106 research outputs found

    Сім сліз Івана Чендея

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    Розглядається творчість Івана Чендея на рівні структурних та функціональних особливостей символічних образів сльози, уточнюються оцінки окремих творів з погляду їхньої взаємодії з часом

    Tort, Social Security, and No-Fault Schemes: Lessons from Real-World Experiments

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    Background Anthropometric measurements are useful in clinical practice since they are non-invasive and cheap. Previous studies suggest that sagittal abdominal diameter (SAD) may be a better measure of visceral fat depots. The aim of this study was to prospectively explore and compare how laboratory and anthropometric risk markers predicted subclinical organ damage in 255 patients, with type 2 diabetes, after four years. Methods Baseline investigations were performed in 2006 and were repeated at follow-up in 2010. Carotid intima-media thickness (IMT) was evaluated by ultrasonography and aortic pulse wave velocity (PWV) was measured with applanation tonometry over the carotid and femoral arteries at baseline and at follow-up in a cohort of subjects with type 2 diabetes aged 55–65 years old. Results There were significant correlations between apolipoprotein B (apoB) (r = 0.144, p = 0.03), C - reactive protein (CRP) (r = 0.172, p = 0.009) at baseline and IMT measured at follow-up. After adjustment for sex, age, treatment with statins and Hba1c, the associations remained statistically significant. HbA1c, total cholesterol or LDL-cholesterol did not correlate to IMT at follow-up. Baseline body mass index (BMI) (r = 0.130, p = 0.049), waist circumference (WC) (r = 0.147, p = 0.027) and sagittal Abdominal Diameter (SAD) (r = 0.184, p = 0.007) correlated to PWV at follow-up. Challenged with sex, SBP and HbA1c, the association between SAD, not WC nor BMI, and PWV remained statistically significant (p = 0.036). In a stepwise linear regression, entering both SAD and WC, the association between SAD and PWV was stronger than the association between WC and PWV. Conclusions We conclude that apoB and CRP, but not LDL-cholesterol predicted subclinical atherosclerosis. Furthermore, SAD was more independent in predicting arterial stiffness over time, compared with WC, in middle-aged men and women with type 2 diabetes.Funding Agencies|Medical Research Council of Southeast Sweden||Center for Medical Image Science and Visualization (CMIV)||Linkoping University||Futurum||King Gustaf V and Queen Victoria Freemason Foundation||GE Healthcare||Swedish Heart-Lung Foundation||Swedish Research Council Grant|12661|</p

    Reduced pulsatile wall motion of abdominal aortic aneurysms after endovascular repair

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    AbstractPurpose: The reduced size of abdominal aortic aneurysms (AAAs) after endovascular repair suggests lowered intraaneurysmal pressure. In the presence of endoleaks, the size is not decreased. Although postoperative intraaneurysmal pressure is difficult to record, the pulsatile wall motion (PWM) of aneurysms can be measured noninvasively. The aim of this study was to assess the PWM of AAAs before and after endovascular repair and to relate the change in the PWM to aneurysmal size and presence of endoleaks. Methods: Forty-seven patients underwent endovascular repair of an AAA. The aneurysm diameter and PWM were measured with the use of ultrasonic echo-tracking scans preoperatively; at 1, 3, and 6 months; and thereafter biannually. Fifteen aneurysms developed endoleaks, whereas 32 were completely excluded. The leaks were characterized with the use of computed tomographic scanning and angiography. Median follow-up was 12 months (interquartile range, 5 to 24 months). Results: The preoperative PWM of the aneurysms was 1.0 mm (range, 0.8 to 1.3 mm). After complete endovascular exclusion, the PWM was 25% (range, 16% to 37%) of the preoperative value (p < 0.001), and aneurysm diameter decreased by 8 mm (range, 6 to 14 mm) (p < 0.001). After 18 months, no further diameter reduction occurred. In three patients without endoleaks but with enlarging aneurysms, the postoperative PWM showed less reduction (p < 0.05). Aneurysms with endoleaks showed no diameter decrease, and the postoperative PWM was 50% higher than that in the totally excluded cases (p < 0.01). In five patients with transient endoleaks, the PWM was reduced after leakage ceased (p < 0.05). Leaks of various sources displayed similar PWM. Conclusion: The size and PWM of aneurysms are reduced after endovascular repair. The diameter reduction may cease after 1.5 years. Endoleaks are associated with higher PWM than expected. Pressure may be transmitted without evidence of leaks. (J Vasc Surg 1998;27:624-31.

    Reduced Arteriovenous Shunting Capacity After Local Heating and Redistribution of Baseline Skin Blood Flow in Type 2 Diabetes Assessed With Velocity-Resolved Quantitative Laser Doppler Flowmetry

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    OBJECTIVE-To compare the microcirculatory velocity distribution in type 2 diabetic patients and nondiabetic control subjects at baseline and after local heating. RESEARCH DESIGN AND METHODS-The skin blood flow response to local heating (44 degrees C for 20 mm) was assessed in 28 diabetic patients and 29 control subjects using a new velocity-resolved quantitative laser Doppler flowmetry technique (qLDF). The qLDF estimates erythrocyte (RBC) perfusion (velocity X concentration), in a physiologically relevant unit (grams RBC per 100 g tissue X millimeters per second) in a fixed output volume, separated into three velocity regions: v less than1 mm/s, v 1-10 mm/s, and v greater than10 mm/s. RESULTS-The increased blood flow occurs in vessels with a velocity greater than1 mm/s. A significantly lower response in qLDF total perfusion was found in diabetic patients than in control subjects after heat provocation because of less high-velocity blood flow (v greater than10 mm/s). The RBC concentration in diabetic patients increased sevenfold for v between 1 and 10 mm/s, and 15-fold for v greater than10 mm/s, whereas no significant increase was found for v less than1 mm/s. The mean velocity increased from 0.94 to 7.3 mm/s in diabetic patients and from 0.83 to 9.7 mm/s in control subjects. CONCLUSIONS-The perfusion increase occurs in larger shunting vessels and not as an increase in capillary flow. Baseline diabetic patient data indicated a redistribution of flow to higher velocity regions, associated with longer duration of diabetes. A lower perfusion was associated with a higher BMI and a lower toe-to-brachial systolic blood pressure ratio.This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes. The American Diabetes Association (ADA), publisher of Diabetes, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version is online at http://diabetes.diabetesjournals.org.:Ingemar Fredriksson, Marcus Larsson, Fredrik Nyström, Toste Länne, Carl Johan Östgren and Tomas Strömberg, Reduced Arteriovenous Shunting Capacity After Local Heating and Redistribution of Baseline Skin Blood Flow in Type 2 Diabetes Assessed With Velocity-Resolved Quantitative Laser Doppler Flowmetry, 2010, Diabetes, (59), 7, 1578-1584.http://dx.doi.org/10.2337/db10-0080Copyright: American Diabetes Association Inc / American Diabetes Association; 1999http://www.diabetes.org

    Opposing Effects of Circadian Clock Genes Bmal1 and Period2 in Regulation of VEGF-Dependent Angiogenesis in Developing Zebrafish

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    SummaryMolecular mechanisms underlying circadian-regulated physiological processes remain largely unknown. Here, we show that disruption of the circadian clock by both constant exposure to light and genetic manipulation of key genes in zebrafish led to impaired developmental angiogenesis. A bmal1-specific morpholino inhibited developmental angiogenesis in zebrafish embryos without causing obvious nonvascular phenotypes. Conversely, a period2 morpholino accelerated angiogenic vessel growth, suggesting that Bmal1 and Period2 display opposing angiogenic effects. Using a promoter-reporter system consisting of various deleted vegf-promoter mutants, we show that Bmal1 directly binds to and activates the vegf promoter via E-boxes. Additionally, we provide evidence that knockdown of Bmal1 leads to impaired Notch-inhibition-induced vascular sprouting. These results shed mechanistic insight on the role of the circadian clock in regulation of developmental angiogenesis, and our findings may be reasonably extended to other types of physiological or pathological angiogenesis

    The influence of social phobia in first episode of psychosis and attentional processing and the ability to use theory of mind

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    Chapter One: Literature Review This chapter reviews the research surrounding the prevalence of comorbid social phobia in people diagnosed with schizophrenia. It then critically evaluates the eight studies that have specifically explored the relationships, if any, between social phobia and psychotic symptoms. The review surmises that the research findings are inconsistent, which seem to be attributable to methodological differences between all the studies in terms of participant selection, chronicity of psychotic symptoms and lack of consistent measures. Chapter Two: Research Report This study investigates attentional processing, the influence of social phobia and the ability to use Theory of Mind (ToM: the ability to infer other people's mental states and behaviour) in people diagnosed with their first episode of psychosis, when compared to healthy matched controls. The results showed that the first episode group attended towards negative evaluation, somatic sensations, physical threat, but not social situation word groups. Social phobia was highly prevalent in the first episode of psychosis cohort (37%) and this anxiety disorder was unrelated to psychotic symptoms. ToM processing was impaired in the first episode group. ToM was not related to social phobia symptoms, but was related to social functioning. Chapter Three: Critical Appraisal This section presents an overview of the experiences and personal reflections of the work that constitutes this thesis and includes the main personal learning points.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

    Outsourcing ethical dilemmas: regulating international surrogacy arrangements

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    This article argues that the English legislative regime is ineffective in regulating international surrogacy, particularly with regard to commercial payments. It suggests that if English law views surrogacy as exploitative, we have a responsibility to protect women both in England and abroad, and the only way to do so effectively is to create a domestic system of regulation that caters adequately for the demand in this country. This requires a system of authorisation for surrogacy before it is undertaken; ex-post facto examinations of agreements completed in other jurisdictions, after the child is already living with the commissioning parents, cannot be seen as an acceptable compromise, as authorisation will inevitably be granted in the child's best interests.This is the author accepted manuscript. The final version is available from Oxford University Press via http://dx.doi.org/10.1093/medlaw/fwv04

    A dynamic view on the diameter of abdominal aortic aneurysms

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    OBJECTIVES: To study 40-55 mm aneurysms and calculate their size in relation to the individual predicted normal aortic diameter to see if this might add anything in the evaluation of treatment. MATERIAL AND METHODS: The anteroposterior diameter of 40-55 mm AAAs was measured with an echo-tracking ultrasonic technique in 147 consecutive patients. The weight and height were registered and body surface area calculated. The predicted normal aortic diameters were defined according to nomograms and the diameter increase from the predicted normal aortic size in the individual aneurysms calculated. RESULTS: The median AAA diameter was 48 mm (range 40-55), the BSA 1.85 m2 (1.42-2.37), and the predicted AO size 19.4 mm (14.3-21.6). The calculated increase of size in the individual aneurysms was 2.51 (1.9-3.53), that is the spread of data doubled as compared to conventional diameter measurements. When females and males were studied separately the AAA diameter was 46.5 mm (40-55) and 48 mm (40-55), respectively (NS). Since the BSA was significantly lower in women than in men, 1.63 (1.42-1.95) and 1.89 (1.47-2.37), respectively (p < 0.0001), also the predicted normal aortic size was lower, 16.4 (14.3-17.8) vs. 19.7 (18.0-21.6) (p < 0.0001). Thus, the AAA diameter increase from the predicted size was larger in women than in men; 2.93 (2.25-3.53) vs. 2.46 (1.90-2.94), respectively (p < 0.0001). CONCLUSION: To define an aneurysm as a localised dilatation of an artery exceeding 50% of the expected normal diameter is now possible. This may facilitate how to treat especially smaller aneurysms and give new information concerning patterns of growth and risk of rupture
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