Transcranial Doppler for predicting delayed cerebral ischemia after subarachnoid hemorrhage.

OBJECTIVE: Transcranial Doppler (TCD) is widely used to monitor the temporal course of vasospasm after subarachnoid hemorrhage (SAH), but its ability to predict clinical deterioration or infarction from delayed cerebral ischemia (DCI) remains controversial. We sought to determine the prognostic utility of serial TCD examination after SAH. METHODS: We analyzed 1877 TCD examinations in 441 aneurysmal SAH patients within 14 days of onset. The highest mean blood flow velocity (mBFV) value in any vessel before DCI onset was recorded. DCI was defined as clinical deterioration or computed tomographic evidence of infarction caused by vasospasm, with adjudication by consensus of the study team. Logistic regression was used to calculate adjusted odds ratios for DCI risk after controlling for other risk factors. RESULTS: DCI occurred in 21% of patients (n = 92). Multivariate predictors of DCI included modified Fisher computed tomographic score (P = 0.001), poor clinical grade (P = 0.04), and female sex (P = 0.008). After controlling for these variables, all TCD mBFV thresholds between 120 and 180 cm/s added a modest degree of incremental predictive value for DCI at nearly all time points, with maximal sensitivity by SAH day 8. However, the sensitivity of any mBFV more than 120 cm/s for subsequent DCI was only 63%, with a positive predictive value of 22% among patients with Hunt and Hess grades I to III and 36% in patients with Hunt and Hess grades IV and V. Positive predictive value was only slightly higher if mBFV exceeded 180 cm/s. CONCLUSION: Increased TCD flow velocities imply only a mild incremental risk of DCI after SAH, with maximal sensitivity by day 8. Nearly 40% of patients with DCI never attained an mBFV more than 120 cm/s during the course of monitoring. Given the poor overall sensitivity of TCD, improved methods for identifying patients at high risk for DCI after SAH are needed.

Suitability of Ultra Wideband for Mobile Devices

Mobiililaitteet ovat kehittyneet merkittävästi viimeisen vuosikymmenen aikana. Ne eivät enää ole pelkästään puhelimia tai kämmentietokoneita, vaan multimediatietokoneita, jotka pystyvät tuottamaan korkealaatuisia elämyksiä käyttäjälleen.Sisällön laadun paraneminen johtaa väistämättä myös siirrettävän tietomäärän kasvamiseen. Siksi uusia, nopeampia tiedonsiirtomenetelmiä on otettava käyttöön. Ultra Wideband (UWB) on uusi radioaaltotekniikka, jokamahdollistaa korkeat tiedonsiirtonopeudet lyhyillä etäisyyksillä. Tekniikka operoi erittäin leveällä 3.1 - 10.6 gigahertsin taajuuskaistalla.UWB on suunnattu nopeaan, langattomaan tiedonsiirtoon personal area networkin (PAN) laitteiden välillä. Tämän diplomityön tarkoituksena on arvioida UWBn soveltuvuutta mobiililaitteisiin. Arviointi tehdään teoreettiselta pohjalta, sillä UWBtä ei vielä ole implementoitu kaupallisiin laitteisiin. Ensin esitellään UWBn tekniikka ja ominaisuudet, jonka jälkeen sen soveltuvuutta arvioidaan esimerkkikäyttötapausten valossa. Esimerkkikäyttötapauksiksi on valittu kolme tyypillistä mutta erilaista toimintoa, jotka mahdollisimman hyvin kuvaavat mobiililaitteiden käyttöä.

Mudanças na ultra-estrutura da parede celular de mangas 'Tommy Atkins' tratadas com cloreto de cálcio na pré-colheita

Mangas 'Tommy Atkins' produzidas na região de Ibirá, São Paulo, foram pulverizadas na pré-colheita com cloreto de cálcio, nas concentrações de 0,0%, 2,5% e 5,0%, em três épocas de seu desenvolvimento (40; 60 e 90 dias após a floração) a fim de verificar a influência do cálcio na estrutura da parede celular destes frutos através de microscopia eletrônica de transmissão, imediatamente após a colheita e depois de 35 dias de armazenamento. Para fixar o material da polpa, utilizou-se metodologia descrita por Jacob e Gowanlock (1995). Nas condições experimentais, verificou-se que os frutos do tratamento-controle (sem cloreto de cálcio), no dia da colheita, já apresentavam desestruturação da parede celular e dissolução da lamela média (LM). A degradação da parede celular ocorre inicialmente na LM, levando à formação de espaços vazios bastante distintos, apresentando uma dissolução ainda maior, com o armazenamento prolongado (35 dias). Os frutos tratados com cloreto de cálcio a 5,0% apresentaram uma LM bem definida e ausência de espaços vazios, mesmo após o armazenamento, mostrando ser uma concentração efetiva na preservação da lamela média.

Ultra-low dose - new approaches in menopausal hormone therapy.

Despite increasing life expectancy, the age of onset of natural menopause has not significantly changed in recent decades. Thus, women spend about one-third of their lives in an estrogen-deficient state if untreated. There is a need for appropriate treatment of acute symptoms and prevention of the sequelae of chronic estrogen deficiency. International guidelines call for the use of the lowest effective hormone dosage for vasomotor symptom relief, the major indication for menopausal hormone therapy (MHT). In 2011, an oral continuous combined ultra-low-dose MHT was approved in Switzerland. This publication was elaborated by eight national menopause specialists and intends to review the advantages and disadvantages of ultra-low-dose MHT after the first years of its general use in Switzerland. It concludes that, for many women, ultra-low-dose MHT may be sufficient to decrease vasomotor symptoms, but not necessarily to guarantee fracture prevention.