921 resultados para Tumeur invasive (TOV)
Resumo:
Invasive candidiasis (IC) is an opportunistic systemic mycosis caused by Candida species (commonly Candida albicans) that continues to pose a significant public health problem worldwide. Despite great advances in antifungal therapy and changes in clinical practices, IC remains a major infectious cause of morbidity and mortality in severely immunocompromised or critically ill patients, and further accounts for substantial healthcare costs. Its impact on patient clinical outcome and economic burden could be ameliorated by timely initiation of appropriate antifungal therapy. However, early detection of IC is extremely difficult because of its unspecific clinical signs and symptoms, and the inadequate accuracy and time delay of the currently available diagnostic or risk stratification methods. In consequence, the diagnosis of IC is often attained in advanced stages of infection (leading to delayed therapeutic interventions and ensuing poor clinical outcomes) or, unfortunately, at autopsy. In addition to the difficulties encountered in diagnosing IC at an early stage, the initial therapeutic decision-making process is also hindered by the insufficient accuracy of the currently available tools for predicting clinical outcomes in individual IC patients at presentation. Therefore, it is not surprising that clinicians are generally unable to early detect IC, and identify those IC patients who are most likely to suffer fatal clinical outcomes and may benefit from more personalized therapeutic strategies at presentation. Better diagnostic and prognostic biomarkers for IC are thus needed to improve the clinical management of this life-threatening and costly opportunistic fungal infection...
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This study aimed to identify physiological markers in superficially scalded 'Rocha' pear (Pyrus communis L 'Rocha') that would relate to chlorophyll a fluorescence (CF), allowing a non-invasive diagnosis of the disorder. Conditions chosen before shelf life provided two fruit groups with different developing patterns and severity of superficial scald: T fruit fully developed the disorder in storage, while C fruit developed it progressively throughout shelf life. Principal component analysis (PCA) of all the measured variables, and simple linear correlations among several major parameters and scald index (SI)/shelf life showed that scald and ripening/aging were concurring processes, and that it was not possible to isolate a particular variable that could deliver a direct non-invasive diagnosis of the disorder. For both fruit groups the SI resulted from the balance between the reducing power (OD200) and the content of conjugated trienols (CTos) and alpha-farnesene (alpha-Farn) in the fruit peel. At OD200 > 150 there was a linear relationship between CTos and OD200, suggesting that the level of antioxidants was self-adjusted in order to compensate the CTos level. However, at OD200 < 150 this relationship disappeared. A consistent linear relationship between dos and alpha-Farn existed throughout shelf life in both fruit groups, contrarily to the early storage stage, when those compounds do not relate linearly. The CF variables F-0, F-v/F-m, and the colorimetric variables, L* and h degrees were used in multi-linear regressions with other physiological variables. The regressions were made on one of the fruit groups and validated through the other. Reliable regressions to alpha-Farn and CTos were obtained (R approximate to 0.6; rmsec approximate to rmsep). Our results suggest that a model based on CF and colorimetric parameters could be used to diagnose non-invasively both the contents and the relationship between alpha-Farn and CTos and hence the stage of scald development. (C) 2011 Elsevier By. All rights reserved.
Resumo:
This study aimed to identify physiological markers in superficially scalded 'Rocha' pear (Pyrus communis L 'Rocha') that would relate to chlorophyll a fluorescence (CF), allowing a non-invasive diagnosis of the disorder. Conditions chosen before shelf life provided two fruit groups with different developing patterns and severity of superficial scald: T fruit fully developed the disorder in storage, while C fruit developed it progressively throughout shelf life. Principal component analysis (PCA) of all the measured variables, and simple linear correlations among several major parameters and scald index (SI)/shelf life showed that scald and ripening/aging were concurring processes, and that it was not possible to isolate a particular variable that could deliver a direct non-invasive diagnosis of the disorder. For both fruit groups the SI resulted from the balance between the reducing power (OD200) and the content of conjugated trienols (CTos) and alpha-farnesene (alpha-Farn) in the fruit peel. At OD200 > 150 there was a linear relationship between CTos and OD200, suggesting that the level of antioxidants was self-adjusted in order to compensate the CTos level. However, at OD200 < 150 this relationship disappeared. A consistent linear relationship between dos and alpha-Farn existed throughout shelf life in both fruit groups, contrarily to the early storage stage, when those compounds do not relate linearly. The CF variables F-0, F-v/F-m, and the colorimetric variables, L* and h degrees were used in multi-linear regressions with other physiological variables. The regressions were made on one of the fruit groups and validated through the other. Reliable regressions to alpha-Farn and CTos were obtained (R approximate to 0.6; rmsec approximate to rmsep). Our results suggest that a model based on CF and colorimetric parameters could be used to diagnose non-invasively both the contents and the relationship between alpha-Farn and CTos and hence the stage of scald development. (C) 2011 Elsevier By. All rights reserved.
Resumo:
Objective: This study aims at determining if a collection of 16 motor tests on a physical simulator can objectively discriminate and evaluate practitioners' competency level, i.e. novice, resident, and expert. Methods: An experimental design with three study groups (novice, resident, and expert) was developed to test the evaluation power of each of the 16 simple tests. An ANOVA and a Student Newman-Keuls (SNK) test were used to analyze results of each test to determine which of them can discriminate participants' competency level. Results: Four of the 16 tests used discriminated all of the three competency levels and 15 discriminated at least two of the three groups (α= 0.05). Moreover, other two tests differentiate beginners\' level from intermediate, and other seven tests differentiate intermediate level from expert. Conclusion: The competency level of a practitioner of minimally invasive surgery can be evaluated by a specific collection of basic tests in a physical surgical simulator. Reduction of the number of tests needed to discriminate the competency level of surgeons can be the aim of future research.
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Introduction: La ventilation non invasive (VNI) est un outil utilisé en soins intensifs pédiatriques (SIP) pour soutenir la détresse respiratoire aigüe. Un échec survient dans près de 25% des cas et une mauvaise synchronisation patient-ventilateur est un des facteurs impliqués. Le mode de ventilation NAVA (neurally adjusted ventilatory assist) est asservi à la demande ventilatoire du patient. L’objectif de cette étude est d’évaluer la faisabilité et la tolérance des enfants à la VNI NAVA et l’impact de son usage sur la synchronie et la demande respiratoire. Méthode: Étude prospective, physiologique, croisée incluant 13 patients nécessitant une VNI dans les SIP de l’hôpital Ste-Justine entre octobre 2011 et mai 2013. Les patients ont été ventilés successivement en VNI conventionnelle (30 minutes), en VNI NAVA (60 minutes) et en VNI conventionnelle (30 minutes). L’activité électrique du diaphragme (AEdi) et la pression des voies aériennes supérieures ont été enregistrées pour évaluer la synchronie. Résultats: La VNI NAVA est faisable et bien tolérée chez tous les enfants. Un adolescent a demandé l’arrêt précoce de l’étude en raison d’anxiété reliée au masque sans fuite. Les délais inspiratoires et expiratoires étaient significativement plus courts en VNI NAVA comparativement aux périodes de VNI conventionnelle (p< 0.05). Les efforts inefficaces étaient moindres en VNI NAVA (résultats présentés en médiane et interquartiles) : 0% (0 - 0) en VNI NAVA vs 12% (4 - 20) en VNI conventionnelle initiale et 6% (2 - 22) en VNI conventionnelle finale (p< 0.01). Globalement, le temps passé en asynchronie a été réduit à 8% (6 - 10) en VNI NAVA, versus 27% (19 - 56) et 32% (21 - 38) en périodes de VNI conventionnelle initiale et finale, respectivement (p= 0.05). Aucune différence en termes de demande respiratoire n’a été observée. Conclusion: La VNI NAVA est faisable et bien tolérée chez les enfants avec détresse respiratoire aigüe et permet une meilleure synchronisation patient-ventilateur. De plus larges études sont nécessaires pour évaluer l’impact clinique de ces résultats.
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Human scent, or the volatile organic compounds (VOCs) produced by an individual, has been recognized as a biometric measurement because of the distinct variations in both the presence and abundance of these VOCs between individuals. In forensic science, human scent has been used as a form of associative evidence by linking a suspect to a scene/object through the use of human scent discriminating canines. The scent most often collected and used with these specially trained canines is from the hands because a majority of the evidence collected is likely to have been handled by the suspect. However, the scents from other biological specimens, especially those that are likely to be present at scenes of violent crimes, have yet to be explored. Hair, fingernails and saliva are examples of these types of specimens. In this work, a headspace solid phase microextraction gas chromatography-mass spectrometry (HS-SPME-GC-MS) technique was used for the identification of VOCs from hand odor, hair, fingernails and saliva. Sixty individuals were sampled and the profiles of the extracted VOCs were evaluated to assess whether they could be used for distinguishing individuals. Preliminary analysis of the biological specimens collected from an individual (intra-subject) showed that, though these materials have some VOCs in common, their overall chemical profile is different for each specimen type. Pair-wise comparisons, using Spearman Rank correlations, were made between the chemical profiles obtained from each subject, per a specimen type. Greater than 98.8% of the collected samples were distinguished from the subjects for all of the specimen types, demonstrating that these specimens can be used for distinguishing individuals. Additionally, field trials were performed to determine the utility of these specimens as scent sources for human scent discriminating canines. Three trials were conducted to evaluate hair, fingernails and saliva in comparison to hand odor, which was considered the standard source of human odor. It was revealed that canines perform similarly to these alternative human scent sources as they do to hand odor implying that, though there are differences in the chemical profiles released by these specimens, they can still be used for the discrimination of individuals by trained canines.
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Non-intrusive monitoring of health state of induction machines within industrial process and harsh environments poses a technical challenge. In the field, winding failures are a major fault accounting for over 45% of total machine failures. In the literature, many condition monitoring techniques based on different failure mechanisms and fault indicators have been developed where the machine current signature analysis (MCSA) is a very popular and effective method at this stage. However, it is extremely difficult to distinguish different types of failures and hard to obtain local information if a non-intrusive method is adopted. Typically, some sensors need to be installed inside the machines for collecting key information, which leads to disruption to the machine operation and additional costs. This paper presents a new non-invasive monitoring method based on GMRs to measure stray flux leaked from the machines. It is focused on the influence of potential winding failures on the stray magnetic flux in induction machines. Finite element analysis and experimental tests on a 1.5-kW machine are presented to validate the proposed method. With time-frequency spectrogram analysis, it is proven to be effective to detect several winding faults by referencing stray flux information. The novelty lies in the implement of GMR sensing and analysis of machine faults.
Resumo:
Introduction: La ventilation non invasive (VNI) est un outil utilisé en soins intensifs pédiatriques (SIP) pour soutenir la détresse respiratoire aigüe. Un échec survient dans près de 25% des cas et une mauvaise synchronisation patient-ventilateur est un des facteurs impliqués. Le mode de ventilation NAVA (neurally adjusted ventilatory assist) est asservi à la demande ventilatoire du patient. L’objectif de cette étude est d’évaluer la faisabilité et la tolérance des enfants à la VNI NAVA et l’impact de son usage sur la synchronie et la demande respiratoire. Méthode: Étude prospective, physiologique, croisée incluant 13 patients nécessitant une VNI dans les SIP de l’hôpital Ste-Justine entre octobre 2011 et mai 2013. Les patients ont été ventilés successivement en VNI conventionnelle (30 minutes), en VNI NAVA (60 minutes) et en VNI conventionnelle (30 minutes). L’activité électrique du diaphragme (AEdi) et la pression des voies aériennes supérieures ont été enregistrées pour évaluer la synchronie. Résultats: La VNI NAVA est faisable et bien tolérée chez tous les enfants. Un adolescent a demandé l’arrêt précoce de l’étude en raison d’anxiété reliée au masque sans fuite. Les délais inspiratoires et expiratoires étaient significativement plus courts en VNI NAVA comparativement aux périodes de VNI conventionnelle (p< 0.05). Les efforts inefficaces étaient moindres en VNI NAVA (résultats présentés en médiane et interquartiles) : 0% (0 - 0) en VNI NAVA vs 12% (4 - 20) en VNI conventionnelle initiale et 6% (2 - 22) en VNI conventionnelle finale (p< 0.01). Globalement, le temps passé en asynchronie a été réduit à 8% (6 - 10) en VNI NAVA, versus 27% (19 - 56) et 32% (21 - 38) en périodes de VNI conventionnelle initiale et finale, respectivement (p= 0.05). Aucune différence en termes de demande respiratoire n’a été observée. Conclusion: La VNI NAVA est faisable et bien tolérée chez les enfants avec détresse respiratoire aigüe et permet une meilleure synchronisation patient-ventilateur. De plus larges études sont nécessaires pour évaluer l’impact clinique de ces résultats.
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This PowerPoint presentation goes over the ways in which aquatics pest and weeds can be controlled.
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Résumé : Le carcinome hépatocellulaire (HCC) est la troisième cause commune de décès de cancer et affecte plus les hommes que les femmes. Le HCC résulte d’une dérégulation des voies de signalisation impliquées dans l’initiation de l’inflammation menant ainsi à des répercussions désastreuses. De part la complexité de ce type de cancer, les traitements qui existent à ce jour ne sont pas très prometteurs et ont un faible pourcentage de « rémission ». L’immunothérapie soulève beaucoup d’espoir quant à l’orientation vers un traitement efficace plausible. En effet, plusieurs suppresseurs de tumeur se retrouvent réprimés, parmi lesquels le SOCS1. C’est dans cette optique que nos recherches se sont orientées en mettant la lumière sur le SOCS1 «suppresseur de signalisation des cytokines 1 (SOCS1) » qui est réprimé au niveau du HCC et dont la restauration pourrait contribuer à un pronostic favorable à la rémission. La protéine SOCS1 a beaucoup attisé la curiosité des chercheurs de part son rôle suppresseur de tumeur. Pour comprendre les mécanismes d’action de SOCS1 et son implication dans la neutralisation de la tumeur, nous avons généré trois types stables de la lignée cellulaire du carcinome hépatocellulaire de souris Hepa1-6, une portant un vecteur vide, l’autre exprimant le type sauvage du gène SOCS1 (SOCS1-WT; Hepa-S) et une portant une mutation au niveau du domaine SH2 (SOCS1-R105K; Hepa-R). Le mutant ne peut plus inhiber la signalisation des cytokines. Lors de l'implantation sous-cutanée des cellules Hepa1-6 modifiées, chez des souris C57BL/6 et NOD.scid.gamma (NSG). Nous avons observé que les cellules Hepa1-6 exprimant le vecteur de contrôle (Hepa-V) formaient de grosses tumeurs tandis que les cellules Hepa-S formaient de petites tumeurs chez les deux types de souris. Les cellules Hepa-R quant à elles, formaient de grosses tumeurs seulement chez des souris immunodéficientes (NSG) mais montraient une croissance nettement retardée lorsqu’elles étaient greffées aux souris (C57BL/6) immunocompétentes. Partant de ce constat intrigant, nous avons postulé que SOCS1 favorise l'immunogénicité des cellules tumorales par son domaine SOCS Box. Par conséquent, les cellules Hepa-R offrent une occasion unique de démêler le potentiel pro-immunogène de SOCS1, et ceci dans le but d'élucider les fonctions immunogènes de SOCS1 dans le cancer du foie. Jusqu'à présent aucune précédente recherche ne s’est aventurée à chercher l’implication de SOCS1 dans l’augmentation de l’immunogénicité.
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A prospective randomised controlled clinical trial of treatment decisions informed by invasive functional testing of coronary artery disease severity compared with standard angiography-guided management was implemented in 350 patients with a recent non-ST elevation myocardial infarction (NSTEMI) admitted to 6 hospitals in the National Health Service. The main aims of this study were to examine the utility of both invasive fractional flow reserve (FFR) and non-invasive cardiac magnetic resonance imaging (MRI) amongst patients with a recent diagnosis of NSTEMI. In summary, the findings of this thesis are: (1) the use of FFR combined with intravenous adenosine was feasible and safe amongst patients with NSTEMI and has clinical utility; (2) there was discordance between the visual, angiographic estimation of lesion significance and FFR; (3). The use of FFR led to changes in treatment strategy and an increase in prescription of medical therapy in the short term compared with an angiographically guided strategy; (4) in the incidence of major adverse cardiac events (MACE) at 12 months follow up was similar in the two groups. Cardiac MRI was used in a subset of patients enrolled in two hospitals in the West of Scotland. T1 and T2 mapping methods were used to delineate territories of acute myocardial injury. T1 and T2 mapping were superior when compared with conventional T2-weighted dark blood imaging for estimation of the ischaemic area-at-risk (AAR) with less artifact in NSTEMI. There was poor correlation between the angiographic AAR and MRI methods of AAR estimation in patients with NSTEMI. FFR had a high accuracy at predicting inducible perfusion defects demonstrated on stress perfusion MRI. This thesis describes the largest randomized trial published to date specifically looking at the clinical utility of FFR in the NSTEMI population. We have provided evidence of the diagnostic and clinical utility of FFR in this group of patients and provide evidence to inform larger studies. This thesis also describes the largest ever MRI cohort, including with myocardial stress perfusion assessments, specifically looking at the NSTEMI population. We have demonstrated the diagnostic accuracy of FFR to predict reversible ischaemia as referenced to a non-invasive gold standard with MRI. This thesis has also shown the futility of using dark blood oedema imaging amongst all comer NSTEMI patients when compared to novel T1 and T2 mapping methods.