Effects of dietary folate intake on migraine disability and frequency

Objective Migraine is a highly disabling disease affecting a significant proportion of the Australian population. The Methylenetetrahydrofolate Reductase (MTHFR) C677T variant has been associated with increased levels of homocysteine and risk of migraine with aura (MA). Folic acid, Vitamin B6 and B12 supplementation has been previously shown to reduce increased levels of homocysteine and decrease migraine symptoms. However the influence of dietary folate intake on migraine has been unclear. The aim of the current study was to analyse the association of dietary folate intake in the form of dietary folate equivalent (DFE), folic acid (FA) and total food folate (TFF) on migraine frequency, severity and disability. Methods A cohort of 141 adult females of Caucasian descent with MA was genotyped for the MTHFRC677T variant using restriction enzyme digestion. Dietary folate information was collected from all participants and analysed using the “FoodWorks” 2009 package. Folate consumption was compared to migraine frequency, severity and disability using linear regression. Results A significant inverse relation was observed between DFE [R2= 0.201, P= 0.045, CI (-0.004, -0.001)] and FA [R2= 0.255, P= 0.036, 95% CI (-0.009, -0.002)] consumption and migraine frequency. It was also observed that in individuals with the CC genotype for the MTHFR C677T variant, migraine frequency was significantly linked to FA consumption [R2= 0.077, P= 0.029, CI (-0.009, -0.005)]. Conclusions The results from this study indicate that folate intake in the form of folic acid may influence migraine frequency in female MA sufferers.

Structure of pentacyclo[7.4.2.02,6.06,15.011,14]pentadec-4-ene-7,13-dione, a novel pentacyclic C15 quinane system

C 15H 1602 (a synthetic precursor to dodecahedrane), monoclinic, P21/n, a = 12.171 (5), b = 6.976(5), c = 13.868 (3) A, B = 102.56 (3) ° , Z = 4, D m = 1.30, D c = 1.318 g cm -3, F(000) = 488, g(Mo K¢t) = 0.92 cm- 1. Intensity data were collected on a Nonius CAD-4 diffractometer and the structure was solved by direct methods. Full-matrix least-squares refinement gave R = 0.077 (R w = 0.076) for 1337 observed reflections. All the five-membered rings are cis fused and have envelope (C s symmetry) conformations.

Crystal structure of ferroelectric sodium meta vanadate, NaVO3

The crystal structure of ferroelectric sodium meta vanadate, NaVO3 has been solved using three dimensional X-ray data and refined to an R-value of 0.077 for 375 observed reflections. The crystal belongs to the monoclinic system with space group Cc and with unit cell dimensions a = 10.494 (9) Aring, b = 9.434 (7) Aring, c = 5.863 (6) Aring and β = 108° 48' in the room temperature ferroelectric phase. The unit cell dimensions in the high temperature paraelectric phase (above 380°C) are a = 10.595 (15) Aring, b = 9.671 (10) Aring, c = 5.926 (8) Aring and β = 108° 45' with space group C2/c. The crystal structure may be viewed as consisting of alternate channels of sodium polyhedra and VO4 tetrahedra.

Ultrastructure of the Spermatozoa of the Yangtze Finless Porpoise (Neophocaena phocaenoides asiaeorientalis)

P>Semen sample was collected from two captive adult Yangtze finless porpoises (Neophocaena phocaenoides asiaeorientalis) during physical examination. One individual was aged about 9 years with body length 143 cm (total length) and body weight 46.1 kg in 2003. The age of the other was unknown and its body length was 147 cm and body weight was 43 kg in 2004. Ultrastructure of their spermatozoa was examined using scanning and transmission electron microscope. The sperm concentration was 4.17 x 10(9) spermatozoa per ml by the cytometer. The approximate dimensions of the spermatozoa were as follows: head length, 3.366 +/- 0.140 mu m (mean +/- SE, n = 15); head width, 1.896 +/- 0.099 mu m (n = 15); and neck length, 1.004 +/- 0.074 mu m (n = 10). The tail included midpiece, principal piece and terminal piece. The length of the midpiece was 1.882 +/- 0.077 mu m (n = 9). There is no apparent boundary between the principal piece and the terminal piece, so the length of the principal piece and the terminal piece was 44.612 +/- 3.485 mu m (n = 5). Total length of the spermatozoa was 53.314 +/- 4.580 mu m (n = 10). The acrosome covered approximately 45.8% of the anterior portion of the head.

Replacement of methane from quartz sand-bearing hydrate with carbon dioxide-in-water emulsion

The replacement of CH4 from its hydrate in quartz sand with 90:10, 70:30, and 50:50 (W-CO2:W-H2O) carbon dioxide-in-water (C/W) emulsions and liquid CO2 has been performed in a cell with size of empty set 36 x 200 mm. The above emulsions were formed in a new emulsifier, in which the temperature and pressure were 285.2 K and 30 MPa, respectively, and the emulsions were stable for 7-12 h. The results of replacing showed that 13.1-27.1%, 14.1-25.5%, and 14.6-24.3% of CH4 had been displaced from its hydrate with the above emulsions after 24-96 It of replacement, corresponding to about 1.5 times the CH4 replaced with high-pressure liquid CO2. The results also showed that the replacement rate of CH4 with the above emulsions and liquid CO2 decreased from 0.543, 0.587, 0.608, and 0.348 1/h to 0.083, 0.077, 0.069, and 0.063 1/h with the replacement time increased from 24 to 96 h. It has been indicated by this study that the use of CO2 emulsions is advantageous compared to the use of liquid CO2 in replacing CH4 from its hydrate.

长白山阔叶红松林冠层光合生产力的模拟研究

森林作为陆地生态系统的主体，在碳的生物地球化学循环中起着关键的作用，因此对森林生态系统生产力的研究具有重要意义。本文以长白山阔叶红松林为研究对象，在2005年7月~9月对其主要优势种红松、紫椴、蒙古栎、水曲柳的生理生态学参数进行了测定，并利用单叶尺度的光合作用-气孔导度-能量平衡耦合模型，以及冠层尺度的多层模型，对单叶尺度以及冠层尺度的光合作用进行了模拟，主要的结论有： （1）长白山阔叶红松林主要优势树种红松、紫椴、蒙古栎、水曲柳的生理生态学参数：光合有效辐射吸收率a、初始量子效率α、光饱和时的最大净光合作用速率Pmax、最大的Rubisco催化反应速率Vcmax、CO2饱和时的最大净光合作用速率Jmax有着明显且不同的季节变化。7、8月水曲柳的α值最大，分别为0.077、0.064，9月紫椴的最大，为0.051。红松的Vcmax值在7、9月为四个树种中最大的，分别为：49.085、43.072μmol•m-2•s-1，8月为水曲柳最大，为66.041μmol•m-2•s-1。 （2）对优势树种单叶尺度的净光合作用速率An和气孔对CO2的导度gsc进行模拟发现：紫椴、蒙古栎、水曲柳的An、gsc的值在7~9月要大于红松，进入植物生长末期的9月则随着生理活性的下降而迅速下降，而红松则表现较为平稳且略有上升。7月蒙古栎的An、gsc的最大值最大分别为15.055μmol•m-2•s-1、0.400 mol•m-2•s-1；8月水曲柳的最大分别为22.944μmol•m-2•s-1、0.567 mol•m-2•s-1；9月紫椴的最大分别为12.045μmol•m-2•s-1、0.249 mol•m-2•s-1。 （3）通过模拟得到：长白山阔叶红松林冠层2005年8月的净光合作用速率An有着明显的日变化特征， 8月林冠的净光合作用速率最大值可以达到44.880μmol•m-2•s-1，该月白天净光合作用速率的总量可以达到23.580 mol•m-2。通过与观测值比较发现模拟结果能够较好地反映冠层光合作用的特征。

黄土高原典型土壤剖面土壤颗粒组成分形特征

采集从北向南依次分布的干润砂质新成土(神木)、黄土正常新成土(延安)和土垫旱耕人为土(杨陵)等典型土壤剖面0～200cm土层土样,通过测定土样颗粒体积分形维数及基本性质,以期阐明黄土高原典型土壤颗粒体积分形特征及其与土壤基本性质间的相关性。结果表明,从南到北,土壤颗粒体积分形维数呈下降趋势,而不同土层土壤颗粒体积分形维数差异不显著。土垫旱耕人为土、黄土正常新成土和干润砂质新成土表层(0～10cm)颗粒体积分形维数分别为2.723±0.024、2.609±0.077和2.589±0.025,表层以下(10～200cm)颗粒平均体积分形维数分别为2.729±0.034、2.584±0.054和2.558±0.034;颗粒体积分形维数与<0.01mm的物理性黏粒及<0.002mm的黏粒体积百分含量呈极显著正相关关系,与0.002～0.05mm的粉粒和>0.05mm的砂粒体积百分含量呈极显著负相关关系,与粉粒的显著性较小,而土壤中物理性黏粒体积百分含量与土壤全氮、有机碳及矿物固定态铵均达到极显著正相关关系,而砂粒体积百分含量与上述土壤基本性质均呈极显著负相关关系。

一种新型的铅钙板栅合金——Pb-Ca-Sn-Al-Na

钠加到Pb—Ca—Sn—Al合金中,可以改善它的延伸率和浇铸性能。对于Pb—Ca—Sn—Al合金来说,钠是有效的变晶剂,它的最佳含量是0.01～0.077％。

藏药短管兔耳草中松果菊苷和麦角甾苷的RP-HPLC分析

建立了藏药短管兔耳草中松果菊苷和麦角甾苷含量的高效液相色谱分析法.采用Waters XTerra RP18色谱柱(150mm×4.6 mm,5μm),以甲醇-1%冰醋酸溶液(28:72,V:V)为流动相,流速1.0 mL/min,检测波长330 nm,柱温30℃,在20 min内分离检测了该两种化合物.松果菊苷和麦角甾苷进样量分别在0.077～4.950μg(r=0.999 9)和0.085～5.450μg(r=0.999 9)内呈良好线性,平均加样回收率分别为98.35%和92.50%,RSD分别为2.35%和2.86%.所建立的方法简便、快捷、结果准确可靠,重现性好,可用于藏药短管兔耳草的质量控制,并为兔耳草属植物中苯丙素苷类化合物的分离分析提供一定的参考.

The Low Density Transiting Exoplanet WASP-15b

We report the discovery of a low-density exoplanet transiting an 11th magnitude star in the Southern hemisphere. WASP-15b, which orbits its host star with a period P = 3.7520656 ± 0.0000028 d, has a mass M p = 0.542 ± 0.050 M J and radius R p = 1.428 ± 0.077 R J, and is therefore one of the least dense transiting exoplanets so far discovered (?p = 0.247 ± 0.035 g cm-3). An analysis of the spectrum of the host star shows it to be of spectral type around F5, with an effective temperature T eff = 6300 ± 100 K and [Fe/H] = -0.17 ± 0.11.

Field observation of sequestration of uranium in iron-rich sediments under sequential reduction-oxidation conditions at the DOE Oak Ridge IFRC

At the U.S. DOE Oak Ridge Integrated Field Research Challenge (ORIFRC) site, the iron content of shallow subsurface materials (i.e. weathered saprolite) is relatively high (up to 5-6% as w/w), and therefore, the forms of the iron species present plays a critical role in the long-term sequestration of uranium. A long term pilot-scale study of the bioreduction and reoxidation of uranium conducted at the ORIFRC area 3 site, adjacent to the former S-3 disposal ponds (source zone), has provided us with the opportunity to study the impact of iron species on the sequestration of U(VI). The aqueous U(VI) concentrations at the site were decreased to below the EPA MCL through the intermittent injection of ethanol as the electron donor. Previous field tests indicated that both oxygen and nitrate could oxidize the bioreduced U(IV) and cause a short-term rebound of aqueous phase uranium concentration after the oxidative agents were delivered directly to the bioreduced zone.

A field test has been conducted to examine the long-term effect of exposure of bioreduced sediments to nitrate in contaminated groundwater for more than 1,380 days at the Area 3 site. Contaminated groundwater was allowed to invade the previously bioreduced zone via the natural groundwater gradient after an extended period in which reducing conditions were maintained and the bioreduced zone was protected from the influx of upgradient contaminated groundwater. The geochemical response to the invasion of contaminated groundwater was dependent on whether the monitoring location is in the middle or the fringe of the previously bioreduced zone. In general, the nitrate concentrations in the previously bioreduced area, increased gradually from near zero to ~50-300 mM within 200 days and then stabilized. The pH declined from bioreduced levels of 6.2-6.7 to below 5.0. Uranium concentrations rebounded in all monitoring wells but at different rates. At most locations U concentrations rebounded, declined and then rebounded again. Methane gas disappeared while a significant level (20,000 to 44,000 ppmv) N2O was found in the groundwater of monitoring wells after three years of reoxidization.

The U(IV) in sediments was mainly reoxidized to U(VI) species. Based on XANES analysis, the predominate uranium in all samples after re-oxidation was similar to a uranyl nitrate form. But the U content in the sediment remained as high as that determined after bioreduction activates were completed, indicating that much of the U is still sequestrated in situ. SEM observations of surged fine sediments revealed that clusters of colloidal-sized (200-500nm) U-containing precipitates appeared to have formed in situ, regardless from sample of FW106 in non-bioactivity control area or of pre-bioreduced FW101-2 and FW102-3. Additionally, SEM-EDS and microprobe analysis, showed that the U-containing precipitates (~1% U) in FW106 are notably higher in Fe, compared to the precipitates (~1-2.5% U) from FW101-2 and FW102-3. However, XRF analysis indicated that the U content was remained as high as 2180 and 1810 mg/kg with U/Fe ratio at 0.077 and 0.055 vs 0.037 g/g, respectively in pre-bioreduced FW101-2 and FW102-3, suggesting more U sequestrated by Fe in pre-bioreduced sediments.

A comparison between accelerated hypofractionation and stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer (NSCLC): Results of a propensity score-matched analysis

BACKGROUND AND PURPOSE: Stereotactic ablative radiotherapy (SABR) has become standard for inoperable early-stage non-small cell lung cancer (NSCLC). However, there is no randomized evidence demonstrating benefit over more fractionated radiotherapy. We compared accelerated hypofractionation (AH) and SABR using a propensity score-matched analysis.

MATERIALS AND METHODS: From 1997-2007, 119 patients (T1-3N0M0 NSCLC) were treated with AH (48-60Gy, 12-15 fractions). Prior to SABR, this represented our institutional standard. From 2008-2012, 192 patients (T1-3N0M0 NSCLC) were treated with SABR (48-52Gy, 4-5 fractions). A total of 114 patients (57 per cohort) were matched (1:1 ratio, caliper: 0.10) using propensity scores.

RESULTS: Median follow-up (range) for the AH cohort was 36.3 (2.5-109.1) months, while that for the SABR group was 32.5 (0.3-62.6)months. Three-year overall survival (OS) and local control (LC) rates were 49.5% vs. 72.4% [p=0.024; hazard ratio (HR): 2.33 (1.28, 4.23), p=0.006] and 71.9% vs. 89.3% [p=0.077; HR: 5.56 (1.53, 20.2), p=0.009], respectively. On multivariable analysis, tumour diameter and PET staging were predictive for OS, while the only predictive factor for LC was treatment cohort.

CONCLUSIONS: OS and LC were improved with SABR, although OS is more closely related to non-treatment factors. This represents one of the few studies comparing AH to SABR for early-stage lung cancer.

Desenvolvimento de filmes à base de quitosano com microencapsulação de agentes naturais: cinéticas de libertação

Dissertação de mestrado, Tecnologia de Alimentos, Instituto Superior de Engenharia, Universidade do Algarve, 2013

A lesão de isquémia/reperfusão em transplante hepático: análise genética, morfológica e correlação clínica

RESUMO: O transplante hepático ortotópico é uma terapêutica aceite para casos selecionados de falência hepática terminal. O procedimento tem-­‐se aperfeiçoado, evidenciado pelo aumento da taxa de sobrevida de 30 para 75% aos 5 anos, mas cerca de 13 a 27% dos enxertos desenvolve falência primária (PNF) ou disfunção primária (DF) após o transplante. As consequências são devastadoras para a sobrevida do doente e do enxerto. A sua etiologia é multifactorial, incluindo factores relacionados com o dador e o receptor, tempos de isquémia, agressões cirúrgicas, bem como características anatomopatológicas do enxerto. A lesão de isquémia/reperfusão mantem-­‐se como um factor de risco intra operatório, com implicações directas sobre toda a evolução do transplante : existe uma relação íntima entre a PNF e a DF, a preservação do enxerto, a lesão de isquémia/reperfusão, e a falência do transplante. Além disso, está comprovada evidência que sugere que a lesão de I/R torna um aloenxerto mais vulnerável por aumento da imunogenicidade, aumentando a probabilidade de episódios de rejeição precoce e tardia. Com base na prática clínica quotidiana do CHBPT HCC, estudaram-­‐se 54 casos de transplante hepático, agrupados segundo grupos por alocação do enxerto respectivo: Grupo 1(n=27): dador cadáver para receptor cirrótico, Grupo 2 (n=15): dador cadáver para receptor PAF, Grupo 3 (n=12): dador PAF para receptor cirrótico. Observaram-­‐se as alterações histológicas e moleculares sobre o enxerto até ao final da operação do receptor, e as suas consequências clínicas,avaliando: -­‐ As diferentes capacidades de resistência e cada enxerto à lesão de isquémia/reperfusão. -­‐ As situações em que os factores do receptor se sobrepõem às do enxerto na definição do prognóstico, e vice versa. -­‐ A relevância das lesões histológicas e moleculares precoces no tecido hepático na evolução do enxerto e do receptor. Foram colhidas biópsias por agulha dos 54 enxertos hepáticos,42 provenientes de cadáver com coração batente(morte cerebral) e 12 provenientes de dador vivo com PAF, em três tempos diferentes do processo de colheita e transplante hepático: ­‐ A primeira(T0)antes da clampagem da aorta do dador -­‐ A segunda (T1) no final da isquémia fria -­‐ A terceira (T2) após a reperfusão do enxerto, durante o encerramento da parede abdominal. A estas amostras foi extraído RNA total, convertido em cDNA por transcrição reversa e feita a análise da expressão dos genes da CTLA4, IL-­‐1β, IL-­‐4, IL-­‐6, IL-­‐13, TNF-­‐α, Perforina, Selectina, (SELE), Fas-­‐ligando, Granzima-­‐B, Heme-­‐Oxigenase 1(HO1)e Óxido Nítrico Sintetase(iNOS2A)por PCR quantitativo segundo o método do Ct comparativo, utilizando como referência a expressão dos genes da amostra não-­‐isquémica –T0. Os fragmentos de todas as biópsias foram seccionados, para envio de amostra comparativa para processamento histológico habitual, sem qualquer alteração ao protocolo seguido habitualmente na Unidade de Transplantação do Hospital Curry Cabral. A presença de alguns parâmetros histológicos definidos, como esteatose, necrose, vacuolização, congestão sinusoidal e infiltração neutrofílica, foi registada e contabilizada numa classificação numérica. O seguimento clínico e laboratorial, bem como o acompanhamento de eventuais complicações, foi registado e correlacionado com os dados das colheitas de órgãos e com os dados das biópsias. Foram consideradas as seguintes variáveis, como as mais relevantes e objectivas para a interpretação da evolução clínica, tendo sido comparadas estatisticamente com os dados recolhidos, laboratoriais e clínicos: disfunção do enxerto, 207 pós operatórias, número de internamentos igual ou superior a 2 e rejeição crónica e/ou morte do receptor. Foram identificadas características clínicas menos favoráveis, a considerar, nalgumas circunstâncias: género feminino do receptor (sobretudo associado a enxerto masculino, p=0,077), isquémia fria superior a 500 minutos (p=0,074), isquémia quente superior a 90 minutos (p=0,099). Na análise laboratorial, distinguiram-­‐se duas características histológicas desfavoráveis e irreversíveis, como índice de mau prognóstico: a necrose e a balonização (p=0,029); no painel genético escolhido neste estudo,a expressão basal de IL-­‐1β(p=0,028), de SELE p=0,013)e de FAS-­‐L (p=0,079)relacionaram-­‐se com pior prognóstico. Algumas características protectoras intrínsecas dos enxertos só se revelaram indirectamente, como menor infiltração neutrofílica e maior expressão de HO1 e de iNOS nos enxertos PAF, não tendo sido possível provar uma interferência directa nos resultados clínicos. Não se obteve expressão mensurável de genes anti-­‐ inflamatórios nas biopsias hepáticas processadas neste estudo, como a IL13 e a I 4: assim, com a metodologia utilizada, não foi possível obter um perfil de expressão genética associado a boa evolução clínica. O perfil inverso foi sugerido apenas pela expressão basal dos 3 genes mencionados (FAS-­‐L,IL-­‐1β e SELE)no mesmo painel, com o protocolo seguido neste conjunto de 54 doentes. As características do receptor sobrepuseram-­‐se às do enxerto no caso de: -­‐ diagnóstico de PAF no receptor, que determinou uma maior predisposição para a disfunção do enxerto, o que, por sua vez, determina uma menor sobrevida. No entanto, o diagnóstico de PAF no receptor exibe uma curva de sobrevida mais favorável. -­‐ receptores com um baixo balanço de risco (BAR)definiram características favoráveis para enxertos com níveis baixos e moderados de esteatose, fazendo que esta característica, definida como um risco acrescido, não só não se manifestasse clinicamente,como parecesse um factor favorável. As características do enxerto sobrepuseram-­‐se às do receptor no caso de: -­‐ tempo de isquémia fria superior a 500 minutos -­‐ balonização, necrose, FAS-­‐L,IL-­‐1β e SELE em T0 A integração dos resultados moleculares e morfológicos com a evolução clínica, realça o papel da mobilização precoce de neutrófilos nos desempenhos menos favoráveis do enxerto hepático. -------------ABSTRACT: Orthotopic liver transplantation is na accepted therapeutic procedure for selected cases of terminal liver failure. The procedure has been improved, evidenced by the rise of survival rates from 30 to 70% at 5 years, but 13 to 27% of the liver grafts develops primary non function (PNF) or primary dysfunction (PDF) after transplantation. The consequences are devastating for the survival of the patient and of the graft. Its etiology is multifactorial, including factos related with the donor and with the recipient, ischemic times, surgical aggressions, as well as the histological characteristics of the graft. The ischemia/reperfusion lesion is still an intraoperative risk factor, with direct implications in the whole transplant outcome: there is a close interrelation between PNF and DF, graft preservation, ischemia / reperfusion lesion and graft failure. Beyond his, there is proved evidence that suggests that I/R lesion turns the allograft more vulnerable by increasing its immunogenity, increasing the probability of precocious and late rejection episodes. Based on the daily clinical practice at CHBPT /HCC, 54 cases of hepatic transplantation have been studied, grouped by allocation of each graft: Group (n=27):deceased do nortocirrhotic recipient, Group 2 (n=15): deceased donor to FAP recipient, Group 3 (n=12): FAP living donor to cirrhotic recipient. The histologic and molecular changes in the liver graft were observed until the end of the recipiente operation,together with its clinical consequences, evaluating:-­‐The different capacity of resistance of each graft to the ischemia / reperfusion lesion -­‐ The situations where the recipiente factos overlap the ones of the graft, in the definition of prognosis, and vice versa.-­‐ The relevance of the precocious histologic and molecular lesions of the hepatic tissue in the clinical outcome of the graft and the recipient. Needle biopsies were obtained from 54 liver grafts, 42 deceased brain dead donors and 12 from FAP living donors, at three diferente times of the harvesting and the hepatic transplantation: The first one (T0) before clamping the donor aorta -­‐ The second one (T2) in the end of cold ischemia time -­‐ The third one (T) after the reperfusion of the graft, during the closure of the abdominal wall. Total RNAwas extracted to these samples, converted to cDNA by reverse transcription and the analysis of gene expression was made for CTLA4,IL-­‐1β,IL-­‐4,IL-­‐6,IL-­‐13,TNF-­‐α,Perforin,E Selectin (SELE),Fas-­‐ligand,Granzyme-­‐B,Heme-­‐oxigenase 1 (HO1) and Nitric Oxide Sintetase (iNOS2A) by quantitative PCR, according with the Ct comparative method, using the expression of the non ischemic sample – T0. The fragments of all the biopsies were divided, to send a comparative sample to the usual histologic processement, keeping the same usual protocol at the Transplantation Unit of Curry Cabral Hospital. The presence of some defined histologic parameters, such as steatosis, necrosis, vacuolization, sinusoidal congestion and neutrophilic infiltration, was registered and catalogued in a numeric classification. The clinical and laboratory follow-­‐up, as well as the following of eventual complications, was registered and correlated with the data from organ procurement operations and with the data from the biopsies. The following variables were considered as the most relevant and objective ones, to the interpretation of the clinical evolution, being statistically compared with the clinical and laboratorial collected data: graft dysfunction, post-­‐operative complications, number of readmissions of 2 or more and chronic rejection and /or recipiente death. There were identified some unfavorable clinical characteristics, to be considered under certain circumstances: recipiente female gender (specially associated with malegraft, p=0,077), cold ischemia time of more than 500 minutes (p=0,074), warm ischemia time of more than 90 minutes (p=0,099). In the laboratory analysis, two histologic characteristics were identified as unfavorable and irreversible, associated with bad prognosis: necrosis and balonization (p=0,029); in the gene panel selected in this study, the basal expression of IL-­‐1β (p=0,028), SELE (p=0,013) and FAS-­‐L (p=0,079)were related with worse prognosis.Some intrinsic protective characteristics of the grafts were only indirectly revealed, such as less neutrophilic infiltration and bigger expression of HO1 and iNOS in FAP grafts, being impossible to prove any direct inte ference in the clinical results. A relevant and measurable expression of the anti inflammatory genes IL13 and IL4 was not obtained: with the used methodology, it was impossible to obtain a gene expression profile associated with a favorable clinical outcome.The inverse profile was suggested only by the basal expression of the three mentioned genes (FAS-­‐L, IL-­‐ 1β e SELE) in the same gene panel, according with the followed protocol in this group of 54 patients. The characteristics of the recipient overlapped those from the graft, in the case of :-­‐ FAP diagnosis in the recipient, which determined a bigger predisposition to graft dysfunction, which by itself determines a shorter survival. However, FAP diagnosis in the recipiente depicts a more favorable survival curve. -­‐ Recipients with a low balance risk índex (BAR) defined favorable characteristics to grafts with low and moderate grades of steatosis, making that this characteristic, associated with bad prognosis, looked like a favorable factor, and with no clinical interference. The graft characteristics overlapped those from the receptor in the case of: -­‐ Cold ischemic time more than 500 minutes -­‐ Balonization, necrosis, FAS-­‐L, IL-­‐1β and SELE at T0. The integration of molecular and morphologic results with the clinical evolution, stresses the role of a precocious neutrophils mobilization in the worse outcomes of liver grafts.

Identification de facteurs de risque d'insuffisance rénale en trauma

Contexte: la survenue d’IRA chez les patients ayant subi un traumatisme est une problématique qui a été peu étudiée jusqu’à ce jour. La présence de cette atteinte rénale a été démontrée comme étant associée à un risque accru de morbidités et de mortalité chez les sujets atteints. Objectifs: identifier les facteurs prédictifs d’insuffisance rénale ou plus récemment appelée atteinte rénale dans cette population particulière et tenter de trouver des facteurs qui peuvent être mesurés dans les premières heures de la prise en charge du patient. Aussi, nous avons cherché à savoir si l’injection de produit de contraste est associée à un risque accru d’insuffisance rénale aiguë dans cette population. Méthodes et résultats: la recherche a eu lieu à l’Hôpital du Sacré-Coeur de Montréal, un centre de traumatologie tertiaire en milieu urbain. Nous avons utilisé le registre des patients hospitalisés en traumatologie dans notre centre hospitalier entre 2002 et mars 2007 de même que les banques de données de laboratoire et de radiologie pour obtenir les données sur la créatinine et les examens avec produits de contraste. Finalement, une revue de dossiers structurée fut conduite pour recueillir le reste de l’information requise. L’incidence d’IRA dans la population étudiée est estimée à environ 5 %. Une analyse cas témoins fut conduite pour identifier les facteurs prédictifs d’IRA. Quarante-neuf cas d’IRA diagnostiqués par le médecin traitant et 101 témoins sélectionnés au hasard ont été analysés. Les facteurs prédictifs suivants ont été identifiés à l’analyse univariée : la première valeur de créatinine obtenue (p<0,001), l’instabilité hémodynamique (p<0,001), les antécédents d’insuffisance rénale chronique tels que notés dans le dossier par le médecin traitant (p=0,009), une maladie cardiaque (p=0,007), une chirurgie dans les 48 premières heures suivant le traumatisme (p=0,053), le niveau de gravité du traumatisme (Injury Severity Score) (p=0,046) et l’injection de produit de contraste au cours des 48 heures suivant le trauma (p=0,077). Parmi ces facteurs, deux ont été identifiés comme prédicteurs indépendants d’IRA à l’analyse multivariée. Une des valeurs était la première valeur de créatinine obtenue RC = 6,17 (p<0,001, IC95 % 2,81 – 13,53) pour chaque augmentation de 0.5mg/dL de créatinine. L’autre facteur était la présence d’instabilité hémodynamique RC 11,61 (p<0,001, IC95 % 3,71 – 36,29). Conclusion: des informations obtenues tôt dans la prise en charge du patient permettent de prédire le risque d’IRA chez ces patients. L’administration de contraste (intraveineuse ou intra-artérielle) ne s’est pas avérée un facteur indépendant de prédiction d’insuffisance rénale aiguë dans cette population dans le modèle multivarié.