287 research outputs found
Aorto-venous fistula between an abdominal aortic aneurysm and an aberrant renal vein: a case report
<p>Abstract</p> <p>Introduction</p> <p>The potential complications of an abdominal aortic aneurysm include rupture, compression of surrounding structures, thrombo-embolic events and fistula. The most common site of arterio-venous fistula is the inferior vena cava. Fistula involving a renal vein is particularly uncommon.</p> <p>Case presentation</p> <p>This report describes a 54-year-old Caucasian woman who was admitted to the emergency department with fatigue, severe dyspnea and bilateral lower limb edema. In the first instance this anamnesis suggested possible heart failure. In fact, our patient presented with multi-organ system failure due to a fistula between an infra-renal aortic aneurysm and an aberrant retro-aortic renal vein.</p> <p>Conclusions</p> <p>To our knowledge, this is the first report of a woman with a fistula between an infra-renal aortic aneurysm and an aberrant retro-aortic left renal vein. Aorto-venous fistulas may be asymptomatic or may present with symptoms characteristic of arterio-venous shunting and/or aneurysm rupture. This type of fistula is a rare cause of heart failure. Clinical examination and imaging are essential for detection.</p
Artificial Neural Networks Versus Multiple Logistic Regression to Predict 30-Day Mortality After Operations For Type A Ascending Aortic Dissection§
There are few comparative reports on the overall accuracy of neural networks (NN), assessed only versus multiple logistic regression (LR), to predict events in cardiovascular surgery studies and none has been performed among acute aortic dissection (AAD) Type A patients. OBJECTIVES: We aimed at investigating the predictive potential of 30-day mortality by a large series of risk factors in AAD Type A patients comparing the overall performance of NN versus LR. METHODS: We investigated 121 plus 87 AAD Type A patients consecutively operated during 7 years in two Centres. Forced and stepwise NN and LR solutions were obtained and compared, using receiver operating characteristic area under the curve (AUC) and their 95% confidence intervals (CI) and Gini's coefficients. Both NN and LR models were re-applied to data from the second Centre to adhere to a methodological imperative with NN. RESULTS: Forced LR solutions provided AUC 87.9+/-4.1% (CI: 80.7 to 93.2%) and 85.7+/-5.2% (CI: 78.5 to 91.1%) in the first and second Centre, respectively. Stepwise NN solution of the first Centre had AUC 90.5+/-3.7% (CI: 83.8 to 95.1%). The Gini's coefficients for LR and NN stepwise solutions of the first Centre were 0.712 and 0.816, respectively. When the LR and NN stepwise solutions were re-applied to the second Centre data, Gini's coefficients were, respectively, 0.761 and 0.850. Few predictors were selected in common by LR and NN models: the presence of pre-operative shock, intubation and neurological symptoms, immediate post-operative presence of dialysis in continuous and the quantity of post-operative bleeding in the first 24 h. The length of extracorporeal circulation, post-operative chronic renal failure and the year of surgery were specifically detected by NN. CONCLUSIONS: Different from the International Registry of AAD, operative and immediate post-operative factors were seen as potential predictors of short-term mortality. We report a higher overall predictive accuracy with NN than with LR. However, the list of potential risk factors to predict 30-day mortality after AAD Type A by NN model is not enlarged significantly
Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic review
Atrial Fibrillation (AF) is the most common arrhythmia occurring after cardiac surgery. Its incidence varies depending on type of surgery. Postoperative AF may cause hemodynamic deterioration, predispose to stroke and increase mortality. Effective treatment for prophylaxis of postoperative AF is vital as reduces hospitalization and overall morbidity. Beta - blockers, have been proved to prevent effectively atrial fibrillation following cardiac surgery and should be routinely used if there are no contraindications. Sotalol may be more effective than standard b-blockers for the prevention of AF without causing an excess of side effects. Amiodarone is useful when beta-blocker therapy is not possible or as additional prophylaxis in high risk patients. Other agents such as magnesium, calcium channels blocker or non-antiarrhythmic drugs as glycose-insulin - potassium, non-steroidal anti-inflammatory drugs, corticosteroids, N-acetylcysteine and statins have been studied as alternative treatment for postoperative AF prophylaxis
Rezension zu: Uygun-AltunbaĆ, AyĆe (2017): Religiöse Sozialisation in muslimischen Familien. Eine vergleichende Studie
PluralitÀtsfÀhige Habitusbildung in der islamischen ReligionspÀdagogik: Eine kritische religionspÀdagogische Diskussion
Wachsende kulturelle und religiöse PluralitĂ€t sind unverkennbar wesentliche Merkmale einer modern geprĂ€gten, multikulturellen Gesellschaft geworden. Eine plural geprĂ€gte Gesellschaft wie die österreichische stellt daher fĂŒr islamische ReligionslehrerInnen eine wichtige Herausforderung in der Schule dar. Die islamische ReligionspĂ€dagogik steht im europĂ€ischen Kontext vor der Aufgabe, die erforderlichen religionspĂ€dagogischen Kompetenzen von islamischen ReligionslehrerInnen zu fördern und weiterentwickelte Ausbildungsmöglichkeiten anzubieten, damit sie im Religionsunterricht in einer pluralen Gesellschaft handlungsfĂ€hig bleiben. Im vorliegenden Beitrag wird das religionspĂ€dagogische Habitusmodell in seiner Bedeutung fĂŒr kompetenzorientiertes Handeln von islamischen ReligionslehrerInnen untersucht und diskutiert, welche Perspektiven eine pluralitĂ€tsfĂ€hige islamische ReligionspĂ€dagogik in diesem Zusammenhang entwickeln kann. Im Mittelpunkt des Beitrages steht der Diskurs um die erforderlichen Kompetenzen islamischer ReligionslehrerInnen, die ihnen in der pĂ€dagogischen Praxis pluralitĂ€tsfĂ€higes Handeln ermöglichen und in ihren Habitus einflieĂen sollen. Die Habitusbildung wird dabei im Lehrberuf als ein nie abgeschlossener Prozess begriffen, in dem auch die Persönlichkeit der LehrerInnen eine bedeutende Rolle spielt. Der Beitrag möchte den Aspekt der ReflexivitĂ€t in Bezug auf das Habituskonzept im Rahmen einer pluralitĂ€tsfĂ€higen ReligionspĂ€dagogik als SchlĂŒsselkompetenz behandeln. Das Ziel der religionspĂ€dagogischen Habitusbildung bei islamischen ReligionslehrerInnen ist es, die erworbenen Kompetenzen zu integrieren und weiterzuentwickeln, sodass die muslimischen SchĂŒlerInnen von diesen Kompetenzen der LehrerInnen profitieren könne
ReligiositÀt unter muslimischen Studierenden in Wien
Die vorliegende Arbeit setzt sich auf qualitativer Grundlage mit der ReligiositĂ€t muslimischer Studierender tĂŒrkischer Herkunft in Wien auseinander. Die Auswahl der FĂ€lle zielt auf die Erfassung von Personen, die aus sogenannten bildungsfernen Schichten stammen, um deren spezifisches VerhĂ€ltnis zwischen Bildung, IdentitĂ€t, Integration und individuell gelebter Reli-giositĂ€t untersuchen zu können. Im theoretischen Teil der Arbeit werden zunĂ€chst die Begriffe der Religion und â im Unterschied dazu â jener der ReligiositĂ€t (als die subjektive Aus-drucksform von Religion) bestimmt, sowie das Konzept der IdentitĂ€t prĂ€zisiert. Daran an-schlieĂend wird das zugrundeliegende Konzept der Dimensionen von ReligiositĂ€t nach Charles Glock erlĂ€utert, das den theoretischen Rahmen fĂŒr die qualitative Studie bildet.
Der qualitativ-empirische Teil orientiert sich bezĂŒglich der Erhebungsmethode an Andreas Witzel und dessen Konzept des problemzentrierten Interviews. FĂŒr die Auswertung wird auf ein an der PhĂ€nomenologie orientiertes Verfahren, das fĂŒr die Erfordernisse einer qualitativen Untersuchung angepasst wurde, zurĂŒckgegriffen. Die DurchfĂŒhrung der Untersuchung erfolgt anhand von EinzelfĂ€llen, die zunĂ€chst jeweils fĂŒr sich und daran anschlieĂend unter Bezug-nahme auf die Dimensionen der ReligiositĂ€t nach Glock analysiert werden.
Als wichtigste Ergebnisse können vor allem die folgenden Aspekte genannt werden: Religio-sitĂ€t erscheint auf der Grundlage der Erhebungen als das Resultat individuell geprĂ€gter Aus-einandersetzungen mit Religion, die den jeweiligen gesellschaftlichen Zustand und die eigene Stellung darin zu reflektieren versuchen. Die religiöse IdentitĂ€t der befragten Personen erweist sich als dynamischer Prozess, der sich in stĂ€ndiger Wechselwirkung zu den gesellschaftlichen Bedingungen, der eigenen Tradition sowie der eignen Biografie entfaltet. Bildung hat fĂŒr die interviewten Studierenden insbesondere die Funktion zwischen der eigenen muslimischen ReligiositĂ€t und der Mehrheitsgesellschaft zu vermitteln. Auf diese Weise trĂ€gt Bildung auch zur erfolgreichen Integration bei.The present master thesis explores the religiousness of Muslim students with a Turkish back-ground in Vienna on the basis of a qualitative methodical approach. The selection of individ-ual cases aims at capturing people who are from a non-academic social parentage in order to examine the relation between identity, education, integration and their individual religious-ness.
The theoretical part consists of clarifying the notions of religion, religiousness, and identity, before explaining the concept of religiousness by Charles Glock. The theory of the five di-mensions of religiousness formulated by Charles Glock is being used as a background for the analysis of the empirical material.
The qualitative-empirical part uses the problem-centred interview introduced by Andreas Witzel as a method of investigation. The evaluation of the interviews utilizes a transformed method of phenomenology to examine the individual cases. On grounds of individual cases an analysis of the dimensions of religiousness is carried out to investigate the relation between individual and collective aspects of religiousness by considering their connection to identity, education and integration.
As the most important results the following aspects can be finally mentioned: On grounds of the empirical case studies, religiousness is shown to be a result of an individual engagement with religion, as well as the social situation in which the persons need to exist, and how they position themselves within society. Their religious identity shows itself as a dynamic process which evolves in constant interplay with the social conditions, the historical tradition, as well as in connection with their individual biography. Education finally plays the role of mediating between their Muslim religiousness, and the modern western society in which they live, thus enabling a successful form of integration
Analyse du rĂŽle des dĂ©rivĂ©s de polysulfanes de lâail dans le rĂ©seau microtubulaire et l'autophagie : lâeffet anticancĂ©reux dans le cancer colorectal
Colorectal cancer is a major cause of morbidity and mortality worldwide. Epidemiological studies reveal an inverse correlation between the risk of developing colon cancer and a garlic-rich diet. Many scientific studies reported the anti-cancer activity of diallyl polysulfides (DAPS) derived from garlic in various types of cancer in vitro and in vivo. The best-known mechanism of action is the induction of mitotic arrest followed by apoptosis. Here tubulin is identified as a new therapeutic target for DAPS. Tubulin is fundamental in the progression of autophagy, an essential energy source for the development of advanced cancer, and autophagy activation plays a role of chemoresistance against the treatment of colon cancer.The hypothesis of this project is that garlic-derived DAPS interact with tubulin to alter the microtubule network organization responsible for the inhibition of cell proliferation and modulation of autophagy in colon cancer.First, we analyzed the impact of DATTS/DBTTS on the microtubular network. We have shown that DATTS/DBTTS interacts with tubulin by mass spectrometry. We have shown that the microtubule organization is altered in the three cell lines: HT-29 (BRAF mutated), SW480 (KRAS mutated) and SW620 (metastatic, KRAS mutated), which were more sensitive to DBTTS than DATTS. In a second step, we studied the anticancer activity of DBTTS in colon cancer. We showed that DBTTS induced mitotic arrest followed by cell death in all cell lines. Its anti-proliferative activity is validated in a 3D culture system and in vivo. We have also shown that the effect of DBTTS is comparable to microtubule altering agents. In a third step, we evaluated the impact of DBTTS in autophagy. Inhibition of autophagy is accompanied by accumulation of the p62 protein, which plays a survival role in HT-29 cells only.Altogether, we identified here autophagy as a survival mechanism during prolonged mitotic arrest depending the cell type. This study will allow us to consider targeted therapy according to the genetic profile of colon cancerLe cancer colorectal est une cause majeure de morbiditĂ© et de mortalitĂ© dans le monde entier. Des Ă©tudes Ă©pidĂ©miologiques rĂ©vĂšlent une corrĂ©lation inverse entre le risque de dĂ©velopper un cancer du cĂŽlon et un rĂ©gime alimentaire riche en ail. De nombreux travaux scientifiques rapportent l'activitĂ© anti-cancĂ©reuse des polysulfures de diallyle (PSDA) dĂ©rivĂ©s de l'ail dans divers types de cancer in vitro et in vivo. Le mĂ©canisme d'action le mieux connu repose sur l'induction de l'arrĂȘt mitotique suivi de l'apoptose. La tubuline est identifiĂ©e comme nouvelle cible thĂ©rapeutique des PSDA. La tubuline est fondamental dans la progression de l'autophagie, source nutritionnelle essentielle pour le dĂ©veloppement du cancer au stade avancĂ©, et l'activation de l'autophagie joue un rĂŽle de chimiorĂ©sistance dans le traitement du cancer du cĂŽlon. L'hypothĂšse de ce projet est que les PSDA dĂ©rivĂ©s de l'ail interagissent avec la tubuline pour altĂ©rer l'organisation du rĂ©seau microtubulaire responsable de l'inhibition de la prolifĂ©ration cellulaire et de la modulation de l'autophagie dans le cancer du cĂŽlon. Dans un premier temps, nous avons analysĂ© l'impact du TTSDA/TTSDB sur le rĂ©seau microtubulaire. Nous avons montrĂ© que le TTSDA/TTSDB interagissait avec la tubuline par spectromĂ©trie en masse. Nous avons montrĂ© que l'organisation microtubulaire est altĂ©rĂ©e dans les trois lignĂ©es cellulaires : HT-29 (mutĂ©es BRAF), SW480 (mutĂ©es KRAS) et SW620 (mutĂ©es KRAS, mĂ©tastatiques), plus sensibles au TTSDB que le TTSDA. Dans un deuxiĂšme temps, nous avons Ă©tudiĂ© le rĂŽle anticancĂ©reux du TTSDB dans le cancer du cĂŽlon. Nous avons montrĂ© que le TTSDB induisait un arrĂȘt mitotique suivi de la mort cellulaire dans toutes lignĂ©es confondues. Son activitĂ© antiprolifĂ©rative est validĂ©e dans un systĂšme de culture 3D et in vivo. Nous avons aussi montrĂ© que l'effet du TTSDB est comparable aux agents altĂ©rant les microtubules. Dans un troisiĂšme temps, nous avons Ă©valuĂ© l'impact du TTSDB dans l'autophagie. L'inhibition de l'autophagie est accompagnĂ©e par l'accumulation de la protĂ©ine p62, qui joue un rĂŽle de survie dans les cellules HT-29 uniquement. Ensemble, nous avons identifiĂ© l'autophagie comme mĂ©canisme de survie lors de l'arrĂȘt mitotique prolongĂ© en fonction du type cellulaire. Cette Ă©tude permettra d'envisager un ciblage thĂ©rapeutique selon le profil gĂ©nĂ©tique du cancer du cĂŽlo
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