672 resultados para 1463
Resumo:
La Contratación Pública constituye una fuente muy importante de la demanda de bienes y servicios, especialmente en la Comunidad Autónoma del País Vasco en donde el Gobierno Autonómico, también llamado la Administración General Vasca, desarrolla un papel capital como impulsor de dicha contratación pública. Por otro lado, la Economía Social, y especialmente el movimiento cooperativo, tiene en ese mismo ámbito geográfico un papel de gran peso en el conjunto de la Economía Vasca, por sus cifras de empleo y aportación al PIB, así como por tradición y arraigo social. Cabe preguntarse en tal caso, cuál es el papel que desempeñan las cooperativas en la Contratación Pública en aquella Comunidad Autónoma, cómo y cuáles son los contratos de los que resultan adjudicatarias, qué importes suponen esos contratos para las cuentas públicas y, en definitiva, si su papel de adjudicatarias se corresponde con el que desempeñan en el conjunto de la Economía Vasca. Del examen de los contratos publicados en el Perfil del Contratante del Gobierno Vasco, se obtienen datos suficientes que, una vez procesados y analizados, se visualizan en tablas y porcentajes que constituyen la base de un diagnóstico que responde a las preguntas planteadas y evidencia la situación de debilidad de las cooperativas en el campo de la contratación pública vasca.
Resumo:
The photodissociation and photoionization dynamics of HBr via low-n Rydberg and ion-pair states was studied by using 2 + 1 REMPI spectroscopy and velocity map imaging of photoelectrons. Two-photon excitation at about 9.4–10 eV was used to prepare rotationally selected excited states. Following absorption of the third photon the unperturbed F 1Δ(2) and i 3Δ(2) states ionize directly into the ground vibrational state of the molecular ion according to the Franck–Condon principle and upon preservation of the ion core. In case of the V 1Σ+(0+) ion-pair state and the perturbed E 1Σ+(0+), g 3Σ−(0+), and H 1Σ+(0+) Rydberg states the absorption of the third photon additionally results in a long vibrational progression of HBr+ in the X 2Π state as well as formation of electronically excited atomic photofragments. The vibrational excitation of the molecular ion is explained by autoionization of repulsive superexcited states into the ground state of the molecular ion. In contrast to HCl, the perturbed Rydberg states of HBr show strong participation of the direct ionization process, with ionic core preservation.
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Aim: Flow-mediated dilation (FMD) is a surrogate marker of endothelial function, which has been proposed as a barometer of vascular health. Impaired microvascular response to reactive hyperaemia is thought to be the mechanism behind reduced shear stress and subsequently impaired FMD, which has been associated with cardiovascular events. This study aims to assess the effect of pioglitazone on the vasculature of patients with impaired glucose tolerance (IGT).
Materials and Methods: Forty IGT patients with no cardiovascular disease were compared with 24 healthy age- and sex-matched controls. Endothelial function was assessed using FMD of the brachial artery. Adiponectin (ADN) levels were measured and insulin sensitivity was calculated using homeostasis model assessment of insulin resistance (HOMA-IR). A randomised double-blind placebo-controlled trial of the IGT subjects was then performed, with subjects receiving either pioglitazone 30 mg od or matched placebo for 12 weeks before the measurements were repeated.
Results: The IGT subjects had a significantly impaired FMD compared with the controls (p < 0.001). Diastolic shear stress (DSS) was also significantly reduced in IGT (p = 0.04). High molecular weight (HMW) ADN was significantly lower in the IGT group than in controls (p = 0.03). On analysis of the IGT group after 12 weeks treatment, FMD was significantly increased in the pioglitazone group compared with placebo (p = 0.03) as was endothelium-independent dilation (EID) (p = 0.03). A significant increase in total ADN (p < 0.001), HMW ADN (p < 0.001) and HMW/total ratio (p = 0.001) occurred in the pioglitazone group compared with placebo.
Conclusions: Pioglitazone improved endothelial function in IGT. Treatment with pioglitazone may reduce the risk of cardiovascular disease in this patient group.
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Aim: Accumulating evidence indicates that RUNX3 is an important tumour suppressor that is inactivated in many cancer types. This study aimed to assess the role of microRNA (miRNA) in the regulation of RUNX3.
Resumo:
Mr C, a 68-year-old Chinese male with diabetes mellitus, previous stroke and ischaemic cardiomyopathy on clopidogrel, presented with haematochezia. Colonoscopy showed a sigmoid ulcer, which was treated endoscopically. Histology of the biopsy from the ulcer revealed non-specific changes. However, he presented with recurrent bleeding from this non-healing sigmoid ulcer. A review of the histologic specimen revealed CMV intranuclear inclusion bodies. He was treated with intravenous ganciclovir, with no further hematochezia.
Keywords Hematochezia, cytomegalovirus, ulcer
Resumo:
Few research papers in economics have examined the extent, causes or consequences of physical stature decline in aging populations. Using repeated observations on objectively measured data from the English Longitudinal Study of Ageing (ELSA), we document that reduction in height is an important phenomenon among respondents aged 50 and over. On average, physical stature decline occurs at an annual rate of between 0.08% and 0.10% for males, and 0.12% and 0.14% for females—which approximately translates into a 2cm to 4cm reduction in height over the life course. Since height is commonly used as a measure of long-run health, our results demonstrate that failing to take age-related height loss into account substantially overstates the health advantage of younger birth cohorts relative to their older counterparts. We also show that there is an absence of consistent predictors of physical stature decline at the individual level. However, we demonstrate how deteriorating health and reductions in height occur simultaneously. We document that declines in muscle mass and bone density are likely to be the mechanism through which these effects are operating. If this physical stature decline is determined by deteriorating health in adulthood, the coefficient on measured height when used as an input in a typical empirical health production function will be affected by reverse causality. While our analysis details the inherent difficulties associated with measuring height in older populations, we do not find that significant bias arises in typical empirical health production functions from the use of height which has not been adjusted for physical stature decline. Therefore, our results validate the use of height among the population aged over 50.
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Objective Conventional surgical management of prolapsing haemorrhoids is by excisional haemorrhoidectomy. Postoperative pain has restricted the application of such procedures in the day case setting. These operations remain associated with a period of restricted activity. The use of circular stapling devices as an alternative to the excisional approach in the management of haemorrhoids has been described. This study reports our experience of stapled haemorrhoidopexy as a day case procedure.
Methods Patients with third or fourth degree haemorrhoids were eligible for the procedure. Patients were considered suitable candidates for day case surgery based on conventional parameters. Symptoms were assessed using a previously validated symptom severity rating score. Stapled haemorrhoiclopexy was carried out using a circular stapling device. Pain scores were obtained prior to discharge. Patients were admitted if pain was uncontrolled despite oral analgesia. Symptoms were re-scored at six-week follow-up.
Results Over a 70-month period 168 consecutive stapled haemorrhoidopexies were performed or directly supervised by one consultant colorectal surgeon. One hundred and ten (65%) patients were considered appropriate candidates for day case surgery by conventional criteria. Ninety-six (87.3%) patients successfully underwent stapled haemorrhoidopexyon a day case basis. Fourteen (12.7%) patients required admission on the day of surgery (5 for early Postoperative bleeding, 4 for pain necessitating continuing opiate analgesia, two for urinary retention and three for surgery performed late in the day). Six (5%) patients were re-admitted postoperatively; four for pain relief and two because of urinary retention. Of the day case patients, 91 (82.7%) and 56 (50.9%) had been seen for 6 week and 6 month review, respectively, at the time of analysis. Symptom scores were 6 (pre-operatively) vs 0 (postoperatively) (P <0.01). 76/91 (83.5%) patients reviewed at 6/52 were asymptomatic.
Conclusion Stapled haemorrhoidopexy is a safe and effective procedure that can be carried out on selected patients on a day case basis. Complications are of a similar nature to excisional haemorrhoidectomy.
Resumo:
Im Text wird die Niederdruckplasmabehandlung thematisiert. Besonders der Aufbau, Ablauf und die Einflussfaktoren der Niederdruckplasmabehandlung werden aufgezeigt, aber auch die Vor- und Nachteile des Verfahrens werden beleuchtet.