Codeine and breastfeeding: cases and STIS position

Codeine is commonly used in North America in the postpartum period for pain associated with episotomyand caesarean section. Analgesic properties of codeine are mainly due to its metabolisation intomorphine (5-10%) via CYP2D6. This enzyme is subject to genetic variability, which can alter theamount of active narcotic excreted into breastmilk. A recent case report highlighted this issue, reportingfatal consequences in a newborn whose mother was taking codeine for episiotomy-related pain (1-2). New-born's blood (post-mortem) and mother's milk showed high morphine concentrations. Genotypeanalysis classified the mother as a CYP2D6 ultrarapid metabolizer, a genotype associated withenhanced formation of morphine from codeine. The authors concluded "clinical and laboratory picturewas consistent with opioid toxicity leading to neonatal death". Subsequent comments expressed reasonnabledoubts on this conclusion, though (3-4). Since, anxiety increased about the safety of codeineduring breastfeeding and genetic screening was proposed as a prevention strategy.STIS position:? Codeine with paracetamol is not a usual pain prescription in the postpartum period in Switzerland.This markedly reduces codeine use during lactation in our country, and may partly explain why webarely collected 3 codeine exposures through breastmilk in 15 years at the STIS (all reported afterabove case's publication and without side effects).? Other centrally acting analgesics are not considered safer (5) than codeine during lactation andrequire close observation for somnolence in both the mother and the infant in case of repeated maternaldosage. A lack of monitoring was salient in the case reported above (1).? If the incidence of CYP2D6 polymorphism (1-10% of individuals in Western Europe) (6) can beconsidered of clinical significance, it is not the exclusive predisposing factor to toxic effects. Healthynewborns can be particularly sensitive to even usual doses of narcotic analgesics because of immaturedrug disposition (7). Conditions leading to impaired clearance or increased susceptibility inthe infant (e.g. preterm birth, metabolic diseases) represent further risk factors for opioid toxicity,regardless of the molecule.In conclusion, when prescribed on a large scale, codein can be rarely associated with adverse drugreactions in breastfed infants (8-9). However, other central acting analgesics cannot be considered asinvariably safer. Therefore, paracetamol and well documented NSAID should be used in 1st choiceduring lactation. In case of severe pain, codeine (with paracetamol) remains an acceptable choice butrequires close monitoring, and breastfeeding mothers should be educated regarding risks related toaccumulation in the newborn. Finally, it is doubtful whether CYP2D6 genetic screening would preventall toxic effects, as other risk factors exist for opioids toxicity

Les enjeux spatiaux et sociaux d'une dynamique interethnique en transition dans les quartiers de centre-ville. La construction des diverses formes de représentation dans la manière de définir un quartier de Nice.

Résumé Cette thèse de doctorat se fixe comme objectif général de définir la spécificité d'un espace urbain situé en centre-ville à travers sa dynamique sociale et interethnique. Il s'agit de relever les différentes formes et manifestations ethniques, mais également de comprendre la manière dont est vécue cette socialité, tout en tenant compte du contexte urbain dans lequel elles se situent. La particularité de ce travail est le fait de proposer une démarche alliant deux disciplines à savoir la géographie et la sociologie, dans le but de proposer une recherche transdisciplinaire, avec comme conséquence la mise en oeuvre d'une démarche commune nourrie des deux disciplines. Les quartiers ethniques situés en centre-ville ne se présentent pas comme des espaces figés, puisque des changements fréquents sont observés aussi bien au niveau de leur population que de l'affectation des locaux commerciaux et des logements. Ils semblent davantage se caractériser comme des « espaces à l'avenir indéterminé » dans le sens où leur avenir aussi bien au niveau de leur structure urbaine que de leurs rapports sociaux ne peut être prévisible et qu'ils sont par ailleurs susceptibles d'être soumis à de nombreux changements, d'où l'idée également d' « espaces en mutations ». Pour aborder ces thématiques de recherche, nous avons opté pour une étude fondée sur le principe de la représentation et de l'une des formes essentielles à travers lesquelles elles se produisent et se manifestent, à savoir les images. Cette recherche privilégie ainsi une analyse dynamique du phénomène interethnique, l'inscrivant dans le courant constructiviste qui s'intéresse notamment à l'étude des pratiques des acteurs sociaux et leurs représentations, dans le sens qu'elles sont le fruit d'une construction sociale. Dans ce type de démarche analytique, il s'agit de prendre en considération à la fois l'analyse du chercheur et la réalité objective et subjective du vécu des acteurs urbains qui regroupent les riverains, les commerçants, les membres associatifs, les politiques et les médias. C'est justement l'association de ces deux approches qui permet de définir un quartier urbain. Abstract "The spatial and social stakes of an interethnic dynamics in transition in the downtown area. The construction of the various forms of representations in order to define an urban quarter in Nice" The general objective of this PHD is to define the specificity of an urban space located in the downtown area with social and interethnic dynamics. Specifically the diverse ethnic form and sign to include the understanding mariner where society has lived in a specific urban context. The particularity of this work is to advance an analytic method using two disciplines: geography and sociology, in order to bring up a transdisciplinarian research with a common method. The ethnic quarters in the inner-city area are not presented as fixed spaces, since frequent changes were observed in the population level and at the allotment level of the commercial premises and the lodgings. Defined as "undetermined future spaces" as their future in the urban structure or the social relations can not be foresee and are supposed to be subjective to many changes. Therefore speaking of "mutations spaces". The option of this type of thematic research is the study of the principle of representation and essential form which shows and produces the images. Research promotes a dynamic analyses of the interethnic phenomena, inside the constructivist which is focused the practices of social actors, their own representations, and products of a social construction. The production of analytical approach is necessary in order to consider the analyses of the research worker and the objective and subjective reality of the life of the urban actors. It gathers the residents, tradesmen, members of associations, politicians and the press. The association of these types of approach define a urban quarter.

Using free data mining software and clustering algorithms to find predictors from student qualifications

In this project a research both in finding predictors via clustering techniques and in reviewing the Data Mining free software is achieved. The research is based in a case of study, from where additionally to the KDD free software used by the scientific community; a new free tool for pre-processing the data is presented. The predictors are intended for the e-learning domain as the data from where these predictors have to be inferred are student qualifications from different e-learning environments. Through our case of study not only clustering algorithms are tested but also additional goals are proposed.

Numa urge genderizada: vivências dos espaços

A cidade foi sendo perspetivada como um lugar masculino em que as mulheres (e, em particular, as mulheres imigrantes) não eram cidadãs plenas no sentido em que não adquiriram o acesso integral e livre às ruas e sobreviveram nos interstícios da cidade. Apesar de todas as conquistas das mulheres e do aparente cosmopolitismo das cidades europeias, as cidades continuam a ser espaços genderizados, espaços de conflito e de discriminação, contextos plenos de ameaças e interdições. Neste artigo apresentaremos algumas reflexões sobre a forma como as mulheres imigrantes brasileiras, cabo-verdianas e ucranianas se relacionam com o espaço - cidade de Lisboa - com base nos dados do projeto de investigação da autora financiado pelo Observatório da Imigração “Mulheres imigrantes em Portugal. Memórias, dificuldades de integração e projetos de vida”.

Áreas residenciais clandestinas na Cidade da Praia: caso Latada e Achada Eugénio Lima Trás

O principal objectivo desta dissertação é expor a problemática das áreas residenciais clandestinas na cidade da Praia. Este processo de produção do espaço urbano acompanhou o desenvolvimento da urbe, em resultado das razões sociais, económicas, políticas e institucionais tendo consequências urbanísticas e sociais graves. Surge porque as diferentes estruturas não souberam ou não foram capazes de dar resposta aos anseios da população em matéria de habitação e solo para construção. Este estudo apresenta um conjunto de informação acerca da realidade das áreas residenciais clandestinas que visa dar a dimensão da problemática na cidade da Praia, seguido de uma análise mais detalhada de duas áreas residenciais. A caracterização sócio-económica e a análise do processo construtivo permitiram produzir conhecimentos mais profundos sobre estes fragmentos do tecido urbano. Na dissertação procurámos articular a questão do planeamento com a habitação e as áreas residenciais clandestinas através da análise dos diferentes planos propostos ou aplicados na urbe. Procurámos perceber como os planos abordaram esta problemática e as soluções apresentadas para a sua superação. Da mesma forma, a apreciação feita em relação à habitação e à política de solos através das resoluções legais propostas para contornar a situação urbanística da cidade. Para uma melhor compreensão do tema discutimos a sua abrangência teórica na perspectiva de diferentes autores e efectuamos o entrosamento entre a componente empírica da produção do espaço urbano com a reflexão teórica. Perante a fragmentação da urbe em núcleos planeados e espontâneos, partimos na auscultação do poder local para a problemática. A intervenção deste em reverter o actual panorama e a política preconizada em relação a reconversão das áreas residenciais clandestinas visando a sua integração no quadro do ordenamento da aglomeração

Plano Detalhado de Chã de Caldeiras na Ilha do Fogo – Cabo Verde

A presente dissertação procurou identificar os principais problemas e desafios que o Processo de Planeamento Urbano Sustentável (Amado,2005) coloca ao nível local no contexto insular e, através do desenhar de soluções, promover o desenvolvimento equilibrado, coeso e sustentável do respetivo território. Através de uma análise teórica procurou-se conhecer e compreender o Quadro Legal do Ordenamento do Território em Cabo Verde. A fase inicial do Ordenamento do Território no País, com a aprovação da Lei de Bases do Ordenamento do Território e Planeamento Urbanístico na década de 90, bem como a insularidade do território, a mão-de-obra pouco qualificada e os poucos recursos financeiros são os grandes desafios que o país enfrenta a nível do Ordenamento do Território. O núcleo urbano de Chã de Caldeiras, que pertence ao município de Santa Catarina do Fogo, Freguesia de Santa Catarina do Fogo, é caraterizado por uma paisagem única, comportando zonas de reserva como o Parque Natural do Fogo e pela proximidade ao vulcão, sendo uma das localidades com maiores atrativos naturais no arquipélago de Cabo Verde. Ora, devido à inexistência de qualquer instrumento de gestão territorial até à atualidade, a área de intervenção do Plano Detalhado, apresenta uma fraca hierarquização da rede urbana e malha viária, construções inacabadas e de fraca qualidade, inexistência de praças e locais de convívio e carencias em termos de infraestruturas básicas (agua, luz e saneamento). Este trabalho pretende ser um contributo para um Desenvolvimento Sustentável para Chã de Caldeiras, (re)qualificando o espaço urbano, zelando pelos interesses da população local e garantindo desta forma a melhoria da qualidade de vida num espaço temporal alargado.

Extent and limitations of density functional theory in describing magnetic systems

The performance of density-functional theory to solve the exact, nonrelativistic, many-electron problem for magnetic systems has been explored in a new implementation imposing space and spin symmetry constraints, as in ab initio wave function theory. Calculations on selected systems representative of organic diradicals, molecular magnets and antiferromagnetic solids carried out with and without these constraints lead to contradictory results, which provide numerical illustration on this usually obviated problem. It is concluded that the present exchange-correlation functionals provide reasonable numerical results although for the wrong physical reasons, thus evidencing the need for continued search for more accurate expressions.

Extent and limitations of density functional theory in describing magnetic systems

The performance of density-functional theory to solve the exact, nonrelativistic, many-electron problem for magnetic systems has been explored in a new implementation imposing space and spin symmetry constraints, as in ab initio wave function theory. Calculations on selected systems representative of organic diradicals, molecular magnets and antiferromagnetic solids carried out with and without these constraints lead to contradictory results, which provide numerical illustration on this usually obviated problem. It is concluded that the present exchange-correlation functionals provide reasonable numerical results although for the wrong physical reasons, thus evidencing the need for continued search for more accurate expressions.

Spinal cord T-cell infiltration in the spared nerve injury model of neuropathic pain: a time course study

Background : Numerous studies have shown that immune cells infiltrate the spinal cord after peripheral nerve injury and that they play a major contribution to sensory hypersensitivity in rodents. In particular, the role of monocyte-derived cells and T lymphocytes seems to be prominent in this process. This exciting new perspective in research on neuropathic pain opens many different areas of work, including the understanding of the function of these cells and how they impact on neural function. However, no systematic description of the time course or cell types that characterize this infiltration has been published yet, although this seems to be the rational first step of an overall understanding of the phenomenon. Objective : Describe the time course and cell characteristics of T lymphocyte infiltration in the spinal cord in the Spared Nerve Injury (SNI) model of neuropathic pain in rats. Methods : Collect of lumbar spinal cords of rats at days 2, 7, 21 and 40 after SNI or sham operation (n=4). Immunofluorescence detecting different proteins of T cell subgroups (CD2+CD4+, CD2+CD8+, Th1 markers, Th2 markers, Th17 markers). Quantification of the infiltration rate of the different subgroups. Expected results : First, we expect to see an infiltration of T cells in the spinal cord ipsilateral to nerve injury, higher in SNI rats than in sham animals. Second, we anticipate that different subtypes of T cells penetrate at different time points. Finally, the number of T lymphocytes are expected to decrease at the latest time point, showing a resolution of the process underlying their infiltrating the spinal cord in the first place. Impact : A systematic description of the infiltration of T cells in the spinal cord after peripheral nerve injury is needed to have a better understanding of the role of immune cells in neuropathic pain. The time course that we want to establish will provide the scientific community with new perspectives. First, it will confirm that T cells do indeed infiltrate the spinal cord after SNI in rats. Second, the type of T cells infiltrating at different time points will give clues about their function, in particular their inflammatory or anti-inflammatory profile. From there on, other studies could be lead, investigating the functional side of the specific subtypes put to light by us. Ultimately, this could lead to the discovery of new drugs targeting T cells or their infiltration, in the hope of improving neuropathic pain.

Technological, biopharmaceutical and pharmacokinetic advances: new formulations of application on the skin and oral mucosa

Currently a growing interest to improve the pharmacological therapy exists, not only by the production and the appearance of new drugs, but guaranteeing that the uses of those which already exist, become more effective. In fact, the conventional pharmaceutical formulations of different drugs present a few secondary effects due to oral administration. In order to avoid these undesired side effects, the purpose of current therapeutic is the development and research of formulations as an alternative to others routes of administration. Therefore, in spite of the undoubtedly complete parenteral absorption, the transdermal and transbuccal routes appear to be a rather attractive alternative to provide an efficient absorption. In this chapter a new technological, biopharmaceutical and pharmacokinetic approach of strategies for application on skin and buccal mucosa are reported. In the future new transdermal drug delivery systems will emerge to be more effective, equipped with an improved aesthetic appearance, better adherence and greater diffusion. But to reach these aims, it is necessary previous knowledge of histology and physiology of skin, and factors involved in the penetration of drugs through it.

Public Art. Timeline of the XXth Century Evolution

The concept of public art is a polysemic term, and the dispersion of its meaning is reflected in the different ways of working during the XXth Century. It cross the fields of sculpture, monument, visual arts and urban space, defined from a civic perspective. This timeline had been constructed after the publications of my PhD: http://www.tesisenred.net/handle/10803/1549

Arte publico 2010

El concepto de arte público es un término polisémico cuyos significados se reflejan en la diversidad de recursos que podemos hallar en internet. Por lo tanto, la aproximación a dichos recursos requerirá una acotación del propio concepto, que transita entre los ámbitos de la escultura, el monumento, las artes visuales y el espacio urbano entendido desde su vertiente cívica. La aproximación a los contenidos de internet vinculados con el arte público se aborda desde tres áreas temáticas cuyo análisis nos ayudará a organizar un volumen heterogéneo de información. La primera área incide en el papel de los centros de investigación y ayuntamientos en la promoción, inventariado y catalogación de las colecciones de arte en el espacio público. La segunda se centra en aquellos sitios web que son entendidos como fuentes de información y herramientas; los denominados think tanks. La tercera y última destaca la presencia en la red de páginas oficiales dedicadas a autores y obras específicas. The concept of public art is a polysemic term, and the dispersion of its meaning is reflected in the diversity of resources we can find on the web. Therefore, the approach to these resources needs a delimitation of the concept, crossing the fields of Sculpture, Monument, Visual arts and Urban space, defined from a civic perspective. The management of these resources is addressed from three strands, whose analysis will help us to organize a heterogeneous volume of information. The first affects the role of research centers and municipalities in the promotion, inventory and cataloging of collections of art in public spaces. The second focuses on those websites understood as sources of information and resources, the so-called think tanks. The third highlights the presence in the web of official sites devoted to specific authors and works. Keywords: public art, monument, public space, internet

Space-time front-ends for RAKE receivers in the FDD mode of UTRA

A unified and general vision of different space-time processors is presented. Many popular receivers can beaccomodated, like V-RAKE receivers, weighted V-RAKE, or spatial narrowband beamforming. By makingappropriate assumptions on the space/time characteristic of the interference it is possible to enhance theperformance of the receiver through spatial/temporal pre-processors. These receivers will be tested in the FDDmode of UTRA.

Por un espacio público no estatal. Contra la hegemonía neoliberal y el declive de la democracia

Este artículo plantea la necesidad de crear un espacio público no estatal para defender el "bien común" en las democracias occidentales. La importante crisis de los partidos políticos y de las instituciones representativas exige la creación de nuevas instituciones desde la sociedad civil que tengan como principal fin la defensa del "bien común". La participación de los ciudadanos que formen parte de estas instituciones deberá estar regida por los principios del voluntarismo, la transparencia y el compromiso cívico. En la primera sección se realiza una breve descripción de las políticas que están poniendo hoy en cuestión el Estado de derecho y la democracia en los países occidentales: el neoliberalismo y el autoritarismo (1). En la segunda parte, se abordan los límites que presentan las teorías neoconstitucionalistas y del garantismo frente a la actual deriva autoritaria y neoliberal de las instituciones estatales (2). El texto concluye reivindicando la elaboración de una nueva antropología de la democracia que abra la puerta a la construcción de este nuevo espacio público independiente de las instituciones del actual modelo de Estado de derecho (3).

Urbanités marchandes : le commerce dans la production de la qualité urbaine et ses régulations : le cas de Lausanne

While collective identity markers are constantly evolving in today's city, the hyper-consumption society has allowed retail, even though greatly transformed, to remain a community hub for socialization. Society's commodification takes shape precisely within the public realm and the urban scene: sprawling analogous drivable retail-only suburbs and turning city centers into bland, soulless and undefined places displaying homogeneous frontages characterized by the same retail storefronts worldwide. More than ever, urban policies on retail oriented servicescapes seem crucial to urban and regional planning from a sustainable perspective. Thorough the study case of Lausanne, our research focuses on how the urban planning model and its policies could set into place spatial strategies to enhance urban quality and to reorganize retail centralities without succumbing to the prevailing commodification of the public realm. -- Les indicateurs d'identité collective se reformulent dans la ville actuelle, mais la société de l'hyperconsommation a permis au commerce, aussi transformé soit-il, de rester un lieu d'échange et de brassage social. La marchandisation de la société prend des formes précises dans l'espace et a un impact certain sur le paysage urbain : multipliant les espaces marchands périphériques monofonctionnels ou encore transformant nos centres-villes en paysages anodins, présentant des vitrines semblables quel que soit le pays où elles se situent. Plus que jamais, une régulation des espaces de consommation semble incontournable pour l'aménagement du territoire et l'urbanisme dans une perspective de durabilité. À travers le cas lausannois, cette thèse s'interroge sur la façon dont les modèles urbanistiques de régulation des jeux d'acteurs privés peuvent participer à la mise en place de stratégies de qualification urbaine et d'organisation des centralités commerciales sans céder à la tentation de la marchandisation des espaces publics.