Caractérisation pharmacocinétique et pharmacodynamique de la lidocaïne avec ou sans adrénaline lors d’un bloc paravertébral du plexus brachial chez le chien

Au cours des vingt dernières années, l’anesthésie régionale est devenue, autant en médecine vétérinaire qu’humaine, un outil essentiel à l’élaboration de protocoles analgésiques péri-opératoires. Parmi l’éventail de techniques mises au point en anesthésie canine, le bloc paravertébral du plexus vertébral (PBPB) et sa version modifiée sont d’un grand intérêt pour toute procédure du membre thoracique, dans sa portion proximale. Toutefois, l’essentiel des données publiées à ce jour provient d’études colorimétriques, sans évaluation clinique, et peu d’information est disponible sur les techniques de localisation nerveuse envisageables à ce site. Notre étude visait à décrire une approche échoguidée du PBPB modifié, puis à caractériser ses paramètres pharmacocinétiques et pharmacodynamiques après administration de lidocaïne (LI) ou lidocaïne adrénalinée (LA). Huit chiens ont été inclus dans un protocole prospectif, randomisé, en aveugle et croisé, réparti sur trois périodes. L’impact pharmacodynamique du bloc effectué avec LI ou LA a été évalué régulièrement pour 180 min suivant son exécution. Le traitement à l’adrénaline n’a pas démontré d’impact significatif (P = 0,845) sur la durée du bloc sensitif, tel qu’évalué par un stimulus douloureux mécanique appliqué aux dermatomes ciblés. À l’opposé, l’atteinte proprioceptive évaluée par la démarche a été trouvée prolongée (P = 0,027) et le bloc moteur mesuré par le pic de force verticale (PVF) au trot sur la plaque de force s’est avéré plus marqué (PVF réduit; P = 0,007) sous LA. À l’arrêt comme au trot, le nadir de la courbe PVF-temps a été trouvé retardé (P < 0,005) et la pente ascendante de retour aux valeurs normales adoucie (P = 0,005). Parallèlement aux évaluations cliniques, des échantillons plasmatiques ont été collectés régulièrement afin de quantifier et décrire le devenir pharmacocinétique de la lidocaïne. Parmi les trois élaborés, un modèle bi-compartimental doté d’une double absorption asynchrone d’ordre zéro a finalement été sélectionné et appliqué aux données expérimentales. Sous LA, la Cmax a été trouvée significativement diminuée (P < 0,001), les phases d’absorption prolongées [P < 0,020 (Dur1) et P < 0,001 (Dur2)] et leurs constantes réduites [P = 0,046(k01) et P < 0,001 (k02)], le tout en concordance avec les effets proprioceptifs et moteurs rapportés. Bien que l’extrapolation du dosage soit maintenant théoriquement envisageable à partir du modèle mis en lumière ici, des études supplémentaires sont encore nécessaires afin d’établir un protocole de PBPB d’intérêt clinique. L’analyse sur plaque de force pourrait alors devenir un outil de choix pour évaluer l’efficacité du bloc dans un cadre expérimental.

Acquisition de tables d’opération pour le bloc opératoire

Rapport de projet de maîtrise présenté en vue de l'obtention du grade de M.Sc.A. en génie biomédical, option génie clinique.

Acquisition de tables d’opération pour le bloc opératoire

Rapport de projet de maîtrise présenté en vue de l'obtention du grade de M.Sc.A. en génie biomédical, option génie clinique.

United Arab Emirates

The United Arab Emirates (UAE) is part of the geographic region known as the Middle East. With a land mass of 82,000 square kilometres, predominantly desert and mountains it is bordered by Oman, Saudi Arabia and the Arabian Gulf. The UAE is strategically located due to its proximity to other oil rich Middle Eastern countries such as Kuwait, Iraq, Iran, and Saudi Arabia. The UAE was formed from a federation of seven emirates (Abu Dhabi, Dubai, Sharjah, Ras Al Khaimah, Ajman, Fujuriah, and Um Al Quain) in December 1971 (Ras Al Khaimah did not join the federation until 1972) (Heard-bey, 2004, 370). Abu Dhabi is the political capital, and the richest emirate; while Dubai is the commercial centre. The majority of the population of the various Emirates live along the coast line as sources of fresh water often heavily influenced the site of different settlements. Unlike some near neighbours (Iran and Iraq) the UAE has not undergone any significant political instability since it was formed in 1971. Due to this early British influences the UAE has had very strong political and economic ties with first Britain, and, more recently, the United States of America (Rugh, 2007). Until the economic production of oil in the early 1960’s the different Emirates had survived on a mixture of primary industry (dates), farming (goats and camels), pearling and subsidies from Britain (Davidson 2005, 3; Hvit, 2007, 565) Along with near neighbours Kuwait, Bahrain, Oman, Qatar and Saudi Arabia, the UAE is part of the Gulf Cooperation Council (GCC), a trading bloc. (Hellyer, 2001, 166-168).

Historical and Personal Perspectives on the Fall of the Berlin Wall, 1989: address to 20th anniversary forums.

The story of the fall of the Berlin Wall was an aspect of the “imagination gap” that we had to wrestle with as journalists covering the collapse of the Eastern Bloc in Europe. It was scarcely possible to believe what you found yourself reporting, and that work became a two-track process. On one hand a mass social movement was dictating the pace and direction of events; on the other, the institutional business of politics as usual, to provide a framework for all the change that was happening, had to be managed – and reported on. In later analyseds we could see, that crisis in the Soviet Union led to the crisis over the Berlin Wall; and from the fall of the Wall, came Germany’s reunification, and with that also, formation of the European Union as it is today. The government of the Federal Republic of Germany convinced its neighbours that a reunited Germany, within an expanded EU, would be a very acceptable “European Germany” -- not the leader of a “German Europe”. It committed itself financially, supporting the new Euro currency. The former communist states of Eastern Europe demanded to join and expand the EU; in order to remove themselves from the Soviet Union, enjoy human rights, and share in Western prosperity. So today, following on from the events of 1989, the European Union is an amalgam of 27 member countries, with close to 500 million citizens and accounting for 30 % of world Gross National Product.

Striving to realise the European idea : judging the news media’s accounts of how the Berlin Wall gave impetus to a new order across Europe

The 1990 European Community was taken by surprise, by the urgency of demands from the newly-elected Eastern European governments to become member countries. Those governments were honouring the mass social movement of the streets, the year before, demanding free elections and a liberal economic system associated with “Europe”. The mass movement had actually been accompanied by much activity within institutional politics, in Western Europe, the former “satellite” states, the Soviet Union and the United States, to set up new structures – with German reunification and an expanded EC as the centre-piece. This paper draws on the writer’s doctoral dissertation on mass media in the collapse of the Eastern bloc, focused on the Berlin Wall – documenting both public protests and institutional negotiations. For example the writer as a correspondent in Europe from that time, recounts interventions of the German Chancellor, Helmut Kohl, at a European summit in Paris nine days after the “Wall”, and separate negotiations with the French President, Francois Mitterrand -- on the reunification, and EU monetary union after 1992. Through such processes, the “European idea” would receive fresh impetus, though the EU which eventuated, came with many altered expectations. It is argued here that as a result of the shock of 1989, a “social” Europe can be seen emerging, as a shared experience of daily life -- especially among people born during the last two decades of European consolidation. The paper draws on the author’s major research, in four parts: (1) Field observation from the strategic vantage point of a news correspondent. This includes a treatment of evidence at the time, of the wishes and intentions of the mass public (including the unexpected drive to join the European Community), and those of governments, (e.g. thoughts of a “Tienanmen Square solution” in East Berlin, versus the non-intervention policies of the Soviet leader, Mikhail Gorbachev). (2) A review of coverage of the crisis of 1989 by major news media outlets, treated as a history of the process. (3) As a comparison, and a test of accuracy and analysis; a review of conventional histories of the crisis appearing a decade later.(4) A further review, and test, provided by journalists responsible for the coverage of the time, as reflection on practice – obtained from semi-structured interviews.

Endochondral ossification in vitro is influenced by mechanical bending

Bone development is influenced by the local mechanical environment. Experimental evidence suggests that altered loading can change cell proliferation and differentiation in chondro- and osteogenesis during endochondral ossification. This study investigated the effects of three-point bending of murine fetal metatarsal bone anlagen in vitro on cartilage differentiation, matrix mineralization and bone collar formation. This is of special interest because endochondral ossification is also an important process in bone healing and regeneration. Metatarsal preparations of 15 mouse fetuses stage 17.5 dpc were dissected en bloc and cultured for 7 days. After 3 days in culture to allow adherence they were stimulated 4 days for 20 min twice daily by a controlled bending of approximately 1000-1500 microstrain at 1 Hz. The paraffin-embedded bone sections were analyzed using histological and histomorphometrical techniques. The stimulated group showed an elongated periosteal bone collar while the total bone length was not different from controls. The region of interest (ROI), comprising the two hypertrophic zones and the intermediate calcifying diaphyseal zone, was greater in the stimulated group. The mineralized fraction of the ROI was smaller in the stimulated group, while the absolute amount of mineralized area was not different. These results demonstrate that a new device developed to apply three-point bending to a mouse metatarsal bone culture model caused an elongation of the periosteal bone collar, but did not lead to a modification in cartilage differentiation and matrix mineralization. The results corroborate the influence of biophysical stimulation during endochondral bone development in vitro. Further experiments with an altered loading regime may lead to more pronounced effects on the process of endochondral ossification and may provide further insights into the underlying mechanisms of mechanoregulation which also play a role in bone regeneration.

The molar effect on citizenship and nomad immigration: Reading, readingthe world and self

This presentation explores molarization and overcoding of social machines and relationality within an assemblage consisting of empirical data of immigrant families in Australia. Immigration is key to sustainable development of Western societies like Australia and Canada. Newly arrived immigrants enter a country and are literally taken over by the Ministry of Immigration regarding housing, health, education and accessing job possibilities. If the immigrants do not know the official language(s) of the country, they enroll in language classes for new immigrants. Language classes do more than simply teach language. Language is presented in local contexts (celebrating the national day, what to do to get a job) and in control societies, language classes foreground values of a nation state in order for immigrants to integrate. In the current project, policy documents from Australia reveal that while immigration is the domain of government, the subject/immigrant is nevertheless at the core of policy. While support is provided, it is the subject/immigrant transcendent view that prevails. The onus remains on the immigrant to “succeed”. My perspective lies within transcendental empiricism and deploys Deleuzian ontology, how one might live in order to examine how segmetary lines of power (pouvoir) reflected in policy documents and operationalized in language classes rupture into lines of flight of nomad immigrants. The theoretical framework is Multiple Literacies Theory (MLT); reading is intensive and immanent. The participants are one Korean and one Sudanese family and their children who have recently immigrated to Australia. Observations in classrooms were obtained and followed by interviews based on the observations. Families also borrowed small video cameras and they filmed places, people and things relevant to them in terms of becoming citizen and immigrating to and living in a different country. Interviews followed. Rhizoanalysis informs the process of reading data. Rhizoanalysis is a research event and performed with an assemblage (MLT, data/vignettes, researcher, etc.). It is a way to work with transgressive data. Based on the concept of the rhizome, a bloc of data has no beginning, no ending. A researcher enters in the middle and exists somewhere in the middle, an intermezzo suggesting that the challenges to molar immigration lie in experimenting and creating molecular processes of becoming citizen.

EU Accession and FDI inflows : The cases of the Czech Republic and Slovakia

Central and East European countries have faced a difficult process of transition since the dissolution of the Soviet bloc. Ten transition countries (Hungary, Poland, teh Czech Republic, Slovakia, Slovenia, Lithuania, Latvia, Estonia, Bulgaria and Romania have chosen to join the EU and have moulded their transition reforms to ensure the compliance of their legal and institutional framework with EU requirements. The high levels of FDI attracted by the candidate countries for EU membership had been attributed to rapid transition of the countries aiming to join the European Union and the fact that favourable evaluations by EU authorities of the progress made by the candidates had a large impact on improving investor confidence. The aim of this paper is to investigate the reform strategies of the Czech Republic and Slovakia undertaken when the countries were preparing for EU membership and the dynamics of FDI inflows into these economies. Subsequently a comparative analysis of FDI stocks in these countries is conducted. We find that both countries faced similar economic challenges in implementing structural and institutional reforms. In accordance with EU requirements the Czech Republic and Slovakia have perfected their legal and institutional framework, increased the authority of regulatory and supervisory bodies and focused on implementation of new or amended legislation. During the period of the analysis (1998 - 2007) the Czech Republic and Slovakia have attracted increasing amounts of FDI. Comparative analysis in terms of important determinants of FDI reveals further similar features: macroeconomic stability; an open and liberalised market; low labour costs compared to EU-15 and a similar breakdown of FDI inflows by investor country. Consequently, the fact that the Czech Republic received much larger volumes of net FDI inflows could be attributed to the difference in market size between the two states. This conclusion is consistent with previous empirical studies that list market size among the main determinants of FDI. However, when we look at FDI as a percentage of GDP the evidence is more mixed. In 2004 - 2007, Slovakia has surpassed the Czech Republic twice. Whether this tendency will persist remains to be seen. The analysis in this paper based on empirical data. However, the choice of the method, namely case studies and comparative analysis, means that the conclusions of this study are theoretical and remain to be further tested in quantitative models.

Trade Blocs and the Cold War : The CMEA and the EC challenge, 1969-1976

The coherence of the Soviet bloc was seriously tested at the turn of the 1970s, as the Soviet Union and its allies engaged in intensive negotiations over their relations with the European Communities (EC). In an effort to secure their own national economic interests many East European countries began independent manoeuvres against the wishes of their bloc leader. However, much of the intra-bloc controversy was kept out of the public eye, as the battle largely took place behind the scenes, within the organisation for economic cooperation, the Council for Mutual Economic Assistance (CMEA). The CMEA policy-making process vis-à-vis the EC is described in this study with reference to primary archival materials. This study investigates the negotiating positions and powers of the CMEA member states in their efforts to deal with the economic challenge created by the progress of the EC, as it advanced towards the customs union. This entails an analysis of the functioning principles and performance of the CMEA machinery. The study traces the CMEA negotiations that began in 1970 over its policy toward the EC. The policy was finally adopted in 1974, and was followed by the first official meeting between the two organisations in early 1975. The story ends in 1976, when the CMEA s efforts to enter into working relations with the EC were seemingly frustrated by the latter. The first major finding of the study is that, contrary to much of the prior research, the Soviet Union was not in a hegemonic position vis-à-vis its allies. It had to use a lot of its resources to tame the independent manoeuvring of its smaller allies. Thus, the USSR was not the kind of bloc leader that the totalitarian literature has described. Because the Soviet Union had to spend so much attention on its own bloc-politics, it was not able to concentrate on formulating a policy vis-à-vis the EC. Thus, the Soviet leadership was dependent on its allies in those instances when the socialist countries needed to act as a bloc. This consequently opened up the possibility for the USSR s allies to manoeuvre. This study also argues that when the CMEA did manage to find a united position, it was a force that the EC had to reckon with in its policy-making. This was particularly the case in the implementation of the EC Common Commercial Policy. The other main finding of the study is that, although it has been largely neglected in the previous literature on the history of West European integration, the CMEA did in fact have an effect on EC decision-making. This study shows how for political and ideological reasons the CMEA members did not acknowledge the EC s supranational authority. Therefore the EC had no choice but to refrain from implementing its Common Commercial Policy in full.

Rab9A is required for delivery of cargo from recycling endosomes to melanosomes

Melanosomes are a type of lysosome-related organelle that is commonly defective in Hermansky-Pudlak syndrome. Biogenesis of melanosomes is regulated by BLOC-1, -2, -3, or AP-1, -3 complexes, which mediate cargo transport from recycling endosomes to melanosomes. Although several Rab GTPases have been shown to regulate these trafficking steps, the precise role of Rab9A remains unknown. Here, we found that a cohort of Rab9A associates with the melanosomes and its knockdown in melanocytes results in hypopigmented melanosomes due to mistargeting of melanosomal proteins to lysosomes. In addition, the Rab9A-depletion phenotype resembles Rab38/ 32-inactivated or BLOC-3-deficient melanocytes, suggesting that Rab9A works in line with BLOC-3 and Rab38/ 32 during melanosome cargo transport. Furthermore, silencing of Rab9A, Rab38/ 32 or its effector VARP, or BLOC-3-deficiency in melanocytes decreased the length of STX13-positive recycling endosomal tubules and targeted the SNARE to lysosomes. This result indicates a defect in directing recycling endosomal tubules to melanosomes. Thus, Rab9A and its co-regulatory GTPases control STX13-mediated cargo delivery to maturing melanosomes.

Atuação da Câmara dos Deputados na regulamentação das normas para eleição dos membros do PARLASUL de 2014

O Brasil precisa definir sua situação da representação parlamentar no parlamento do MERCOSUL, o PARLASUL. Importantes questões não estão sendo tratadas com a devida atenção, pois atualmente os Parlamentares da Representação Brasileira do MERCOSUL são os políticos em atividade no Congresso Nacional, indicados pelos partidos, de forma semelhante às outras comissões do Senado e da Câmara dos Deputados e dividem suas extensas atividades diárias com os trabalhos desse novo parlamento e isso acaba comprometendo a atuação perante esse bloco econômico. Para tal, está tramitando na Câmara dos Deputados o Projeto de Lei nº 5279 de 2009, de autoria do Deputado Carlos Zarattini, que estabelece normas para as eleições dos parlamentares do MERCOSUL. Por ser um projeto de grande relevância, sua tramitação está sendo longa. Além disto, apresenta pontos polêmicos que afetam diretamente outra grande discussão do ambiente político nacional, a reforma política, principalmente com sistema de listas preordenadas pelos partidos políticos e o financiamento público exclusivo de campanha. Analisa o comportamento dos parlamentares brasileiros na estrutura de escolha dos representantes para o PARLASUL, que tendem a aprovar o projeto. Para um maior entendimento desta eleição e de todo processo da criação de um bloco econômico, a pesquisa aborda desde os primórdios das Relações Internacionais que originaram a criação de uma integração sul-americana, bem como um exame dos dados históricos da evolução do MERCOSUL e do PARLASUL.

Eleições na integração regional : desenvolvimento das proposições nacionais para as eleições diretas do parlamento do Mercosul

Analisa o andamento das propostas legislativas para eleições dos parlamentares do Mercosul em todos os Estados-Membros do bloco. Apresenta e avalia a situação das discussões sobre as eleições diretas nos Estados que ainda não aprovaram as diretrizes para as eleições mercosulinas, bem como a já aprovada e aplicada legislação eleitoral paraguaia.

Modos de pensar e de fazer: o cuidado de enfermagem à pessoa com HIV/Aids representado pela equipe de enfermagem

Este estudo propõe uma reflexão acerca do cuidado de enfermagem e suas práticas voltadas à pessoa com HIV/Aids desenvolvido por profissionais da equipe de enfermagem. O objetivo geral foi analisar as representações sociais e as práticas de cuidado de enfermagem a pessoa com HIV/Aids para a equipe de enfermagem que atua no Programa de DST/Aids no Município do Rio de Janeiro. Trata-se de uma pesquisa qualitativa, fundamentada na Teoria das Representações Sociais. Quanto à metodologia este estudo foi desenvolvido com 16 unidades de saúde inseridas no Programa Nacional de DST-Aids do Ministério da Saúde, que prestam assistência a pessoas que vivem com HIV/Aids em nível ambulatorial. Participaram desse estudo 37 profissionais, sendo 20 enfermeiros e 17 técnicos e auxiliares de enfermagem. Os dados foram coletados através de entrevista semiestruturada, tendo sido analisadas através da utilização do software ALCESTE 4.10; e questionário de identificação sócio-profissional, cuja análise de dados foi realizada com estatística descritiva. A partir da análise ALCESTE foram definidas 7 classes, divididas em dois blocos temáticos, sendo o primeiro denominado O HIV/Aids e seus impactos sociais através do olhar da equipe de enfermagem. Este bloco abarcou 3 classes, sendo elas: Preconceito e vulnerabilidade no cotidiano do cuidado de enfermagem de pessoas atingidas pelo HIV/Aids (classe1); As relações familiares e o envolvimento com o HIV/Aids (classe 4) e Memórias sócio profissionais sobre o HIV/Aids (classe 7). O segundo bloco temático denomina-se O HIV/Aids e as práticas de cuidado, e abarca 4 classes da análise, denominadas: A complexidade do atendimento ambulatorial da pessoa com HIV/Aids (classe 2); As práticas de cuidado da equipe de enfermagem e da equipe multiprofissional (classe 3); A educação em saúde como prática do cuidado de enfermagem (classe 5) e Medidas de proteção e biossegurança dos profissionais de enfermagem (classe 6). No primeiro bloco observa-se as representações da doença, os estigmas enfrentados pela pessoa com HIV/Aids, as relações com familiares e profissionais de saúde e as memórias da equipe de enfermagem com relação a doença. Observa-se que mesmo após ter havido mudanças no perfil da doença, as marcas do passado ainda se fazem presentes no cotidiano desses sujeitos, o que se reflete no cuidado de enfermagem, nas relações familiares e na vida em sociedade. O segundo bloco descreve as práticas institucionais e profissionais de cuidado à pessoa com HIV/Aids, observando-se o destaque da autoproteção no cuidado de enfermagem aos sujeitos com HIV/Aids. Também são destacados elementos como o cuidado do outro, tais como o vínculo, a postura acolhedora, o apoio psicológico e o relacionamento interpessoal, que são modalidades reconhecidas como participantes das práticas de cuidado, assim como a educação em saúde. Conclui-se que os diversos conteúdos que compõem as representações sociais e as práticas de cuidado de enfermagem a pessoa com HIV/Aids se apresentam sentimentos, práticas, atitudes, memórias, conceitos e imagens atuais e antigas, com a presença do cuidado instrumental, mas também do cuidado relacional.

Serviço social, assistência social e drogas: um estudo do trabalho profissional do assistente social nos centros de referência especializados de assistência social no município do Rio de Janeiro

Esta dissertação discute o entendimento dos assistentes sociais que atuam nos centros de referência especializados de assistência social de três coordenadorias de desenvolvimento social do município do Rio de Janeiro sobre o tema das drogas, com o objetivo de analisar se as ações profissionais são dirigidas a uma perspectiva crítica, desconsiderando valores conservadores na sua intervenção, e se, durante seu trabalho profissional, buscam contribuir criticamente para a garantia dos direitos dos usuários. Para tal, realizamos entrevista com os assistentes sociais inseridos nesses centros, e através das respostas apresentadas, analisamos como o tema das drogas é abordado pelos profissionais de serviço social. A contribuição para a garantia de direitos requer do profissional de Serviço Social a possibilidade de realizar mediações entre as políticas e a contextualidade do usuário, considerando, também, as possibilidades e limites no percurso histórico que atravessa o uso das drogas. Cabe inclusive situar a compreensão das drogas e sua relação com o desenvolvimento do capital, em que a estratégia proibicionista responde aos interesses de um determinado bloco do poder. Dessa forma esse estudo resgata a construção histórica da profissão de Serviço Social no Brasil, destacando os processos que marcaram uma possibilidade de ruptura com o conservantismo profissional e, por conseguinte, suscitavam uma perspectiva profissional mais crítica e densa teoricamente. Apresenta uma análise do desenvolvimento capitalista, destacando as tendências e estratégias atuais para o enfrentamento da questão social, sob o contexto neoliberal. E por fim, acrescido da pesquisa empírica realizadanos CREAS o estudo buscou identificar se os profissionais de serviço social conseguem fortalecer o projeto ético-político da profissão, ou se as marcas deixadas pela herança conservadora, que gestaram a profissão são resgatadas e utilizadas no trabalho profissional.