Musculoskeletal pain in female asylum seekers and hypovitaminosis D3

Résumé de l'article L'hypovitaminose D3 est bien connue et courante chez la population âgée en Occident. Toutefois, elle est probablement sous-diagnostiquée chez les jeunes femmes immigrantes, bien qu'elle soit bien documentée, principalement en Angleterre dans la population Indo-Pakistanaise. Lorsque ce déficit est diagnostiqué, le traitement substitutif est simple et bon marché. Nous avons suspecté une haute prévalence chez de jeunes femmes requérantes d'asile, surtout chez celles provenant de cultures différant quant à l'exposition solaire et la diète. Nous publions donc une série de 11 cas de patientes avec une hypovitaminose D symptomatique issues de la consultation générale de la Policlinique Médicale Universitaire. Toutes les patientes présentaient une anamnèse d'une faible exposition solaire et de douleurs osseuses diffuses, d'une fatigue, d'une faiblesse musculaire ou des modifications de la marche. Toutefois, les premiers diagnostics évoqués par les médecins étaient une possible somatisation (3 patientes), des douleurs dorso-lombaires chroniques (4 patientes) et des symptômes somatiques multiples et inexpliqués (3 patientes). Le diagnostic a été posé d'emblée chez une patiente seulement. La durée moyenne des plaintes avant la pose du diagnostic était de 38 mois et 5 jours. Avec le traitement de cholecalciférol et de calcium, les symptômes disparaissaient entre 1 et 3 mois, chez une patiente ils ont duré sept mois. Le taux moyen de 250H vitamine D3 était de 10.9 nmol/l (IR 21-131). Le taux moyen de calcium était de 2.19 mmol/l (2.15-2.55) et quatre patientes présentaient une hypocalcémie. Nous pensons donc que les femmes requérantes d'asile sont à risque d'une durée prolongée de symptômes, de part la possible haute prévalence de cette condition et la difficulté chez les médecins à la reconnaître. Le diagnostic d'hypovitaminose devrait être recherché chez les femmes requérantes d'asile souffrant de douleurs musculo-squelettiques de longue durée. Le premier diagnostic souvent évoqué, dans un contexte psychosocial souvent difficile, était de l'ordre d'un trouble somatoforme douloureux ou de somatisations. Toutefois, les douleurs liées à l'hypovitaminose D3 sont relativement bien définies ; elles sont symétriques, osseuses, débutent souvent dans la région lombaire pour ensuite s'étendre au bassin, aux membres inférieures proximalement et à la cage thoracique. Le traitement substitutif est simple, peu onéreux et il serait judicieux d'initier d'autres études pour évaluer le besoin d'une substitution de routine dans la population présentée. Abstract: Deficiency of vitamin D, which can lead to osteomalacia, is common in elderly patients in Western countries. However, it is still widely underdiagnosed in young immigrant women, even though the condition has been extensively reported in the immigrant Indo- Asian population in the United Kingdom since the 1960s. A recent study reports an average 59 months before diagnosis was established, and another study found a prevalence of 78% of hypovitaminosis D3 (compared with 58% in controls) in an Indo-Asian population attending a UK rheumatology clinic. When recognised, hypovitaminosis D3 is easily treatable. A study on osteomalacic myopathy in veiled Arabic women in Denmark found that muscle strength returned to normal (except in maximal voluntary con-traction) after six months' treatment. We expected to see this disease in female asylum seekers, especially in those from societies with different customs regarding exposure to sunlight and diet We report 11 cases of symptomatic hypovitaminosis D3 in female asylum seekers (table 1). We focus on the pathology encountered by the primary care doctors caring for these 11 patients, the length of time between the appearance of symptoms, and the establishment of the diagnosis of hypovitaminosis D3 as well as the women's response to treatment by the improvement of a wide range of clinical symptoms-bone pain, muscular weakness, and fatigue.

Quaternary coral reef refugia preserved fish diversity.

The most prominent pattern in global marine biogeography is the biodiversity peak in the Indo-Australian Archipelago. Yet the processes that underpin this pattern are still actively debated. By reconstructing global marine paleoenvironments over the past 3 million years on the basis of sediment cores, we assessed the extent to which Quaternary climate fluctuations can explain global variation in current reef fish richness. Comparing global historical coral reef habitat availability with the present-day distribution of 6316 reef fish species, we find that distance from stable coral reef habitats during historical periods of habitat loss explains 62% of the variation in fish richness, outweighing present-day environmental factors. Our results highlight the importance of habitat persistence during periods of climate change for preserving marine biodiversity.

Vaiṣṇavism, Saivism and minor religious systems / by sir R. G. Bhandarkar

Collection : Grundriss der indo-arischen Philologie und Altertumskunde ; 3, 60

Microvariation in the languages of the Iberian Peninsula

This issue of the Catalan Journal of Linguistics was conceived with the idea to promote comparative studies of the languages spoken in the Iberian Peninsula. The importance of comparison in linguistics dates back to neogrammarians in the xix century due to their interest of discovering the common roots of most of the languages spoken in Europe. In order to get to that objective, comparison of phonological patterns were crucial to retrieve the common Indo-European origins

Phylogenetic analysis of plastid and nuclear DNA sequences reveals a rapid late Miocene radiation of the temperate bamboo tribe Arundinarieae (Poaceae, Bambusoideae)

Background: Arundinarieae are a large tribe of temperate woody bamboos for which phylogenetics are poorly understood because of limited taxon sampling and lack of informative characters. Aims: This study assessed phylogenetic relationships, origins and classification of Arundinarieae. Methods: DNA sequences (plastid trnL-F; nuclear ITS) were used for parsimony and Bayesian inference including 41 woody bamboo taxa. Divergence dates were estimated using a relaxed Bayesian clock. Results: Arundinarieae were monophyletic but their molecular divergence was low compared to the tropical Bambuseae. Ancestors of the Arundinarieae lineage were estimated to have diverged from the other bamboos 23 (15-30) million years ago (Mya). However, the Arundinarieae radiation occurred 10 (6-16) Mya compared to 18 (11-25) Mya for the tropical Bambuseae. Some groups could be defined within Arundinarieae, but they do not correspond to recognised subtribes such as Arundinariinae or Shibataeinae. Conclusions: Arundinarieae are a relatively ancient bambusoid lineage that underwent a rapid radiation in the late Miocene. The radiation coincides with the continental collision of the Indo-Australian and Eurasian Plates. Arundinarieae are distributed primarily in East Asia and the Himalayas to northern Southeast Asia. It is unknown whether they were present in Asia long before their radiation, but we believe recent dispersal is a more likely scenario. Keywords: Arundinarieae; Bambuseae; internal transcribed spacer (ITS); molecular clock; phylogenetics; radiation; temperate bamboos; Thamnocalaminae; trnL-F

Uma metodologia para o projeto teórico de conversores moleculares de luz

Recentlly, we have proposed the representation of lanthanides within AM1 as sparkles for the purpose of obtaing ground state geometries of their complexes. We tested our quantum chemical sparkle model (SMLC/AM1) for the prediction of the crystallographic structure of complexes with coordination number nine, eight and seven. A technique is introduced for the theoretical prediction of eletronic spectra of the organic part of lanthanide complexes by replacing the metal ion by a point charge with the ligands held in their positions as determined by the SMLC/AM1, and by computing the theoretical spectra via the intermediate neglect of differential overlap/spectroscopic-configuration interaction (INDO/S-CI).

Termocromismo em soluções de alcóxidos de Vanádio(IV): uma abordagem pela modelagem molecular

The thermochromic behavior exhibited by vanadium(IV) alkoxides, [V2(μ-OPr i)2(OPr i) 6] and [V2(μ-ONep)2(ONep)6 ], OPr i = isopropoxide and ONep = neopentoxide, was studied by molecular modeling using DFT, TDDFT and INDO/S methods. The vibrational and electronic spectra calculated for [V2(μ-OPr i)2(OPr i) 6] were very similar to the experimental data registered for crystalline samples of the complex and for its solutions at low temperature (< 210 K), while spectra recorded at high temperature (> 315 K) were compatible with those calculated for the monomeric form, [V(OPr i)4]. These results consistently point to a monomer/dimer equilibrium as an explanation for the solution thermochromism of {V(OPr i)4}n. In spite of the structural similarity between [V2(μ-ONep)2(ONep)6 ] and [V2(μ-OPr i)2(OPr i) 6] in the solid state, the thermochromic behavior of the former could not be explained by the same model, and the possibility of tetranuclear aggregation at low temperatures was also investigated.

Estudo analítico sôbre Nephrops rubellus Moreira (Crustáceo - Decapodo - Macruro)

O presente trabalho tem por objetivo registrar a ocorrência de um Crustáceo denominado "Lagostim" - Nephrops rubellus MOREIRA, em águas das cercanias da Ilha Xavier, situada no litoral do Estado de Santa Catarina. O espécime foi capturado em rede "trawl", pelo barco de pesca "Libertador" a uma profundidade de 30 a 60 braças, em meados de junho de 1950. A espécie, que foi descrita em 1903 por CARLOS MOREIRA, parece não ser das mais comuns no litoral brasileiro, tendo sido, contudo, assinalada a sua presença no litoral argentino, por DOELLO JURADO, em 1938. O presente trabalho parece justificar-se por se tratar de um Crustáceo apenas referido na nossa literatura especializada há cerca de meio século e também por não concordarem totalmente os caracteres do exemplar em apreço com os do anteriormente descrito. Foi elaborada uma chave para o gênero Nephrops, destinada a determinar as espécies atlânticas e indo-pacíficas, tendo sido tomado como ponto de partida a chave organizada por DE MAN.

Efeito da temperatura sobre a severidade de Plasmodiophora brassicae

A temperatura é um dos parâmetros importantes para que ocorra a infecção, processo primordial para que haja doença, visando-se verificar a influência deste parâmetro sobre a severidade de Plasmodiophora brassicae em plantas de couve chinesa Pak choi, montou-se testes de infecção em temperaturas variando de 5 em 5ºC, indo de 10 a 40ºC, e observou-se uma redução da severidade da doença nas mudas de 28 dias de idade, nas temperaturas acima de 30ºC, verificando-se que nas temperaturas de 20 a 25ºC a ocorrência da condição ótima para o desenvolvimento da doença.

Nollapersoonalause suomessa ja virossa. Tutkimus kirjoitetun kielen aineistosta

The present study focuses on the zero person constructions both in Finnish and Estonian. In the zero person construction, there is no overt subject and the verb is in the 3rd person singular form: Fin. Tammikuussa voi hiihtää Etelä-Suomessakin. Est. Jaanuaris saab suusatada ka Lõuna-Soomes ‘In January one can ski even in South-Finland’. The meaning of the zero construction is usually considered generic and open. However, the zero may be interpreted as indexically open so that the reference can be construed from the context. This study demonstrates how the zero may be interpreted as referring to the speaker, the addressee, or anybody. The zero person construction in Finnish has been contrasted to the generic pronoun constructions in Indo-European languages. For example, the zero person is translated in English as you or one; in Swedish and German as man. The grammar and semantics of the Finnish zero person construction have been studied earlier to some extent. However, the differences and similarities between Finnish and Estonian, two closely related languages, have not been thoroughly studied before. The present doctoral thesis sheds light on the zero person construction, its use, functions, and interpretation both in Finnish and Estonian. The approach taken is contrastive. The data comes from magazine articles published in Finnish and translated into Estonian. The data consists of Finnish sentences with the zero person and their Estonian translations. In addition, the data includes literary fiction, and non-translated Estonian corpora texts as well. Estonian and Finnish are closely related and in principle the personal system of the two languages is almost identical, nevertheless, there are interesting differences. The present study shows that the zero person construction is not as common in Estonian as it is in Finnish. In my data, a typical sentence with the zero person in both languages is a generic statement which tells us what can or cannot be done. When making generic statements the two languages are relatively similar, especially when the zero person is used together with a modal verb. The modal verbs (eg. Fin. voida ‘can’, saada ‘may’, täytyä ‘must’; Est. võima ‘may’, saama ‘can’, tulema ’must’) are the most common verbs in both Finnish and Estonian zero person constructions. Significant differences appear when a non-modal verb is used. Overall, non-modal verbs are used less frequently in both languages. Verbs with relatively low agentivity or intentionality, such as perception verb nähdä in Finnish and nägema in Estonian, are used in the zero person clauses in both languages to certain extent. Verbs with more agentive and intentional properties are not used in the Estonian zero person clauses; in Finnish their use is restricted to specific context. The if–then-frame provides a suitable context for the zero person in Finnish, and the Finnish zero person may occur together with any kind of verb in conditional if-clause. Estonian if-clauses are not suitable contexts for zero person. There is usually a da-infinitive, a generic 2nd person singular or a passive form instead of the zero person in Estonian counterparts for Finnish if-clauses with zero person. The aim of this study was to analyze motivations for choosing the zero person in certain contexts. In Estonian, the use of the zero person constructions is more limited than in Finnish, and some of the constraints are grammatical. On the other hand, some of the constraints are motivated by the differences in actual language use. Contrasting the two languages reveals interesting differences and similarities between these two languages and shows how these languages may use similar means differently.

Korjausrakentamisen pk-yritysten ennakoivan osaamisen ja liiketoiminnan kehittämishanke

Korjausrakentamiseen käytetään koko talonrakentamisen arvosta lähes puolet. Keskeiset korjausrakentamisen haasteet ja kasvutekijät löytyvät rakennuskannan vanhenemisesta ja väestön ikärakenteen muutoksesta. Suomen rakennuskannan - erityisesti asuinkerrostalojen - korjaustarve on merkittävä. Pääosa asuinkerrostaloistamme on rakennettu 1950–1970-luvuilla. Kun rakennusten kuluvien osien käyttöajaksi oletetaan noin 35 vuotta, on tämän suuren rakennusmassan korjaustoiminta vilkastumassa nopeasti. Vilkastumista kiihdyttää rakentamisajankohtana käyttöön otettu teknologia, jonka käyttöikä on vanhempaa teknologiaa lyhyempi. Hankkeessa laadittiin aluksi kirjallisuuskatsaus koskien korjausrakentamisen toimintaympäristön ja markkinoiden muutosnäkymistä 2010-luvulla, jonka avulla pyrittiin löytämään megatrendejä ja heikkoja signaaleja alan tulavaisuuden näkymistä. Kirjallisuuskatsauksesta käy ilmi, että korjausrakentamisen ennakointinäkökulmana ei ole aikaisemmissa tutkimuksissa korostunut korjausrakentamisen uusien potentiaalisten tuotteiden ja palveluiden muodot sekä alan uuden työvoiman osaamisen kehittämistarpeet. Lisäksi korjausrakentamisalan toimintaa on kuvattu yleisesti teknisestä näkökulmasta kuten uusien rakennustekniikoiden tai raaka-aineiden näkökulmasta eikä niinkään alan klusterinäkökumasta. Seuraavaksi hankkeessa tuotettiin korjausrakentamisen asiakkaille (isännöitsijätoimistot) suunnattu kyselytutkimus. Kyselytutkimuksen tuloksena saatiin näkemys korjausrakentamisen alan lähitulevaisuuden palvelutarpeista ja niihin liittyvistä liiketoiminnan ja osaamisen kehittämistarpeista. Korjaushankkeisiin tarjottavien palveluiden merkitys on kasvamassa 2010-luvulla lämmön-, kosteuden- ja ääneneristystä sekä ilmanvaihtoa koskevien vaatimusten toteuttamisessa, korjaus- ja muutossuunnittelussa, rakenteiden kunto- ja riskiarvioinneissa sekä vahinkokartoituksissa. Sen sijaan Internet-sivustojen kautta tarjotut kustannusarviolaskurit ja ohjeet sekä kiintokalusteiden purku- ja asennus-työt eivät ole isännöitsijöiden mukaan kasvussa. Erityisesti nostettiin esille korjausrakentamisen klusteriosaamisen kehittämistarpeita. Isännöitsijöiden kyselyn perusteella toteutettiin hankkeessa korjausrakentamisen pk-yritysten teemahaastattelut. Yrityksiä pyydettiin ottamaan kantaa kirjallisuusanalyysin ja kyselyn osoittamiin keskeisten kehityssuuntien vaikutuksiin niiden liiketoiminnan ja henkilökunnan osaamisen kehittämistarpeiden näkökulmasta. Osaamistarpeista haastattelujen perusteella voidaan vetää sellaisia johtopäätöksiä, että uudisrakentamisessa ja korjausrakentamisessa tarvittava osaaminen eroaa melko tavalla toisistaan. Liiketoimintaosaamisessa suurin ero vaikuttaa olevan kustannuslaskelmien sekä urakkalaskelmien tekemisessä: korjausrakentamisen tarjouslaskelmissa on pystyttävä ottamaan huomioon rakennusprojektissa vastaan tulevat yllätykset, vasta purkutöiden jälkeen, missä kunnossa korjattavat rakenteet ovat ja kuinka suuri työ on edessä. Työn arvioinnin ja suunnittelun sekä laskelmien tekemisen vaatii erittäin vankkaa ammattitaitoa ja pitkää työkokemusta omalta alalta. Nuorisoasteen koulutuksessa korjausrakentamisen sektorin osaamisen kehittäminen olisi varmistettava järjestämällä vaihtelevissa kohteissa riittävän pitkiä työssäoppimisjaksoja. Hankkeen loppupuolella koottiin asiantuntijatyöryhmä, joka arvioi hankkeen keskeisiä tuloksia ja teki johtopäätöksiä

Angiossarcoma de Mama: Relato de Caso

O angiossarcoma primário da mama é um tumor raro, que incide entre os 14 e 82 anos, com média aos 35 anos de idade. Seu aspecto clínico predominante é o de uma massa indolor, com aumento difuso na mama, que se apresenta com cor violácea ou enegrecida. Como ocorre com outros tipos de sarcoma, o tamanho médio da lesão é de aproximadamente 5 cm quando do diagnóstico. Histologicamente, o angiossarcoma caracteriza-se pela proliferação de células endoteliais que formam canais vasculares comunicantes entre si infiltrando estruturas glandulares e o tecido adiposo. Seu diagnóstico histológico é difícil e nem sempre é estabelecido de imediato, principalmente nos casos com baixo grau de malignidade, devido geralmente à escassez do material biopsiado. Pela dificuldade diagnóstica e pela agressividade, trata-se de neoplasia de prognóstico desfavorável pelas freqüentes metástases. Em nosso serviço, uma paciente de 18 anos procurou atendimento por apresentar nódulo doloroso de rápido crescimento, que foi biopsiado com diagnóstico de hemangioma, sendo indicada ressecção ampla. Três meses após, evoluiu com recidiva tumoral, que foi novamente biopsiada sendo indicada mastectomia, por tratar-se de angiossarcoma de baixo grau de malignidade. Após novas recidivas, indicou-se quimioterapia e, posteriormente, radioterapia. Em vigência desta, evoluiu com novas metástases, indo a óbito por metástase pulmonar.

Metástase em couro cabeludo de câncer do colo uterino: relato de caso

Carcinoma de colo uterino é neoplasia comum, porém a ocorrência de metástase cutânea em câncer do colo uterino é rara, variando de 0,1 a 2,0%. Os sítios primários comuns em pacientes com metástase cutânea são mama, pulmão, intestino grosso e ovário. O intervalo entre o diagnóstico do câncer cervical e as lesões metastáticas varia indo desde a apresentação simultânea com a lesão inicial até 5 anos após o tratamento apresentando-se como nódulos em 86,7% das vezes. Representa manifestação de doença avançada e de mau prognostico. Apresentamos um caso de metástase cutânea de câncer de colo uterino em couro cabeludo. A paciente, 43 anos, tinha diagnóstico de carcinoma epidermóide indiferenciado do colo uterino. Evoluiu, seis meses após a cirurgia radical, com recidiva vaginal, sendo tratada com radioterapia pélvica. Quatro meses depois apresentou três nódulos metastáticos indolores em couro cabeludo. A paciente submeteu-se à quimioterapia com regressão completa das lesões do couro cabeludo.