Myocardial revascularization and bilateral lung transplantation without cardiopulmonary bypass

Coronary artery disease is occasionally encountered in lung transplant recipients and is a risk factor for perioperative complications and poor survival. Besides combined heart-lung transplantation, various techniques of myocardial revascularization can be performed before, or at the time of lung transplantation. We report herein a patient with end-stage bronchoemphysema and two-vessel coronary disease who underwent ‘off-pump' coronary artery bypass graft immediately followed by bilateral lung transplantatio

Fuzzy logic application for economical-financial performance evaluation of production cooperatives

In this work a methodology based on Fuzzy Logic was developed for classification and evaluation of Economical-financial Performance of production cooperatives. Continuous scales were introduced and Fuzzy Logic based sub-models, were created to evaluate Own Capital Return, Payment Capacity and Capital Structure of a production cooperative. By applying the developed model, the Performance dynamics of two production cooperatives (Coopermil and Cotricampo) was analyzed in a 5 year's period.. Evaluations carried out through numeric simulation in order to analyse the influence of several indicators on a production cooperative performance and expert evaluations showed good correlation.Neste trabalho foi desenvolvida uma metodologia baseada em Lógica Fuzzy para classificação e avaliação de Desempenho Econômico-financeiro das cooperativas de produção. Foram introduzidas as escalas contínuas e criados submodelos baseados em Lógica Fuzzy para avaliar Retorno sobre o Capital Próprio, Capacidade de Pagamento e Estrutura de Capital de uma cooperativa de produção. Aplicando o modelo desenvolvido foi analisada a dinâmica de desempenho de duas cooperativas de produção (Coopermil e Cotricampo) no período de 5 anos. As avaliações realizadas pelas simulações numéricas para análise de influência de vários indicadores sobre desempenho de uma cooperativa de produção e as avaliações periciais mostraram uma boa correlação

Pseudovasculitis and corticosteroid therapy

Pseudovasculitis, vasculitis-like syndromes, vasculitis look-alikes, or mimics of vasculitis represent a heterogeneous collection of disorders that are capable of simulating vasculitis. Inappropriate diagnosis leads to delay or absence of proper management and exposure to potentially deleterious treatment modalities such as corticosteroids and cytotoxic agents. We report the case of fibromuscular dysplasia suspected to be a polyarteritis nodosa. The progression of the lesions visualized by the ultrasonographic study and computed tomography (CT) scan after 10days of treatment led to an emergency laparotomy. The possible deleterious role of steroids given to treat the suspected vasculitis is discusse

French national cohort of first use of dalbavancin: a high proportion of off-label use

Dalbavancin is a glycopeptide antibiotic with a long half-life, recently marketed in Europe for skin and soft tissue infections (SSTI), but real-life use is not well-known. We aimed to describe all first prescriptions in France over an 18-month period. We performed a retrospective study on all adult patients who received at least one dose of dalbavancin from July 1, 2017 to September 31, 2018. Data were collected thanks to a standard questionnaire. Failure was defined as: persistent or reappearance of signs of infection; and/or switch to suppressive antibiotic treatment; and/or death from infection. We included 75 patients from 29 French hospitals. Main indications were bone and joint infections (BJIs) (64.0%), endocarditis (25.3%), and SSTIs (17.3%). Main bacteria involved were: Staphylococcus aureus (51.4%), including methicillin-resistant S. aureus (MRSA) (19.4%); and coagulase-negative staphylococci (CNS) (44.4%). Median MICs for staphylococci to vancomycin and dalbavancin ranged from 0.875 mg/L to 2.0 mg/L, and 0.040 mg/L to 0.064 mg/L, respectively. Dalbavancin was used after a mean of 2.3 ± 1.2 lines of antimicrobial treatment. Main treatment regimens for dalbavancin were a weekly 2-dose regimen (1500mg each) in 38 (53.2%) cases, and a single-dose regimen (1500mg) in 13 (18.3%) cases. Overall, at the patients\u27 last visit, clinical cure was observed in 54/72 patients, while failure was found in 14/72 patients. First uses of dalbavancin in France were mostly off-label. Most of them were due to BJIs, and often as rescue therapy for severe infections. Even in off-label situations, dalbavancin seems safe and effective

Estado térmico de produtos armazenados em silos com sistema de aeração: estudo teórico e experimental Thermal state of stored products in storage bins with aeration system: experimental-theoretical study

O resfriamento de grãos por ventilação de ar ambiente aplica-se amplamente nas etapas finais de secagem e para controle posterior da temperatura de grãos armazenados. O objetivo deste trabalho é realizar estudo teórico-experimental sobre o estado térmico de massa de grãos de soja sujeita à aeração. Foram obtidos dados experimentais sobre a dinâmica de resfriamento de massa pré-aquecida de grãos de soja para diferentes alturas da coluna de grãos e velocidades do ar. A análise dos resultados mostrou que a taxa de resfriamento varia significativamente durante todo o processo e em todo o domínio e a difusividade térmica das camadas não poderia ser considerada constante. Para simular a dinâmica de resfriamento, foram apresentados dois modelos matemáticos. No primeiro modelo, o domínio de resfriamento foi dividido pela fronteira móvel em duas zonas, representadas por diferentes difusividades térmicas (análogo de problema de Stefan). No outro modelo, todo o domínio foi dividido hipoteticamente em pequenas camadas e foi considerado que o processo de equilíbrio térmico entre o ar e a massa de grãos para essas camadas é atingido instantaneamente ("reatores homogêneos"). Os resultados de simulações mostraram concordância satisfatória com os dados experimentais.<br>The cooling of grains by ventilation with ambient air applies widely in the final stages of drying and for the subsequent temperature control of stored grains. The objective of this work is to carry out an experimental-theoretical study on the thermal state of a soybean mass, subject to the aeration. The experimental data on cooling dynamics of preheated soybean mass were obtained for different heights of the grain column and air velocities. The analysis of the results showed that the cooling rate varies significantly during all process in all domains and the thermal diffusivity of the layers cannot be considered as a constant. To simulate the cooling dynamics two mathematical models were introduced. In the first model the cooling domain was divided by means of the movable frontier in two zones represented by different coefficients of thermal diffusivity (analogous of Stefan's problem). In another model all the domain was divided hypothetically in small layers and was considered that the thermal balance between the air and the mass of grains for these layers is reached instantly ("homogeneous reactors"). The results of simulations showed a satisfactory agreement with the experimental data

Aplicaçao da lógica fuzzy para avaliaçaoeconomico-financeira de cooperativas de produçao

Neste trabalho foi desenvolvida uma metodologia baseada em Lógica Fuzzy para classificação e avaliação de Desempenho Econômico-financeiro das cooperativas de produção. Foram introduzidas as escalas contínuas e criados submodelos baseados em Lógica Fuzzy para avaliar Retorno sobre o Capital Próprio, Capacidade de Pagamento e Estrutura de Capital de uma cooperativa de produção. Aplicando o modelo desenvolvido foi analisada a dinâmica de desempenho de duas cooperativas de produção (Coopermil e Cotricampo) no período de 5 anos. As avaliações realizadas pelas simulações numéricas para análise de influência de vários indicadores sobre desempenho de uma cooperativa de produção e as avaliações periciais mostraram uma boa correlação.In this work a methodology based on Fuzzy Logic was developed for classification and evaluation of Economical-financial Performance of production cooperatives. Continuous scales were introduced and Fuzzy Logic based sub-models, were created to evaluate Own Capital Return, Payment Capacity and Capital Structure of a production cooperative. By applying the developed model, the Performance dynamics of two production cooperatives (Coopermil and Cotricampo) was analyzed in a 5 year�s period.. Evaluations carried out through numeric simulation in order to analyse the influence of several indicators on a production cooperative performance and expert evaluations showed good correlation

Les mots du discours formés à partir des verbes dire / skazat' en français et en russe

PARIS7-Bibliothèque centrale (751132105) / SudocSudocFranceF