973 resultados para MANIFESTACIONES EXTRA ARTICULARES
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SIN FINANCIACIÓN
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Ce mémoire de recherche-création porte sur les fonctions extra-narratives telles que définies par Gérard Genette, soit les fonctions de régie, testimoniale, de communication et idéologique, dans le contexte d’un récit à narrateurs multiples. Deux approches ont été privilégiées ici : l’écriture d’un roman comportant plusieurs instances de narration, et l’analyse d’un roman offrant un type comparable de structure narrative, soit Trou de mémoire d’Hubert Aquin. Ainsi, la partie création comprend des extraits d’Horions, roman hybride combinant les formes romanesque, poétique et dramatique, et dont ne figurent dans ce mémoire que des extraits des passages romanesques. Une instance narrative d’abord anonyme, puis nommée à la toute fin, retrace son passé en prêtant une voix à des êtres qui l’habitent, notamment un homme violent et un fils aphasique. Ces personnages-narrateurs exercent, outre la fonction narrative, d’autres fonctions qui justifient en quelque sorte leur présence : l’un est témoin de l’intrigue qu’il rapporte, l’autre communique avec un narrataire intra-diégétique, un troisième rend compte des émotions du protagoniste… Quant à la partie réflexion, elle se fonde sur les notions de narrateur, de narrataire et de situation narrative, mais se concentre sur les fonctions extra-narratives exercées par les diverses instances prenant la parole au fil du récit. Ces notions permettent de rendre compte de la structure narrative d’ensemble du roman Trou de mémoire d’Hubert Aquin, lequel juxtapose plusieurs voix, soit celles de Pierre X. Magnant, Rachel Ruskin, Olympe Ghezzo-Quénum et Charles-Édouard Mullahy. Un bref retour sur l’écriture d’Horions et sur les enjeux du récit à plusieurs narrateurs se prévalant des diverses fonctions extra-narratives complète la démarche.
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In Brazil, the production of cowpea is concentrated in the Northeast and North; however, in recent years, its cultivation has expanded to the Cerrado biome of the Brazilian Midwest region, where it is incorporated into production arrangements in the form of off-season
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No presenta resumen este articulo.
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Caviro Extra è un’azienda con sede a Faenza, impegnata nella lavorazione dei sottoprodotti derivanti dalla vinificazione e nella produzione di energia sostenibile ottenuta sia dai propri scarti di lavorazione che da rifiuti agroalimentari di aziende terze. Lo stabilimento svolge autonomamente il trattamento dei reflui abbattendo le sostanze inquinanti e permettendo così lo scarico in pubblica fognatura. Lo scopo della tesi è quello di studiare la fattibilità, tramite lo studio bibliografico, dell’implementazione di un bioreattore aerobico a membrana (MBR) come soluzione impiantistica atta a fronteggiare l’alto carico idraulico ed ammoniacale gestito durante il periodo della campagna di vinificazione. In un’ottica di sostenibilità ambientale si è presentato un secondo scopo , cioè quello di andare a recuperare le acque reflue tramite osmosi inversa. Dallo studio di letteratura scientifica riguardo la capacità di nitrificazione del bioreattore a membrana si hanno risultati favorevoli. Indicando tale sistema come una soluzione efficiente e stabile che può essere applicata nella nitrificazione di acque reflue contenenti un’alta concentrazione di azoto ammoniacale. L’integrazione di un sistema MBR con un’osmosi inversa ha, altresì, dimostrato miglioramenti ulteriori della qualità dell'acqua trattata; dimostrando di fornire un’alta reiezione di nitrato come di cloruri e di solfati ad alta concentrazione iniziale come nel caso in esame e di poter essere la soluzione impiantistica per alleggerire il carico ammoniacale al settore biologico e allo stesso tempo recuperare acqua riducendo la necessità di emungimento da pozzi artesiani. L’azienda verificherà mediante l’attività di testing la reale fattibilità in termini di potenziale miglioramento di depurazione, costi operativi e semplicità di gestione attraverso l’implementazione di impianti pilota sia sulla tecnologia analizzata (MBR+RO) sia su un processo MBBR di tipo ibrido fango attivo/biomassa adesa.
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Nel corso degli ultimi anni si è assistito ad un aumento di episodi fraudolenti nel settore alimentare. Ciò è vero anche per il settore oleario: per il suo elevato valore economico, nutrizionale e sensoriale, l’olio extra vergine di oliva è un bersaglio perfetto dei frodatori, che realizzano molteplici tipologie di adulterazione. Questo lavoro di tesi si è focalizzato, in particolare, sull’adulterazione dell’olio extra vergine di oliva con olio di semi di girasole. Su campioni preparati in laboratorio per simulare la frode, a partire da due oli extra vergini di oliva addizionati con percentuali diverse di olio di girasole, sono state effettuate determinazioni analitiche utilizzando un sensore spettrale, basato sulla spettroscopia nel vicino infrarosso, seguite da un’elaborazione chemiometrica dei risultati. Lo strumento portatile è stato sviluppato da una start-up olandese presso cui ho svolto il tirocinio curriculare. Il modello di stima risultante dalle risposte fornite dai 16 pixel del sensore ha mostrato una capacità di rilevazione soddisfacente nei confronti di questa adulterazione, conducendo ad un errore medio nella stima della percentuale di olio di girasole aggiunto intorno al 3%. Tale risultato, se verrà confermato da ulteriori analisi grazie alle quali il modello predittivo potrà essere reso più robusto, potrebbe incoraggiare l’utilizzo di questa metodologia analitica come tecnica rapida di screening, facilmente applicabile anche in un contesto industriale, a supporto delle più laboriose e complesse tecniche analitiche tradizionali, nella rilevazione di adulterazioni di oli extra vergini di oliva con oli di semi di girasole.
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Dalla letteratura si evince come, in una gravidanza fisiologica, il parto extra ospedaliero sia un’alternativa sicura, al pari dell’assistenza ospedaliera. In Italia avviene in una bassa percentuale di casi, nonostante sul territorio siano presenti strutture per poter attuare questa scelta. Un piccolo aumento è avvenuto negli ultimi due anni probabilmente dovuto anche alla pandemia da Covid. In particolare in Emilia Romagna, sono state indagate le informazioni e le modalità che i servizi territoriali e ospedalieri offrono alle gestanti in merito ai luoghi del parto. Un secondo obiettivo è stato capire, tramite le testimonianze delle donne, come avessero reperito le informazioni e a chi si fossero rivolte per la pianificazione del parto. Si è posta l’attenzione sull’opinione di Ostetric* del SSN circa il parto extra ospedaliero. Sono state effettuate 8 interviste semi-strutturate, e raccolti 27 questionari tra Ostetriche operanti nei Consultori e nei punti nascita ospedalieri. È stata raccolta, inoltre, l’opinione di 62 donne che hanno partorito in ambiente extra ospedaliero. I dati sono stati utilizzati in forma anonima. Dallo studio emerge la necessità di ampliare gli spazi e i tempi dedicati alla scelta del luogo del parto al fine di offrire alle coppie ogni alternativa possibile; le Ostetriche e le donne coinvolte suggeriscono diversi metodi per facilitare la conoscenza e il contatto con la realtà extra ospedaliera: da una più ampia diffusione di informazioni da parte delle strutture del SSN a momenti di formazione condivisa con chi opera a domicilio o in casa di Maternità. Le donne sottolineano la difficoltà di reperire informazioni dettagliate e di come la scelta sia spesso influenzata da pregiudizi. I consultori dovrebbero fornire informazioni dettagliate su tutti i luoghi del parto a tutte le donne per permettere una scelta libera da opinioni soggettive. Dovrebbero essere presi accordi specifici tra chi pratica l’assistenza in ospedale e chi in altri ambiti.
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A imagem descreve o processo de trabalho do cirurgião-dentista no contexto da Estratégia Saúde da Família, no cenário extra-clínica. Descreve os grupos prioritários, como deve ser organizado o acolhimento, menciona as principais atividades clínicas e cita instituições para referência e a contra-referência.
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Clozapine displays stronger systemic metabolic side effects than haloperidol and it has been hypothesized that therapeutic antipsychotic and adverse metabolic effects of these drugs are related. Considering that cerebral disconnectivity through oligodendrocyte dysfunction has been implicated in schizophrenia, it is important to determine the effect of these drugs on oligodendrocyte energy metabolism and myelin lipid production. Effects of clozapine and haloperidol on glucose and myelin lipid metabolism were evaluated and compared in cultured OLN-93 oligodendrocytes. First, glycolytic activity was assessed by measurement of extra- and intracellular glucose and lactate levels. Next, the expression of glucose (GLUT) and monocarboxylate (MCT) transporters was determined after 6 and 24 h. And finally mitochondrial respiration, acetyl-CoA carboxylase, free fatty acids, and expression of the myelin lipid galactocerebroside were analyzed. Both drugs altered oligodendrocyte glucose metabolism, but in opposite directions. Clozapine improved the glucose uptake, production and release of lactate, without altering GLUT and MCT. In contrast, haloperidol led to higher extracellular levels of glucose and lower levels of lactate, suggesting reduced glycolysis. Antipsychotics did not alter significantly the number of functionally intact mitochondria, but clozapine enhanced the efficacy of oxidative phosphorylation and expression of galactocerebroside. Our findings support the superior impact of clozapine on white matter integrity in schizophrenia as previously observed, suggesting that this drug improves the energy supply and myelin lipid synthesis in oligodendrocytes. Characterizing the underlying signal transduction pathways may pave the way for novel oligodendrocyte-directed schizophrenia therapies.
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Brazilian epidemiological studies on rheumatoid arthritis are scarce, mainly in the northeast; thus many data currently available originate from the international literature. To describe demographic, clinical and serological characteristics of patients with rheumatoid arthritis (RA) followed-up by the same physician, in state of Piauí, Brazil. Data were collected between August 2010 and March 2013, in three health services of Piauí that provided health care in Rheumatology: a university-affiliated hospital, a public outpatient clinic and a private clinic. The numbers represent mean ± SD or percentage: 47.5±11.03 years-old non-Caucasian woman, non-smoker (59.2%), low educational level, mean disease duration of 7.7 years ± 7.6, and major extra-articular manifestations were rheumatoid nodules (19.4%) and sicca syndrome (46.9%). Features of rheumatoid arthritis obtained in this study are similar to those found in some national and international studies, but we observed higher female preponderance and illiteracy rate, in addition to a moderately severe erosive disease on average, with frequent sicca and other extra-articular manifestations.
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The objectives of the study were to evaluate the performance of sentinel lymph node biopsy (SLNB) in detecting occult metastases in papillary thyroid carcinoma (PTC) and to correlate their presence to tumor and patient characteristics. Twenty-three clinically node-negative PTC patients (21 females, mean age 48.4 years) were prospectively enrolled. Patients were submitted to sentinel lymph node (SLN) lymphoscintigraphy prior to total thyroidectomy. Ultrasound-guided peritumoral injections of (99m)Tc-phytate (7.4 MBq) were performed. Cervical single-photon emission computed tomography and computed tomography (SPECT/CT) images were acquired 15 min after radiotracer injection and 2 h prior to surgery. Intra-operatively, SLNs were located with a gamma probe and removed along with non-SLNs located in the same neck compartment. Papillary thyroid carcinoma, SLNs and non-SLNs were submitted to histopathology analysis. Sentinel lymph nodes were located in levels: II in 34.7 % of patients; III in 26 %; IV in 30.4 %; V in 4.3 %; VI in 82.6 % and VII in 4.3 %. Metastases in the SLN were noted in seven patients (30.4 %), in non-SLN in three patients (13.1 %), and in the lateral compartments in 20 % of patients. There were significant associations between lymph node (LN) metastases and the presence of angio-lymphatic invasion (p = 0.04), extra-thyroid extension (p = 0.03) and tumor size (p = 0.003). No correlations were noted among LN metastases and patient age, gender, stimulated thyroglobulin levels, positive surgical margins, aggressive histology and multifocal lesions. Sentinel lymph node biopsy can detect occult metastases in PTC. The risk of a metastatic SLN was associated with extra-thyroid extension, larger tumors and angio-lymphatic invasion. This may help guide future neck dissection, patient surveillance and radioiodine therapy doses.
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Obesity is increasing worldwide and is triggered, at least in part, by enhanced caloric intake. Food intake is regulated by a complex mechanism involving the hypothalamus and hindbrain circuitries. However, evidences have showing that reward systems are also important in regulating feeding behavior. In this context, amygdala is considered a key extra-hypothalamic area regulating feeding behavior in human beings and rodents. This review focuses on the regulation of food intake by amygdala and the mechanisms of insulin resistance in this brain area. Similar to the hypothalamus the anorexigenic effect of insulin is mediated via PI3K (phosphoinositide 3-kinase)/Akt (protein kinase B) pathway in the amygdala. Insulin decreases NPY (neuropeptide Y) and increases oxytocin mRNA levels in the amygdala. High fat diet and saturated fatty acids induce inflammation, ER (endoplasmic reticulum) stress and the activation of serine kinases such as PKCθ (protein kinase C theta), JNK (c-Jun N-terminal kinase) and IKKβ (inhibitor of nuclear factor kappa-B kinase beta) in the amygdala, which have an important role in insulin resistance in this brain region. Overexpressed PKCθ in the CeA (central nucleus of amygdala) of rats increases weight gain, food intake, insulin resistance and hepatic triglycerides content. The inhibition of ER stress ameliorates insulin action/signaling, increases oxytocin and decreases NPY gene expression in the amygdala of high fat feeding rodents. Those data suggest that PKCθ and ER stress are main mechanisms of insulin resistance in the amygdala of obese rats and play an important role regulating feeding behavior.
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To evaluate the sparing of fertility and ovaries in women submitted to surgical treatment for benign adnexal tumors. Between February 2010 and January 2014, 206 patients were included in this observational study as they were submitted to surgical treatment for benign ovarian tumors at CAISM, a tertiary hospital. Fertility sparing surgery was defined as tumorectomy or unilateral salpingoophorectomy without hysterectomy in premenopausal women. Preservation of the ovary occurred when at least one ovary or part of it was mantained. Of the 206 women with benign tumors, 120 (58%) were premenopausal and 86 (42%) were postmenopausal. There were 36 (30%) ovarian germ cell tumors, 31 (26%) epithelial neoplasms and 11 (9%) sex-cord stromal tumors among premenopausal women. In the group of postmenopausal women, 35 (41%) epithelial neoplasms, 27 (31%) sex-cord stromal tumors and 8 (9%) ovarian germ cell tumors were identified. Among 36 women with non-neoplastic ovarian tumors, 21 (58%) had endometriomas and 8 (22%) functional cysts. Among 22 women with extra-ovarian tumors, uterine leiomyomatosis was the most frequent finding (50%). In the group of women who were ≤ 35 years old, 26 (57%) were treated by tumorectomy and 18 (39%) were submitted to unilateral salpingoophorectomy with sparing of the uterus and the contralateral ovary. Women who were ≤ 35 years old were more frequently operated by laparoscopy which was associated with a higher number of fertility sparing procedures when compared to laparotomy (p<0.01). Twenty-six (28%) women submitted to hysterectomy with bilateral salpingoophorectomy were premenopausal. Although there is a trend to perform only tumorectomy in women who are ≤ 35 years old, a significant number of young women is still treated by salpingoophorectomy. Among 36- to 45-year-old women, only 70% had their fertility spared, while 20% had both ovaries removed. However, whenever possible, we must try to preserve the ovaries, mainly in premenopausal women.
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Avian Pathogenic Escherichia coli (APEC) strains are extra-intestinal E. coli that infect poultry and cause diseases. Nitrite is a central branch-point in bacterial nitrogen metabolism and is used as a cytotoxin by macrophages. Unlike nitric oxide (NO), nitrite cannot diffuse across bacterial membrane cells. The NirC protein acts as a specific channel to facilitate the transport of nitrite into Salmonella and E. coli cells for nitrogen metabolism and cytoplasmic detoxification. NirC is also required for the pathogenicity of Salmonella by downregulating the production of NO by the host macrophages. Based on an in vitro microarray that revealed the overexpression of the nirC gene in APEC strain SCI-07, we constructed a nirC-deficient SCI-07 strain (ΔnirC) and evaluated its virulence potential using in vivo and in vitro assays. The final cumulative mortalities caused by mutant and wild-type (WT) were similar; while the ΔnirC caused a gradual increase in the mortality rate during the seven days recorded, the WT caused mortality up to 24h post-infection (hpi). Counts of the ΔnirC cells in the spleen, lung and liver were higher than those of the WT after 48 hpi but similar at 24 hpi. Although similar number of ΔnirC and WT cells was observed in macrophages at 3 hpi, there was higher number of ΔnirC cells at 16 hpi. The cell adhesion ability of the ΔnirC strain was about half the WT level in the presence and absence of alpha-D-mannopyranoside. These results indicate that the nirC gene influences the pathogenicity of SCI-07 strain.