La valeur prédictive et pronostique d’une faible expression des récepteurs d’oestrogènes en cancer du sein

L’objectif de ce projet fut d’évaluer le bénéfice associé à la thérapie antihormonale (TA) pour les cancers du sein avec des récepteurs d’estrogènes (ER) faiblement positifs (<10 fmol/mg de cytosol). Nous avons identifié 2221 patientes avec cancer du sein dont ER ont été évalués par méthode biochimique (Ligand-Based Assay ou LBA) de 1976 à 1995 et suivies jusqu’en 2008. Des modèles à risques proportionnels de Cox ont été utilisés pour évaluer l’impact des différents niveaux de ER sur la survie au cancer du sein chez les patientes ayant reçu ou non une TA. Parmi les 2221 patientes incluses dans l’étude, 661 (29,8%) ont reçu une TA. Chez celles avec TA, une diminution significative de la mortalité spécifique au cancer du sein n’a été démontrée que pour les niveaux de ER ≥10 fmol/mg de cytosol. Ainsi, ceci ne supporte pas une TA pour les cancers du sein faiblement positif pour ER testés en LBA.

Efficacité comparée du lavage pulmonaire thérapeutique par ventilation liquidienne totale et par solution diluée de surfactant exogène dans un modèle ovin de syndrome d’inhalation méconiale

Introduction : Le syndrome d’aspiration méconiale (SAM) est une pathologie respiratoire du nouveau-né qui, dans les cas les plus sévères, peut rester réfractaire aux traitements couramment utilisés et nécessiter in fine le recours à une oxygénation membranaire extracorporelle. Le développement d’un ventilateur liquidien par l’équipe Inolivent a ouvert une nouvelle voie thérapeutique en rendant possible l’utilisation de la ventilation liquidienne totale (VLT) qui utilise un perfluorocarbone liquide afin d’assurer les échanges gazeux tout en effectuant un lavage pulmonaire thérapeutique. En 2011, l’équipe Inolivent a montré la supériorité de la VLT pour retirer le méconium et assurer les échanges gazeux de façon plus efficace que le traitement contrôle, le lavage thérapeutique avec une solution diluée de surfactant exogène (S-LBA). À ce jour, il n’a jamais été montré la possibilité de ramener des agneaux en respiration spontanée au décours d’une VLT pour le traitement d’un SAM sévère. Les objectifs de cette étude sont i) montrer la possibilité de ramener des agneaux nouveau-nés en respiration spontanée sans aide respiratoire après le traitement d’un SAM sévère par VLT, ii) comparer l’efficacité avec le lavage par S-LBA. Méthodes : 12 agneaux nouveau-nés anesthésiés et curarisés ont été instrumentés chirurgicalement. Après l’induction d’un SAM sévère, les agneaux ont subi un lavage pulmonaire thérapeutique soit par VLT (n = 6) ou par S-LBA (n = 6). Les agneaux ont été sevrés de toute ventilation mécanique et suivit en respiration spontanée durant 36 h. Résultats : Il est possible de ramener en respiration spontanée des agneaux nouveau-nés traités par VLT pour le traitement d’un SAM sévère. Le temps nécessaire au sevrage de la ventilation mécanique conventionelle a été plus court chez le groupe S-LBA. Conclusion : Notre étude met en lumière pour la première fois connue à ce jour, la possibilité de ramener en respiration spontanée des agneaux nouveau-nés suivant une VLT dans le traitement d’un SAM sévère. Ces résultats très importants ouvrent la voie à des études sur l’utilisation de la VLT dans le traitement de détresses respiratoires aigües.

Psichological and behavioral problems among left-behind adolescents. The case of Ecuador

Objetivo: evaluar el impacto de la migración de los padres en el bienestar psicológico de los ado - lescentes en abandono (LBA) en el Ecuador. Ado - lescentes abandonados son quienes permanecen en su país de origen, mientras su (s) padre (s) mi - graron. Métodos: en un estudio Transversal, 659 adoles - centes de edad escolar (43% mujeres, con una edad media de 13.9 +- 1.2) llenaron los cuestio - narios de fortalezas y dificultades (SDQ), y deter - minantes socio-demográficos. Las estadísticas fue - ron utilizadas para comparar el impacto de los determinantes socio-demográficos en el grupo de adolescentes en abandono (LBA) y adolescentes en no abandono (NLBA). Resultados: El 46% de los (LBA) puntuaron sig - nificativamente más alto en el cuestionario (SDQ) que los (NLBA), especialmente las niñas. Los de - terminantes socio-demográficos fueron significa - tivamente asociados con menos problemas psico - lógicos, por ejemplo, hablando acerca de problemas personales y migración después de la edad de 5 años en LBA. Conclusiones: la migración de los padres tiene un impacto en el bienestar psicológico de los adolescentes en abandono en el Ecuador. Las ca - racterísticas socio-demográficas influencian dicho impacto. Este artículo enfatiza un importante y hasta ahora ignorado problema de salud publica en el Ecuador. Esto subraya la necesidad del des - arrollo de políticas de salud y una profunda in - vestigación

Preparo de amostras citológicas de efusões, lavados (broncoalveolar e peritoneal) e líquor pelo método “plasma-tromboplastina”

Dissertação (mestrado)—Universidade de Brasilia, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2016.

Brachycephalic obstructive airway syndrome : a review with six clinical cases

Dissertação de Mestrado Integrado em Medicina Veterinária

Landscape strategies in Bronze Age Southwestern Cyprus (2500-1100 B.C.)

This thesis concerns the analysis of the socio-economic transformation of communities in Bronze Age southwestern Cyprus. Through the adoption of a dialectical perspective of analysis, individuals and environment are considered part of the same unity: they are cooperating agents in shaping society and culture. The Bronze Age is a period of intense transformation in the organization of local communities, made of a continuous renegotiation of the socio-economic roles and interactions. The archaeological record from this portion of the island allows one to go beyond the investigation of the complex and articulated transition from the EBA-MBA agro-pastoral and self-sufficient communities to the LBA centralized and trade-oriented urban-centres. Through a shifting of analytical scales, the emerging picture suggests major transformations in the individual-community-territory dialectical relations. A profound change in the materials conditions of social life, as well as in the superstructural realm, was particularly entailed by the dissolution of the relation to the earth, due to the emergence of new forms of land exploitation/ownership and to the shift of the settlement pattern in previously unknown areas. One of the key points of this thesis is the methodological challenge of working with legacy survey data as I re-analysed a diverse archaeological legacy, which is the result of more than fifty years of survey projects, rescue and research-oriented excavations, as well as casual discoveries. Source critique and data evaluation are essential requirements in an integrative and cross-disciplinary regional perspective, in the comprehensive processing of heterogeneous archaeological and environmental datasets. Through the estimation of data precision and certainty, I developed an effective - but simple - method to critically evaluate existing datasets and to inter-correlate them without losing their original complexity. This powerful method for data integration can be applied to similar datasets belonging to other regions and other periods as it originates from the evaluation of larger methodological and theoretical issues that are not limited to my spatial and temporal focus. As I argue in this thesis, diverse archaeological legacies can be efficiently re-analysed through an integrative and regional methodology. The adoption of a regional scale of analysis can provide an excellent perspective on the complexity of transformations in ancient societies, thus creating a fundamental bridge between the local stories and grand landscape narratives.

Canopy-scale biophysical controls of transpiration and evaporation in the Amazon Basin.

Canopy and aerodynamic conductances (gC and gA) are two of the key land surface biophysical variables that control the land surface response of land surface schemes in climate models. Their representation is crucial for predicting transpiration (λET) and evaporation (λEE) flux components of the terrestrial latent heat flux (λE), which has important implications for global climate change and water resource management. By physical integration of radiometric surface temperature (TR) into an integrated framework of the Penman?Monteith and Shuttleworth?Wallace models, we present a novel approach to directly quantify the canopy-scale biophysical controls on λET and λEE over multiple plant functional types (PFTs) in the Amazon Basin. Combining data from six LBA (Large-scale Biosphere-Atmosphere Experiment in Amazonia) eddy covariance tower sites and a TR-driven physically based modeling approach, we identified the canopy-scale feedback-response mechanism between gC, λET, and atmospheric vapor pressure deficit (DA), without using any leaf-scale empirical parameterizations for the modeling. The TR-based model shows minor biophysical control on λET during the wet (rainy) seasons where λET becomes predominantly radiation driven and net radiation (RN) determines 75 to 80 % of the variances of λET. However, biophysical control on λET is dramatically increased during the dry seasons, and particularly the 2005 drought year, explaining 50 to 65 % of the variances of λET, and indicates λET to be substantially soil moisture driven during the rainfall deficit phase. Despite substantial differences in gA between forests and pastures, very similar canopy?atmosphere "coupling" was found in these two biomes due to soil moisture-induced decrease in gC in the pasture. This revealed the pragmatic aspect of the TR-driven model behavior that exhibits a high sensitivity of gC to per unit change in wetness as opposed to gA that is marginally sensitive to surface wetness variability. Our results reveal the occurrence of a significant hysteresis between λET and gC during the dry season for the pasture sites, which is attributed to relatively low soil water availability as compared to the rainforests, likely due to differences in rooting depth between the two systems. Evaporation was significantly influenced by gA for all the PFTs and across all wetness conditions. Our analytical framework logically captures the responses of gC and gA to changes in atmospheric radiation, DA, and surface radiometric temperature, and thus appears to be promising for the improvement of existing land?surface?atmosphere exchange parameterizations across a range of spatial scales.

Canopy-scale biophysical controls of transpiration and evaporation in the Amazon Basin.

Canopy and aerodynamic conductances (gC and gA) are two of the key land surface biophysical variables that control the land surface response of land surface schemes in climate models. Their representation is crucial for predicting transpiration (?ET) and evaporation (?EE) flux components of the terrestrial latent heat flux (?E), which has important implications for global climate change and water resource management. By physical integration of radiometric surface temperature (TR) into an integrated framework of the Penman?Monteith and Shuttleworth?Wallace models, we present a novel approach to directly quantify the canopy-scale biophysical controls on ?ET and ?EE over multiple plant functional types (PFTs) in the Amazon Basin. Combining data from six LBA (Large-scale Biosphere-Atmosphere Experiment in Amazonia) eddy covariance tower sites and a TR-driven physically based modeling approach, we identified the canopy-scale feedback-response mechanism between gC, ?ET, and atmospheric vapor pressure deficit (DA), without using any leaf-scale empirical parameterizations for the modeling. The TR-based model shows minor biophysical control on ?ET during the wet (rainy) seasons where ?ET becomes predominantly radiation driven and net radiation (RN) determines 75 to 80?% of the variances of ?ET. However, biophysical control on ?ET is dramatically increased during the dry seasons, and particularly the 2005 drought year, explaining 50 to 65?% of the variances of ?ET, and indicates ?ET to be substantially soil moisture driven during the rainfall deficit phase. Despite substantial differences in gA between forests and pastures, very similar canopy?atmosphere "coupling" was found in these two biomes due to soil moisture-induced decrease in gC in the pasture. This revealed the pragmatic aspect of the TR-driven model behavior that exhibits a high sensitivity of gC to per unit change in wetness as opposed to gA that is marginally sensitive to surface wetness variability. Our results reveal the occurrence of a significant hysteresis between ?ET and gC during the dry season for the pasture sites, which is attributed to relatively low soil water availability as compared to the rainforests, likely due to differences in rooting depth between the two systems. Evaporation was significantly influenced by gA for all the PFTs and across all wetness conditions. Our analytical framework logically captures the responses of gC and gA to changes in atmospheric radiation, DA, and surface radiometric temperature, and thus appears to be promising for the improvement of existing land?surface?atmosphere exchange parameterizations across a range of spatial scales.