Direct electrical stimulation using a battery-operated device for induction and modulation of colonic contractions in pigs.

Direct electrical stimulation of the colon offers a promising approach for the induction of propulsive colonic contractions by using an implantable device. The objective of this study was to assess the feasibility to induce colonic contractions using a commercially available battery-operated stimulator (maximum pulse width of 1 ms and maximum amplitude of 10 V). Three pairs of pacing electrodes were inserted into the cecal seromuscular layer of anesthetized pigs. During a first set of in vivo experiments conducted on six animals, a pacing protocol leading to cecum contractions was determined: stimulation bursts with 1 ms pulse width, 10 V amplitude (7-15 mA), 120 Hz frequency, and 30-s burst duration, repeated every 2-5 min. In a second testing phase, an evaluation of the pacing protocol was performed in four animals (120 stimulation bursts in total). By using the battery-operated stimulator, contractions of the cecum and movement of contents could be induced in 92% of all stimulations. A cecal shortening of about 30% and an average intraluminal pressure increase of 10.0 +/- 6.0 mmHg were observed.

Chirurgie [Surgery].

The evolution of visceral surgery is characterized by defining with ever increasing precision the real role of new techniques. Hernia repair, abdominal compartment syndrome, pancreatic and colorectal cancers, as well as haemorrhoids, confirm this reality. Although laparoscopy has clear indications in hernia repairs, many still prefer open approach. The abdominal compartment syndrome, now better understood thanks to laparoscopy, is increasingly important in intensive care. The role of laparoscopy for pancreatic and colorectal cancers is still limited. The development of minimally invasive techniques has led to a reduced morbidity of surgery for haemorrhoids and better results. The economic impact of new technologies must remain a primary concern.

Anemia on admission predicts short- and long-term outcomes in patients with acute ischemic stroke.

BACKGROUND: It is still debatable whether anemia predicts stroke outcome. AIM: To describe the characteristics of patients with acute ischemic stroke (AIS) and anemia and identify whether hemoglobin status on admission is a prognostic factor of AIS outcome. METHODS: All 2439 patients of the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) between January 2003 and June 2011 were selected. Demographics, risk factors, prestroke treatment, clinical, radiological and metabolic variables in patients with and without anemia according to the definition of the World Health Organization were compared. Functional disability and mortality were recorded up to 12 months from admission. RESULTS: Anemic patients (17.5%) were older, had lower body mass index, higher rates of coronary artery disease (CAD), atrial fibrillation, diabetes mellitus and peripheral artery disease. Anemia was associated with more severe stroke manifestations, lower systolic and diastolic blood pressure measurements, worse estimated glomerular filtration rate and elevated C-reactive protein concentrations upon admission and with increased modified Rankin scores during the follow-up. Anemic patients had higher 7-day, 3-month and 12-month mortality, which was associated with hemoglobin status and other factors, including age, CAD, stroke severity, and baseline C-reactive levels. Hemoglobin levels were inversely associated with recurrent stroke and mortality throughout the 12-month follow-up. CONCLUSION: Anemia is common among AIS patients and is associated with cardiovascular comorbidities. Low hemoglobin status independently predicts short and long-term mortality.

The efficacy of pharmacotherapy for decreasing the expansion rate of abdominal aortic aneurysms: a systematic review and meta-analysis.

BACKGROUND: Pharmacotherapy may represent a potential means to limit the expansion rate of abdominal aortic aneurysms (AAAs). Studies evaluating the efficacy of different pharmacological agents to slow down human AAA-expansion rates have been performed, but they have never been systematically reviewed or summarized. METHODS AND FINDINGS: Two independent reviewers identified studies and selected randomized trials and prospective cohort studies comparing the growth rate of AAA in patients with pharmacotherapy vs. no pharmacotherapy. We extracted information on study interventions, baseline characteristics, methodological quality, and AAA growth rate differences (in mm/year). Fourteen prospective studies met eligibility criteria. Five cohort studies raised the possibility of benefit of beta-blockers [pooled growth rate difference: -0.62 mm/year, (95%CI, -1.00 to -0.24)], but this was not confirmed in three beta-blocker RCTs [pooled RCT growth rate difference: -0.05 mm/year (-0.16 to 0.05)]. Statins have been evaluated in two cohort studies that yield a pooled growth rate difference of -2.97 (-5.83 to -0.11). Doxycycline and roxithromycin have been evaluated in two RCTs that suggest possible benefit [pooled RCT growth rate difference: -1.32 mm/year (-2.89 to 0.25)]. Studies assessing NSAIDs, diuretics, calcium channel blockers and ACE inhibitors, meanwhile, did not find statistically significant differences. CONCLUSIONS: Beta-blockers do not appear to significantly reduce the growth rate of AAAs. Statins and other anti-inflammatory agents appear to hold promise for decreasing the expansion rate of AAA, but need further evaluation before definitive recommendations can be made.

Human papilloma virus type and recurrence rate after surgical clearance of anal condylomata acuminata.

BACKGROUND: Anal condylomata acuminata (ACA) are caused by human papilloma virus (HPV) infection which is transmitted by close physical and sexual contact. The result of surgical treatment of ACA has an overall success rate of 71% to 93%, with a recurrence rate between 4% and 29%. The aim of this study was to assess a possible association between HPV type and ACA recurrence after surgical treatment. METHODS: We performed a retrospective analysis of 140 consecutive patients who underwent surgery for ACA from January 1990 to December 2005 at our tertiary University Hospital. We confirmed ACA by histopathological analysis and determined the HPV typing using the polymerase chain reaction. Patients gave consent for HPV testing and completed a questionnaire. We looked at the association of ACA, HPV typing, and HIV disease. We used chi, the Monte Carlo simulation, and Wilcoxon tests for statistical analysis. RESULTS: Among the 140 patients (123 M/17 F), HPV 6 and 11 were the most frequently encountered viruses (51% and 28%, respectively). Recurrence occurred in 35 (25%) patients. HPV 11 was present in 19 (41%) of these recurrences, which is statistically significant, when compared with other HPVs. There was no significant difference between recurrence rates in the 33 (24%) HIV-positive and the HIV-negative patients. CONCLUSIONS: HPV 11 is associated with higher recurrence rate of ACA. This makes routine clinical HPV typing questionable. Follow-up is required to identify recurrence and to treat it early, especially if HPV 11 has been identified.

Le syndrome douloureux abdominal (SDA) aux urgences: quelle analgésie [Acute abdominal pain: what about analgesia]

Acute abdominal pain tends not to be treated by surgeons and emergency physicians. However, literature has become clear that analgesics are effective and do not disturb clinical examination, diagnostic process and do not delay surgery. Thus, early treatment of acute abdominal pain is recommended. In the absence of scientific evidence, protocols must be established by each institution and validated by quality process.

Characteristics and early and long-term outcome in patients with acute ischemic stroke and low ejection fraction.

OBJECTIVES: We assessed the clinical characteristics of patients with acute ischemic stroke (AIS) with left ventricular ejection fraction (EF) ≤ 35% and investigated the association of low EF with early and long-term outcome. METHODS: A total of 2439 patients of the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) were selected. Demographics, risk factors, pre-stroke treatment, and clinical, radiological and metabolic variables in patients with and without low EF were compared. Functional independence (modified Rankin Score ≤ 2) and mortality were recorded 1 week up to 12 months from admission. RESULTS: Low EF patients (n=119) were more commonly men, older, had higher rates of coronary artery disease and atrial fibrillation (AF), and more frequent pretreatment with anticoagulants, antiplatelets and antihypertensive agents. On admission, they presented with higher stroke severity and had lower values of systolic blood pressure, higher heart rate, and worse estimated glomerular filtration rate. Stroke-related disability and death rates were higher in low EF patients during follow-up (19.5% vs. 7.8% at 1 week, and 36.1% vs. 16.5% at 12 months). Increasing age, stroke severity, and AF were independent predictors of one-year mortality in these patients while prior use of statins had a favorable effect on early mortality. CONCLUSIONS: AIS in patients with low EF is associated with older age, cardiac comorbidities, and more severe clinical presentation. Low EF can identify a subset of AIS patients at high risk of early and long-term functional disability and mortality.

Human papilloma virus type and recurrence rate after surgical clearance of anal condylomata acuminata

Résumé : Le condylome acuminé anal (CAA), transmis par contact sexuel, résulte d'une infection par Human Papilloma Virus (HPV). Son traitement chirurgical est grevé d'un taux de récidive de 4-29%. Le but de cette étude était d'identifier une éventuelle corrélation entre type d'HPV présent dans les CAA excisés chirurgicalement et taux de récidive de la maladie, Cette étude rétrospective porte sur 140 patients opérés au Centre Hospitalier Universitaire Vaudois de CAA, entre 1990 et 2005. Le diagnostic lésionnel a été confirmé par un examen histomorphologique. Le(s) type(s) d'HPV présent(s) dans ces lésions a été déterminé par Polymerase Chain Reaction (PCR). Les patients ont donné leur accord à cette analyse et complété un questionnaire. Une éventuelle corrélation entre récidive de CAA, type d'HPV et status HIV a été recherchée. HPV 6 et 11 sont les virus les plus fréquemment découverts (51% et 28%, respectivement) chez les 140 patients (123H/17F). Trente-cinq (25%) d'entre eux ont présenté une récidive. HPV 11 était present chez 19 (41%) sujets. Ceci est statistiquement significatif (P<0.05), en comparaison aux autres HPVs. Il n'y a par contre pas de différence significative entre la fréquence de récidive des 33 (24%) patients HIV-positifs et le reste du collectif. HPV 11 est donc associé à un taux de récidive de CAA significativement élevé. Un suivi strict des patients atteints est nécessaire pour identifier une récidive et la traiter sans délai, notamment lorsque HPV 11 est present. Ces résultats innovateurs soulèvent la question de la nécessité de pratiquer une typisation virale systématique sur les lésions excisées. La justification d'une telle attitude demande toutefois encore d'être confirmée.

Donne e lavoro. Prospettive per una storia delle montagne europeee XVIII-XX secc.

Si ritiene comunemente che le spinte emancipatrici femminili si siano imposte con maggior vigore nei luoghi contraddistinti da mercati lavorativi più sviluppati e da maggiori opportunità di impiego retribuito, mentre nei contesti periferici, caratterizzati da marginalità economica, queste spinte sarebbero state più flebili. Il ritardo della modernizzazione di molte regioni di montagna sarebbe quindi responsabile del perdurare di una realtà femminile segnata da dipendenza e "arretratezza" sociale e culturale. Il volume si propone di analizzare in modo critico il nesso tra marginalità (economica, culturale, geografica) e discriminazione femminile, ampliando le prospettive di genere e contribuendo così al dibattito in corso da diversi anni sulle società di montagna del passato e sul loro divenire all'interno della realtà europea. I contributi abbracciano diversi contesti montani europei e prendono in esame alcuni nodi tematici quali i profili dei ruoli femminili, il loro inserimento nel mercato lavorativo e le rappresentazioni che scaturiscono dalle loro attività, delineando molteplici prospettive per lo studio del binomio genere-montagna.

Jóvenes y efecto barrio. Un estudio comparativo en la periferia de Barcelona y Milán

La presente investigación analiza la influencia del barrio sobre la configuración y desarrollo de los trayectos juveniles -especialmente en las dimensiones formativas, laborales y de ocio-, al mismo tiempo que tiene en cuenta la ciudad y el impacto de las instituciones sociales ubicadas en el barrio. La pregunta de investigación entorno a la cual gira el presente trabajo es si vivir en un barrio desfavorecido influye en el desarrollo personal, laboral y social de los jóvenes (de entre 16 y 24 años) que residen en él, así como la forma en qué influye. Para ello, se ha desarrollado una metodología variada, que combina: a). el análisis cuantitativomediante el uso de datos censales y del padrón municipal -, b). el análisis cualitativo, a través de instrumentos como la entrevista semi-estructurada oral, la entrevista estructurada escrita y la observación participante; y, c). el análisis comparativo entre ciudades (Barcelona y Milán), barrios (Trinitat Nova, Ciutat Meridiana, Comasina y Sant"Ambrogio) y jóvenes.

Aquecimento em forno de microondas / desenvolvimento de alguns conceitos fundamentais

The microwave oven became a common domestic equipment, due mainly to the short time spent to heat foods. One of the most interesting characteristics of the microwave oven is the selective heating. Different from the conventional oven, where the heating is not selective, the heating by microwave depends on the chemical nature of the matter. Many Students of Chemistry have no knowledge of the principles involved in this selective heating, in spite of the daily microwave oven use. The heating by microwave is feasible for chemistry courses. In discussions about the microwave absorption by the matter it is possible to explore chemical properties like: heat capacity, chemical bound, molecular structure, dipole moments, polarization and dielectric constant. This paper presents the basic principles involved in the microwave heating. It is proposed a simple and inexpensive experiment that could be developed in general chemistry courses, to illustrate the relationship between heating and the chemical properties of some solvents. Experiments to check the power of the microwave oven are also proposed.

Controle de oídio em pepino parternocárpico com produtos alternativos em cultivo protegido

O oídio é a doença mais importante para pepino partenocárpico em cultivo protegido na Região Norte do Paraná, em períodos de baixa umidade. As características desse agrossistema propiciam condições favoráveis ao uso de medidas alternativas para o controle dessa doença. Assim, cinco produtos alternativos foram avaliados para o controle de oídio em pepino partenocárpico, híbrido Hokushin, em cultivo protegido: leite cru de vaca, óleo de nim, acibenzolar-s-metil, extrato aquoso de cama de frango, extrato cítrico (Ecolife® 40) e o fungicida azoxistrobin, nas concentrações (ingrediente ativo por litro de água): 50,0 ml; 5,0 ml; 0,025g; 2,0 ml da diluição 1:2 v/v, e 0,06g, respectivamente. Os melhores resultados foram verificados para o óleo de nim, com eficiência de controle superior a azoxistrobin (36,8 e 27,8 %, respectivamente). Extrato de cama de frango e ecolife apresentaram os piores desempenhos, com eficiência de controle de 6,5 e 10,5%, respectivamente.