Anemia and chronic kidney disease are potential risk factors for mortality in stroke patients : a historic cohort study

Rapport de synthèseApproche et objectifL'objectif de la recherche était de préciser les relations existant entre l'insuffisance rénale chronique, l'anémie et l'accident vasculaire cérébral parmi des patients hospitalisés au Centre Hospitalier Universitaire Vaudois (CHUV) pour un accident vasculaire cérébral (AVC). Les auteurs ont déterminé la prévalence de l'anémie et de l'insuffisance rénale chronique parmi ces patients et examiné s'ils sont des facteurs de risque indépendants de la mortalité suite à un AVC.L'insuffisance rénale chronique est associée à un risque élevé de développer un AVC. L'anémie est une complication et une conséquence fréquente qui découle de l'insuffisance rénale chronique et est également un facteur de risque pour les maladies cérébro- et cardiovasculaires.MéthodeLa présente étude de cohorte rétrospective se base sur le registre des AVC du CHUV et inclut tous les patients traités suite à un premier AVC au service de neurologie du CHUV entre les années 2000 et 2003.Les variables utilisées pour l'analyse sont les caractéristiques démographiques, l'insuffisance rénale chronique, le débit de filtration glomérulaire.(GFR), l'anémie et d'autres facteurs de risque d'AVC. Ils ont été récoltés au moyen du système informatique du laboratoire du CHUV, d'entretiens téléphoniques (patients ou proches) et du registre des AVC du CHUV.L'insuffisance rénale chronique a été calculée sur base de la ,,Kidney Disease Outcomes Quality Initiative (K/DOQI)-CKD Classification", laquelle est divisée en cinq stades. L'anémie a été définie par une hémoglobine de < 120g/L pour les femmes et < 130g/L pour les hommes.Les analyses statistiques réalisées sont des tests Chi-carré, des tests de Τ ainsi que des courbes de Kaplan-Meier et le modèle de régression de Cox.RésultatsParmi 890 patients adultes avec un AVC, le GFR moyen était de 64.3 ml/min/1.73 m2, 17% souffraient d'anémie et 10% sont décédés pendant la première année après la sortie de l'hôpital, suite à l'"AVC index". Parmi ceux-ci, 61% avaient une insuffisance rénale chronique de stade 3-5 et 39% de stade 1 ou 2 selon les critères de K/DOQI.D'autre part un taux d'hémoglobine élevé a pu être associé à un risque moins élevé de mortalité un an après la sortie de l'hôpital.Conclusion et perspectiveNous avons constaté que l'anémie ainsi que l'insuffisance rénale chronique sont fréquents parmi les patients souffrant d'un AVC et qu'ils sont des facteurs de risque d'un taux de mortalité élevé après un an. En conséquence, il pourrait être utile de traiter les patients souffrant d'anémie et d'insuffisance rénale dès que possible afin de diminuer les complications et comorbidités résultants de ces maladies.La perspective est de rendre les cliniciens attentif à l'importance de l'insuffisance rénale et de l'anémie parmi les patients ayants développé un AVC, ainsi que d'initier le traitement approprié afin de diminuer les complications, les comorbidités ainsi que les récidives d'un AVC. L'efficacité et l'économicité des interventions visant à améliorer le pronostic chez les patients présentant un AVC et souffrant d'une insuffisance rénale chronique et / ou d'une anémie doivent être évaluées par des études appropriées

b \bar b b\bar b production in proton-nucleus collisions at the LHC

A sizable rate of events, with several pairs of $b$-quarks produced contemporarily by multiple parton interactions, may be expected at very high energies as a consequence of the large parton luminosities. The production rates are further enhanced in hadron-nucleus reactions, which may represent a convenient tool to study the phenomenon. We compare the different contributions to $b{\bar b}b{\bar b}$ production, due to single and double parton scatterings, in collisions of protons with nuclei at the CERN-LHC.Comment: 13 pages, 4 figure

Synthetic blocks for bone regeneration : A systematic review and meta-analysis

This systematic review is aimed at evaluating the effectiveness of synthetic block materials for bone augmentation in preclinical in vivo studies. An electronic search was performed on Pubmed, Scopus, EMBASE. Articles selected underwent risk-of-bias assessment. The outcomes were: new bone formation and residual graft with histomorphometry, radiographic bone density, soft tissue parameters, complications. Meta-analysis was performed to compare new bone formation in test (synthetic blocks) vs. control group (autogenous blocks or spontaneous healing). The search yielded 214 articles. After screening, 39 studies were included, all performed on animal models: rabbits (n = 18 studies), dogs (n = 4), rats (n = 7), minipigs (n = 4), goats (n = 4), and sheep (n = 2). The meta-analysis on rabbit studies showed significantly higher new bone formation for synthetic blocks with respect to autogenous blocks both at four-week (mean difference (MD): 5.91%, 95% confidence intervals (CI): 1.04, 10.79%, p = 0.02) and at eight-week healing (MD: 4.44%, 95% CI: 0.71, 8.17%, p = 0.02). Other animal models evidenced a trend for better outcomes with synthetic blocks, though only based on qualitative analysis. Synthetic blocks may represent a viable resource in bone regenerative surgery for achieving new bone formation. Differences in the animal models, the design of included studies, and the bone defects treated should be considered when generalizing the results. Clinical studies are needed to confirm the effectiveness of synthetic blocks in bone augmentation procedures

An environment to share in-service training on the net: An action-research about charge in primary and middle school

The net was one of the determining factors in a training of a Group of 4 primary and middle school teachers (L. M. in Forni Di Sopra and C. D. F. in Villa Santina, P. C. in Tolmezzo and D. S. in Gemona, all places in the mountains of Friuli, in the Nord-East of Italy) in an action-research on the electric charge. It was developed through meetings with researchers in physics education and Exchange and sharing of experiences and projects on the net, in an environment designed for teaching activities and under the guidance of a project tutor. The environment allowed to establish different kinds of relations: between teachers, between them and researchers, between classes. It offered to teachers (two in middle school and two in primary school) a place for discussions during the design of paths to be presented to their classes, to structure and share the products of their training both during and after it, to reflect on their training path

Recognition and genotyping of minor germplasm of Friuli Venezia Giulia revealed high diversity

The wealth of vine varieties that used to exist in Friuli Venezia Giulia has been progressively lost. In order to ascertain the current situation regarding vine germplasm in the region, between 2001 and 2008, a wide-ranging study was conducted of recovery, conservation and molecular characterization with microsatellite markers (SSR) of accessions of minor germplasm at risk of erosion or extinction. A total of 178 accessions were analyzed and 93 varieties identified. Of these, 44 are already registered in the Italian Catalogue, 8 have been imported and are well-known foreign varieties even if not registered in the Italian Catalogue, 38 are potentially autochthonous and of these only 15 are described or at least cited in the literature; there are no hypotheses on the remaining three. In order to obtain information on possible genetic similarities, three types of software were used to process the molecular data, but only Structure allowed the existence of two principal groupings to be hypothesized for some of the presumed Friuli autochthons: one that gravitates around ‘Prosecco’ and the other around ‘Refoscone’.

Double parton scatterings in b-quark pairs production at the LHC

A sizable rate of events where two pairs of b-quarks are produced contemporarily is foreseen at the CERN LHC, as a consequence of the large parton luminosity. At very high energies both single and the double parton scatterings contribute to the process, the latter mechanisms, although power suppressed, giving the dominant contribution to the integrated cross section.Comment: 17 pages, 6 figure

Antimicrobial activity, toxicity and accumulated hard-tissue debris (AHTD) removal efficacy of several chelating agents

Aim: To evaluate the antimicrobial, toxicity and cleaning effectiveness of ethylenediaminetetraacetic acid (EDTA) and maleic acid (MA) alone and combined with cetrimide (CTR). Methodology: Cytotoxic and genotoxic effects were assessed on Chinese hamster cells V79 using the MTT, clonogenic and micronucleus assays, respectively. The bacterial inhibitory and bactericidal concentrations (MIC and MBC, respectively) were determined on a strain of Enterococcus faecalis. Antimicrobial tests were performed on a biofilm model after treatment with the chelating agents by using a biofilm eradication concentration (MBEC) and confocal laser scanning microscope (CLSM) assays. Quantification of cell biomass and percentage of live and dead cells in the biomass were assessed for each group. The percentage reduction of accumulated hard-tissue debris (AHTD) after root canal preparation and final irrigation protocols was evaluated by micro-CT. Statistical tests of one-way analysis of variance (anova), Bonferroni test, Kruskal\u2013Wallis test, Dunn\u2019s multiple comparison test and Wilcoxon matched-pairs signed-rank tests were used. Results: Cetrimide alone as well as in combination with EDTA and MA at dilutions of 1/10 and 1/100 was significantly more toxic as compared to untreated controls (P < 0.001). All tested mixtures were nontoxic at a dilution of 1/1000. EDTA retained a weak inhibitory and bactericidal effect against planktonic cells, whilst MA inhibited cells growth and killed 99.9% of the cells when diluted. CTR revealed the most prominent effect, being inhibitory and bactericidal, also when diluted. Cetrimide alone or combined with EDTA was able to remove, respectively, 40% (P < 0.01) and 60% (P < 0.001) of the entire biomass after 1 min. Conversely, MA alone and in combination with CTR did not have a significant effect on biomass reduction. After final irrigation, the AHTD volume was significantly decreased in all groups (P < 0.05). EDTA + CTR and MA + CTR were associated with a significant reduction in the percentage of AHTD on the entire root canal compared to the same solutions without surfactant. Conclusions: 7% MA was less cytotoxic in comparison with 17% EDTA. The addition of cetrimide to EDTA and MA removed accumulated hard-tissue debris effectively from the canal walls and increased their antimicrobial activity when compared to the same solutions without detergents

A double parton scattering background to Higgs boson production at the LHC

The experimental capability of recognizing the presence of b quarks in complex hadronic final states has addressed the attention towards final states with b\bar{b} pairs for observing the production of the Higgs boson at the LHC, in the intermediate Higgs mass range.We point out that double parton scattering processes are going to represent a sizeable background to the process.Comment: 9 pages, 2 figure

Unpicking the links between research and teaching in Higher Education

ABSTRACT The Bradley Report (2008) highlights a need to investigate the experiences of international students in regard to learning and teaching with a focus on local and contextual issues. This presentation results from Participatory Action Research (Haslett, 2009) to explore learning and teaching issues relevant to international undergraduate nursing students at one campus of a Queensland University. Nursing education research is informed by many approaches, including the traditional science positivist approaches. The positivist approaches assume an ordered 'real' world of teaching, which is in stark contrast to the experience of many neophyte nurse educators. In this project, PAR exposed the differences between espoused teaching theories and best practice as promoted by the University and actual teaching beliefs and practices of staff. There were commonalities in staff perceptions that international nursing student learners have different and specific needs and international students were initially conceptualised as 'the problem'. Through PAR meetings, staff revealed different understandings of 'the problem', tensions between workload and University promotion of an internationalised curriculum. In these discussions, different teaching and learning strategies were shared. The differences between these reflected the experience of the teachers, revealing the different underlying beliefs about teaching and learning and exposing different staff values. Some staff employed a framework of equity to help contextualise the issues and their response to the challenges of teaching international student learners. Through discussions and sharing a real 'sense of the possible' was created for staff. This engagement in the process and the realisation that action was possible was a highlight of the project to date. The next step is enacting agreed upon actions. This project provides a concrete experience of PAR, which we can share and offer for further consideration

Repair of large sinus membrane perforations using stabilized collagen barrier membranes : surgical techniques with histologic and radiographic evidence of success

The most frequent intraoperative complication with sinus elevation is perforation of the schneiderian membrane. In most instances, the repair of this perforation is necessary to contain particulate grafting material and complete the procedure. New techniques are presented here for the management of large perforations of the schneiderian membrane. A bioabsorbable collagen membrane is stabilized outside the antrostomy and then folded inward to create either a new superior wall that can obliterate a large perforation or a “pouch” that can completely contain the particulate material. This can make it possible to complete a procedure that otherwise may have had to be aborted by preventing dispersion of the particulate graft within the sinus cavity. Clinical cases are shown, along with follow-up at 6 to 9 months, demonstrating histologic and/or radiographic evidence of success, continued sinus health, and superior vital bone formation. The authors have used this technique on 20 consecutive patients without experiencing any procedural failures