Thérapies inhalées dans la mucoviscidose [Inhaled therapies for cystic fibrosis].

Inhaled therapies play a significant role in the management of cystic fibrosis patients. Mucolytic and airway-rehydrating agents improve mucociliary clearance and respiratory functional status. Nebulized antibiotherapy achieve high local concentration, while reducing systemic toxicity. Tolerance to inhaled treatments is good excepting frequent bronchoconstriction which can usually be prevented by prior administration of beta2-mimetics. The majority of treatments are only available in liquid formulations. Thus, nebulization is the most frequently used inhalation mode. Vibrating-mesh nebulizers have significantly reduced inhalation time.

Prospección pesquera del calamar gigante (dosidicus gigas) a bordo del buque japonés "Shinko Maru 2" (04 de noviembre - 17 de diciembre de 1989)

Presenta los resultados obtenidos durante la prospección efectuada a bordo del buque japonés "Shinko Maru 2" entre el 04 de noviembre y el 17 de diciembre de 1989, cuyo objetivo principal fue evaluar la factibilidad de explotar comercialmente el Dosidicus gigas (ORBIGNY) "calamar gigante" o "pota" en el mar peruano. El área de estudio comprendió desde los 03°30 ' S hasta el Callao (12°00 'S). Se emplearon dos sistemas de captura: con calamareras automáticas y luces de atracción (JIGGING) y otra con redes de deriva (DRIFT NET), llevándose a cabo 32 y 24 operaciones de pesca respectivamente.

Epidémiologie et prévention du mélanome cutané en Suisse. [Epidemiology and prevention of melanoma in Switzerland].

[Quintessence] - L'incidence du mélanome malin augmente rapidement depuis plus de 50 ans. - La Suisse, avec 1700 nouveaux cas diagnostiqués par an, est, avec la Norvège, le pays d'Europe le plus touché par le mélanome. - Des différences régionales sont récemment apparues avec une incidence plus élevée dans les cantons romands. - Les changements observés en Suisse dans l'attitude et le comportement face au soleil sont trop récents et modestes pour influencer l'incidence. - La détection précoce effectuée depuis près de 20 ans a permis d'augmenter la survie et le taux de mélanomes fins sans toutefois altérer l'incidence des lésions épaisses. - La mortalité associée au mélanome malin a récemment diminué, d'abord chez les femmes. L'efficacité de la prévention devrait se confirmer à terme si les efforts entrepris se poursuivent. [Auteurs] [Summary] - The incidence of malignant melanoma has steadily increased in Caucasian populations over the last 50 years. - With some 1700 new cases per year, Switzerland has, with Norway, the highest rate of melanoma in Europe. - Regional differences within Switzerland are emerging, with a higher incidence in western (French-speaking) cantons. - Observed changes in sun protection attitudes and knowledge in the Swiss population have yet to impact on the incidence trend. - Early detection, as pursued since the mid-1980s in Switzerland, has led to a substantial increase in survival and rates of thin melanoma, without major change in rates of thick melanoma. - Mortality from melanoma has recently decreased, initially in women. The effectiveness of prevention campaigns should eventually be confirmed if current efforts persist. [Authors]

Plan d'El-Arych : Pour servir à la relation de la campagne de Syrie / J. F. S. Bailly del.

Échelle(s) : [ca 1:3 300], 100 mètres [= 3 cm]

In situ introducer sheath dilatation for complex aortic access.

Aortic access problems due to diseased or small peripheral vessels are a major issue in endovascular aneurysm repair (EVAR). In the emergency setting, like aortic rupture after blunt trauma, or in patients with a hostile abdomen, a more proximal access to the aorta is not a pleasant perspective. We developed in situ introducer sheath dilatation as a bail-out technique for patients with difficult aortic access under various circumstances including EVAR, intra-aortic balloon pump insertion and cannulation for perfusion. The method described allows to increase the access vessel diameter by 50% (from 6 to 9 mm) or the luminal circumference from 18 to 27 F. We have used this technique in five patients without complication, very much in contrast to the traditionally practiced 'forced device insertion'.

Fundações de edifícios – Fundações superficiais

Nesse último século, tem-se vindo a se preocupar com a construção civil em relação às fundações de edifícios, que é uma das partes que tem maior relevância a uma estrutura e se por ter falhado nessa parte será a maior preocupação dos profissionais da construção civil. Assim, para que haja maior segurança e qualidade em geral, deve-se encarar a construção do início da fundação até ao fim, porque os principais problemas surgidos nos edifícios são sobretudo assentamento de fundações, por não se ter a preocupação de preparar de uma certa forma o terreno de fundação. Neste trabalho abordamos a problemática da qualidade de fundações de edifícios, no eu caso fundações superficiais. Primeiramente abordamos os princípios e conceitos básicos a ter em conta na elaboração de um projecto de fundações. Seguidamente apresentamos estudos que evidenciam a importância da qualidade de fundações em edifício e são apresentados os principais erros cometidos na elaboração do projecto de fundações e os principais factores que influenciam a sua qualidade e alguns princípios a ter em conta com a qualidade do edifício. O trabalho realizado, foi com o intuito de se adquirirem conhecimentos no que se disrespeito as fundações a cerca da sua resistência e consistência em relação aos edifícios de habitação. Por último, apresentamos uma aplicação prática de um estudo de uma fundação superficial que demonstra a aplicação dos procedimentos na elaboração de uma fundação com garantia de qualidade e segurança do edifício. Os dados e resultados dessa aplicação são apresentados e analisados, sendo retiradas algumas conclusões acerca dos procedimentos em relação aos edifícios.

Radiopuhe 20.10.1954

Puhe

Intravitreal ranibizumab (Lucentis) for the treatment of myopic choroidal neovascularization.

BACKGROUND: Macular choroidal neovascularization (CNV) is one of the most vision-threatening complications of myopia, which can lead to severe vision loss. The purpose of this study was to evaluate the safety and efficacy of intravitreal ranibizumab in the treatment of myopic CNV. METHODS: We conducted a prospective, consecutive, interventional study of patients with subfoveal or juxtafoveal CNV secondary to pathologic myopia (PM) treated with intravitreal injection of ranibizumab in the Jules Gonin University Eye Hospital from June 2006 to February 2008. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and fluorescein angiography (FA) were performed at baseline and monthly for all patients. Indications for retreatment were loss in BCVA associated either with persistent leakage from CNV shown on FA, and/or evidence of CNV activity on OCT. RESULTS: The study included 14 eyes of 14 patients. The mean spherical equivalent refractive error was -12.5 (range, -8.0 D to -16.0 D). Mean time of follow-up was 8.4 months (range from 3 to 16 months, SD: 3). The mean number of intravitreal injections administered for each patient was 2.36 (SD 1.5). The mean initial visual acuity (VA) was 0.19 decimal equivalent (log-MAR: 0.71, SD: 0.3). A statistically significant improvement to a mean VA of 0.48 decimal equivalent (log-MAR:0.32, SD: 0.25) was demonstrated at the final follow-up. VA improved by a mean of 3.86 (SD 2.74) lines. Nine patients (64%) demonstrated a gain of 3 or more lines. Mean central macular thickness (CMT) measured with OCT was 304 microm (SD: 39) at the baseline, and was reduced significantly at the final follow-up to 153 microm (SD: 23). Average CMT reduction was 170 microm (SD: 57). No injection complications or drug-related side effects were noted during the follow-up period. CONCLUSIONS: In this small series of eyes with limited follow-up, intravitreal ranibizumab was a safe and effective treatment for CNV secondary to PM, resulting in functional and anatomic improvements.

La thrombose veineuse profonde chez l'adolescent [Venous thromboembolic disease in adolescents]

Deep vein thrombosis in children and adolescents is a quite rare event. Risk factors most often associated with DVT in this particular population are: central vein catheters, neoplasia, vascular malformations and oral contraception. Diagnosis and management of DVT in adolescents does not differ greatly from that of adults. Compression ultrasound is the initial exam of choice. Hospitalization is often not necessary and treatment can be started by using low molecular weight heparin followed by oral anti-vitamin K antagonists. Thrombophilia screening is not routinely recommended and should be reserved for those patients for whom results would change therapeutical management.

n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia.

BACKGROUND: The use of n-3 fatty acids may prevent cardiovascular events in patients with recent myocardial infarction or heart failure. Their effects in patients with (or at risk for) type 2 diabetes mellitus are unknown. METHODS: In this double-blind study with a 2-by-2 factorial design, we randomly assigned 12,536 patients who were at high risk for cardiovascular events and had impaired fasting glucose, impaired glucose tolerance, or diabetes to receive a 1-g capsule containing at least 900 mg (90% or more) of ethyl esters of n-3 fatty acids or placebo daily and to receive either insulin glargine or standard care. The primary outcome was death from cardiovascular causes. The results of the comparison between n-3 fatty acids and placebo are reported here. RESULTS: During a median follow up of 6.2 years, the incidence of the primary outcome was not significantly decreased among patients receiving n-3 fatty acids, as compared with those receiving placebo (574 patients [9.1%] vs. 581 patients [9.3%]; hazard ratio, 0.98; 95% confidence interval [CI], 0.87 to 1.10; P=0.72). The use of n-3 fatty acids also had no significant effect on the rates of major vascular events (1034 patients [16.5%] vs. 1017 patients [16.3%]; hazard ratio, 1.01; 95% CI, 0.93 to 1.10; P=0.81), death from any cause (951 [15.1%] vs. 964 [15.4%]; hazard ratio, 0.98; 95% CI, 0.89 to 1.07; P=0.63), or death from arrhythmia (288 [4.6%] vs. 259 [4.1%]; hazard ratio, 1.10; 95% CI, 0.93 to 1.30; P=0.26). Triglyceride levels were reduced by 14.5 mg per deciliter (0.16 mmol per liter) more among patients receiving n-3 fatty acids than among those receiving placebo (P<0.001), without a significant effect on other lipids. Adverse effects were similar in the two groups. CONCLUSIONS: Daily supplementation with 1 g of n-3 fatty acids did not reduce the rate of cardiovascular events in patients at high risk for cardiovascular events. (Funded by Sanofi; ORIGIN ClinicalTrials.gov number, NCT00069784.).

La col·laboració de la ciutadania en les polítiques de seguretat

El debat al voltant de la col•laboració de la ciutadania en les polítiques de seguretat contraposa una visió de la col•laboració amb la policia i les autoritats de seguretat com un deure cívic en pro de l’interès general, amb una altra visió que entén les demandes de col•laboració per part de l’Administració com una delegació de les tasques policials, que, en afavorir la delació i la denúncia entre ciutadans, és contraproduent per a la cohesió social. Es tracta d’una contraposició que, més enllà de la lògica discrepància entre perspectives ideològiques diferents, fa pensar en una manca de consens social de fons sobre aspectes bàsics de la convivència social. Aquest treball pretén ser una aproximació a aquesta qüestió complexa, a partir de l’anàlisi documental de diversos textos publicats sobre la matèria i d’un seguit d’articles d’opinió publicats en mitjans de comunicació o en blocs, i de l’entrevista semioberta administrada a vuit persones amb diferent perspectiva sobre la seguretat.