Aho bidezko antikoagulatzaile zuzenen maneiua fibrilazio aurikular ez-balbularra eta giltzurrun gutxiegitasun kronikoa duten pazienteengan

[EUS] Sarrera: Giltzurrun gutxiegitasun kronikoa (GGK) duten pazienteengan fibrilazio aurikular ez-balbularraren (FAEB) prebalentzia oso esanguratsua da. FAEBean aho bidezko antikoagulatzaile zuzenek (AAKZ) tronboenbolismoaren prebentzioaren panorama aldatu dute. Hala ere, entsegu klinikoetan GGKa fase aurreratuetan duten pazienteak baztertu zirenez paziente hauetan AAKZen maneiua zalantzan dago. Helburua: Lanaren helburu nagusia FAEBean tronboenbolismoaren prebentziorako AAKZen terapiaren maneiua GGKa pairatzen duten pazienteetan aztertzea da. Material eta metodoak: Berrikuspen bibliografikoa egiteko PubMed, Ovid eta Euskal Herriko Unibertsitateko (EHU) liburutegiaren datu baseetan eta Uptodate web orrialdean egin da bilaketa. MesH eta DeCS tesauroetan ikerketan aztergai izango diren deskriptoreen bilaketa egin da eta inklusio eta esklusio kriterioak zehaztu dira. Azkenik banan banan hautatu egin dira jorratuko diren baliabide bibliografikoak. Emaitzak: Lehenengo estadioetako GGKa duten pazienteetan AAKZek warfarinarekin konparatuz arrisku-onura erlazio hobea dute. GGKa duten pazienteentzat AAKZen artean apixaban aukera egokiena da. Hala ere, GGKan KrA jaisten doan heinean antikoagulazioari buruzko ebidentzia eskasa da. Horregatik paziente hauetan antikoagulatzearen erabakia pazientearekin batera baloratu behar da. GGTeko pazienteetan praktika klinikoaren arabera apixaban edo warfarina (2.0tik-3.0ko INR-arekin) preskribitu daitezke. AAKZen dosifikazio egokia egiteko Cockcroft-Gault metodoa erabiliz KrAren kalkulua egin behar da. Bestetik, AAKZekin tratuta dauden eta GGK duten pazienteetan monitorizazioa urtean behin baino gehiagotan egin behar da. Ondorioak: FAEB eta GGT duten pazienteetan aho bidezko antikoagulazioari buruzko zorizko entsegu kliniko sendoak behar dira. Horregatik, paziente hauetan aho bidezko antikoagulazioaren terapiaren aukeraketa banakakoa izan behar da eta pazientearen eta medikuaren arteko erabaki partekatuetan oinarritu egin behar da

Diseño de un molde de inyección para el mango plástico de una cepilladora eléctrica

El proyecto consiste en el diseño de un molde de inyección para la posterior fabricación en serie de mangos plásticos para una cepilladora eléctrica. La pieza a fabricar, será un mango plástico perteneciente a la cepilladora eléctrica DPP-665 de la marca DEXTER. El proyecto se llevará a cabo mediante el módulo MoldWizard de Siemens PLM-NX10 y Autodesk Moldflow Adviser 2017.Proiektu honetan injekzio molde bat diseinatuko da eskuil elektriko baten plastikozko kirtena seriean fabrikatzeko. Fabrikatuko den pieza DEXTER markako DPP-665 eskuil elektrikoari dagokio. Proiektua aurrera eramateko Siemens PLM-NX10-ko MoldWizard modulua eta Autodesk Moldflow Adviser 2017 software-a erabili dira.The Project consists in the design of an injection mould for the mass production of the handle of an electric planer. The plastic handle is part of a DEXTER brand electric planer which model is DPP-665. The project will be carried out using Siemens PLM-NX10´s MoldWizard module and Autodesk Moldflow Adviser 2017

Conceptual and Operational Integration of Governance, Financing, and Business Models for Urban Nature-Based Solutions

Governance, financing, and business models are deeply interlinked and relevant for the successful implementation of urban nature-based solutions (NBS). However, during the definition of urban NBS projects the importance and interrelation of these models are usually neglected. To overcome this limitation, this paper presents an overarching framework (conceptual and operational) and a derived preselection web tool which interrelate governance, financing, and business models for NBS projects. First, based on recent literature, governance, financing, and business models that could be applied to NBS were mapped, and their integration proposed. Later, key contextual factors influencing NBS implementation were identified. They form the basis of a WHAT–WHO–HOW framework that structures the links between specific NBS projects, their implementation context, and the most suitable models. From that framework, and an analysis of 50 successful NBS case studies, a suitability matrix was developed with known models. The matrix allows pairing types of NBS and their initiating actors with suitable financing and governance models. Lastly, a tailored NBS business model canvas was designed to evaluate the business model components. From the overarching framework, the preselection web tool was created to guide decision-making on suitable governance, finance, and business models in the early phases of NBS projects.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 73046

Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report

<p>Abstract</p> <p>Background</p> <p>Acute low back pain is a very common symptom and reason for many medical consultations. In some unusual circumstances it could be linked to a rare aetiology.</p> <p>Case presentation</p> <p>We report a 70-year-old man with an 8-month history of left posterior thigh and leg pain who had sudden confusion after a fall from standing. It was due to cerebral fat embolism suspected by computed tomography scan, later confirmed by brain magnetic resonance imaging (MRI). A spinal MRI scan was then performed and revealed a sacral fracture which drained into an unknown perineurial cyst (Tarlov cyst). Under medical observation the patient fully recovered within three weeks.</p> <p>Conclusions</p> <p>Sacral perineurial cysts are rare, however they remain a potential cause of lumbosacral radiculopathy.</p

Parents' perception of self-advocacy of children with myositis: an anonymous online survey

<p>Abstract</p> <p>Background</p> <p>Children with complex medical issues experience barriers to the transition of care from pediatric to adult providers. We sought to identify these barriers by elucidating the experiences of patients with idiopathic inflammatory muscle disorders.</p> <p>Methods</p> <p>We collected anonymous survey data using an online website. Patients and their families were solicited from the US and Canada through established clinics for children with idiopathic inflammatory muscle diseases as well as with the aid of a nonprofit organization for the benefit of such individuals. The parents of 45 older children/young adults suffering from idiopathic inflammatory muscle diseases were surveyed. As a basis of comparison, we similarly collected data from the parents of 207 younger children with inflammatory muscle diseases. The survey assessed transition of care issues confronting families of children and young adults with chronic juvenile myositis.</p> <p>Results</p> <p>Regardless of age of the patient, respondents were unlikely to have a designated health care provider assigned to aid in transition of care and were unlikely to be aware of a posted policy concerning transition of care at their pediatrician's office. Additionally, regardless of age, patients and their families were unlikely to have a written plan for moving to adult care.</p> <p>Conclusions</p> <p>We identified deficiencies in the health care experiences of families as pertain to knowledge, self-advocacy, policy, and vocational readiness. Moreover, as children with complex medical issues grow up, parents attribute less self-advocacy to their children's level of independence.</p

Metaphysics In Midwestern America: Spiritual Frontiers Fellowship.

PhDCultural anthropologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/190267/2/7804834.pd

Legislative Documents

Also, variously referred to as: House bills; House documents; House legislative documents; legislative documents; General Court documents

The impact of organization culture on employee work attitudes, readiness for change, and organizational performance

Ph.D.Michael Yor