Quantitative Assessment of T1 Relaxation and Diffusion as a Prognostic Tool for Brain Development: A Longitudinal Preliminary Study on Preterm Babies

BACKGROUND: Despite major advances in care of premature infants, survivors exhibit mild cognitive deficits in around 40%. Beside severe intraventricular haemorrhages (IVH) and cystic periventricular leucomalacia (PVL), more subtle patterns such as grade I and II IVH, punctuate WM lesions and diffuse PVL might be linked to the cognitive deficits. Grey matter disease is also recognized to contribute to long-term cognitive impairment.¦OBJECTIVE: We intend to use novel MR techniques to study more precisely the different injury patterns. In particular MP2RAGE (magnetization prepared dual rapid echo gradient) produces high-resolution quantitative T1 relaxation maps. This contrast is known to reflect tissue anomalies such as white matter injury in general and dysmyelination in particular. We also used diffusion tensor imaging, a quantitative technique known to reflect white matter maturation and disease.¦DESIGN/METHODS: All preterm infants born under 30 weeks of GA were included. Serial 3T MR-imaging using a neonatal head-coil at DOL 3, 10 and at term equivalent age (TEA), using DTI and MP2RAGE sequences was performed. MP2RAGE generates a T1 map and allows calculating the relaxation time T1. Multiple measurements were performed for each exam in 12 defined white and grey matter ROIs.¦RESULTS: 16 patients were recruited: mean GA 27 2/7 w (191,2d SD±10,8), mean BW 999g (SD±265). 39 MRIs were realized (12 early: mean 4,83d±1,75, 13 late: mean 18,77d±8,05 and 14 at TEA: 88,91d±8,96). Measures of relaxation time T1 show a gradual and significant decrease over time (for ROI PLIC mean±SD in ms: 2100.53±102,75, 2116,5±41,55 and 1726,42±51,31 and for ROI central WM: 2302,25±79,02, 2315,02±115,02 and 1992,7±96,37 for early, late and TEA MR respectively). These trends are also observed in grey matter area, especially in thalamus. Measurements of ADC values show similar monotonous decrease over time.¦CONCLUSIONS: From these preliminary results, we conclude that quantitative MR imaging in very preterm infants is feasible. On the successive MP2RAGE and DTI sequences, we observe a gradual decrease over time in the described ROIs, representing the progressive maturation of the WM micro-structure and interestingly the same evolution is observed in the grey matter. We speculate that our study will provide normative values for T1map and ADC and might be a predictive factor for favourable or less favourable outcome.

Implementação da Vertente Educação Especial no Plano Curricular do Curso de Ciências da Educação e Praxis Educativa na Universidade Jean Piaget de Cabo Verde: Realidades e Desafios

Este estudo foi realizado na Universidade Jean Piaget de Cabo Verde com o propósito de conhecer a percepção dos alunos e professores sobre a respectiva Universidade em matéria do cumprimento das Culturas, Políticas e Práticas inclusivas, vistas como fundamentais para a implementação da vertente Educação Especial no plano curricular do curso de Ciências da Educação e Praxis Educativa (CED). Sendo assim, questionamos aos professores e alunos se a Universidade Jean Piaget de Cabo Verde reúne as condições necessárias para o propósito acima referido, bem como procurámos saber até que ponto os actuais e potenciais estudantes de Ciências da Educação e Praxis Educativa estarão interessados em seguir a vertente Educação Especial. Na tentativa de respondermos a estas questões, formulamos 3 hipóteses que se seguem:  Na percepção de professores e alunos, a UniPiaget reúne as condições necessárias para a implementação da vertente Educação Especial;  Os estudantes do curso de Ciência da Educação e Praxis Educativa revelam grande interesse em candidatar-se à Vertente Educação Especial;  De entre os alunos e professores, a maioria avaliam favoravelmente que a UniPiaget dispõe de um corpo docente capacitado para trabalhar com alunos com Necessidades Educativas Especiais. Os dados foram recolhidos através de inquéritos por questionários, estes que foram adaptados dos modelos do Index for Inclusion de Tony Booth e Mel Aiscow, e a análise foi com auxílio dos programas Excel e SPSS versão 15.0 for Windows. Enfim de referir que com este estudo conseguimos apurar que a UniPiaget tem trabalhado muito para proporcionar a todos um ensino de qualidade, tornando-se numa instituição educativa procedentes em matéria da inclusão.

La percepción del riesgo de inundación: experiencias de aprendizaje en la costa brava

Taking as an example three study cases in the Costa Brava area, this paper examines through surveys and interviews the perception of floods among residents living in hazardous areas. perception is then related to vulnerability, flood management, and citizens preferences regarding alternatives to curb flood losses in the future. The study concludes that flood awareness and the willingness to take actions regarding this hazard is clearly related to the degree of social involvement with the affairs of the local community

Estadísticas de los desembarques de la pesquería marina peruana 1999

El presente informe reúne los daros de desembarque de los recursos hidrobiológicos marinos procedentes de la pesquería industria, la de consumo y la de pesca artesanal; y describe en forma detallada el comportamiento estadístico de las 32 especies de mayor importancia comercia. De igual modo, se encuentran incluidas las dos principales pesquerías pelágicas y demersales, las mismas que son el sustento de las pesquería nacional.

Are adolescents with chronic conditions particularly at risk for bullying?

OBJECTIVE: To compare the prevalence and intensity of victimization from bullying, and the characteristics of the victims of bullying, comparing adolescents with and without chronic conditions. DESIGN: School survey. SETTING: Post-mandatory schools. PARTICIPANTS: A total of 7005 students (48% females) aged 16-20 years, distributed into adolescents with chronic conditions (728, 50% females) and controls (6277, 48% females). Chronic condition was defined as having a chronic disease and/or a physical disability.OUTCOME MEASURES: Prevalence of bullying; intensity of bullying; and socio-demographic, bio-psychosocial, familial, school, and violence context characteristics of the victims of bullying. RESULTS: The prevalence of bullying in our sample was 13.85%. Adolescents with chronic conditions were more likely to be victims of bullying (Adjusted Odds Ratio [AOR] 1.53), and to be victims of two or three forms of bullying (AOR 1.92). Victims of bullying with chronic conditions were more likely than non-victims to be depressed (Relative Risk Ratio [RRR] 1.57), to have more physical symptoms (RRR 1.61), to have a poorer relationship with their parents (RRR 1.33), to have a poorer school climate (RRR 1.60), and to have been victims of sexual abuse (RRR 1.79) or other forms of violence (RRR 1.80). Although these characteristics apply to victims in general, in most cases they are less pronounced among victims without chronic conditions. CONCLUSIONS: Chronic conditions seem to be a risk factor for victimization from bullying. Therefore, as adolescents with chronic conditions are increasingly mainstreamed, schools should be encouraged to undertake preventive measures to avoid victimization of such adolescents.

Anuario Científico y Tecnológico IMARPE 2011

Reúne la principal información sobre las actividades científicas y tecnológicas realizadas durante el año 2011, por las cinco Direcciones de Investigación de la Sede Central y por las diez sedes descentralizadas del IMARPE, también llamadas Laboratorios Costeros y Continental. Se destacan resultados relevantes referidos a los Programas de Investigación, sus Líneas de Investigación y los Objetivos Específicos consignados en la Matriz de Actividades y Proyectos de Investigaciones Científicas y Tecnológicas del año 2011.

Anuario Científico y Tecnológico IMARPE 2012

Reúne información sobre los Programas de investigación y actividades/proyectos realizados por las Direcciones de Investigación de la Sede Central y las diez Sedes Descentralizadas del IMARPE. Se destacan los resultados logrados en base a la Matriz de Actividades y Proyectos de Investigaciones Científicas y Tecnológicas durante el año 2012.

Anuario Científico y Tecnológico IMARPE 2013

El Anuario Científico Tecnológico IMARPE, reúne información sobre las actividades científicas y tecnológicas realizadas durante el año 2013, por las cinco Direcciones Generales de Investigación y por las diez Sedes Descentralizadas del IMARPE. Se destacan resultados relevantes referidos a los Programas de Investigación, sus Líneas de Investigación y los Objetivos Específicos consignados en la Matriz de Actividades y Proyectos de Investigación Científica y Tecnológica del año 2013.

Patients with AIDS-defining cancers are not universally screened for HIV: a 10-year retrospective analysis of HIV-testing practices in a Swiss university hospital.

OBJECTIVES: Kaposi's sarcoma (KS), invasive cervical carcinoma (ICC) and non-Hodgkin lymphoma (NHL) have been listed as AIDS-defining cancers (ADCs) by the Centers for Disease Control and Prevention since 1993. Despite this, HIV screening is not universally mentioned in ADC treatment guidelines. We examined screening practices at a tertiary centre serving a population where HIV seroprevalence is 0.4%. METHODS: Patients with KS, ICC, NHL and Hodgkin lymphoma (HL), treated at Lausanne University Hospital between January 2002 and July 2012, were studied retrospectively. HIV testing was considered part of the oncology work-up if performed between 90 days before and 90 days after the cancer diagnosis date. RESULTS: A total of 880 patients were examined: 10 with KS, 58 with ICC, 672 with NHL and 140 with HL. HIV testing rates were 100, 11, 60 and 59%, and HIV seroprevalence was 60, 1.7, 3.4 and 5%, respectively. Thirty-seven patients (4.2%) were HIV-positive, of whom eight (22%) were diagnosed at oncology work-up. All newly diagnosed patients had CD4 counts < 200 cells/μL and six (75%) had presented to a physician 12-236 weeks previously with conditions warranting HIV testing. CONCLUSIONS: In our institution, only patients with KS were universally screened. Screening rates for other cancers ranged from 11 to 60%. HIV seroprevalence was at least fourfold higher than the population average. As HIV-positive status impacts on cancer patient medical management, HIV screening should be included in oncology guidelines. Further, we recommend that opt-out screening should be adopted in all patients with ADCs and HL.

SIMULIT : manuel de l'utilisateur

SIMULIT est un programme permettant la simulation de l'occupation des lits des hôpitaux de soins aigus. La mise en oeuvre de SIMULIT et des programmes annexes requiert de l'utilisateur qu'il sache créer et modifier un fichier à l'aide d'un éditeur, et lancer l'exécution d'un programme sur la machine dont il dispose. Le schéma général de la mise en oeuvre se trouve à l'annexe 1 de ce cahier.

Anuario Científico Tecnológico IMARPE 2014

El Anuario Científico Tecnológico IMARPE, reúne información sobre programas de investigación y actividades y proyectos realizados por las Direcciones de Investigación de la Sede Central y las diez sedes descentralizadas del IMARPE, Se destacan los resultados logrados en base a la Matriz de Actividades y proyectos de Investigaciones Científicas y Tecnológicas durante el 2014.

Estudi sobre la qualitat de vida de les persones amb demència ateses a la Unitat d'avaluació de deteriorament cognitiu de l'Hospital de la Santa Creu

OBJECTIU: determinar la qualitat de vida de les persones amb demència ateses en una unitat avaluadora de deteriorament cognitiu. MÈTODE: estudi descriptiu transversal amb una mostra consecutiva no probabilística, formada per 42 persones amb demència tipus Alzheimer lleu o moderada i els seus cuidadors. La Qualitat de Vida (QV) es va avaluar amb el qüestionari QoL-AD (Quality of Life Alzheimer’s Disease) en les versions per al pacient (QoL-ADp) i per al cuidador (QoL-ADc). RESULTATS: la mitjana de puntuació del QoL-ADp va ser de 35,38 punts (DE = 5,24) i del QoL-Adc, de 30,60 (DE 5,33). La diferència entre aquests resultats és significativa (p&0,001). Els pacients amb simptomatologia depressiva i els seus cuidadors van puntuar significativament més baix el QoL-AD (p&0,001). En les freqüències per ítems del QoL-ADp s’observa que: més del 75% van valorar com a bona/excel·lent les condicions de vida, família, matrimoni/relació estreta, vida social, situació financera i vida en general; el 61% valoraren bona/excel·lent la capacitat per realitzar tasques a casa; prop del 50% pensava que l’estat d’ànim, l’energia, la salut física, la capacitat per fer coses per diversió i la visió de si mateixos era dolenta/regular, i el 85,7% opinava que la seva memòria era dolenta/regular. CONCLUSIONS: els resultats obtinguts en el QoL-AD no difereixen dels obtinguts en altres investigacions. Suggereixen que les intervencions que genera l’avaluació de la QV en la pràctica clínica inclouen aspectes centrats pròpiament en la malaltia i aspectes vinculats amb les relacions socials.

Current developments in the radiotherapy approach to elderly and frail patients with glioblastoma multiforme.

The benefit of postoperative radiotherapy (RT) has been demonstrated in elderly patients aged 65 years or older with glioblastoma multiforme. Hypofractionated RT schedules can reduce the time and morbidity of treatment while maintaining comparable survival outcomes to lengthy conventional RT. Current international randomized clinical trials are studying the optimized hypofractionated RT regimens, hypofractionated RT in comparison with temozolomide chemotherapy and hypofractionated RT in comparison with the same RT plus temozolomide. Given the guarded prognosis of the elderly and frail patients, quality of life and side effects of treatment should be closely examined. As more than half of cancers in the world occur in developing countries, hypofractionated RT could be better utilized as a cost-effective treatment for this group of patients.

Implications of diagnosis related groups (DRGs) for the management of hospitals.

Although tremendous advances have been made in the diagnosis and treatment of patients, hospital administrative systems have progressed relatively slowly. The types of information available to managers in industrial sectors are not available in the health sector. For this reason, many phenomena, such as the variations of average costs and lengths of stay between different hospitals, have remained poorly explained.The DRG system defines groups of patients that consume relatively homogeneous quantities of hospital resources. On the basis, it is possible to standardize average lengths of stay and average hospital costs in terms of the differences in case mix treated. Thus DRGs can serve as an explanation of variations in these factors between different hospitals, and also (but not only) for prospective reimbursement schems. As in a number of other European countries, a project has been set up in Switzerland to examine the possibilities of using DRGs in hospital management, planning and financing.

Mobilidade de íons em solo ácido com aplicação de calcário, ácido orgânico e material vegetal em superfície

Há controvérsias quanto à eficiência da correção da acidez da camada subsuperficial pela aplicação de calcário na presença de materiais vegetais de plantas de cobertura e faltam informações sobre os mecanismos envolvidos no processo. O objetivo deste estudo foi quantificar a contribuição dos materiais vegetais de plantas de cobertura, com ênfase nos seus conteúdos de ácidos orgânicos de baixa massa molar e nutrientes solúveis, sobre a mobilização, no perfil do solo, dos produtos da dissolução do calcário aplicado em superfície. Foram desenvolvidos dois experimentos em laboratório, usando colunas de PVC de 30 cm de altura com amostras deformadas de um Latossolo Vermelho textura muito argilosa. Os tratamentos constituíram-se da aplicação isolada ou conjunta de calcário para atingir 80 % de saturação por bases (6,1 t ha-1) e de materiais vegetais (20 t ha-1) de nabo forrageiro e aveia-preta, bem como de soluções de ácidos orgânicos e sais neutros aproximadamente equivalentes ao conteúdo dessas espécies. A calagem isolada ou em associação com os materiais vegetais promoveu a redução da acidez somente na camada superficial (0-8 cm). A baixa taxa de recuperação dos ácidos orgânicos adicionados (< 7,2 %) indica que essas substâncias presentes na massa seca do nabo forrageiro foram rapidamente degradadas por microrganismos ou adsorvidas aos colóides do solo, tendo pouca influência na mobilização de cátions. Parte substancial do efeito sobre a mobilização de íons pela aplicação de material vegetal de nabo forrageiro se deveu à composição química do material, em vista da alta solubilidade em água dos cátions (65 a 71 %) e ânions (84 %). Além disso, a solução de sais foi o tratamento mais eficiente para deslocar o Al do solo para as soluções percoladas. A adição de materiais vegetais teve pouca influência na mobilização no perfil do solo dos produtos da dissolução do calcário aplicado em superfície.