375 research outputs found

    Management der Primären Ciliären Dyskinesie

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    Die Primäre Ciliäre Dyskinesie (PCD, MIM 242650) ist eine seltene hereditäre Multisystemerkrankung mit klinisch heterogenem Phänotyp. Leitsymptom ist eine chronische Sekretretention der oberen und unteren Atemwege, welche durch die Dysfunktion motiler respiratorischer Zilien entsteht. In der Folge kommt es zur Ausbildung von Bronchiektasen, häufig zu einer Infektion durch Pseudomonas aeruginosa sowie einer abnehmenden Lungenfunktion bis hin zum Lungenversagen. Bislang gibt es kaum evidenzbasierte Therapieempfehlungen, da randomisierte Langzeitstudien zur Behandlung der PCD fehlten. In diesem Jahr wurden die Daten einer ersten placebokontrollierten Medikamentenstudie bei PCD veröffentlicht. Anlässlich dieses Meilensteins im Management der PCD wurde der vorliegende Übersichtsartikel als Konsens von Patientenvertretern sowie Klinikern, die langjährige Erfahrung in der Behandlung der PCD haben, verfasst. Diese Arbeit bietet eine Zusammenfassung aktuell eingesetzter Behandlungsverfahren, die überwiegend auf persönlichen Erfahrungen und Expertenmeinungen beruhen oder von anderen Atemwegserkrankungen wie der Cystischen Fibrose (CF), COPD oder Bronchiektasen-Erkrankung abgeleitet werden. Da es derzeit keine kurative Therapie für PCD gibt, stehen symptomatische Maßnahmen wie die regelmäßige Reinigung der Atemwege und die Behandlung von rezidivierenden Atemwegsinfektionen im Fokus. Nicht respiratorische Manifestationen werden organspezifisch behandelt. Um neben der ersten Medikamentenstudie mehr evidenzbasiertes Wissen zu generieren, werden weitere Projekte etabliert, u. a. ein internationales PCD-Register. Hierüber wird Patienten der Zugang zu klinischen und wissenschaftlichen Studien erleichtert und die Vernetzung behandelnder Zentren gefördert. Des Weiteren können Erkenntnisse über eine Genotyp-spezifische Erkrankungsschwere erlangt werden, um folglich die therapeutische Versorgung der Patienten zu verbessern und somit zu individualisieren. = Primary Ciliary Dyskinesia (PCD, MIM 242650) is a rare, hereditary multiorgan disease characterized by malfunction of motile cilia. Hallmark symptom is a chronic airway infection due to mucostasis leading to irreversible lung damage that may progress to respiratory failure. There is no cure for this genetic disease and evidence-based treatment is limited. Until recently, there were no randomized controlled trials performed in PCD, but this year, data of the first placebo-controlled trial on pharmacotherapy in PCD were published. This cornerstone in the management of PCD was decisive for reviewing currently used treatment strategies. This article is a consensus of patient representatives and clinicians, which are highly experienced in care of PCD-patients and provides an overview of the management of PCD. Treatments are mainly based on expert opinions, personal experiences, or are deduced from other lung diseases, notably cystic fibrosis (CF), COPD or bronchiectasis. Most strategies focus on routine airway clearance and treatment of recurrent respiratory tract infections. Non-respiratory symptoms are treated organ specific. To generate further evidence-based knowledge, other projects are under way, e. g. the International PCD-Registry. Participating in patient registries facilitates access to clinical and research studies and strengthens networks between centers. In addition, knowledge of genotype-specific course of the disease will offer the opportunity to further improve and individualize patient care

    Проект организации ремонтной мастерской в условиях компании "Сандайское коллективное сельхозпредприятие" п. Тяжин, Кемеровской области

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    Анотация В обеспечении успешной деятельности хозяйств, важная роль принадлежит их ремонтной службе. Сельское хозяйство страны располагает развитой системой ремонтно-обслуживающих предприятий и мастерских хозяйств, пунктов технического обслуживания машин. Однако перед сельским хозяйством стоят серьезные задачи по совершенствованию инженерной службы на селе. Страна ещё несет большие потери из-за выхода машин из строя, их невысокого ресурса, невысокого качества ремонта и технического обслуживания. Существенным обстоятельством, действующим в пользу развития собственных ремонтных мастерских хозяйств, является возможность выполнения определенного объема ремонтных работ в осенне-зимний период силами работников хозяйств, не занятых сельскохозяйственными работами. Это повышает занятость в хозяйствеAnnotation In ensuring the success of the economy, an important role belongs to their repair service. The country's agriculture has developed a system repair and service enterprises and workshops farms, settlements maintenance of machinery. However, before agriculture faces serious challenges in improving the engineering service in rural areas. The country still suffers great losses because of the failure of the machines, their low resources, poor quality of repair and maintenance. An important fact, acting in favor of the development of their own repair shops farms, is the ability to perform a certain amount of repair work in the autumn-winter period the forces of farm workers are not engaged in agricultural work. This increases employment in the sector of workers and contributes to the stabilization frames

    A Jungly Feeling: the Atmospheric Design of Zoos

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    This is the author accepted manuscript. The final version is available from Palgrave Macmillan via the DOI in this recordThis chapter examines the importance of atmosphere in understanding our experiences of zoos. It focuses in particular on the role played by sound in the production of atmospheres in the zoo context. Zoos often work hard to generate atmospheres which are appropriate to their purpose as sites for entertainment, education and conservation, and the encouragement of environmentally responsible behaviour. Drawing on first-hand experiences and observations of zoo visiting, the chapter considers some of the different types of atmosphere that zoos create, pointing to some of the ways in which atmospheres may allude or resist the attempts made to direct or construct them. The chapter also suggests that the non-human animals kept in zoos are likely to have their own atmospheric experiences of zoo space, which are perhaps very different in character from those of visitors and staff. We argue that zoos are atmospherically heterogeneous and complex and face continual challenges as they try to design and maintain atmospheres in line with institutional aims and visitor expectations. A key atmospheric challenge for zoos is to reconcile visitors’ desire to observe and experience forms of natural and ecological otherness with the realities of managing and displaying closely controlled animal populations

    Adult-type granulosa cell tumor of the ovary : a FOXL2-centric disease

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    Adult-type granulosa cell tumors (aGCTs) account for 90% of malignant ovarian sex cord-stromal tumors and 2-5% of all ovarian cancers. These tumors are usually diagnosed at an early stage and are treated with surgery. However, one-third of patients relapse between 4 and 8 years after initial diagnosis, and there are currently no effective treatments other than surgery for these relapsed patients. As the majority of aGCTs (>95%) harbor a somatic mutation in FOXL2 (c.C402G; p.C134W), the aim of this study was to identify genetic mutations besides FOXL2 C402G in aGCTs that could explain the clinical diversity of this disease. Whole-genome sequencing of 10 aGCTs and their matched normal blood was performed to identify somatic mutations. From this analysis, a custom amplicon-based panel was designed to sequence 39 genes of interest in a validation cohort of 83 aGCTs collected internationally. KMT2D inactivating mutations were present in 10 of 93 aGCTs (10.8%), and the frequency of these mutations was similar between primary and recurrent aGCTs. Inactivating mutations, including a splice site mutation in candidate tumor suppressor WNK2 and nonsense mutations in PIK3R1 and NLRC5, were identified at a low frequency in our cohort. Missense mutations were identified in cell cycle-related genes TP53, CDKN2D, and CDK1. From these data, we conclude that aGCTs are comparatively a homogeneous group of tumors that arise from a limited set of genetic events and are characterized by the FOXL2 C402G mutation. Secondary mutations occur in a subset of patients but do not explain the diverse clinical behavior of this disease. As the FOXL2 C402G mutation remains the main driver of this disease, progress in the development of therapeutics for aGCT would likely come from understanding the functional consequences of the FOXL2 C402G mutation.Peer reviewe

    Trueness of CAD/CAM digitization with a desktop scanner – an in vitro study

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    Desktop scanners are devices for digitization of conventional impressions or gypsum casts by indirect Computer-Aided Design/Computer-Assisted Manufacturing (CAD/CAM) in dentistry. The purpose of this in vitro study was: 1, to investigate whether virtual models produced by the extraoral scanner have the same trueness as sectioned casts; and 2, to assess if digitization with an extraoral scanner influences the surface information

    Shelled pteropods in peril: Assessing vulnerability in a high CO2 ocean

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    The impact of anthropogenic ocean acidification (OA) on marine ecosystems is a vital concern facing marine scientists and managers of ocean resources. Euthecosomatous pteropods (holoplanktonic gastropods) represent an excellent sentinel for indicating exposure to anthropogenic OA because of the sensitivity of their aragonite shells to the OA conditions less favorable for calcification. However, an integration of observations, experiments and modelling efforts is needed to make accurate predictions of how these organisms will respond to future changes to their environment. Our understanding of the underlying organismal biology and life history is far from complete and must be improved if we are to comprehend fully the responses of these organisms to the multitude of stressors in their environment beyond OA. This review considers the present state of research and understanding of euthecosomatous pteropod biology and ecology of these organisms and considers promising new laboratory methods, advances in instrumentation (such as molecular, trace elements, stable isotopes, palaeobiology alongside autonomous sampling platforms, CT scanning and high-quality video recording) and novel field-based approaches (i.e. studies of upwelling and CO2 vent regions) that may allow us to improve our predictive capacity of their vulnerability and/or resilience. In addition to playing a critical ecological and biogeochemical role, pteropods can offer a significant value as an early-indicator of anthropogenic OA. This role as a sentinel species should be developed further to consolidate their potential use within marine environmental management policy making
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