1000 resultados para ethinylestradiol plus norgestrel


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BACKGROUND: Giant cell arteritis (GCA) is a systemic segmental vasculitis of unknown etiology, typically affecting elderly patients. Elevated erythrocyte-sedimentation rate (ESR) is usually found in such patients. PATIENTS AND METHODS: One hundred and twenty three patients underwent temporal artery biopsy in our institution between 1977 and 1995. Among them, 66 (53.7%) biopsies were positive (i.e. histologic findings were very suggestive of GCA). The clinical charts from all patients with positive biopsies were retrieved and 47 were eligible for our study (inadequate data in 19 cases). RESULTS: Seven of the 47 patients with positive biopsies (15%) had a normal ESR and 70% (33/47 cases) had neuro-ophthalmic complications including anterior ischemic optic neuropathy, central retinal artery occlusion, choroidal ischemia and extraocular muscle and/or cranial nerve palsy (III, IV, VI). No differences were found between the groups with normal or elevated ESR as 87.5% (6/7 cases) of the group with normal ESR exhibited neuro-ophthalmic complications. CONCLUSIONS: ESR was normal in 15% of our GCA patients and these patients had the same frequency of neuro-ophthalmic complications as the GCA patients with elevated ESR. Thus, our study does not support the previous concept that patients with higher ESR are more at risk for neuro-ophthalmic complications. GCA with normal ESR is not rare and such patients should be investigated with other blood studies (C-reactive protein) and with fluorescein angiography.

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La contribution d'Yves Emery et Julien Niklaus étudie les effets du new managerialism dans le secteur social. Les nouveaux outils de pilotage ont profondément transformé les conditions cadres du travail social, de l'organisation des tâches ainsi que de l'action professionnelle. Les auteurs cherchent à savoir dans quelle mesure ces transformations influencent la motivation et la satisfaction au travail des travailleurs et travailleuses sociales. Ils comparent deux institutions présentant des degrés différents de managérialisation et constatent, avec surprise, une motivation supérieure dans les organisations davantage managérialisées, alors que la satisfaction au travail ne présente pas de différences.