Mise en place d'un cathéter veineux central chez l'adulte. 2. Technique détaillée [The central vein catheterization. 2. Procedure, step by step]

La pose d'un cathéter veineux central peut se faire par plusieurs abords. La connaissance de l'anatomie, du matériel, la maîtrise des détails de la procédure pour chaque type d'abord et une attention particulière à l'asepsie sont des prérequis importants pour limiter les risques de complications et pour donner une information complète et exhaustive au patient. Cet article peut être utilisé comme base pour le développement d'une check-list, utile pour les médecins qui doivent procéder à la pose d'un cathéter veineux central mais qui ne possèdent pas encore une maîtrise du geste. Several approaches exist for central vein catheterization. Mastery of the various steps of this procedure and understanding of the basics of asepsis are critical to prevent any complication. They also built the basis for an exhaustive communication with the patient, to obtain an informed consent. This article can in addition be used to develop a checklist in order to (self-)assess competence in procedural skills

Mise en place d'un cathéter veineux central chez l'adulte. 1. Indications, précautions et complications [Bases of central venous catheterization]

La pose d'un cathéter veineux central est un geste fréquent dans un service de médecine interne. En suivant la formation des médecins-assistants, nous nous sommes aperçus que certaines questions, doutes ou craintes concernant cette procédure nous sont régulièrement adressées: «Est-ce qu'un cathéter sous-clavier peut être posé avec une thrombocytopénie modérée?»; «Quel site de ponction présente le moins de risques pour le patient?»; «Après combien de jours un cathéter doit-il être changé?». Cet article se propose de répondre à ces questions et à d'autres, en partant d'une mini-revue de la littérature actuelle. Central venous catheterization is a frequently performed procedure in internal medicine units. Residents in training frequently share the same questions, doubts and fears about this procedure : "Should I perform a subclavian catheterization in a patient with mild thrombopenia?"; "Which site has the lesser complication rate?"; "After how long does a catheter need to be replaced?". This mini-review of the current literature tries to answer this and other questions

Regulating industrial forest concessions in Central Africa and South America

Tropical countries face special specific problems in implementing sustainable forest management (SFM). In many countries, questions are raised on whether tropical forests should be publicly, commonly or privately owned and managed in order to enhance sustainability. Other debates also focus on whether small-scale enterprises are better positioned than large-scale industrial concessions to reduce poverty and attain sustainable management. In countries where large tracts of forest are state-owned, concessions are viewed as a means of delivering services of public and collective interest through an association of private investment and public regulation. However, the success of an industrial concession model in countries with large forest resource endowment to achieve multiple goals such as sustainable forest management and local/regional development depends on two critical assumptions. First, forest functions and services should be managed and maintained as public goods. In many cases, additional uses - and corresponding rights - can take place alongside logging activities. Industrial concessions can be more efficient than other tenure models (such as community-based forest management and small-scale enterprises) in achieving SFM, add value to raw material and comply with growing environmental norms. This is especially the case in market-remote areas with low population density and poor infrastructure. Secondly, to achieve these different outcomes, any concession system needs to be monitored and regulated, especially in contexts dominated by asymmetrical information between regulating authorities and concessionaires. New institutional responses have recently been put forward in several countries, providing valuable materials to design a renewed policy mix which associates public and private incentives. This paper provides a survey of the experience of forest concessions in several Central African and South American countries. The concession system is examined in order to clarify the issues involved, the problems encountered, and what can be learned from the shared experience of these countries in the last decade. This paper argues that despite a sometimes patchy record, concessions can help promote SFM so long as they are packaged with a certain number of specific measures. (C) 2008 Elsevier B.V. All rights reserved.

The Mesozoic and Cenozoic motion of Adria (central Mediterranean): a review of constraints and limitations

This paper presents kinematic analysis on the motion of Adria, which is the continental mass that bridges Africa and Europe in the central Mediterranean. Palaeomagnetic data show a general coherence between the motion of Adria and Africa since the Late Paleozoic. This mutual motion, for the period from 120 Ma and the present, is verified by comparing inferred palaeolatitudes from relatively stable parts of Adria (Apulia, Gargano, Istria, and the Southern Alps) and the Hyblean Plateau, with latitudinal changes that are calculated from the motion of Africa with respect to hotspots. Additional constraints on the motion of Adria are provided from the Late Paleozoic-Early Mesozoic passive margin of Adria in the Ionian Sea. The seismic structure of the floor of the Ionian Sea resembles the structure of the oceanic crust in marginal back-arc basins, suggesting that it formed as a small ocean basin. Furthermore, the Ionian lithosphere in the Calabrian arc has been subjected to rapid rollback, which commonly occurs only when the subducting slab is made of oceanic lithosphere. This oceanic domain marks the Pennian-Triassic to Jurassic plate boundary between Adria and Africa, suggesting that a small amount of independent motion between Adria and Africa took place at that time. Since the Jurassic, Adria and Africa have shared a relatively coherent motion path. (C) 2004 Lavoisier SAS. All rights reserved.

The Farol Deposit (Depósito do Farol) – a Pleistocene beach deposit from Cape Mondego (Figueira da Foz, West Central Portugal)*

Among the Pleistocene and Holocene units recorded near the marine cliffs of Cape Mondego (Figueira da Foz, West Central Portugal) stands out the Farol Deposit (Depósito do Farol), at an altitude of ±95 m above present sea level. It is a marine terrace with three exposures of interstratified conglomerates and sands, overlapped by calclititic-fanglomerates. This sedimentary setting indicates that deposition took place in a seashore environment influenced by the proximity of a marine palaeocliff. The deposit has an interesting subfossil fauna with abraded and fragmented shells of Nucella lapillus (LINNÉ, 1758), Patella vulgata (LINNÉ, 1758) and Littorina littorea (LINNÉ, 1758), suggesting the existence of an environment with colder surface seawater, when compared with the present day Portuguese seashore. These specimens belonged to marine communities adapted to live in intertidal rocky platforms, which have been exposed to the cyclic action of waves and tidal flows, on the swash and surf zones. The Farol Deposit can be related to an Early/Middle Pleistocene “cold-water” episode, earlier to the Isotopic Stages 7 and 11. This episode occurred before the deposition of the units Quiaios Sands (Areias de Quiaios) and Cantanhede Sands (Areias de Cantanhede) (Sicilian?), but later than the Arazede Sands (Areias de Arazede) and Marinha das Ondas Sands (Areias de Marinha das Ondas) (Early Pleistocene).

Simulação da Central de Cogeração da Refinaria de Matosinhos (Petrogal)

Mestrado em Engenharia Química – Ramo Optimização Energética na Indústria Química

Current epidemiological profile of Chagasic megaesophagus in Central Brazil

Introduction Chagasic megaesophagus (CM) is the most common digestive manifestation of Chagas disease in Brazil, and the State of Goiás is one of the most affected regions. In recent decades, the Hospital das Clínicas (HC)/Universidade Federal de Goiás (UFG) has been a reference center for the study and treatment of CM. The objective of this study was to characterize the current epidemiological profile of patients with CM observed at the HC of the UFG from 1998 to 2010. Methods In total, 939 patient records were analyzed, and age, gender, place of birth, serology, symptoms and radiological classification according to Rezende et al. were analyzed. Results The median patient age was 55 years. Male patients were more (54%) prevalent than female patients. The prevalence of younger patients (less than 31 years of age) was 4.2%, but 82.1% of the younger patients were from State of Bahia. Patients older than 40 years were the majority (85.5%). The radiological groups were distributed as follows: Group I (35.9%), Group II (32.9%), Group III (17%) and Group IV (14.2%). Conclusions Compared with previous studies by the same group in 1975, 1994 and 1995, the number of younger patients decreased, and the frequency curve has shifted to older patients.

Spatial and temporal distribution of a tiger beetle guild (Coleoptera: Carabidae: Cicindelinae) along a 105m long transect in the reserva florestal A. Ducke near Manaus (Central Amazonia)

The spatial and temporal distribution of a guild of eight diurnal tiger beetle species was studied on a 105 m long transect near the field station of the Reserva Florestal A. Ducke near Manaus (AM), Brazil. The transect followed a path that included both shaded and an open areas. Five of the species, restricted to primary forest, occurrred only in shaded areas of the transect, and three species occurred in open areas. Of all eight species only two of the open habitat species showed no clear seasonality in adult activity. In six species the activity of adults was limited to the rainy season. The most pronounced annual rhythm was found in Pentacomia ventralis, an open habitat species. Activity of adults was limited to October/November. First in-star larvae appeared shortly thereafter. Larval development mainly took place from January to May. The third instar larva entered a dormancy which lasted up to 10 months, and which enabled the synchronisation of emerging adults with annual seasons.

The Irish pub as a third place : a sociological exploration of people, place and identity

There is considerable interest in alcohol in Irish society, yet minimal sociologcial understanding of its consumption, particularly of the sites where most drinking occurs: the country's 8750 pubs. Despite widespread public discussions on the role of the pub, there is scant social science evidence to better inform debate. Pubs are central to Irish community and are key sites of social interaction. American sociologist Ray Oldenburg has argued that "third places" (neither workplace nor home) are crucial to the maintenance of the community and the enhancement of social capital. According to Oldenburg, the role of the third place in the community is to provide continuity, regularity, a sense of place - all of which conceptually contribute to the construction of the self, the projection of the self within the public sphere, the distribution of social capital and the generation of a collective identity. The pub is the archetypal third place, but Oldenburg is concerned that modern pubs are less able to provide this vital function. Social scientists have suggested that community is in a state of fragmentation and decline due to changes in modes of social interaction and a decrease in shared spaces, resulting in a weakened connection to place. Community without propinquity has been characterised by social alienation, fragmentation and what Oldenburg refers to as the "problem of place" (13). Third places, and thus the Irish pub, have been particularly affected. In order to increase the sociological knowledge of the pub in Ireland, this project critically engages with the pub to assess the importance that public drinking houses have in the everyday. Moreover, this research sets out to investigate the people/place relationship using the pub as an investigative lens and examine the ways in which people shape place, place shapes people and how that relationship is implicated in the construction of irish identities. Furthermore, this is also an articulation of a cultural shift within Ireland and Irish places whose effects are deep and multi-layered. This project aims to explore the development of the contemporary geography of identity as the irish pub as a third place is transformed or disappears from the social landscape.

IPH responds to Central Statistics Office (ROI) Consultation on Census 2011 Outputs

Before each census the CSO engages in an extensive public consultation process. Consultation on the content of Census 2011 took place in 2008 and the content has been agreed by the Government. The second phase of the consultation process sought the views of the public on the outputs that will be produced from the 2011 census. IPH responded to a series of CSO questions that were posted on the CSO website.

Phorcotabanus cinereus (Wiedemann, 1821) (Diptera, Tabanidae), an ornithophilic species of Tabanid in Central Amazon, Brazil

In Central Amazon, Brazil, the tabanid Phorcotabanus cinereus (Wiedemann) was recorded attacking the native duck Cairina moschata (Linnaeus) (Anseriformes, Anatidae). The flight and behavior of the tabanid during the attacks and the host's defenses were videotaped and analyzed in slow motion. The tabanid was recorded flying rapidly around the heads of the ducks before landing. Landing always took place on the beak, and then the tabanid walked to the fleshy caruncle on the basal part of the beak to bite and feed. Firstly the duck defends itself through lateral harsh head movements, and then, when it is being bitten, it defends itself by rubbing its head on the body, or dipping the head into water, when swimming. If disturbed, the fly resumed the same pattern of flight as before and would generally try to land again on the same host and bite in the same place. This feeding activity was observed predominantly between 9:30 am and 4:30 pm and always in open areas, near aquatic environments, from June 1996 to January 1997, the dry season in Central Amazon. To test the attractiveness of other animals to P. cinereus, mammals, caimans and domestic and wild birds were placed in suitable habitat and the response of P. cinereus observed. P. cinereus did not attack these animals, suggesting that this species has a preference for ducks, which are plentiful in the region.

Development of place navigation in rats from weaning to puberty.

Young hooded rats were trained to escape onto a hidden platform after swimming in a pool of opaque water. Subjects 21, 28, 35, 42, and 64 days of age on the first training day were given 28 trials on 5 consecutive days. Half of the rats were required to localize the platform in relation to external room cues only ("place only" condition) and the other half were helped by the presence of a visible cue on the platform ("cue + place" condition). A deficiency in place navigation was observed in the 21- and 28-day groups; they showed slow escape and took circuitous routes more often than older rats. This deficiency was related to a poor spatial bias toward the training position when the subjects were allowed to swim for 30 s in the absence of the platform, at the end of the 28-trial training period (probe trial). The 35-day group showed adult-like learning ability in both training conditions, but failed to show searching behavior during the probe trial after having been trained in the presence of the proximal cue. Only rats older than 40 days showed typical adult behavior such as swimming directly toward the platform from any starting position and localized searching around the absent platform's position during the probe trial, no matter what the training conditions were. These results suggest that central nervous system structures responsible for place learning in the rat are functional from around 32 days of age, but fail to trigger searching behavior following cued training before the sixth week.

Seroepidemiology of hepatitis B virus infection and high rate of response to hepatitis B virus Butang®vaccine in adolescents from low income families in Central Brazil

In order to evaluate the seroepidemiology and response to Butang® vaccine in adolescents from low income families in Central Brazil, blood samples of 664 adolescents were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) markers, and multiple logistical regression analysis was carried out to determine variables associated with hepatitis B virus (HBV) infection markers. further, three 20 µg butang® vaccine doses were offered to all susceptible individuals (n = 304). Among those who accepted them (n = 182), the seroresponse was evaluated in 170 individuals by quantitative anti-HBs. an overall hbv prevalence of 5.9% was found: four adolescents were HBsAg positive, 24 were anti-HBc, anti-HBs-reactive, and 11 were anti-HBc only. The analyse of risk factors showed that age 16-19 years, place of birth outside Goiás, school B and body piercing were statistically associated with HBV infection markers (p < 0.05). All 170 adolescents responded to butang®, and a geometric mean titer (gmt) of 4344 mui/ml was obtained. these results reinforce the importance of hepatitis b vaccine in adolescents despite of the hbv regional endemicity, and suggest that three doses of 20 µg of the butang® should guarantee protective anti-hbs levels to individuals at a critical time for hepatitis b acquiring such as latter adolescence and adulthood.