Fondaparinux in the initial and long-term treatment of venous thromboembolism.

BACKGROUND: Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice. METHODS: We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer. RESULTS: Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05). CONCLUSIONS: An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients.

Development and initial validation of the Parental PELICAN Questionnaire (PaPEQu) - an instrument to assess parental experiences and needs during their child's end-of-life care.

AIM: To develop and test the Parental PELICAN Questionnaire, an instrument to retrospectively assess parental experiences and needs during their child's end-of-life care. BACKGROUND: To offer appropriate care for dying children, healthcare professionals need to understand the illness experience from the family perspective. A questionnaire specific to the end-of-life experiences and needs of parents losing a child is needed to evaluate the perceived quality of paediatric end-of-life care. DESIGN: This is an instrument development study applying mixed methods based on recommendations for questionnaire design and validation. METHOD: The Parental PELICAN Questionnaire was developed in four phases between August 2012-March 2014: phase 1: item generation; phase 2: validity testing; phase 3: translation; phase 4: pilot testing. Psychometric properties were assessed after applying the Parental PELICAN Questionnaire in a sample of 224 bereaved parents in April 2014. Validity testing covered the evidence based on tests of content, internal structure and relations to other variables. RESULTS: The Parental PELICAN Questionnaire consists of approximately 90 items in four slightly different versions accounting for particularities of the four diagnostic groups. The questionnaire's items were structured according to six quality domains described in the literature. Evidence of initial validity and reliability could be demonstrated with the involvement of healthcare professionals and bereaved parents. CONCLUSION: The Parental PELICAN Questionnaire holds promise as a measure to assess parental experiences and needs and is applicable to a broad range of paediatric specialties and settings. Future validation is needed to evaluate its suitability in different cultures.

Alzheimer's disease-like APP processing in wild-type mice identifies synaptic defects as initial steps of disease progression.

BACKGROUND: Alzheimer's disease (AD) is the most frequent form of dementia in the elderly and no effective treatment is currently available. The mechanisms triggering AD onset and progression are still imperfectly dissected. We aimed at deciphering the modifications occurring in vivo during the very early stages of AD, before the development of amyloid deposits, neurofibrillary tangles, neuronal death and inflammation. Most current AD models based on Amyloid Precursor Protein (APP) overproduction beginning from in utero, to rapidly reproduce the histological and behavioral features of the disease within a few months, are not appropriate to study the early steps of AD development. As a means to mimic in vivo amyloid APP processing closer to the human situation in AD, we used an adeno-associated virus (AAV)-based transfer of human mutant APP and Presenilin 1 (PS1) genes to the hippocampi of two-month-old C57Bl/6 J mice to express human APP, without significant overexpression and to specifically induce its amyloid processing. RESULTS: The human APP, βCTF and Aβ42/40 ratio were similar to those in hippocampal tissues from AD patients. Three months after injection the murine Tau protein was hyperphosphorylated and rapid synaptic failure occurred characterized by decreased levels of both PSD-95 and metabolites related to neuromodulation, on proton magnetic resonance spectroscopy ((1)H-MRS). Astrocytic GLT-1 transporter levels were lower and the tonic glutamatergic current was stronger on electrophysiological recordings of CA1 hippocampal region, revealing the overstimulation of extrasynaptic N-methyl D-aspartate receptor (NMDAR) which precedes the loss of long-term potentiation (LTP). These modifications were associated with early behavioral impairments in the Open-field, Y-maze and Morris Mater Maze tasks. CONCLUSIONS: Altogether, this demonstrates that an AD-like APP processing, yielding to levels of APP, βCTF and Aβ42/Aβ40 ratio similar to those observed in AD patients, are sufficient to rapidly trigger early steps of the amyloidogenic and Tau pathways in vivo. With this strategy, we identified a sequence of early events likely to account for disease onset and described a model that may facilitate efforts to decipher the factors triggering AD and to evaluate early neuroprotective strategies.

Brain metastasis as initial presentation of papillary adenocarcinoma of the lung: case report

The authors describe the case of a 33-year-old patient with history of seizures alone without any previous symptom, being diagnosed with brain metastases from primary papillary adenocarcinoma of the lung. Emphasis is given to the diagnostic investigation for brain metastasis and prognostic evaluation of papillary adenocarcinoma of the lung, and a brief literature review on such diseases is performed.

Medical nutrition in oncology : potential solution for managing malnutrition in cancer patients in Switzerland

The objective of this study is to: - Describe the cancer related complications, prevalence and economic burden of cancer; - Provide the review of the studies that have been done until now proving that specialized nutrition; can improve quality of life (QoL), shorten the length of hospital stay and reduce overall cost of patients care; - Describe different types of specialized nutritional support and tools/ guidelines used for nutritional screening; - Justify the use of specialized nutrition as an integral part of cancer treatment [Author, p. 6] [Contents] 3. General overview of cancer. 4. Specialized nutritional support and nutritional screening. 4.4 European guidelines for nutritional screening [Screening tools: Malnutrition Universal Screening Tool (MUST); Nutritional Risk Screening (NRS-2002); Mini Nutritional Assessment (MNA)]. 5. Implementation of nutritional support in Swiss hospitals as an integral part of oncology treatment. 5.1 Nutritional guidelines used in Switzerland. 5.2 Status of prevention of malnutrition in cancer patients in Swiss hospitals. 5.3 Malnutrition in Swiss hospitals: medical costs and potential economies. 5.4 Recommendations for implementation of nutritional guidelines and nutritional support in Swiss hospitals.

Leishmaniavirus : a possible target against metastatic leishmaniasis

Leishmaniasis is widely spread disease found in bath tropical and temperate regions but limited to the habitat of its sand fly vector. lt affects over 12 million people with 2 million new cases each year. As cutaneous leishmaniasis patients show varying levels of immunity to the disease after recovery, the development of a vaccine has much promise as a prevention strategy. Unfortunately however, existing anti-leishmanial vaccines are plagued by safety issues and have only ever shown limited efficacy .So, despite much effort, no effective vaccine is currently available. Recent studies suggest a correlation between the presence of Leishmania RNA virus (LRV) and the development of mucocutaneous leishmaniasis (MCL), which is characterised by the presence of secondary lesions in nasal and buccal mucosa, causing destructive and disfiguring facial lesions. Moreover, recent research has associated the viral presence to treatment fa ilure in patients. ln the first part of this work, we propose that these viral particles may serve as promising vaccine candidates due to their powerful TLR-3 antigenicity, launching an early cell-mediated attack on stimulated cells and thus eliminating their virulent complications. The second part of this work discusses a preliminary study on the lymphocyte immune response against Leishmania guyanensis infection. The lymphocyte response (and in particular, the raie of CDS+ T cells) is controversial and varies greatly between Leishmania species. Here, we illustrate the importance of a small CDS+ T cell subpopulation, expressing the CDSaa+ receptor. These intraepithelial lymphocytes are mainly present in the skin, vagina and intestinal tissue and are best known for their raie in the early immune response against pathogens. Similarly to traditional CDS+ cells, they secrete the tissue-destructive enzymes, perforin and granzyme, which can result in a hyper-inflammatory cutaneous lesion, raising a possibility for their raie in Leishmania infection. lndeed, our initial results in a murine mode( of Leishmania guyanensis infection suggest a pathogenic raie for CDSaa+ T cells. Further research into species-specific immune responses against the various Leishmania parasites is critical to realising the clinical potential of immunotherapy in the treatment and prevention of this disfiguring disease . -- La Leishmaniose est une maladie infectieuse causée par le parasite Leishmania. Elle est localisée dans les régions où son vecteur se reproduit, c'est-à-dire dans des régions tropicales ou tempérées. Cette pathologie affecte 12 millions des personnes dans le monde et 2 millions de nouveaux cas sont recensés chaque année. D'autres facteurs, tels la déforestation, les conditions d'hygiène ou encore l'accès limité aux médicaments, aggravent la pathologie et renforcent sa propagation. Les patients affectés par la leishmaniose et qui arrivent à en guérir, présentent une protection contre une réinfection. Pour cette raison, le développement d'un vaccin reste la meilleure solution pour combattre ce fléau. Mais, à ce jour, et malgré beaucoup d'efforts, aucun vaccin efficace n'a encore été développé. Un autre facteur responsable de l'aggravation de la pathologie et de la résistance de ces parasites aux drogues est un virus qui peut infecter certaines souches de Leishmania. Ce virus, appelé Leishmania RNA virus, peut induire une réponse inflammatoire exagérée, ce qui a comme résultat l'aggravation de la pathologie, la survie et la dissémination de ce parasite au sein de l'hôte infecté. Vu l'absence d'un vaccin contre ce parasite, Leishmania, nous proposons de développer un vaccin non pas contre le parasite lui- même mais contre l'agent qui provoque l'exacerbation de la pathologie, c'est-à-dire le virus. Dans cette étude, nous décrivons le développement d'un vaccin contre LRV, qui empêche le parasite d'induire des inflammations exagérées dans les souris. En d'autres mots, nous essayons de prévenir toutes les complications générées par cet hyperpathogène qu'est le LRV, en utilisant sa capside comme cible pour le développement d'un vaccin. Dans la deuxième partie de ce manuscrit, nous avons aussi étudié plus en détail la réponse immunitaire, et en particulier la réponse des lymphocytes T COB suite à l'infection du parasite Leishmania guyanensis porteur du LRV.

Optical characterization of sol-gel glasses derived from Eu3+ complex-forming precursors

Fabrication of new optical devices based upon the incorporation of rare earth ions via sol-gel methods depends on elimination of dopant ion clusters and residual hydroxyl groups from the final material. The optical absorption and/or luminescence properties of luminescent rare earth ions are influenced by the local bonding environment and the distribution of the rare-earth dopants in the matrix. Typically, dopants are incorporated into gel via dissolution of soluble species into the initial precursor sol. In this work, Eu3+ is used as optical probe, to assess changes in the local environment. Results of emission, excitation, fluorescence line narrowing and lifetimes studies of Eu3+-doped gels derived from Si(OCH3)4 and fluorinated/chelate Eu3+ precursors are presented. The precursors used in the sol-gel synthesis were: tris (6,6,7,7,8,8,8-heptafluoro-2,2-dimethyl-3,5-octanedionate) Eu(III), Eu (III) trifluoromethanesulfonate, Eu(III) acetylacetonate hydrate, Eu (III) trifluoroacetate trihidrate, tris (2,2,6,6-tetramethyl-3,5- heptanedionate) Eu(III) and Eu(NO3)3.6H2O. The results were interpreted in terms of the evolution of the Eu3+ fluorescence in systems varying from solution to the gels densified to 800ºC. The lifetimes studies indicate that the fluorinated precursors are effective at reducing the water content in densified gels.

High voltage discharge for degradation of organic contaminants in water

The pulsed dielectric barrier discharge (PDBD) and pulsed corona discharge (PCD) were compared for their efficiency to degrade phenol in water solution. Results show that PCD has higher efficiency than PDBD to degrade phenol. When initial pH of water solution was elevated, phenol degradation in the PCD reactor was significantly enhanced, although no considerable effect was seen in the PDBD reactor. The PCD reactor was also able to degrade lignin significantly, both in synthetically prepared solution and in pulp and paper mill wastewater. Water temperature did not affect phenol degradation; however, lignin was better oxidized at lower temperature.

Combining Customer Requirements and Modularity in Complete Tap Water Solution

This thesis studies forming a complete solution concept for tap water systems in project business environment. The aim of the study is to find tools and means for the target company to determine the scope of their tap water solution offering and to research what kind of organizational capabilities and resources are needed to supply such system solutions. With the help of literature, the characteristics of systems selling and project business and thematics of systems integration and integrated solutions are examined, and the significance of modularity and customer requirements in the given operational environment is discussed. After this, a checklist tool for customer requirements management is developed for the tap water system along with a module allocation method. The study proposes that with the checklist and module allocation the technical specifications can be extensively and innovatively defined for the system. The tools developed are a part of a complete tap water solution concept, which suggests that integrated solutions might constitute possibilities for the company to outperform its competitors when the traditional business methods of the industry are becoming obsolete.

One pot obtention of a tetrabutylammonium hydroxide solution for ironporphyrin-OH- interaction studies in organic solvents

In this work we report the obtention of a tetrabutylammonium hydroxide (TBAOH) solution in acetonitrile in a one pot process in order to study the interaction ironporphyrinOH- in non-aqueous systems. All the reactions were carried out under dry argon atmosphere to prevent the contamination of the solution with CO2, which leads to the formation of (TBA)2CO3.

Pilarização de esmectita brasileira para fins catalíticos. Emprego de argila pilarizada na alquilação de benzeno com 1-dodeceno

Al-pillared clay was prepared with a Brazilian bentonite from the Campina Grande region (Paraíba, BRAZIL). It was intercalated at 298 K, during 48 hours, with a solution containing [Al3+] = 0.10 mol/L and molar ratio OH/Al = 2.0 prepared at 333 K, and was calcined at 773K. The catalytic activity was evaluated by alkylation of benzene with 1-dodecene. The characterization methods were: X-ray fluorescence and diffraction analysis; 27Al, 29Si and 23Na MAS NMR and textural analysis by N2 adsorption. The thermal stability of the natural clay was improved by the pillaring procedure, as well as the catalytic activity. The intercalated clay presented the highest initial rate of reaction among the systems tested.

Chemical characterization of tin-lead glazed pottery from the Iberian Peninsula and the Canary Islands: initial steps toward a better understanding of Spanish Colonial pottery in Americas

Majolica pottery was the most characteristic tableware produced in Europe during the Medieval and Renaissance periods. Because of the prestige and importance attributed to this ware, Spanish majolica was imported in vast quantities into the Americas during the Spanish Colonial period. A study of Spanish majolica was conducted on a set of 186 samples from the 10 primary majolica production centres on the Iberian Peninsula and 22 sherds from two early colonial archaeological sites on the Canary Islands. The samples were analysed by neutron activation analysis (NAA), and the resulting data were interpreted using an array of multivariate statistical approaches. Our results show a clear discrimination between different production centres, allowing a reliable provenance attribution of the sherds from the Canary Islands.

Desproporcionamento de tolueno sobre zeólitas tipo mordenita - atividade e seletividade na obtenção de xilenos

A sodium mordenite zeolite (Na-MOR) was synthesized and modified by dealumination with chloridric acid solution (H-MOR). X-Ray Diffraction (XRD), Inductive Coupled Plasm (ICP) and Scanning Electron Micrograph (SEM) techniques were used for sample characterization. The zeolite catalytic behavior was evaluated through toluene disproportionation at 435°C. It was verified that mordenites were very selective for the disproportionation reaction and the samples with higher aluminum content showed larger initial activity, however, these samples showed too a higher deactivation velocity due to a blockage of the unidimensional porous system of the zeolite by coke deposits. The selectivity to xylene isomers was practically not influenced by the Si/Al ratio and changed with the time on stream, due to coke formation. Transition state shape selectivity inside the mordenite pores is also discussed.

Substâncias húmicas: sistema de fracionamento sequencial por ultrafiltração com base no tamanho molecular

A sequential system for fractionation by ultrafiltration (SSFU) equipped with advanced membranes filters (molecular size cut-off: 5, 10, 30, 50 and 100 kDalton) of the polyethersulfone type was developed for analytical fractionation of humic substances (HS) extracted from aquatic systems or soils. The device consists of five membrane filters (Sartocon® Micro) operated by a multi-channel peristaltic pump, enabling an easy handling, working in a closed system and with simple collection of the six obtained fractions (F1>100; F2: 100-50; F3: 50-30; F4:30-10; F5: 10-5 and F6 <5 kDalton). Then, the HS sample (250 mL solution 1.0 mg/mL, pH 5.0 to 6.0) to be fractionated is pumped by pump through the series of membrane filters with a tangential flow of 85 mL/min, initial pressure 0.2 to 0.3 bar and permeation flux through the membranes of 0.8 to 1.4 mL/min. The overall time for fractionation and cleaning of the device is about 10 h and 25 mL of each fraction is obtained.