Shone-Anomalie: Fallbericht und Hintergrund

Zusammenfassung: Die Shone-Anomalie wurde 1963 erstmals beschrieben und stellt eine seltene kongenitale kardiovaskuläre Missbildung mit verschiedenen linkskardialen stenotischen Läsionen dar. Die klassische Form besteht aus einem fibrösen supravalvulären Mitralring, einer fallschirmartigen Deformation der Mitralklappe mit nur einem Papillarmuskel ("parachute mitral valve"), einer subvalvulären Aortenstenose und einer Aortenisthmusstenose. Es gibt nur vereinzelte perioperative Fallberichte von erwachsenen Patienten mit dieser kardiovaskulären Missbildung. Allerdings können Patienten mit einer undiagnostizierten, inkompletten Form der Shone-Anomalie auch im Erwachsenenalter für nichtherzchirurgische Operationen vorgesehen sein. In dem vorliegenden Fallbericht wird das anästhesiologische Management einer Patientin, die für eine abdominale Hysterektomie vorgesehen war und an einer bisher nichtdiagnostizierten Shone-Anomalie litt, beschriebe

The effect of an icebreaker on collaborative performance across a video link

Analyses indicate that when the icebreaker took place, participants completed the task significantly faster, in significantly fewer words and negotiated turns during conversation more effectively. This chapter investigates the effect of an initial icebreaker on collaborative task performance across video-mediated communication. It was expected that performance would be enhanced when an icebreaker was used. Participants completed a “collaborative map-reading task,” which involves both participants having to plan a route together (on a map of a town centre with a number of shops), picking up five items from a shopping list along the way. After completing this task participants were given as long as they required to complete the map-reading task. Participants in the control condition completed the map-reading task without taking part in an icebreaker. Participants in the control condition spent on average 8.9% of the dialogue engaging in such activities, compared to 5.7% in the icebreaker condition

An initial face-to-face meeting improves person perceptions of interviewees across VMC

This chapter investigates the effects of initial meeting context on future video-mediated impression formation. This initial meeting either took place over a video link or face-to-face. Participants who had met the interviewee face-to-face prior to the interview rated him significantly more favourably on a number of measures (friendliness, honesty, job suitability and employability) compared to when the initial meeting took place via a video link. Initial meeting context therefore impacted on person perceptions. Video-mediated communication (VMC) is increasingly used to support interviewing at a distance. Although on the one hand this means that individuals can be interviewed for jobs without travelling to the interview destination, research suggests that the presentation of an individual over a video link may result in less favourable impression formation. The consequence of this would be that people would appear “cold” when presenting themselves over VMC

Limits to sustained energy intake XXIV : impact of suckling behaviour on the body temperatures of lactating female mice

We would like to thank the animal house staff and all members of the Energetics group for their invaluable help at various stages throughout the project. This work was supported by Natural Environment Research Council grant (NERC, NE/C004159/1). YG was supported by a scholarship from the rotary foundation. LV was supported by a Rubicon grant from the Netherlands Scientific Organisation (NWO).Peer reviewedPublisher PD

An evidence-based recommendation on bed head elevation for mechanically ventilated patients

A semi-upright position in ventilated patients is recommended to prevent ventilator-associated pneumonia (VAP) and is one of the components in the Ventilator Bundle of the Institute for Health Care Improvement. This recommendation, however, is not an evidence-based one.status: publishe

Medium ring lactams in molecular recognition

beta-Turns are ubiquitous in bioactive conformations of important peptides. We have designed a family of seven-membered lactam dipeptide mimics which are expected to act as conformational constraints in enforcing type VIa beta-turns in peptide chains. Molecular modelling using Macromodel predicts that both 3(S)-acetylamino-7(S)-carboxy-azepan-2-one N-methyl amide (1, the cis-disubstituted lactam, MM2) and 3 (S)-acetylamino-7(R)-carboxy-azepan-2-one N-methyl amide (2a, the trans-disubstituted lactam, MM2 and AMBER) should exhibit features of type VI beta-turns. The synthesis and structural analysis of the cis-(1) and trans-disubstituted (2) seven-membered lactam constraints are reported. X-Ray crystallographic analysis and solution NMR measurements offer insight into the preferred conformations of these molecules. Variable temperature NMR data and vapour pressure osmometry of 1 in solution indicate that it exhibits a strong cooperative recognition phenomenon to form a novel dimer, a feature not demonstrated by the trans-isomer 2a, which has a type VIa beta-turn-like conformation in the solid state. These phenomena can be realistically modelled in molecular dynamics simulations, and demonstrate potential for the design of new materials by self-assembly