Portal Vein Embolization before Right Hepatectomy: Improved Results Using n-Butyl-Cyanoacrylate Compared to Microparticles Plus Coils.

BACKGROUND: There is currently no consensus in the literature on which embolic agent induces the greatest degree of liver hypertrophy after portal vein embolization (PVE). Only experimental results in a pig model have demonstrated an advantage of n-butyl-cyanoacrylate (NBCA) over 3 other embolic materials (hydrophilic gel, small and large polyvinyl alcohol particles) for PVE. Therefore, the aim of this human study was to retrospectively compare the results of PVE using NBCA with those using spherical microparticles plus coils. METHODS: A total of 34 patients underwent PVE using either NBCA (n = 20), or spherical microparticles plus coils (n = 14). PVE was decided according to preoperative volumetry on the basis of contrast-enhanced CT. Groups were compared for age, sex, volume of the left lobe before PVE and future remnant liver ratio (FRL) (volume of the left lobe/total liver volume - tumor volume). The primary end point was the increase in left lobe volume 1 month after PVE. Secondary end points were procedure complications and biological tolerance. RESULTS: Both groups were similar in terms of age, sex ratio, left lobe volume, and FRL before PVE. NBCA induced a greater increase in volume after PVE than did microparticles plus coils (respectively, +74 ± 69 % and +23 ± 14 %, p < 0.05). The amount of contrast medium used for the procedure was significantly larger when microparticles and coils rather than NBCA were used (respectively, 264 ± 43 ml and 162 ± 34 ml, p < 0.01). The rate of PVE complications as well as the biological tolerance was similar in both groups. CONCLUSION: NBCA seems more effective than spherical microparticles plus coils to induce left-lobe hypertrophy.

Meat lipid profile of steers finished in pearl millet pasture with different rates of concentrate

The objective of this work was to evaluate the meat lipid profile from Devon beef steers finished in pearl millet (Pennisetum americanum) pasture and fed at different rates of concentrate supplementary diet. Twelve steers weighing 270 kg, at 12‑month‑average initial age, were randomly distributed into three treatments: pearl millet pasture; and pearl millet pasture plus a concentrate equivalent at 0.5 or 1.0% of body weight, with two replicates. Total contents of saturated and unsaturated fatty acids, the polyunsaturated:saturated ratio and other relevant fatty acids as the vaccenic acid, conjugated linoleic acid, omega‑3, and omega‑6 were not affected by the consumption of a concentrate supplement at 0.5 or 1.0% live weight. However, the 0.5% supplementation level reduced the concentration of dihomo‑γ‑linolenic fatty acid (C20: 3 n‑6), while the 1.0% supplementation level elevated the content of docosahexaenoic (DHA) (C22: 6 n‑3) fatty acid, and the omega‑6:omega‑3 ratio in meat. Consumption of up to 1.0% energy supplementation increases the omega‑6:omega‑3 ratio in meat from Devon steers grazing on pearl millet pasture.

Establiment dels objectius prioritaris i dels criteris de selecció de projectes per a l'aplicació del programa Leader Plus de la Unió Europea a l'Alt Urgell

Els programes Leader de la Unió Europea tenen com a objectiu el desenvolupament de territoris rurals.La comarca catalana de l’Alt Urgell es va beneficiar anteriorment de l’aplicació del programa Leader 2en set municipis del sud de la comarca. L’actual convocatòria anomenada Leader Plus té en canvi unàmbit d’aplicació que afecta a la totalitat del territori de l’Alt Urgell.A més de l’àmbit territorial, també els objectius estratègics són diferents. Leader 2 pretenia corregir lesconseqüències negatives de la crisi industrial de Taurus. Per aquest motiu, el seu objectiu fonamentalconsistia en aturar la pèrdua de població del territori i va donar molta importància a la creaciód’ocupació i les inversions en la indústria. En canvi, el programa Leader Plus té com a objectiu bàsicestabilitzar la població i millorar el benestar econòmic en els nuclis rurals. Per aquesta raó prioritza lesinversions en sectors con el turisme o altres serveis que ajudin a millorar la qualitat de vida de les zonesrurals.Les conclusions d’aquest treball han servit com a referència per a la redacció de les bases que hauran deservir per a la determinació de quins tipus d’inversions es poden acollir a la iniciativa Leader Plus al’Alt Urgell i quines subvencions es poden concedir.

Pulmonary embolism severity index and troponin testing for the selection of low-risk patients with acute symptomatic pulmonary embolism.

Summary Background: The combination of the Pulmonary Embolism Severity Index (PESI) and troponin testing could help physicians identify appropriate patients with acute pulmonary embolism (PE) for early hospital discharge. Methods: This prospective cohort study included a total of 567 patients from a single center registry with objectively confirmed acute symptomatic PE. On the basis of the PESI, each patient was classified into 1 of 5 classes (I to V). At the time of hospital admission, patients had troponin I (cTnI) levels measured. The endpoint of the study was all-cause mortality within 30 days after diagnosis. We calculated the mortality rates in 4 patient groups: group 1: PESI class I-II plus cTnI <0.1 ng mL(-1); group 2: PESI classes III-V plus cTnI <0.1 ng mL(-1); group 3: PESI classes I-II plus cTnI >/= 0.1 ng mL(-1); and group 4: PESI classes III-V plus cTnI >/= 0.1 ng mL(-1). Results: The study cohort had a 30-day mortality of 10% (95% confidence interval [CI], 7.6 to 12.5%). Mortality rates in the 4 groups were 1.3%, 14.2%, 0% and 15.4%, respectively. Compared to non-elevated cTnl, the low-risk PESI had a higher negative predictive value (NPV) (98.9% vs 90.8%) and negative likelihood ratio (NLR) (0.1 vs 0.9) for predicting mortality. The addition of non-elevated cTnI to low-risk PESI did not improve the NPV or the NLR compared to either test alone. Conclusions: Compared to cTnl testing, PESI classification more accurately identified patients with PE who are at low risk of all-cause death within 30-days of presentation.

La actividad de los medios tradicionales en las redes Google Plus y Linkedin

L'era 2.0 ha arribat als nostres dies i amb això, les xarxes socials ja formen part de la vida diària de molts habitants del planeta. Cada dia, milions de persones es connecten i interactuen a través d'elles amb la finalitat d'entretenir-se i informar-se. Tot això ha fet que molts mitjans de comunicació tradicionals hagin hagut de renovar-se per oferir als usuaris un servei que anys enrere ni es plantejaven i que en alguns casos els ha agafat desprevinguts. Per això, el present Treball Final de Carrera analitza l'activitat dels mitjans El País, El Mundo, La Vanguardia i El Periódico de Catalunya a les xarxes socials Google+ i LinkedIn. La popularitat, la interactivitat i la influència seran factors determinants per veure quin és el mitjà que realitza un millor ús d'aquestes xarxes socials, minoritàries, que guanyen terreny en el dia a dia.

Ability of different adiposity indicators to identify children with elevated blood pressure.

OBJECTIVE: Body composition measured by dual-energy X-ray absorptiometry (DXA) is believed to be superior to crude measures such as BMI or waist circumference (WC) to assess health risks associated with adiposity in adults. We compared the ability of BMI, WC, waist-to-height ratio (WHtR), percentage body fat from skinfold thickness, and measures of total and central fat assessed by DXA to identify children with elevated blood pressure (BP). STUDY DESIGN: The QUALITY Study follows 630 Caucasian families (father, mother, and child originally aged 8-10 years). BP, height, weight, WC, and skinfold thickness were measured according to standardized protocols. Elevated BP was defined as systolic or diastolic BP at least 90th age, sex, and height-specific percentile. Total and central fat were determined with DXA. The area under the receiver operating characteristic (ROC) curve (AUC) statistic was computed from logistic models that adjusted for age, sex, height, Tanner stage, and physical activity. RESULTS: All adiposity indicators were highly correlated. WC and WHtR did not show superior ability over BMI to identify children with elevated SBP (P = 0.421 and 0.473). Measures of total and central fat from DXA did not show an improved ability over BMI or WC to identify children with elevated SBP (P = 0.325-0.662). CONCLUSION: Results support the use of BMI in clinical and public health settings, at least in this age group. As all indicators had a limited ability to identify children with elevated BP, results also support measurement of BP in all children of this age independent of a weight status.

Grammaire française méthodique et raisonnée : rédigée d'après un nouveau plan et fondée sur un grand nombre de faits et sur l'autorité des grammairiens les plus connus ([Reprod.]) / par A. Boniface,...

Collection : Archives de la linguistique française ; 46

Grammaire françoise sur un plan nouveau : pour en rendre les principes plus clairs et la pratique plus aisée... ([Reprod.]) / par le P. Buffier,...

Collection : Archives de la linguistique française ; 65