Leiomiomatose peritoneal disseminada: relato de caso

Neste trabalho relata-se o caso de uma paciente de 46 anos de idade com queixa de aumento de volume periumbilical e dor leve antes da menstruação. O quadro evoluiu com aumento gradativo da dor. Foram realizados ultra-som, tomografia computadorizada e ressonância magnética. Após laparotomia exploradora, foi retirado material para biópsia que confirmou o diagnóstico de leiomiomatose peritoneal disseminada.

Référentiel de pratiques professionnelles: soins et surveillance des accès veineux centraux de l'adulte pour la nutrition parentérale [Formative assessment in clinical nutrition: Care management of parenteral nutrition central venous access]

Les voies veineuses centrales (VVC) sont essentielles pour l'administration de la nutrition parentérale. Le risque de complications est dépendant de la qualité des soins apportés à la VVC qui influence de ce fait la qualité de vie des patients et le coût des soins. Beaucoup de complications des VVC, infectieuses ou non, peuvent être prévenues par l'existence de protocoles de soins appropriés et standardisés. L'information sur les soins des VVC et les éventuelles complications est essentielle pour le dépistage et le traitement précoce de ces complications ; elle doit faire l'objet de protocoles partagés entre les patients et les soignants. Cet article décrit une évaluation des pratiques professionnelles sous la forme d'un audit clinique destiné à améliorer la qualité de soins des patients en nutrition parentérale porteurs de VVC. Central venous access devices (CVAD) are essential for the administration of parenteral nutrition. The quality of the care of CVAD influences the risk of complications and so the quality of life of the patients and the costs of care. Numerous infectious or non-infectious complications of CVAD can be prevented by appropriate, standardized protocols of care. Information about the care of CVAD and complications is essential for the early recognition and treatment of complications and should be shared between patients and caregivers. This article describes an audit for CAVD care that can be used to improve quality of care in a professional practice evaluation program.

Apical access and closure devices for transapical transcatheter heart valve procedures.

The majority of transcatheter aortic valve implantations, structural heart procedures and the newly developed transcatheter mitral valve repair and replacement are traditionally performed either through a transfemoral or a transapical access site, depending on the presence of severe peripheral vascular disease or anatomic limitations. The transapical approach, which carries specific advantages related to its antegrade nature and the short distance between the introduction site and the cardiac target, is traditionally performed through a left anterolateral mini-thoracotomy and requires rib retractors, soft tissue retractors and reinforced apical sutures to secure, at first, the left ventricular apex for the introduction of the stent-valve delivery systems and then to seal the access site at the end of the procedure. However, despite the advent of low-profile apical sheaths and newly designed delivery systems, the apical approach represents a challenge for the surgeon, as it has the risk of apical tear, life-threatening apical bleeding, myocardial damage, coronary damage and infections. Last but not least, the use of large-calibre stent-valve delivery systems and devices through standard mini-thoracotomies compromises any attempt to perform transapical transcatheter structural heart procedures entirely percutaneously, as happens with the transfemoral access site, or via a thoracoscopic or a miniaturised video-assisted percutaneous technique. During the past few years, prototypes of apical access and closure devices for transapical heart valve procedures have been developed and tested to make this standardised successful procedure easier. Some of them represent an important step towards the development of truly percutaneous transcatheter transapical heart valve procedures in the clinical setting.

Faculty and Student Perspectives Toward Open Courseware, and Open Access Publishing: Some Comparisons Between European and North American Populations

Instructor and student beliefs, attitudes and intentions toward contributing to local open courseware (OCW) sites have been investigated through campus-wide surveys at Universidad Politecnica de Valencia and the University of Michigan. In addition, at the University of Michigan, faculty have been queried about their participation in open access (OA) publishing. We compare the instructor and student data concerning OCW between the two institutions, and introduce the investigation of open access publishing in relation to open courseware publishing.

The personal research portal : web 2.0 driven individual commitment with open access for development

Peer-reviewed

Collaborative group membership and access control for JXTA

Peer-reviewed

Management of Exceptions on Access Control Policies

Peer-reviewed

Aggregating and Deploying Network Access Control Policies

Peer-reviewed

Towards open access networks – prototyping with the Lappeenranta model

The provision of Internet access to large numbers has traditionally been under the control of operators, who have built closed access networks for connecting customers. As the access network (i.e. the last mile to the customer) is generally the most expensive part of the network because of the vast amount of cable required, many operators have been reluctant to build access networks in rural areas. There are problems also in urban areas, as incumbent operators may use various tactics to make it difficult for competitors to enter the market. Open access networking, where the goal is to connect multiple operators and other types of service providers to a shared network, changes the way in which networks are used. This change in network structure dismantles vertical integration in service provision and enables true competition as no service provider can prevent others fromcompeting in the open access network. This thesis describes the development from traditional closed access networks towards open access networking and analyses different types of open access solution. The thesis introduces a new open access network approach (The Lappeenranta Model) in greater detail. The Lappeenranta Model is compared to other types of open access networks. The thesis shows that end users and service providers see local open access and services as beneficial. In addition, the thesis discusses open access networking in a multidisciplinary fashion, focusing on the real-world challenges of open access networks.

Percutaneous access versus standard femoral exposure for endovascular abdominal aortic aneurysm repair: a randomized, controlled trial

The treatment of abdominal aortic aneurysm (AAA) has shifted from the exposure of the aorta artery in an open repair technique to a small groin cut in an endovascular repair. Recently, a percutaneous access for endovascular repair has appeared. This new technique aims to minimize the complications of the common femoral artery exposure, the patient discomfort and the length of hospitalizationObjectives: To compare the proportion of discharged patients within the first 48 postoperative hours of two common femoral artery accesses for endovascular repair of AAA: the open exposure technique and the percutaneous technique. Secondary objectives include to evaluate the total procedure time, the femoral access complications, the need for extra analgesia and the patient satisfaction and groin discomfort of the two techniquesDesign: Randomized controlled trial conducted between 2014 and 2017Participants: Patients diagnosed with abdominal aortic aneurysm with elective endovascular repair indication