997 resultados para post-relational DBMS
Resumo:
Rsum : Introduction : l'ostoporose est une maladie caractrise par une masse osseuse diminue et une structure osseuse appauvrie amenant une fragilit osseuse augmente et par consquent une augmentation du risque fracturaire. Elle est associe une morbidit et mortalit importantes. Il existe de nombreuses substances disposition pour son traitement. La modalit d'administration est trs variable selon la substance prescrite. Les bisphosphonates, puissants antirsorbeurs osseux, sont la classe mdicamenteuse de rfrence. Malheureusement, prescrits per os, iIs ont frquemment des effets secondaires digestifs limitant leur usage et sont donc mieux tolrs en iv. C'est le pamidronate qui a t le premier prescrit et reste le plus utilis. Mthode : le meilleur rgime d'administration du pamidronate n'tant pas connu, nous avons test son effet diffrentes doses sur les marqueurs du remodelage osseux et la densitomtrie osseuse. Trois modalits d'administration pour une dose annuelle constante (30 mg tous les 3 mois, 40 mg tous les 4 mois et 60 mg tous les 6 mois) ont t compares chez des femmes postmnopauses avec une ostoporose. 39 patientes ont t recrutes sur 2 ans et rparties en 2 groupes appels EFAP 1 et 2 pour Evaluation de la Frquence d'Administration du Pamidronate selon la frquence des contrles de sang. Rsultats : au cours des 6 premiers mois de traitement, on observe une chute rapide des tlopeptides sanguins ds le premier mois qui suit l'injection de 30, 40 ou 60 mg de pamidronate avec toutefois, une inhibition de la rsorption osseuse plus efficace long terme pour les traitements fractionns (30 et 40 mg). Des rsultats similaires sont obtenus pour l'ostocalcine. Il n'existe en revanche pas de modifications significatives des autres paramtres (calcmie, PTH, vitamine D et phosphatase alcaline) dans les 3 groupes. Ces rsultats se confirment aprs 24 mois de traitement avec une efficacit plus marque pour les traitements 30 et 40 mg. Sur le plan des valeurs de densitomtrie osseuse, aprs 2 ans de traitement, les valeurs sont augmentes de faon significative sur la colonne lombaire avec les trais dosages, de faon non significatives sur le col fmoral et de faon significative pour le trochanter avec le dosage de 40 mg seulement. Conclusions : bien que cette tude dmontre des gains de densit osseuse quasi identiques entre les 3 modes d'administration pour une dose annuelle cumule de 120 mg, l'inhibition du remodelage osseux est beaucoup plus importante avec les doses de 30 ou 40 mg tous les 3 ou 4 mois qu'avec 60 mg tous les 6 mois. Ces deux modes d'administration permettent de mieux expliquer le lien entre l'effet sur les marqueurs et sur la densitomtrie osseuse.
Resumo:
BACKGROUND: Radiation optic neuropathy (RON) is a rare, unpredictable, late complication of radiotherapy secondary to obliterative endarteritis. Tumor recurrence has to be ruled out by a clinical and neuroradiological examination. METHODS: Five patients with RON were investigated by magnetic resonance imaging (MRI) during 1992. RESULTS: Radiation-induced lesions of the intracranial visual pathways were easily visible on MRI. Without Gadolinium, a sectorial swelling was detectable, which markedly enhanced with Gadolinium. Intracranial optic nerve was affected in 5/5 cases, optic chiasm in 3/5 cases, and optic tract in 2/5 cases. CONCLUSIONS: MRI is the examination of choice when RON is suspected: it will easily delineate the extent of the lesion, and compression/infiltration by a recurrent tumor will be formally ruled out. A segmental swelling of visual pathway with marked Gadolinium enhancement on MRI is highly suggestive of radionecrosis.
Resumo:
This study analyses the evolution of liver disease in women with chronic hepatitis C during the third trimester of pregnancy and the post-partum period, as a natural model of immune modulation and reconstitution. Of the 122 mothers recruited to this study, 89 were HCV-RNA+ve/HIV-ve and 33 were HCV-RNA-ve/HIV-ve/HCVantibody+ve and all were tested during the third trimester of pregnancy, at delivery and post-delivery. The HCV-RNA+ve mothers were categorized as either Type-A (66%), with an increase in ALT levels in the post-partum period (>40 U/L; P<0.001) or as Type-B (34%), with no variation in ALT values. The Type-A mothers also presented a significant decrease in serum HCV-RNA levels in the post-delivery period (P<0.001) and this event was concomitant with an increase in Th1 cytokine levels (INF, P=0.04; IL12, P=0.01 and IL2, P=0.01). On the other hand, the Type-B mothers and the HCV-RNA-ve women presented no variations in either of these parameters. However, they did present higher Th1 cytokine levels in the partum period (INF and IL2, P<0.05) than both the Type-A and the HCV-RNA-ve women. Cytokine levels at the moment of delivery do not constitute a risk factor associated with HCV vertical transmission. It is concluded that differences in the ALT and HCV-RNA values observed in HCV-RNA+ve women in the postpartum period might be due to different ratios of Th1 cytokine production. In the Type-B women, the high partum levels of Th1 cytokines and the absence of post-partum variation in ALT and HCV-RNA levels may be related to permanent Th1 cytokine stimulation.
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Trichuris trichiura is a soil-transmitted helminth which is prevalent in warm, moist, tropical and subtropical regions of the world with poor sanitation. Heavy whipworm can result either in Trichuris dysenteric syndrome - especially in children - or in a chronic colitis. In heavy infections, worms can spread proximally and may cause ileitis. Here we provide first microscopic evidence for a T. trichiura adult worm embedded in the rectum of a post-Colonial Brazilian adult mummy. During Colonial and post-Colonial times, many European chroniclers described a parasitic disease named Maculo whose symptomatology coincides with heavy helminthiasis. Based on our findings and on comparison of ancient textual evidence with modern description of heavy whipworm, we feel confident in considering that the two syndromes are expressions of the same pathological condition.
Resumo:
Durante los procedimientos endovasculares en el ictus isqumico la informacin per-procedimiento del dao cerebral ayudara a tomar decisiones sobre intentar la recanalizacin arterial. Mtodos Se estudiaron parmetros gasomtricos de sangre extrada durante los procedimientos endovasculares de recanalizacin. Se obtuvieron muestras proximal y distal a la oclusin. Un estudio gasomtrico se realizo inmediatamente. Resultados El estudio mostr diferencias significativas entre las muestras pre-oclusin y postoclusin en la presin parcial de oxgeno (PaO2Pre78,916.3mmHgVs73.414.9 mmHg,p&0,001). Una curva ROC determin que una Post-PaO2&70 mmHg predice mejora clnica. Los pacientes con post-PaO2&70mmHg tuvieron mejor autonoma (medianaMRS:3Vs.6, p=0,024). En el anlisis multivariante el nico predictor independiente de mejora clnica fue la Post-PaO2&70(OR:5,21IC95%:1.38-67.24,p=0,013). Conclusin Es posible la obtencin de muestras de sangre del tejido lesionado distal a la oclusin. La informacin puede ser utilizada para predecir evolucin clnica y en las decisiones durante el procedimiento.
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El novembre de 2010, la Comissi Europea ha finalment donat a conixer la seva "Energia 2020 Comunicaci", un document estratgic en el marc ms ampli del programa "Europa 2020". Una estratgia per al desenvolupament sostenible intel ligent, i creixement inclusiu posa les bases d'un nou enfocament a la poltica d'energia a la UE. En el marc d'Europa 2020, la Iniciativa d'Energia recopila els resultats que ja s'han obtingut a travs de la Estratgia de Lisboa 2000-2010, s'identifiquen les deficincies del passat i i introdueix nous objectius ambiciosos per a la UE en matria de poltica energtica.
Resumo:
The STAR family of proteins links signaling pathways to various aspects of post-transcriptional regulation and processing of RNAs. Sam68 belongs to this class of heteronuclear ribonucleoprotein particle K (hnRNP K) homology (KH) single domain-containing family of RNA-binding proteins that also contains some domains predicted to bind critical components in signal transduction pathways. In response to phosphorylation and other post-transcriptional modifications, Sam68 has been shown to have the ability to link signal transduction pathways to downstream effects regulating RNA metabolism, including transcription, alternative splicing or RNA transport. In addition to its function as a docking protein in some signaling pathways, this prototypic STAR protein has been identified to have a nuclear localization and to take part in the formation of both nuclear and cytosolic multi-molecular complexes such as Sam68 nuclear bodies and stress granules. Coupling with other proteins and RNA targets, Sam68 may play a role in the regulation of differential expression and mRNA processing and translation according to internal and external signals, thus mediating important physiological functions, such as cell death, proliferation or cell differentiation.
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Este estudio tiene como objetivo plantear lo ocurrido en Cancn a partir de los temas que deban tratarse, comprobar el desencuentro que se produjo en la Conferencia, que no se limit a uno de los captulos que deban negociarse, y tras los escenarios de futuro que se crearon valorar el anlisis y toma de posicin que ha efectuado la Comisin Europea.
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In 2006, two municipalities located in the canton of Fribourg (Switzerland), La Tour-de-Trme and Bulle, amalgamated. In this study, we report on the evolution of citizen perceptions as well as try to better understand the reasons behind the respondents various positions concerning this new political and territorial entity. Five-hundred individuals were surveyed almost four years after the amalgamation came into effect. Our results show that if the amalgamation was voted again, it would be necessary to be particularly attentive to citizen access to municipal offices and to local service provisions, to citizen identification to their municipality as well as to the life of the local associations. Indeed, these are clearly important issues for small localities. Furthermore, citizens of the newly amalgamated municipality are mostly sensitive to access to municipal offices and to contact with local representatives. Improving the population's perceptions of these particular issues could lead to a 12 percentage point increase in support for the amalgamation.
Resumo:
PURPOSE: We investigated the incidence and distribution of post-mortem gas detected with multidetector computed tomography (MDCT) to identify factors that could distinguish artifactual gas from cardiac air embolism. MATERIAL AND METHODS: MDCT data of 119 cadavers were retrospectively examined. Gas was semiquantitatively assessed in selected blood vessels, organs, and body spaces (82 total sites). RESULTS: Seventy-four of the 119 cadavers displayed gas (62.2%; CI 95% 52.8-70.9), and 56 (75.7%) displayed gas in the heart. Most gas was detected in the hepatic parenchyma (40%), right heart (38% ventricle, 35% atrium), inferior vena cava (30% infrarenally, 26% suprarenally), hepatic veins (26% left, 29% middle, 22% right), and portal spaces (29%). Male cadavers displayed gas more frequently than female cadavers. Gas was detected 5-84 hours after death; therefore, the post-mortem interval could not reliably predict gas distribution (rho = 0.719, p < 0.0001). We found that a large amount of putrefaction-generated gas in the right heart was associated with aggregated gas bubbles in the hepatic parenchyma (sensitivity = 100%, specificity = 89.7%). In contrast, gas in the left heart (sensitivity = 41.7%, specificity = 100%) or in periumbilical subcutaneous tissues (sensitivity = 50%, specificity = 96.3%) could not predict gas due to putrefaction. CONCLUSION: This study is the first to show that the appearance of post-mortem gas follows a specific distribution pattern. An association between intracardiac gas and hepatic parenchymal gas could distinguish between post-mortem-generated gas and vital air embolism. We propose that this finding provides a key for diagnosing death due to cardiac air embolism.
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Taking on the challenge of understanding and explaining the Symphony of (todays) New World in realistic terms (not realist), this essay aims to analyse the Post-Cold war era by devising a multi-conceptual framework that combines different theoretical contributions not yet linked in a fully explanatory way. This paper suggests two inter-related analytical contexts (or background melodies) to understand Dvoraks "New World. First, the socio-economic structural context that falls under the controversial category of Globalization and, second, the post-modern political structural context that is built on Robert Coopers threefold analysis (Pre-modern, Modern and Post-modern) of todays world [Cooper, R: 1997, 1999]. Lastly, the closing movement (allegro con fuoco) enters the normative arena to assess American foreign policy options in the light of the theoretical framework devised in the first part of the essay.
