Relation entre glucose cérébral et systémique chez le sujet neurolésé: une étude par microdialyse cérébrale

Introduction: Le glucose est le principal substrat énergétique cérébral. Sa concentration dans le cerveau est étroitement liée à la glycémie. Chez le patient neurolésé, du fait de l'augmentation des besoins énergétiques, les réserves cérébrales de glucose sont limitées. Une glycémie suffisamment élevée paraît nécessaire pour assurer un apport adéquat de glucose au cerveau. Objectifs : Le but de cette étude est de mieux comprendre la relation entre glucose cérébral et glycémie lors de lésion cérébrale en analysant la physiologie cérébrale chez des patients neurolésés. Plus précisément nous investiguerons: La relation entre le glucose cérébral et le glucose systémique et son association avec le pronostic vital, l'association entre la neuroglucopénie et différents paramètres cérébraux tel que l'hypertension intracrânienne (HTIC) ou la dysfonction énergétique et finalement l'effet d'une perfusion de glucose 10% sur le glucose cérébral lors d'état de neuroglucopénie. Méthodologie : Analyse d'une base de données prospective comportant des patients souffrant d'un traumatisme crânio-cérébral (TCC) ou une hémorragie sous- arachnoïdienne (HSA) sévères. Les patients comateux sont monitorés par un dispositif intra-parenchymateux avancé, comprenant un cathéter de microdialyse cérébrale et un capteur de PbO2. Résultats : 34 patients consécutifs (moyenne d'âge 42 ans, moyenne de temps jusqu'au début du monitoring : 1.5 jours ± 1 ; moyenne de la durée maximale du monitoring : 6 jours ± 3) ont été étudiés, 25 patients souffrant d'un TCC et 9 patients avec une HSA. Nous avons obtenu une corrélation individuelle entre le glucose cérébral et la glycémie chez 52.9 % des patients. Lorsque la glycémie est inférieure à 5 mmol/l, on observe plus fréquemment des épisodes de neuroglucopénie en comparaison aux valeurs intermédiaires de glycémie (5 - 9.9 mmol/l). Les épisodes d'HTIC (pression intracrânienne (PIC) > 20 mmHg) sont plus fréquemment associés à des épisodes de neuroglucopénie que lorsque la pression intracrânienne est normale 75 % vs. 35%. La dysfonction énergétique est plus souvent associés à des épisodes de neuroglucopénie que lorsque le LPR est normal: 55% contre 36%. Un coefficient de corrélation entre glucose cérébral et glycémie significativement plus élevé a été obtenu chez les survivants que chez les non-survivants (0.1 [interquartile range 0.02- 0.3] contre 0.32 [0.17-0.61]). Chez les patients neuroglucopéniques ayant une corrélation entre glucose cérébral et glycémie, la perfusion de glucose i.v. fait monter le glucose cérébral jusqu'à l'arrêt de la perfusion. Conclusion : Malgré une étroite relation entre glycémie et glucose cérébral en conditions stables, cette relation peut être altérée par des causes cérébrales chez les patients neurolésés montrant que la diminution de la disponibilité du glucose extracellulaire ne résulte pas uniquement d'une hypoglycémie relative mais également de causes cérébrales tel que l'hypoperfusion, l'HTIC ou la dysfonction énergétique.

La relation entre les acteurs politiques et les gestionnaires publics: complémentarité ou séparation? Le constat dans trois cantons suisses

La recherche, faisant l'objet de la présente communication, interroge cette nouvelle répartition des rôles telle qu'elle a été théorisée dans les écrits gestionnaires portant sur la NGP. Nous investiguons donc la véracité de l'affirmation selon laquelle une gestion moderne, efficiente et efficace des affaires publiques implique une séparation plus stricte des sphères politiques et administratives. Autrement dit, est-ce que la mise en oeuvre des réformes managériales au sein des administrations cantonales de Suisse romande change effectivement la nature de la relation entre les hauts fonctionnaires et leurs ministres de tutelle ? Pour apporter un début de réponse à cette question, nous avons décidé de nous approcher de trois cantons romands qui se trouvent dans des dynamiques de réforme administrative d'ampleur différentes. Aussi, notre choix de terrain s'est porté sur le canton du Valais, qui est l'un des plus avancés en matière de NGP, sur le canton de Neuchâtel, qui se trouve dans une dynamique hybride puisque certains services administratifs ont adopté les principes de la contractualisation sur base volontaire et d'autres non, ansi que le canton du Jura qui n'a pas, pour l'instant, opté pour les nouveaux principes et outils de la NGP. La comparaison de ces trois entités, dont les trajectoires de modernisation diffèrent, nous permettra de constater ou non des différences d'appréciation dans la nature des relations politico-administratives des trois cantons. Si l'on se réfère à la description idéale-typique proposée par les tenants de la NGP, nous devrions constater d'importantes divergences. Enfin, il est à relever que cette recherche est pionnière en Suisse puisqu'aucune autre étude à ce jour ne s'est attelée à décrire ces changements relationnels, comme cela a été le cas dans la plupart des pays de l'OCDE.

Integrated random processes exhibiting long tails, finite moments, and power-law spectra

A dynamical model based on a continuous addition of colored shot noises is presented. The resulting process is colored and non-Gaussian. A general expression for the characteristic function of the process is obtained, which, after a scaling assumption, takes on a form that is the basis of the results derived in the rest of the paper. One of these is an expansion for the cumulants, which are all finite, subject to mild conditions on the functions defining the process. This is in contrast with the Lévy distribution¿which can be obtained from our model in certain limits¿which has no finite moments. The evaluation of the spectral density and the form of the probability density function in the tails of the distribution shows that the model exhibits a power-law spectrum and long tails in a natural way. A careful analysis of the characteristic function shows that it may be separated into a part representing a Lévy process together with another part representing the deviation of our model from the Lévy process. This

Relation for the nonequilibrium population of the interface states: effects on the bias dependence of the ideality factors

By an analysis of the exchange of carriers through a semiconductor junction, a general relationship for the nonequilibrium population of the interface states in Schottky barrier diodes has been derived. Based on this relationship, an analytical expression for the ideality factor valid in the whole range of applied bias has been given. This quantity exhibits two different behaviours depending on the value of the applied bias with respect to a critical voltage. This voltage, which depends on the properties of the interfacial layer, constitutes a new parameter to complete the characterization of these junctions. A simple interpretation of the different behaviours of the ideality factor has been given in terms of the nonequilibrium charging properties of interface states, which in turn explains why apparently different approaches have given rise to similar results. Finally, the relevance of our results has been considered on the determination of the density of interface states from nonideal current-voltage characteristics and in the evaluation of the effects of the interfacial layer thickness in metal-insulator-semiconductor tunnelling diodes.

Assessment of driving capability through the use of clinical and psychomotor tests in relation to blood cannabinoids levels following oral administration of 20 mg dronabinol or of a cannabis decoction made with 20 or 60 mg Delta9-THC.

Delta(9)-Tetrahydrocannabinol (THC) is frequently found in the blood of drivers suspected of driving under the influence of cannabis or involved in traffic crashes. The present study used a double-blind crossover design to compare the effects of medium (16.5 mg THC) and high doses (45.7 mg THC) of hemp milk decoctions or of a medium dose of dronabinol (20 mg synthetic THC, Marinol on several skills required for safe driving. Forensic interpretation of cannabinoids blood concentrations were attempted using the models proposed by Daldrup (cannabis influencing factor or CIF) and Huestis and coworkers. First, the time concentration-profiles of THC, 11-hydroxy-Delta(9)-tetrahydrocannabinol (11-OH-THC) (active metabolite of THC), and 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol (THCCOOH) in whole blood were determined by gas chromatography-mass spectrometry-negative ion chemical ionization. Compared to smoking studies, relatively low concentrations were measured in blood. The highest mean THC concentration (8.4 ng/mL) was achieved 1 h after ingestion of the strongest decoction. Mean maximum 11-OH-THC level (12.3 ng/mL) slightly exceeded that of THC. THCCOOH reached its highest mean concentration (66.2 ng/mL) 2.5-5.5 h after intake. Individual blood levels showed considerable intersubject variability. The willingness to drive was influenced by the importance of the requested task. Under significant cannabinoids influence, the participants refused to drive when they were asked whether they would agree to accomplish several unimportant tasks, (e.g., driving a friend to a party). Most of the participants reported a significant feeling of intoxication and did not appreciate the effects, notably those felt after drinking the strongest decoction. Road sign and tracking testing revealed obvious and statistically significant differences between placebo and treatments. A marked impairment was detected after ingestion of the strongest decoction. A CIF value, which relies on the molar ratio of main active to inactive cannabinoids, greater than 10 was found to correlate with a strong feeling of intoxication. It also matched with a significant decrease in the willingness to drive, and it matched also with a significant impairment in tracking performances. The mathematic model II proposed by Huestis et al. (1992) provided at best a rough estimate of the time of oral administration with 27% of actual values being out of range of the 95% confidence interval. The sum of THC and 11-OH-THC blood concentrations provided a better estimate of impairment than THC alone. This controlled clinical study points out the negative influence on fitness to drive after medium or high dose oral THC or dronabinol.

SOIL QUALITY IN RELATION TO FOREST CONVERSION TO PERENNIAL OR ANNUAL CROPPING IN SOUTHERN BRAZIL

Many forested areas have been converted to intensive agricultural use to satisfy food, fiber, and forage production for a growing world population. There is great interest in evaluating forest conversion to cultivated land because this conversion adversely affects several soil properties. We examined soil microbial, physical, and chemical properties in an Oxisol (Latossolo Vermelho distrófico) of southern Brazil 24 years after forest conversion to a perennial crop with coffee or annual grain crops (maize and soybeans) in conventional tillage or no-tillage. One goal was to determine which soil quality parameters seemed most sensitive to change. A second goal was to test the hypothesis that no-tillage optimized preservation of soil quality indicators in annual cropping systems on converted land. Land use significantly affected microbial biomass and its activity, C and N mineralization, and aggregate stability by depth. Cultivated sites had lower microbial biomass and mineralizable C and N than a forest used as control. The forest and no-tillage sites had higher microbial biomass and mineralizable C and N than the conventional tillage site, and the metabolic quotient was 65 and 43 % lower, respectively. Multivariate analysis of soil microbial properties showed a clear separation among treatments, displaying a gradient from conventional tillage to forest. Although the soil at the coffee site was less disturbed and had a high organic C content, the microbial activity was low, probably due to greater soil acidity and Al toxicity. Under annual cropping, microbial activity in no-tillage was double that of the conventional tillage management. The greater microbial activity in forest and no-tillage sites may be attributed, at least partially, to lower soil disturbance. Reducing soil disturbance is important for soil C sequestration and microbial activity, although control of soil pH and Al toxicity are also essential to maintain the soil microbial activity high.

RECOVERY OF AN OXISOL DEGRADED BY THE CONSTRUCTION OF A HYDROELECTRIC POWER PLANT

ABSTRACT The removal of thick layers of soil under native scrubland (Cerrado) on the right bank of the Paraná River in Selvíria (State of Mato Grosso do Sul, Brazil) for construction of the Ilha Solteira Hydroelectric Power Plant caused environmental damage, affecting the revegetation process of the stripped soil. Over the years, various kinds of land use and management systems have been tried, and the aim of this study was to assess the effects of these attempts to restore the structural quality of the soil. The experiment was conducted considering five treatments and thirty replications. The following treatments were applied: stripped soil without anthropic intervention and total absence of plant cover; stripped soil treated with sewage sludge and planted to eucalyptus and grass a year ago; stripped soil developing natural secondary vegetation (capoeira) since 1969; pastureland since 1978, replacing the native vegetation; and soil under native vegetation (Cerrado). In the 0.00-0.20 m layer, the soil was chemically characterized for each experimental treatment. A 30-point sampling grid was used to assess soil porosity and bulk density, and to assess aggregate stability in terms of mean weight diameter (MWD) and geometric mean diameter (GMD). Aggregate stability was also determined using simulated rainfall. The results show that using sewage sludge incorporated with a rotary hoe improved the chemical fertility of the soil and produced more uniform soil pore size distribution. Leaving the land to develop secondary vegetation or turning it over to pastureland produced an intermediate level of structural soil quality, and these two treatments produced similar results. Stripped soil without anthropic intervention was of the lowest quality, with the lowest values for cation exchange capacity (CEC) and macroporosity, as well as the highest values of soil bulk density and percentage of aggregates with diameter size <0.50 mm, corroborated by its lower organic matter content. However, the percentage of larger aggregates was higher in the native vegetation treatment, which boosted MWD and GMD values. Therefore, assessment of some land use and management systems show that even decades after their implementation to mitigate the degenerative effects resulting from the installation of the Hydroelectric Plant, more efficient approaches are still required to recover the structural quality of the soil.

Impact of different adiposity measures on the relation between serum uric acid and blood pressure in young adults.

Serum uric acid (SUA) concentration is independently associated with blood pressure (BP) in adults. We examined this association in young adults at an age where anti-hypertension treatment, other potential confounding factors and co-morbidity are unlikely to occur. We assessed BP, anthropometric variables including weight, height, waist circumference (WC), body fat percent (using bioimpedance), lifestyle behaviors, SUA and blood lipids in 549 participants aged 19-20 years from a population-based cohort study (Seychelles Child Development Study). Mean (s.d.) SUA was higher in males than females, 0.33 (0.08) and 0.24 (0.07) mmol l(-1), respectively. Body mass index (BMI) was higher in females than males but BP was markedly higher in males than in females. SUA was associated with both systolic and diastolic BP. However, the magnitude of the linear regression coefficients relating BP and SUA decreased by up to 50% upon adjustment for BMI, WC or body fat percent. The association between SUA and BP was not altered upon further adjustment for alcohol intake, smoking, triglycerides or renal function. In fully adjusted models, SUA remained associated with BP (P<0.05) in females. In conclusion, adiposity substantially decreased the association between SUA and BP in young adults, and BP was independently associated with SUA in females. These findings suggest a role of adiposity in the link between hyperuricemia and hypertension.

The Power of Images in Antonio Agustin's. Diálogos de Medallas, inscripciones y otras antigüedades (1587)

Socias ofereix una àmplia mirada sobre l'ús de les imatges en les obres de numismàtica primerenques. Diàlegs de medalles, d'Antonio Agustín

Were Spanish migrants attracted by industrial agglomerations?: an analysis for the interwar years in the light of the new economic geography

In this paper we examine whether access to markets had a significant influence onmigration choices of Spanish internal migrants in the inter-war years. We perform astructural contrast of a New Economic Geography model that focus on the forwardlinkage that links workers location choice with the geography of industrial production,one of the centripetal forces that drive agglomeration in the NEG models. The resultshighlight the presence of this forward linkage in the Spanish economy of the inter-warperiod. That is, we prove the existence of a direct relation between workers¿ localizationdecisions and the market potential of the host regions. In addition, the direct estimationof the values associated with key parameters in the NEG model allows us to simulatethe migratory flows derived from different scenarios of the relative size of regions andthe distances between them. We show that in Spain the power of attraction of theagglomerations grew as they increased in size, but the high elasticity estimated for themigration costs reduced the intensity of the migratory flows. This could help to explainthe apparently low intensity of internal migrations in Spain until its upsurge during the1920s. This also explains the geography of migrations in Spain during this period,which hardly affected the regions furthest from the large industrial agglomerations (i.e.,regions such as Andalusia, Estremadura and Castile-La Mancha) but had an intenseeffect on the provinces nearest to the principal centres of industrial development.

Inhibition of Na(+)-K(+)-ATPase by digoxin and its relation with energy expenditure and nutrient oxidation rate.

This study investigates the effects of digoxin, an inhibitor of the Na+ pump (Na(+)-K(+)-ATPase), on resting metabolic rate (RMR), respiratory quotient (RQ), and nutrient oxidation rate. Twelve healthy male subjects followed a double-blind protocol design and received either 1 mg/day digoxin or a placebo 2 days before indirect calorimetry measurements. Digoxin induced a 0.22 +/- 0.07 kJ/min or 3.8 +/- 1.5% (mean +/- SE, P = 0.01) decrease in RMR and a 0.40 +/- 0.13 kJ/min (P = 0.01) decrease in fat oxidation rate, whereas carbohydrate and protein oxidation rates did not change significantly. A dose-response relationship between serum digoxin and RQ was observed. These results suggest that digoxin reduces not only RMR but also fat oxidation rate by mechanisms that remain to be elucidated. Because a linkage and an association between genes coding the Na(+)-K(+)-ATPase and the RQ have been previously observed, the present demonstration of an effect of Na(+)-K(+)-ATPase inhibition on fat oxidation rate strengthens the concept that the activity of this enzyme may play a role in body weight regulation.

Price transmission and market power analysis in the Spanish seafood market chain

[cat] Espanya és un dels principals mercats de productes pesquers d’Europa i del món. El consum de productes pesquers ha estat tradicionalment molt important a Espanya, el 2005 es varen consumir 36,7 kg per persona (MAPA, diversos anys). Malgrat això, el mercat i cóm interactuen els diversos nivells de la cadena de comercialització han gaudit de poca atenció. En aquest estudi, utilitzant dades setmanals, s’analitza per als dotze principals productes pesquers, l’elasticitat en la transmissió de preus al llarg de la cadena de comercialització a Espanya (llotja, mercat central i detallista). Finalment s’investiga la presència d’assimetria en la transmissió de preus entre aquests nivells de mercat. Els resultats obtinguts tenen importants implicacions a l’hora d’analitzar la demanda, poder de mercat i marges al llarg del mercat per als productes pesquers.