Switch of noninvasive ventilation (NIV) to continuous positive airway pressure (CPAP) in patients with obesity hypoventilation syndrome: a pilot study

International audienceObesity is a major worldwide public health issue. The main respiratory complication stemming from obesity is obesity hypoventilation syndrome (OHS). Most of the OHS patients diagnosed during an exacerbation are treated with non invasive ventilation (NIV). Up to date, no prospective study has demonstrated in real life conditions the feasibility of a systematic protocoled switch of NIV to continuous positive airway pressure (CPAP), once stability is achieved

Анализ причин производственного травматизма в организации

Статья посвящена вопросам исследования и снижения производственного травматизма в России. В статье раскрывается проблема производственного травматизма. Приведена статистика производственного травматизма в Российской Федерации. Представлены результаты общероссийского мониторинга, показана динамика производственного травматизма.The article is devoted to the issues of research and reducing industrial injuries in Russia. The article reveals the problem of occupational injuries. The statistics of occupational injuries in the Russian Federation. The results of the all-Russian monitoring are presented, the dynamics of industrial injuries are shown

Genes for hereditary sensory and autonomic neuropathies: a genotype–phenotype correlation

Hereditary sensory and autonomic neuropathies (HSAN) are clinically and genetically heterogeneous disorders characterized by axonal atrophy and degeneration, exclusively or predominantly affecting the sensory and autonomic neurons. So far, disease-associated mutations have been identified in seven genes: two genes for autosomal dominant (SPTLC1 and RAB7) and five genes for autosomal recessive forms of HSAN (WNK1/HSN2, NTRK1, NGFB, CCT5 and IKBKAP). We performed a systematic mutation screening of the coding sequences of six of these genes on a cohort of 100 familial and isolated patients diagnosed with HSAN. In addition, we screened the functional candidate gene NGFR (p75/NTR) encoding the nerve growth factor receptor. We identified disease-causing mutations in SPTLC1, RAB7, WNK1/HSN2 and NTRK1 in 19 patients, of which three mutations have not previously been reported. The phenotypes associated with mutations in NTRK1 and WNK1/HSN2 typically consisted of congenital insensitivity to pain and anhidrosis, and early-onset ulcero-mutilating sensory neuropathy, respectively. RAB7 mutations were only found in patients with a Charcot-Marie-Tooth type 2B (CMT2B) phenotype, an axonal sensory-motor neuropathy with pronounced ulcero-mutilations. In SPTLC1, we detected a novel mutation (S331F) corresponding to a previously unknown severe and early-onset HSAN phenotype. No mutations were found in NGFB, CCT5 and NGFR. Overall disease-associated mutations were found in 19% of the studied patient group, suggesting that additional genes are associated with HSAN. Our genotype–phenotype correlation study broadens the spectrum of HSAN and provides additional insights for molecular and clinical diagnosis

Pain acceptance and personal control in pain relief in two maternity care models: a cross-national comparison of Belgium and the Netherlands

<p>Abstract</p> <p>Background</p> <p>A cross-national comparison of Belgian and Dutch childbearing women allows us to gain insight into the relative importance of pain acceptance and personal control in pain relief in 2 maternity care models. Although Belgium and the Netherlands are neighbouring countries sharing the same language, political system and geography, they are characterised by a different organisation of health care, particularly in maternity care. In Belgium the medical risks of childbirth are emphasised but neutralised by a strong belief in the merits of the medical model. Labour pain is perceived as a needless inconvenience easily resolved by means of pain medication. In the Netherlands the midwifery model of care defines childbirth as a normal physiological process and family event. Labour pain is perceived as an ally in the birth process.</p> <p>Methods</p> <p>Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004-2005. Two questionnaires were filled out by 611 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth either at home or in a hospital. However, only women having a hospital birth without obstetric intervention (N = 327) were included in this analysis. A logistic regression analysis has been performed.</p> <p>Results</p> <p>Labour pain acceptance and personal control in pain relief render pain medication use during labour less likely, especially if they occur together. Apart from this general result, we also find large country differences. Dutch women with a normal hospital birth are six times less likely to use pain medication during labour, compared to their Belgian counterparts. This country difference cannot be explained by labour pain acceptance, since - in contrast to our working hypothesis - Dutch and Belgian women giving birth in a hospital setting are characterised by a similar labour pain acceptance. Our findings suggest that personal control in pain relief can partially explain the country differences in coping with labour pain. For Dutch women we find that the use of pain medication is lowest if women experience control over the reception of pain medication and have a positive attitude towards labour pain. In Belgium however, not personal control over the use of pain relief predicts the use of pain medication, but negative attitudes towards labour.</p> <p>Conclusions</p> <p>Apart from individual level determinants, such as length of labour or pain acceptance, our findings suggest that the maternity care context is of major importance in the study of the management of labour pain. The pain medication use in Belgian hospital maternity care is high and is very sensitive to negative attitudes towards labour pain. In the Netherlands, on the contrary, pain medication use is already low. This can partially be explained by a low degree of personal control in pain relief, especially when co-occurring with positive pain attitudes.</p

Evidence for deep mantle convection and primordial heterogeneity from nitrogen and carbon stable isotopes in diamond

International audienceDiamond, as the deepest sample available for study, provides a unique opportunity to sample and examine parts of the Earth's mantle not directly accessible. In order to provide further constraints on mantle convection and deep volatile cycles, we analysed nitrogen and carbon isotopes and nitrogen abundances in 133 diamonds from Juina (Brazil) and Kankan (Guinea). Host syngenetic inclusions within these diamonds indicate origins from the lithosphere, the asthenosphere-transition zone and the lower mantle. Juina and Kankan diamonds both display overall carbon isotopic compositions within the current upper mantle range but the δ13C signatures of diamonds from the asthenosphere-transition zone extend toward very negative and positive values, respectively. Two Kankan diamonds with both lower mantle and asthenosphere-transition zone inclusions (KK-45 and KK-83) are zoned in δ13C, and have signatures consistent with multiple growth steps likely within both the lower mantle and the asthenosphere-transition zone illustrating the transfer of material through the 670 km seismic discontinuity. At a given locality, diamonds from the upper and the lower mantle show similar δ15N distributions with coinciding modes within the range defined by typical upper mantle samples, as one might expect for a well stirred reservoir resulting from whole mantle convection. Kankan diamonds KK-11 (lower mantle), KK-21 and KK-92 (both lithospheric) display the lowest δ15N values (-24.9%, -39.4% and -30.4%) ever measured in terrestrial samples, which we interpret as reflecting primordial heterogeneity preserved in an imperfectly mixed convective mantle. Our diamond data thus provide support for deeply rooted convection cells, together with the preservation of primordial volatiles in an imperfectly mixed convecting mantle, thereby reconciling the conflicting interpretations regarding mantle homogeneity derived from geochemical and geophysical studies

A checklist of the vertebrates of Kerala State, India

Following the first publication on vertebrates of India (Blanford 1888–1890), a huge wealth of information has been compiled on the vertebrate fauna of various biogeographic zones of the country, especially the Western Ghats.  The state of Kerala comprising of a land area of 38,863km2, 590km coastline, an intricate system of backwaters along the coast, tropical moist forests of the Western Ghats, the highly undulating terrain, and the tropical monsoon is a unique geographical and environmental entity rich in biodiversity.  A region-specific checklist that summarises and documents the current status of vertebrate diversity provides benchmark data for documentation and appreciation of biodiversity at regional level.  Further, with the current rate of global biodiversity loss and concordant conservation efforts, the taxonomic community has a greater responsibility to make scientific information available to scientists, policy makers, politicians, research students and all relevant stakeholders, an attempt that has been made in the present paper.  The State of Kerala has 1847 species of vertebrates in 330 families and 81 orders, of which 386 are endemic to the Western Ghats region (of the Western Ghats - Sri Lanka Hotspot), and 205 species as threatened. Six hundred and eighty species of vertebrates of Kerala have been listed in the various schedules of the Indian Wildlife (Protection) Act, while 148 are listed in the different appendices of CITES.  </p