Complications après hystérectomie pour cancers gynécologiques : Laparoscopie vs Laparotomie.

Objectif : Comparer les hystérectomies réalisées par laparoscopie à celles accomplies par laparotomie pour des pathologies gynécologiques malignes. Méthode : Etude basée sur 169 hystérectomies effectuées pour cancer de l'endomètre, du col ou de l'ovaire, pratiquées dans le service de gynécologie de la Maternité du CHUV de janvier 2002 à décembre 2009 sur des femmes âgées de 28 à 91 ans. Le but est de comparer deux différentes voies d'abord chirurgicales qui sont la laparotomie et la laparoscopie en terme de durée d'hospitalisation, d'indications, de complications per et post opératoires mineures et majeures et de nécessité de reprise ou d'une ré-hospitalisation. Résultats: Cette étude compte 169 patientes, dont 126 hystérectomies réalisées par laparotomie et 43 accomplies par laparoscopie. Les deux groupes sont similaires en terme d'âge (âge moyen : 63ans), d'indice de masse corporelle (26 vs 25) et de parité (1.5 enfants). Le temps opératoire est semblable entre les deux groupes (211 vs 219 minutes). Des hémorragies (pertes sanguines de plus de 1000ml) surviennent dans 24.6% des hystérectomies par laparotomie et dans 11.63% des hystérectomies par laparoscopie. Il existe une différence statistiquement significative entre la nécessité d'une transfusion peropératoire et les deux différentes voie d'abord (p=0.045). Une transfusion peropératoire a été nécessaire dans 13.22% des laparotomies contre seulement 2.33% des laparoscopies. La durée d'hospitalisation est significativement plus longue pour les patientes ayant subi une hystérectomie par laparotomie (12 vs 6 jours; p<0.001). Les complications peropératoires et postopératoires mineures dépendent de manière significative de la voie d'abord (p=0.01 ; p= 0.025). On observe des complications peropératoires dans 31.75% des laparotomies et dans 11.63% des laparoscopies. Les complications postopératoires mineures sont observées dans 28.57% des laparotomies et dans 11.63% des laparoscopies. Dans 7.14% des laparotomies on observe une complications postopératoire majeure et aucune de sont apparues lors d'hystérectomie par laparoscopie. La nécessité de reprise, de ré-opération ou de ré-hospitalisation n'est statistiquement pas différente entre la laparoscopie et la laparotomie. Conclusion : On observe un avantage significatif en faveur de l'hystérectomie par laparoscopie avec une réduction de la durée d'hospitalisation, ainsi que des complications peropératoires et postopératoires mineures et majeures, moins importantes.

Dynamics of ammonium and pH in the solution of soils with different salinity levels, growing irrigated rice

Rice in Rio Grande do Sul State is grown mostly under flooding, which induces a series of chemical, physical and biological changes in the root environment. These changes, combined with the presence of rice plants, affect the availability of exchangeable ammonium (NH4+) and pH of soil solution, whereas the dynamics of both variables can be influenced by soil salinity, a common problem in the coastal region. This study was conducted to evaluate the dynamics of exchangeable NH4+ and pH in the soil solution, and their relation in the solution of Albaqualf soils with different salinity levels, under rice. Four field experiments were conducted with soils with exchangeable Na percentage (ESP) of 5.6, 9.0, 21.2, and 32.7 %. Prior to flooding, soil solution collectors were installed at depths of 5, 10 and 20 cm. The soil solution was collected weekly, from 7 to 91 days after flooding (DAF), to analyze exchangeable NH4+ and pH in the samples. Plant tissue was sampled 77 DAF, to determine N uptake and estimate the contribution of other N forms to rice nutrition. The content of exchangeable NH4+ decreased over time at all sites and depths, with a more pronounced reduction in soils with lower salinity levels, reaching values close to zero. A possible contribution of non-exchangeable NH4+ forms and N from soil organic matter to rice nutrition was observed. Soil pH decreased with time in soils with ESP 5.6 and 9.0 %, being positively correlated with the decreasing NH4+ levels at these sites.

Equivalence of paper and pencil vs internet forms of the ZKPQ-50-CC in Spanish and French samples

This study was designed to check for the equivalence of the ZKPQ-50-CC (Spanish and French versions) through Internet on-line (OL) and paper and pencil (PP) answer format. Differences in means and devia- tions were significant in some scales, but effect sizes are minimal except for Sociability in the Spanish sample. Alpha reliabilities are also very similar in both versions with no significant differences between formats. A robust factorial structure was found for the two formats and the average congruency coefficients were 0.98. The goodness-of-fit indexes obtained by confirmatory factorial analysis are very similar to those obtained in the ZKPQ-50-CC validation study and they do not differ between the two formats. The multi-group analysis confirms the equivalence among the OL-PP formats in both countries. These results in general support the validity and reliability of the Internet as a method in investigations using the ZKPQ-50-CC.

Association of pharmacogenetic markers with premature discontinuation of first-line anti-HIV therapy: an observational cohort study.

BACKGROUND: Poor tolerance and adverse drug reactions are main reasons for discontinuation of antiretroviral therapy (ART). Identifying predictors of ART discontinuation is a priority in HIV care. METHODS: A genetic association study in an observational cohort to evaluate the association of pharmacogenetic markers with time to treatment discontinuation during the first year of ART. Analysis included 577 treatment-naive individuals initiating tenofovir (n = 500) or abacavir (n = 77), with efavirenz (n = 272), lopinavir/ritonavir (n = 184), or atazanavir/ritonavir (n = 121). Genotyping included 23 genetic markers in 15 genes associated with toxicity or pharmacokinetics of the study medication. Rates of ART discontinuation between groups with and without genetic risk markers were assessed by survival analysis using Cox regression models. RESULTS: During the first year of ART, 190 individuals (33%) stopped 1 or more drugs. For efavirenz and atazanavir, individuals with genetic risk markers experienced higher discontinuation rates than individuals without (71.15% vs 28.10%, and 62.5% vs 14.6%, respectively). The efavirenz discontinuation hazard ratio (HR) was 3.14 (95% confidence interval (CI): 1.35-7.33, P = .008). The atazanavir discontinuation HR was 9.13 (95% CI: 3.38-24.69, P < .0001). CONCLUSIONS: Several pharmacogenetic markers identify individuals at risk for early treatment discontinuation. These markers should be considered for validation in the clinical setting.

Arsenic toxicity in Acacia mangium willd. and mimosa Caesalpiniaefolia benth. seedlings

Acacia mangium and Mimosa caesalpiniaefolia are fast-growing woody fabaceous species that might be suitable for phytoremediation of arsenic (As)-contaminated sites. To date, few studies on their tolerance to As toxicity have been published. Therefore, this study assessed As toxicity symptoms in A. mangium and M. caesalpiniaefolia seedlings under As stress in a greenhouse. Seedlings of Acacia mangium and M. caesalpiniaefolia were grown for 120 d in an Oxisol-sand mixture with 0, 50, 100, 200, and 400 mg kg-1 As, in four replications in four randomized blocks. The plants were assessed for visible toxicity symptoms, dry matter production, shoot/root ratio, root anatomy and As uptake. Analyses of variance and regression showed that the growth of A. mangium and M. caesalpiniaefolia was severely hindered by As, with a reduction in dry matter production of more than 80 % at the highest As rate. The root/shoot ratio increased with increasing As rates. At a rate of 400 mg kg-1 As, whitish chlorosis appeared on Mimosa caesalpiniaefolia seedlings. The root anatomy of both species was altered, resulting in cell collapse, death of root buds and accumulation of phenolic compounds. Arsenic concentration was several times greater in roots than in shoots, with more than 150 and 350 mg kg-1 in M. caesalpiniaefolia and A. mangium roots, respectively. These species could be suitable for phytostabilization of As-contaminated sites, but growth-stimulating measures should be used.

Spin-Peierls vs Peierls distortions in a family of conjugated polymers

Distortions in a family of conjugated polymers are studied using two complementary approaches: within a many-body valence bond approach using a transfer-matrix technique to treat the Heisenberg model of the systems, and also in terms of the tight-binding band-theoretic model with interactions limited to nearest neighbors. The computations indicate that both methods predict the presence or absence of the same distortions in most of the polymers studied.

Indice d'aptitude général et indice de compétences cognitives pour le WISC-IV: Normes empiriques vs. normes statistiques

L'indice d'aptitude général (IAG) a été développé dans le WISC-III pour estimer le niveau cognitif général. Il s'agissait de proposer une alternative au QI Total. Plus récemment, l'indice de compétence cognitive (ICC) a été proposé. Jusqu'à il y a peu, seules les normes américaines de ces indices étaient disponibles ; les normes franc ̧ aises IAG et ICC pour le WISC-IV ont été récemment développées à partir d'une procédure d'approximation statistique. Toutefois, les normes développées de cette manière seraient moins appro- priées que les normes construites sur la base d'un échantillon. Cette étude vise à comparer les normes IAG et ICC développées à partir d'une procédure d'approximation statistique à celles créées à partir d'un échantillon de 182 enfants âgés de huit à 12 ans. Les corrélations entre les deux types de normes sont de 0,997 pour IAG et de 0,999 pour ICC ; les différences absolues moyennes sont respectivement de 5,38 et de 2,24 points pour IAG et ICC. Enfin, pour les enfants présentant un score IAGS inférieur à 89, les normes IAGE semblent indiquer que leurs compétences seraient inférieures d'environ 8-10 points à celui indiqué par le score IAGS. Les résultats de cette étude indiquent que les scores IAG et ICC peuvent constituer des informations utiles sur les capacités cognitives de l'enfant.

EFFECTS OF SILICON ON ALLEVIATING ARSENIC TOXICITY IN MAIZE PLANTS

Arsenic is a metalloid highly toxic to plants and animals, causing reduced plant growth and various health problems for humans and animals. Silicon, however, has excelled in alleviating stress caused by toxic elements in plants. The aim of this study was to investigate the effects of Si in alleviating As stress in maize plants grown in a nutrient solution and evaluate the potential of the spectral emission parameters and the red fluorescence (Fr) and far-red fluorescence (FFr) ratio obtained in analysis of chlorophyll fluorescence in determination of this interaction. An experiment was carried out in a nutrient solution containing a toxic rate of As (68 μmol L-1) and six increasing rates of Si (0, 0.25, 0.5, 1.0, 1.5, and 2.0 mmol L-1). Dry matter production and concentrations of As, Si, and photosynthetic pigments were then evaluated. Chlorophyll fluorescence was also measured throughout plant growth. Si has positive effects in alleviating As stress in maize plants, evidenced by the increase in photosynthetic pigments. Silicon application resulted in higher As levels in plant tissue; therefore, using Si for soil phytoremediation may be a promising choice. Chlorophyll fluorescence analysis proved to be a sensitive tool, and it can be successfully used in the study of the ameliorating effects of Si in plant protection, with the Fr/FFr ratio as the variable recommended for identification of temporal changes in plants.

Soil Water Potentials and Capsicum annuum L. under Salinity

ABSTRACT Investigations into water potentials in the soil-plant system are of great relevance in environments with abiotic stresses, such as salinity and drought. An experiment was developed using bell pepper in a Neossolo Flúvico (Fluvent) irrigated with water of six levels of electrical conductivity (0, 1, 3, 5, 7 and 9 dS m-1) by using exclusively NaCl and by simulating the actual condition (using a mixture of salts). The treatments were arranged in a randomized block design, in a 6 × 2 factorial arrangement, with four replicates. Soil matric (Ψm) and osmotic (Ψo) potentials were determined 70 days after transplanting (DAT). Soil total potential was considered as the sum of Ψm and Ψo. Leaf water (obtained with the Scholander Chamber) and osmotic potentials were determined before sunrise (predawn) and at noon at 42 and 70 DAT. There were no significant differences between the salt sources used in the irrigation water for soil and plant water potentials. The supply of salts to the soil through irrigation water was the main factor responsible for the decrease in Ψo in the soil and in bell pepper leaves. The total potential of bell pepper at predawn reached values of -1.30 and -1.33 MPa at 42 and 70 DAT, respectively, when water of 9 dS m-1 was used in the irrigation. The total potential at noon reached -2.19 MPa. The soil subjected to the most saline treatment reached a water potential of -1.20 MPa at 70 DAT. There was no predawn equilibrium between the total water potentials of the soil and the plant, indicating that soil potential cannot be considered similar to that of the plant. The determination of the osmotic potential in the soil solution should not be neglected in saline soils, since it has strong influence on the calculation of the total potential.

Automatic Prediction of Facial Trait Judgments: Appearance vs. Structural Models

Evaluating other individuals with respect to personality characteristics plays a crucial role in human relations and it is the focus of attention for research in diverse fields such as psychology and interactive computer systems. In psychology, face perception has been recognized as a key component of this evaluation system. Multiple studies suggest that observers use face information to infer personality characteristics. Interactive computer systems are trying to take advantage of these findings and apply them to increase the natural aspect of interaction and to improve the performance of interactive computer systems. Here, we experimentally test whether the automatic prediction of facial trait judgments (e.g. dominance) can be made by using the full appearance information of the face and whether a reduced representation of its structure is sufficient. We evaluate two separate approaches: a holistic representation model using the facial appearance information and a structural model constructed from the relations among facial salient points. State of the art machine learning methods are applied to a) derive a facial trait judgment model from training data and b) predict a facial trait value for any face. Furthermore, we address the issue of whether there are specific structural relations among facial points that predict perception of facial traits. Experimental results over a set of labeled data (9 different trait evaluations) and classification rules (4 rules) suggest that a) prediction of perception of facial traits is learnable by both holistic and structural approaches; b) the most reliable prediction of facial trait judgments is obtained by certain type of holistic descriptions of the face appearance; and c) for some traits such as attractiveness and extroversion, there are relationships between specific structural features and social perceptions.

An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke.

OBJECTIVE: We aimed to create an index to stratify cryptogenic stroke (CS) patients with patent foramen ovale (PFO) by their likelihood that the stroke was related to their PFO. METHODS: Using data from 12 component studies, we used generalized linear mixed models to predict the presence of PFO among patients with CS, and derive a simple index to stratify patients with CS. We estimated the stratum-specific PFO-attributable fraction and stratum-specific stroke/TIA recurrence rates. RESULTS: Variables associated with a PFO in CS patients included younger age, the presence of a cortical stroke on neuroimaging, and the absence of these factors: diabetes, hypertension, smoking, and prior stroke or TIA. The 10-point Risk of Paradoxical Embolism score is calculated from these variables so that the youngest patients with superficial strokes and without vascular risk factors have the highest score. PFO prevalence increased from 23% (95% confidence interval [CI]: 19%-26%) in those with 0 to 3 points to 73% (95% CI: 66%-79%) in those with 9 or 10 points, corresponding to attributable fraction estimates of approximately 0% to 90%. Kaplan-Meier estimated stroke/TIA 2-year recurrence rates decreased from 20% (95% CI: 12%-28%) in the lowest Risk of Paradoxical Embolism score stratum to 2% (95% CI: 0%-4%) in the highest. CONCLUSION: Clinical characteristics identify CS patients who vary markedly in PFO prevalence, reflecting clinically important variation in the probability that a discovered PFO is likely to be stroke-related vs incidental. Patients in strata more likely to have stroke-related PFOs have lower recurrence risk.

Birth Certificate Match Report Comparison of Maternal Demographic Characteristics Medicaid vs. Non-Medicaid Reimbursed Births – 2010 Iowa Medicaid

The purpose of the fact sheet is to highlight the characteristics of Iowa women who gave birth in Iowa during calendar year 2010, with a focus on women with labor and delivery costs reimbursed by Medicaid compared to women with labor and delivery costs not reimbursed by Medicaid. This information will be used to guide decision makers in implementing programs that improve the health outcomes of the women and infants who rely on Medicaid coverage.