Exaggerated exercise-induced pulmonary hypertension causes lung water accumulation and right ventricular dysfunction in patients with chronic mountain sickness

Background: Chronic mountain sickness (CMS) is characterized by exaggerated exercise-induced pulmonary hypertension. Evidences suggests that exercise may cause lung fluid accumulation at high altitude. We hypothesized that, in patients with CMS, exercise causes lung fluid accumulation.Methods: In 21 male CMS patients and 20 matched healthy controls born and permanently living in La Paz (Bolivia, 3600m) we assessed with echocardiogram, pulmonary artery pressure (PASP), right and left ventricular function and ultrasoundlung comets (ULCs, a marker of lung fluid accumulation) at rest and during mild bicycle exercise (10 min at 50W).Results: CMS patients presented a more than 2-fold greater exercise-induced increase in pulmonary artery pressure than controls (17.1±8.3 vs 7.2±7.9 mmHg, P=0.003). This exaggerated PASP response to exercise was associated with a roughly 3-fold greater increase in UCLs in patients with CMS than in controls (6.3±5.1 vs. 2.1±5.3, p<0.05), and there existed a significant relationship between PASP and UCLs (r=0.44, p<0.001). Finally, TDI on lateral tricuspid annulus decreased during exercise in patients with CMS (from 13.2±3.2 to 11.5±2.1 cm s-1, p=0.03), but increased in controls (from 13.1±2.9 to 14.9±2.6 cm s-1 , p=0.04). Left ventricular function remained unaltered in the 2 groups.Conclusions: we provide the first direct evidence in CMS patients that exaggerated exercise-induced pulmonary hypertension causes rapid lung fluid accumulation and right ventricular dysfunction. We speculate that in patients with CMS these two phenomena contribute to reduced exercise performances and Figure 1 increased cardiovascular morbidity and mortality that characterise these subjects.

4th International LIS-EPI meeting: una mirada al futuro de la información

Informe sobre el 4th International LIS-EPI Meeting que tuvo lugar en Valencia en noviembre de 2009 bajo el lema ¿La información en 2015¿. Los temas que se trataron fueron el futuro del sector de la información y de las bibliotecas, las rich internet applications (RIAs), el software libre en bibliotecas, el acceso abierto y los dispositivos móviles

E-LIS, una herramienta por y para bibliotecarios

Con la generalización del movimiento Open Access (acceso abierto) se han desarrollado políticas de apoyo a la publicaciónen abierto de revistas científicas, y complementariamente acciones de creación de repositorios digitales. El objetivo, eneste último caso, es posibilitar que los autores depositen sus contenidos (artículos, ponencias, tesis, etc.) para que seanaccesibles en línea por parte de toda la comunidad profesional y científica. En el caso de la bibliotecología y las ciencias afines (documentación, archivística, comunicación...) el repositorio ELIS(http://eprints.rclis.org) es un magnífico ejemplo de herramienta útil realizada por y para el colectivo bibliotecario que cree en el acceso abierto.

Lettre d'un ancien professeur en medecine de la faculté de Paris, a M. Vandermonde, auteur du Journal de medecine, censeur royal, &c. Pour servir de réponse à la Lettre d'un médecin de province à un médecin de Paris . Cette lettre fait la troisiéme piéce d'un ecrit intitulé Recueil de plusieurs piéces concernant le Traité des tumeurs & ulceres, &c.

Comprend : Lettre d'un médecin de province à un médecin de Paris

Pluralité des corps. 3. Les corps liés [Multifaceted body. 3. The contextualised body].

Le corps humain est l'objet privilégié d'action de la médecine, mais aussi réalité vécue, image, symbole, représentation et l'objet d'interprétation et de théorisation. Tous ces éléments constitutifs du corps influencent la façon dont la médecine le traite. Dans cette série de trois articles, nous abordons le corps sous différentes perspectives : médicale (1), phénoménologique (2), psychosomatique et socio-anthropologique (3). Ce troisième et dernier article traite successivement des approches psychosomatiques et socio-anthropologiques du corps et de certains de leurs apports respectifs. The human body is the object upon which medicine is acting, but also lived reality, image, symbol, representation and the object of elaboration and theory. All these elements which constitute the body influence the way medicine is treating it. In this series of three articles, we address the human body from various perspectives: medical (1), phenomenological (2), psychosomatic and socio-anthropological (3). This third and last article focuses on the psychosomatic and socio-anthropological facets of the body and their contribution to its understanding.

Consumer Advisory Bulletin, Door-to-Door Sales: Your Right to Cancel, June 2011

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: Door-to-Door Sales: Your Right to Cancel

An agency-oriented model to explain vine-growing specialization in the province of Barcelona (Catalonia, Spain) in the mid-nineteenth century

[cat] En aquest treball presentem un model per explicar el procés d’especialització vitícola assolit als municipis de la província de Barcelona, a mitjans del s. XIX,que cerca entendre com va sorgir històricament un avantatge comparatiu fruit d’un procés que esdevindria un dels punts de partida del procés d’industrialització a Catalunya. Els resultats confirmen els papers jugats pel impuls “Boserupià” de la població en un context d’intensificació de l’ús de la terra, i d’un impuls del mercat “Smithià” en un context d’expansió de la demanda per part de les economies atlàntiques. També es posa de manifest la importància de les dotacions agro-ecològiques i les condicions socioinstitucionals relacionades amb la desigualtat d’ingrés. La difusió de la vinya donà com a resultat unes comunitats rurals menys desiguals fins al 1820, tot i que aquesta desigualtat augmentà de nou a partir d'aleshores.

The determinants of social spending in Spain (1880-1960): Is Lindert right?

[spa] El principal objetivo de este artículo se centra en analizar los orígenes del Estado de Bienestar en España a partir del marco teórico elaborado por Peter Lindert. Con este fin, se ofrece un análisis econométrico de los factores que determinaron la evolución del gasto social público en este país entre 1880 y 1960. Utilizando nueva evidencia cuantitativa, se construyó un panel de datos por quinquenios con el porcentaje de gasto social respecto al PIB desagregado en tres partidas: sanidad, seguridad social y beneficencia. El análisis permite insertar el caso español en el debate internacional y los resultados revelan interesantes singularidades de este país.

Tree and Brush Control For County Road Right-of-Way, Ocotober 2002

This manual summarizes the roadside tree and brush control methods used by all of Iowa's 99 counties. It is based on interviews conducted in Spring 2002 with county engineers, roadside managers and others. The target audience of this manual is the novice county engineer or roadside manager. Iowa law is nearly silent on roadside tree and brush control, so individual counties have been left to decide on the level of control they want to achieve and maintain. Different solutions have been developed but the goal of every county remains the same: to provide safe roads for the traveling public. Counties in eastern and southern Iowa appear to face the greatest brush control challenge. Most control efforts can be divided into two categories: mechanical and chemical. Mechanical control includes cutting tools and supporting equipment. A chain saw is the most widely used cutting tool. Tractor mounted boom mowers and brush cutters are used to prune miles of brush but have significant safety and aesthetic limitations and boom mowers are easily broken by inexperienced operators. The advent of tree shears and hydraulic thumbs offer unprecedented versatility. Bulldozers are often considered a method of last resort since they reduce large areas to bare ground. Any chipper that violently grabs brush should not be used. Chemical control is the application of herbicide to different parts of a plant: foliar spray is applied to leaves; basal bark spray is applied to the tree trunk; a cut stump treatment is applied to the cambium ring of a cut surface. There is reluctance by many to apply herbicide into the air due to drift concerns. One-third of Iowa counties do not use foliar spray. By contrast, several accepted control methods are directed toward the ground. Freshly cut stumps should be treated to prevent resprouting. Basal bark spray is highly effective in sensitive areas such as near houses. Interest in chemical control is slowly increasing as herbicides and application methods are refined. Fall burning, a third, distinctly separate technique is underused as a brush control method and can be effective if timed correctly. In all, control methods tend to reflect agricultural patterns in a county. The use of chain saws and foliar sprays tends to increase in counties where row crops predominate, and boom mowing tends to increase in counties where grassland predominates. For counties with light to moderate roadside brush, rotational maintenance is the key to effective control. The most comprehensive approach to control is to implement an integrated roadside vegetation management (IRVM) program. An IRVM program is usually directed by a Roadside Manager whose duties may be shared with another position. Funding for control programs comes from the Rural Services Basic portion of a county's budget. The average annual county brush control budget is about $76,000. That figure is thought not to include shared expenses such as fuel and buildings. Start up costs for an IRVM program are less if an existing control program is converted. In addition, IRVM budgets from three different northeastern Iowa counties are offered for comparison in this manual. The manual also includes a chapter on temporary traffic control in rural work zones, a summary of the Iowa Code as it relates to brush control, and rules on avoiding seasonal disturbance of the endangered Indiana bat. Appendices summarize survey and forest cover data, an equipment inventory, sample forms for record keeping, a sample brush control policy, a few legal opinions, a literature search, and a glossary.