37 resultados para Constrictive Pericarditis


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Constrictive pericarditis (CP) is an uncommon disease resulting from chronic pericardial inflammation, fibrosis and calcification. Since there are atypical forms of presentation, with subtle or nonexistent cardiorespiratory symptoms, diagnosis may be challenging and difficult. Recurrent ascites in patients with congestive hepatopathy due to constrictive pericarditis is, in most cases, reversible after pericardiectomy. Nevertheless, development of persistent liver dysfunction may be a long-term complication. The present case describes a 23 years old man with growth delay, dyspnoea and long evolution ascites, whose exhaustive etiological investigation led to diagnosis. Afterwards the patient underwent elective surgery with symptom and general condition improvement. Ascites differential diagnosis and its association with constrictive pericarditis are briefly reviewed in this article.

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We report a case of a 34-year-old male with acute severe heart failure associated with marked concentric left ventricular wall thickening and biopsy evidence of eosinophilic myocardial infiltrate. This appears to be an unusual description of this degree of concentric myocardial thickening in eosinophilic myocarditis coupled with Doppler tissue echocardiography. Following high-dose corticosteroid treatment, wall thickness, systolic and diastolic left ventricular function normalized and the patient experienced a dramatic clinical improvement. (ECHOCARDIOGRAPHY, Volume 20, May 2003).

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Lyme disease has been associated with many systemic and ocular complications. The authors' patient, a 26-year-old man, developed recurrent pars planitis with two episodes of acute pericarditis. Extensive medical investigations were negative except for a highly positive western blot for Borrelia burgdorferi. Specific antibiotic treatment for Lyme disease was followed by a long lasting period without any relapse.

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Includes bibliography

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Fil: Trucco, Emilce. Hospital Español de Mendoza. Departamento de Cardiología.

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Before the Global Financial Crisis many providers of finance had growth mandates and actively pursued development finance deals as a way of gaining higher returns on funds with regular capital turnover and re-investment possible. This was able to be achieved through high gearing and low presales in a strong market. As asset prices fell, loan covenants breached and memories of the 1990’s returned, banks rapidly adjusted their risk appetite via retraction of gearing and expansion of presale requirements. Early signs of loosening in bank credit policy are emerging, however parties seeking development finance are faced with a severely reduced number of institutions from which to source funding. The few institutions that are lending are filtering out only the best credit risks by way of constrictive credit conditions including: low loan to value ratios, the corresponding requirement to contribute high levels of equity, lack of support in non-prime locations and the requirement for only borrowers with well established track records. In this risk averse and capital constrained environment, the ability of developers to proceed with real estate developments is still being constrained by their inability to obtain project finance. This paper will examine the pre and post GFC development finance environment. It will identify the key lending criteria relevant to real estate development finance and will detail the related changes to credit policies over this period. The associated impact to real estate development projects will be presented, highlighting the significant constraint to supply that the inability to obtain finance poses.

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Purpose: The purpose of this paper is to identify changes in bank lending criteria due to the GFC and to explore the associated impacts on new housing supply in Queensland, Australia. Design/methodology/approach: This research involves a survey of each of Australia’s big four banks, as well as two prominent arrangers of development finance. Data on key lending criteria was collected: Pre GFC, during the GFC, and GFC recovery stage. Findings: The GFC has resulted in a retraction of funds available for residential development. The few institutions lending are filtering out only the best credit risks by way of constrictive loan covenants including: low loan to value ratios, high cash equity requirements, regional “no go” zones, and demonstrated borrower track record. The ability of developers to proceed with new housing developments is being constrained by their inability to obtain sufficient finance. Research limitations/implications: This research uses survey data, together with an understanding of the project finance process to extrapolate impacts on the residential development industry across Queensland. No regional or sub-market analysis is included. Future research will include subsequent surveys to track any loosening of credit policies over time and sub-market sector analysis. Practical implications: The inability to obtain project finance is identified as a key constraint to new housing supply. This research will inform policy makers and provide important quantitative evidence of the importance of availability of development finance in the housing supply chain. Social implications: Queensland is facing a supply shortfall, which if not corrected, may lead to upward pressure on house prices and falling housing affordability. Originality/value: There is very little academic research on development funding. This research is unique in linking bank lending criteria to new housing supply and demonstrating the impact on the development industry.

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In australia, 'Aboriginality' is often defined by people in constrictive ways that are heavily influenced by the coloniser's epistemological frameworks. An essential component of this is a 'racial' categorisation of peoples that marks sameness and difference, thereby influencing insider and outsider status. In one sense, this categorisation of people acts to exclude non-aboriginal 'others' from participation in preinvasion indigenous ontologies, ways of living that may not have contained such restrictive identity categories and were thereby highly inclusive of outsiders. One of the effects of this is that aboriginal peoples' efforts for 'advancement' - either out of 'disadvantage' and/or towards political independence (ie, sovereignty) - become confined and restricted by what is deemed possible within the coloniser's epistemological frameworks. This is so much so that aboriginal people are at risk of only reinforcing and upholding the very systems that resulted in their original and continuing dispossession.

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A nonlinear suboptimal guidance scheme is developed for the reentry phase of the reusable launch vehicles. A recently developed methodology, named as model predictive static programming (MPSP), is implemented which combines the philosophies of nonlinear model predictive control theory and approximate dynamic programming. This technique provides a finite time nonlinear suboptimal guidance law which leads to a rapid solution of the guidance history update. It does not have to suffer from computational difficulties and can be implemented online. The system dynamics is propagated through the flight corridor to the end of the reentry phase considering energy as independent variable and angle of attack as the active control variable. All the terminal constraints are satisfied. Among the path constraints, the normal load is found to be very constrictive. Hence, an extra effort has been made to keep the normal load within a specified limit and monitoring its sensitivity to the perturbation.

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Results observed experimentally are presented, about the DC arc plasma jets and their arc-root behaviour generated at reduced gas pressure without or with an applied magnetic field. Pure argon, argon-hydrogen or argon- nitrogen mixture was used as the plasma-forming gas. A specially designed copper mirror was used for a better observation of the arc-root behaviour on the anode surface of the DC non-transferred arc plasma torch. It was found that in the cases without an applied magnetic field, the laminar plasma jets were stable and approximately axisymmetrical. The arc-root attachment on the anode surface was completely diffusive when argon was used as the plasma-forming gas, while the arc-root attachment often became constrictive when hydrogen or nitrogen was added into the argon. As an external magnetic field was applied, the arc root tended to rotate along the anode surface of the non-transferred arc plasma torch.

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Experimentally observed, results are presented for the DCarcplasmajets and theirarc-rootbehaviors generated atreduced gas pressure and without or with an' applied magnetic field. Pure argon, argon -hydrogen or argon-nitrogen mixture is used as the plasma-forming gas. A specially designed copper mirror is constructed and used for better observing the arc-root behavior on the anode surface of the DC non-transferred arcplasma torch. It is shown that for the cases without applied magnetic field, the laminar plasmajets are stable and approximately axisymmetrical. The arc-root attachment on the anode surface is completely diffusive when argon is used as the plasma-forming gas, while the arc-root attachment often becomes constrictive when hydrogen or nitrogen is added into the argon. When an external magnetic field is applied, the arcroot tends to rotate along the anode surface of the non-transferred arcplasma torch.

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Le but de cette étude était d’évaluer les qualifications de performance du système FlexiWare® chez le rat male Sprague Dawley et le singe Cynomolgus éveillés, ainsi que chez le chien Beagle éveillé et anesthésié, suite à l’administration de produits ayant une activité pharmacologique connue. Les produits utilisés incluaient l’albutérol administré par inhalation, la méthacholine, et le rémifentanil administrés par voie intraveineuse. Une solution saline administré par voie intraveneuse, a été utilisée comme substance témoin. Différentes variables ont servi à évaluer la réponse des animaux (rats, chien, singe). Ces dernières comprenaient la fréquence respiratoire (RR), le volume courant (TV), la ventilation minute (MV). Des paramètres additionnels ont été évalués chez le rat, soit les temps d’inspiration (IT) et d’expiration (ET), le temps du pic de débit expiratoire, les pics de débits inspiratoire et expiratoire, le ratio inspiratoire:expiratoire (I:E), le ratio inspiratoire sur respiration totale (I:TB), et l’écoulement expiratoire moyen (EF50). Les résultats obtenus ont démontré que le système FlexiWare® était suffisamment sensible et spécifique pour dépister, chez les espèces animales utilisées, les effets bronchodilateur, bronchoconstricteur et dépresseur central des substances testées. Il pourrait faire partie des méthodes (ICH 2000) utilisées en pharmacologie de sécurité lors de l’évaluation de substances pharmacologiques sur le système respiratoire des animaux de laboratoire. Les espèces animales utilisées ont semblé s’adapter aisément aux procédures de contention. Les paramètres évalués, RR, TV et MV ont permis de caractériser la réponse des animaux suite à l’administration de produits pharmacologiques à effets connus, judicieusement complétés par les variables de débit. L’ajout de paramètres du temps n’était pas primordiale pour détecter les effets des drogues, mais offre des outils complémentaires d’interpréter les changements physiologiques. Cependant, chez le rat conscient, la période d’évaluation ne devrait pas s’étendre au-delà d’une période de deux heures post traitement. Ces études constituent une évaluation des qualifications de performance de cet appareil et ont démontré de manière originale, la validation concurrentielle, en terme de précision (sensibilité et spécificité) et fiabilité pour différentes variables et sur différentes espèces.

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Il a été démontré que la torsion des têtes métatarsiennes est influencée par le mode de locomotion chez les primates et peut être utilisée pour déterminer la présence ou non d’une arche longitudinale chez les ancêtres hominines. Chez l’humain moderne, l’arche longitudinale rend le pied plus inversé que chez les grands singes, provoquant un léger basculement de l’axe dorsoplantaire de l’articulation proximale des métatarses. Ainsi, les têtes métatarsiennes subissent une torsion par rapport à l’axe de la diaphyse pour que leur surface plantaire reste parallèle au sol. Comme les femmes ont une arche longitudinale plus haute que les hommes et comme le port du soulier à semelles rigides provoque des changements morphologiques au niveau du pied, rendant l’arche longitudinale plus haute et l’hallux moins divergeant, il est attendu que la torsion métatarsienne soit différente selon le sexe et le type de soulier porté. Ce mémoire examine donc l’effet du contexte environnemental du pied et de la plasticité de la torsion des têtes métatarsiennes en comparant différentes populations humaines. L’échantillon disponible pour cette étude est constitué de 166 individus provenant de 18 sites archéologiques différents comprenant 57 hommes, 35 femmes et 74 individus de sexe indéterminé qui ont été divisés en quatre grands groupes : Amérindiens, Inuits, Militaires et Euro-canadiens. Il n’y a aucune différence de torsion entre les hommes et les femmes, ce qui suggère que la différence de hauteur de l’arche longitudinale entre les hommes et les femmes n’est pas assez importante pour être perçues au niveau de la torsion des têtes métatarsiennes. La topographie ne semble pas provoquer assez de modifications au niveau du pied pour provoquer une torsion différentielle des têtes métatarsiennes. Cependant, la surface du sol, plat ou accidenté, pourrait être un facteur modifiant ce trait. Finalement, le port de souliers constrictif à semelles dures comparativement aux souliers souples, tels les mocassins, provoque une torsion différentielle des têtes métatarsiennes. Les individus chaussant des souliers à semelles souples ont un premier métatarsien présentant une plus grande éversion et un troisième, quatrième et cinquième métatarsien présentant une plus petite éversion comparativement aux individus chaussant des souliers constrictifs. Ces résultats viennent appuyer l’hypothèse de la capacité plastique de la torsion des têtes métatarsiennes.