducing the aforementioned parameters. In the case of primarily oxidative cells, we also examined the role of glycolysis and lactate transport in providing pyruvate to mitochondria in order to sustain oxidative phosphorylation. The results show that changes in lactate transport capacity and extracellular lactate concentration within the range described experimentally can sustain enhanced oxidative metabolism upon activation. Such a demonstration provides key elements to understand why certain brain cell types constitutively adopt a particular metabolic profile and how specific features can be altered under different physiological and pathological conditions in order to face evolving energy demands.

Iowa Board of Dental Examiners, January 13, 2003, vol 1, no. 1

Newsletter produced by the Iowa Dental Board.

Iowa Board of Dental Examiners, August 5, 2003, Vol 1, no. 2

Newsletter produced by the Iowa Dental Board.

Iowa Board of Dental Examiners, October 27, 2003, Vol 1, no. 3

Newsletter produced by the Iowa Dental Board.

Iowa Board of Dental Examiners, March 29, 2004, Vol 2, no. 1

Newsletter produced by the Iowa Dental Board.

Iowa Board of Dental Examiners, September, 2004, Vol 2, no. 2

Newsletter produced by the Iowa Dental Board.

Iowa Board of Dental Examiners, April 2005, Issue 6

Newsletter produced by the Iowa Dental Board.

Iowa Board of Dental Examiners, January 2006, Issue 7

Newsletter produced by the Iowa Dental Board.

Iowa Board of Dental Examiners, July 8

Newsletter produced by the Iowa Dental Board.

Report on the driver’s license issuance program administered by the Department of Transportation and County Treasurers’ offices for the year ended June 30, 2009

Report on the driver’s license issuance program administered by the Department of Transportation and County Treasurers’ offices for the year ended June 30, 2009