996 resultados para R-TORSION
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[Traditions. Europe. Grèce]
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[Traditions. Europe. Grèce]
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[Traditions. Europe. Grèce]
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[Mazarinade. 1649]
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BACKGROUND: In a simulation based on a pharmacokinetic model we demonstrated that increasing the erythropoiesis stimulating agents (ESAs) half-life or shortening their administration interval decreases hemoglobin variability. The benefit of reducing the administration interval was however lessened by the variability induced by more frequent dosage adjustments. The purpose of this study was to analyze the reticulocyte and hemoglobin kinetics and variability under different ESAs and administration intervals in a collective of chronic hemodialysis patients. METHODS: The study was designed as an open-label, randomized, four-period cross-over investigation, including 30 patients under chronic hemodialysis at the regional hospital of Locarno (Switzerland) in February 2010 and lasting 2 years. Four subcutaneous treatment strategies (C.E.R.A. every 4 weeks Q4W and every 2 weeks Q2W, Darbepoetin alfa Q4W and Q2W) were compared with each other. The mean square successive difference of hemoglobin, reticulocyte count and ESAs dose was used to quantify variability. We distinguished a short- and a long-term variability based respectively on the weekly and monthly successive difference. RESULTS: No difference was found in the mean values of biological parameters (hemoglobin, reticulocytes, and ferritin) between the 4 strategies. ESAs type did not affect hemoglobin and reticulocyte variability, but C.E.R.A induced a more sustained reticulocytes response over time and increased the risk of hemoglobin overshooting (OR 2.7, p = 0.01). Shortening the administration interval lessened the amplitude of reticulocyte count fluctuations but resulted in more frequent ESAs dose adjustments and in amplified reticulocyte and hemoglobin variability. Q2W administration interval was however more favorable in terms of ESAs dose, allowing a 38% C.E.R.A. dose reduction, and no increase of Darbepoetin alfa. CONCLUSIONS: The reticulocyte dynamic was a more sensitive marker of time instability of the hemoglobin response under ESAs therapy. The ESAs administration interval had a greater impact on hemoglobin variability than the ESAs type. The more protracted reticulocyte response induced by C.E.R.A. could explain both, the observed higher risk of overshoot and the significant increase in efficacy when shortening its administration interval.Trial registrationClinicalTrials.gov NCT01666301.
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The Iowa State Highway Commission has adopted a number of rigid safety requirements that the Bureau of Public Roads has set forth as standards for road construction. One of these safety requirements is the elimination of two piers on Interstate grade separations, thus leaving two long spans. These longer spans lower the ability of prestressed concrete beams to compete economically with steel beams. In an effort to be more competitive, the prestressing companies have been studying the use of lightweight aggregate in structural concrete.
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A number of concrete admixtures are presently used in various concretes principally for water reduction, retardation, or air entrainment. Whereas the use of these admixtures in concrete placement is well documented, there is limited information showing their effects on durability and drying shrinkage. Since the durability and the shrinkage of concrete can have a pronounce effect on a structures longevity, wear characteristics, and reaction to loading, it is desirable to know the relative effects of different admixtures prior to concrete placement. The purpose of this study is to provide information which could be used to establish durability and shrinkage criterion for evaluating the admixtures currently in use and those whose use may be proposed.
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Skid resistance is a major concern of the safety engineer since wet pavement conditions are present for approximately 18% of the total accidents in Iowa according to studies by the Traffic and Safety Department. Many of these accidents may be influenced by the low skid resistant quality of the pavement. The size, shape, type, and arrangement of the concrete's particles interrelate with each other in a complex manner to give us frictional resistance. The purpose of this investigation was to determine which method of texturing provides the best skid resistance properties on portland cement concrete pavement.
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The compressive strength of concrete is an important factor in the design of concrete structures and pavements. To assure the quality of the concrete placed at the project, concrete compressive cylinders are made at the jobsite. These cylinders undergo a destructive test to determine their compressive strength. However, the determination of concrete compressive strength of the concrete actually in the structure or pavement is frequently desirable. For this reason, a nondestructive test of the concrete is required. A nondestructive test of concrete compressive strength should be economical, easily performed by field personnel, and capable of producing accurate, reproducible results. The nondestructive test should be capable of detecting the extent of poor concrete in a pavement or structure due to improper handling, placement, or variations in mixing or materials.