Livres : « Effet MHD »

1

Goreham, Steve. The mad, mad, mad world of climatism : Mankind and climate change mania. New Lenox, IL : New Lenox Books, 2013.

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Hoxter, Holly Nicole. The Snowball Effect. New York : HarperCollins, 2010.

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Health Effects Research Laboratory (Research Triangle Park, N.C.), dir. Cerebellar histogenesis in rats exposed to 2450 MHz microwave radiation : Project summary. Research Triangle Park, NC : U.S. Environmental Protection Agency, Health Effects Research Laboratory, 1988.

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4

Health Effects Research Laboratory (Research Triangle Park, N.C.), dir. Cerebellar histogenesis in rats exposed to 2450 MHz microwave radiation : Project summary. Research Triangle Park, NC : U.S. Environmental Protection Agency, Health Effects Research Laboratory, 1988.

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5

1935-, Gandhi Om P., et Health Effects Research Laboratory (Research Triangle Park, N.C.), dir. Behavior, physiology, and energy deposition in rats chronically exposed to 2450 MHz radiation : Project summary. Research Triangle Park, NC : U.S. Environmental Protection Agency, Health Effects Research Laboratory, 1988.

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1935-, Gandhi Om P., et Health Effects Research Laboratory (Research Triangle Park, N.C.), dir. Behavior, physiology, and energy deposition in rats chronically exposed to 2450 MHz radiation : Project summary. Research Triangle Park, NC : U.S. Environmental Protection Agency, Health Effects Research Laboratory, 1988.

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7

Bornmalm-Jardelöw, Gunilla. Högre utbildning och arbetsmarknad : En studie med tillämpningar på svenska förhållanden. [Gothenburg : Nationalekonomiska institutionen, Handelshögskolan vid Göteborgs universitet, 1988.

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8

Overrein, Øystein. Virkninger av motorferdsel på fauna og vegetasjon : Kunnskapsstatus med relevans for Svalbard. Tromsø : Norsk Polarinstitutt, 2002.

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Mitchell, Juliet. Mad men and Medusas : Reclaiming hysteria and the effect of sibling relationships on the human condition. London : Penguin, 2000.

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Mitchell, Juliet. Mad men and Medusas : Reclaiming hysteria and the effect of sibling relationships on the human condition. London : Allen Lane The Penguin Press, 2000.

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Mitchell, Juliet. Mad men and Medusas : Reclaiming hysteria and the effect of sibling relationships on the human condition. London : Allen Lane, 2000.

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Gråbacke, Carina. Möten med marknaden : Tre svenska fackförbunds agerande under perioden 1945-1976. Göteborg : Ekonomisk-historiska institutionen vid Göteborgs universitet, 2002.

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13

Klenner, Frederick R. Clinical guide to the use of vitamin C : The clinical experiences of Frederick R. Klenner, M.D. [Tacoma, Wash.?] : Life Sciences Press, 1991.

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14

Wolf, Preben. Om lokalisering af kriminalitet og kriminelle med henblik på kriminalitetsforebyggende miljøplanlægning og forskning. København : Kriminalpræventive råd, 1985.

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Hurd, Barbara. Stirring the mud : On swamps, bogs, and human imagination. Athens : University of Georgia Press, 2008.

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Khamʻʺ, Bui. ʾAṅʻʺ leʺ Desa Ṭha ne lū tuiʹ e* Lupʻ choṅʻ mhu kroṅʹ ʾA kyuiʺ sakʻ rokʻ puṃ kui Leʹ lā khraṅʻʺ. Toṅ krīʺ : Toṅʻ krīʺ Takkasuilʻ, Pathavī vaṅʻ Ṭhāna, 2004.

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Fischer, William L. Secrets to a healthy heart and low cholesterol : Proven guidelines and documented facts for the natural self-treatment and prevention of heart disease, high cholesterol, and other related ailments in conjunction with the world-famous breakthrough formula by Prof. Flemming Norgaard, M.D., D.D.S. Canfield, Ohio : Fischer Pub. Corp., 1993.

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Walker, Johnny, James Newton et Austin Fisher. Mad Max Effect : Road Warriors in International Exploitation Cinema. Bloomsbury Academic & Professional, 2022.

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Walker, Johnny, James Newton et Austin Fisher. Mad Max Effect : Road Warriors in International Exploitation Cinema. Bloomsbury Publishing Plc, 2021.

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Stover, Eric, K. Alexa Koenig et Laurel E. Fletcher. The Cumulative Effect. Sous la direction de Metin Başoğlu. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374625.003.0012.

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This chapter demonstrates how the US government selectively manipulated the medical and health literatures after the attacks of September 11, 2001 to justify the torture and cruel, inhuman, or degrading treatment of detainees held in US custody. The authors analyze the Department of Justice Office of Legal Counsel’s “Torture Memos” to illustrate the ways in which governments can attempt to circumvent the protections offered by existing definitions of torture, even while claiming to operate within legal limits. The authors offer a stark warning about the ways in which research findings can be perverted—and contradicting studies ignored—to justify governments’ policy aims when those aims conflict with legal constraints.

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Bottema. Mans Role in Shaping Eastern Med. Taylor & Francis, 1990.

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Woods, Bob, et Gill Windle. The effect of ageing on personality. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0052.

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Ageing and personality interact. Whilst experiences that may be associated with age, including changes in roles and social networks, losses and health challenges, may require adaptation of aspects of personality, personality across the life-span fundamentally influences how ageing is experienced. There are indications that extraversion, conscientiousness and openness show reduced levels in later life, but people’s rank order on personality traits remains stable. Development continues into later life, but builds on earlier experiences and ways of coping. Personality resources such as self-esteem, perceived control, self-efficacy and resilience shape the person’s response to adversity in later life, enabling older people to maintain high levels of well-being, despite the challenges. Dementia, the ultimate challenge, is accompanied by personality change, with raised neuroticism and lowered conscientiousness both predicting its onset and accompanying its course. Pre-morbid personality does also appear to have some influence on behavioural problems experienced.

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Bhopal, Raj S. Cause and effect : The epidemiological approach. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198739685.003.0005.

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Cause and effect understanding is the highest form of scientific knowledge. In epidemiology, demonstrating causality is difficult because of the long and complex natural history of many human diseases and because of ethical restraints. Epidemiologists should: hold the attitude that all judgements of cause and effect are tentative; understand that causal thinking demands a judgement; be alert for the play of chance, error, and bias; always consider reverse causality and confounding, utilize the power of causal models that broaden causal perspectives; apply guidelines for causality as an aid to thinking and not as a checklist; and look for corroboration of causality from other scientific frameworks for assessment of cause and effect. The ultimate aim of epidemiology is to use knowledge of cause and effect to break links between disease and its causes and to improve health. The application of erroneous knowledge has serious repercussions.

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Bromley, Lesley. The molecular basis for the placebo effect. Sous la direction de Paul Farquhar-Smith, Pierre Beaulieu et Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0041.

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The landmark paper discussed in this chapter is ‘The neurobiology of placebo analgesia: From endogenous opioids to cholecystokinin’, published by Benedetti and Amanzio in 1997. This major review considered the placebo and nocebo effect in a more scientific framework compared to previous treatise of a nebulous concept whose only role is to act as a comparator for controlled trials. By expounding robust evidence, Benedetti and Amanzio added credence to the placebo effect, with not just psychological but also physiological data, acknowledging it as an effective therapeutic action. Furthermore, the importance of endogenous opioids and cholecystokinin in the mechanism of placebo were put into sharp relief, giving an intuitive basis and scientific validation to this effect.

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Jensen, Niels Rosendal, Frank Ebsen, Bente Jensen et Soren Langager. Handlekompetencer I PAedagogisk Arbejde Med Socialt Udsatte Born Og Unge : - Indsats Og Effekt. Aarhus University Press, 2009.

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Jensen, Niels Rosendal, Frank Ebsen, Bente Jensen et Soren Langager. Handlekompetencer I PAedagogisk Arbejde Med Socialt Udsatte Born Og Unge : - Indsats Og Effekt. Aarhus University Press, 2009.

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Publishing, Van Haren. Half Double Metodologiens Foundation Guide : Projekter På Den Halve Tid Med Den Dobbelte Effekt. Van Haren Publishing, 2022.

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Wenzel, Ulrich, Thorsten Wiech et Udo Helmchen. The effect of hypertension on renal vasculature and structure. Sous la direction de Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0211.

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The concept of hypertensive nephrosclerosis was introduced by Volhard and Fahr in 1914 and has been extensively used in the literature since then, but its existence is controversial. While it is indisputable that malignant hypertension is a cause of end-stage renal disease (ESRD), there remains controversy as to whether the so-called benign nephrosclerosis can also lead to ESRD.Pressure, if it is great enough, will eventually disrupt any structure. Obviously, this is also true of blood pressure. It is therefore not surprising that an experimentally induced great increase in pressure disrupts the integrity of the blood-vessel wall. Such vascular lesions may be caused or at least influenced by several factors: humoral factors such as angiotensin II, catecholamines, mineralocorticoids, and vasopressin may increase vascular permeability, thereby damaging the vessel walls independently of, or superimposed upon, elevated blood pressure.Nephrosclerosis (literally, hardening of the kidney, Greek derivation: nephros, kidney; sclerosis, hardening) refers to diseases with predominant pathological changes occurring in the pre-glomerular vasculature and secondary changes involving the glomeruli and interstitium. Therefore, it is appropriate to describe first those vascular lesions, which, at least under defined experimental conditions, are believed to be caused solely by the presence of hypertension.

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Kinsella, Sinead, et John Holian. The effect of chronic renal failure on critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0218.

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The incidence of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) is increasing, reflecting an increase in the incidence and prevalence of hypertension and type 2 diabetes. Patients with CKD and ESKD frequently experience episodes of critical illness and require treatment in an intensive care unit (ICU)setting. Management requires specific consideration of their renal disease status together with their acute illness. Mortality in critically-ill patients with ESKD is frequently related to their co-morbid conditions, rather than their ESKD status. Illness severity scoring systems allocate high points for renal variables and tend to overestimate actual mortality. Patients with ESKD and CKD requiring ICU admission have better ICU and in-hospital survival than patients with denovo acute kidney injury requiring renal replacement therapy. Appropriately selected patients benefit from ICU admission and full consideration for ICU care should be given to these patients if required, despite their renal disease status. Cardiovascular disease and sepsis account for the majority of ICU admissions in this population and the aetiology of these conditions differs from that in patients without kidney disease. Optimal critical care management of patients with ESKD and CKD requires that these differences are recognized.

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Autenried, Peter *. The effect of cyclosporine and other immunosuppressive agents on systemic MHC expression in the mouse. 1988.

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31

Williams, Andrew D., Robert G. Fassett, Erin J. Howden et Jeff S. Coombes. Effect of lifestyle modifications on patients with chronic kidney disease. Sous la direction de David J. Goldsmith. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0105_update_001.

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While treatment with pharmacological agents is commonplace, lifestyle management in delaying chronic kidney disease progression should also be provided. These include dietary and exercise interventions, and bariatric surgery for obesity – though this last may have effects in both directions. This chapter describes the effects of lifestyle on chronic kidney disease progression and the research evidence for the use of lifestyle interventions.

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Marchand, Serge. The milestone effect of DNIC in our understanding of pain. Sous la direction de Paul Farquhar-Smith, Pierre Beaulieu et Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0039.

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While thousands of articles are published each year on pain, only a few have such a major impact on the understanding of pain mechanisms as the landmark paper discussed in this chapter; published by Le Bars and colleagues in 1979, it introduced the concept of diffuse noxious inhibitory control (DNIC; also called diffuse noxious inhibition) mechanisms. Although this work is more than three decades old, it still has a major influence on both the understanding of pain mechanisms and the development of clinical approaches. It is known that apparently similar pain may be caused by different mechanisms: one may be caused by amplified excitatory mechanisms while the other may be related to a deficit of endogenous pain modulation, such as DNIC or conditioned pain modulation (or CPM); these will not respond to the same treatment. The work by Le Bars and colleagues provided a new understanding of mechanisms underlying pain.

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Munar, Myrna Y., et Ali J. Olyaei. The effect of renal failure on drug handling in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0217.

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The kidneys play an important role in the elimination of many drugs. In chronic kidney disease and acute kidney injury several pharmacokinetic processes are altered. Thus, patients with impaired renal function require adjustment of medication dosing. Many drugs require a loading dose to rapidly achieve therapeutic plasma concentrations. Subsequently, the dose or dosing interval may have to be adjusted as appropriate for the degree for renal function. The most common method to estimate renal function is use of the Cockcroft–Gault (CG) equation. It has been well validated, is easy to remember, and is fairly accurate in estimating kidney function. Most drugs are dosed based on the patient’s weight (mg/kg), which makes the CG method easier to use for most estimates. Other methods are available and a patient’s renal function should always be estimated based on the best available evidence for that specific patient. Patients with chronic kidney disease are at great risk of developing kidney injury from drugs or diagnostic agents. Exposure to nephrotoxins should be avoided as much as possible.

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Beaulieu. Progress Clin Biochem Med (Progress in Clinical Biochemistry and Medicine, Vol 2). Springer, 1985.

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Kortgen, Andreas, et Michael Bauer. The effect of acute hepatic failure on drug handling in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0197.

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Impaired hepatic function is a common event in intensive care unit patients and as the liver plays a central role in drug metabolism and excretion this may lead to profound changes in pharmacokinetics. Underlying mechanisms are altered enzyme function of phase I and phase II metabolism, altered transporter protein function together with cholestasis and hepatic perfusion disorders. Moreover, multidrug therapy may lead to induction and inhibition of these enzymes and transporter proteins. In addition, changes in plasma protein binding and volumes of distribution of drugs are common. Altogether, these changes may not only lead to sometimes unpredictable plasma levels of xenobiotics, but also to drug-induced liver injury when hepatocellular accumulation of noxious substances occurs. Concomitant renal dysfunction may further complicate this situation. Pharmacodynamic alterations might also occur. In conclusion, the clinician must carefully evaluate medication given to patients with hepatic failure. Therapeutic drug monitoring should be performed wherever available to guide therapy.

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Laycock, Helen. Nocebo and its importance in clinical practice. Sous la direction de Paul Farquhar-Smith, Pierre Beaulieu et Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0045.

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The landmark paper discussed in this chapter is ‘When words are painful: unravelling the mechanism of the nocebo effect’, published in 2007 by Benedetti et al. This major review considered the placebo and nocebo effect in a more scientific framework compared to the previous nebulous concept of a placebo as an agent whose only role is was to act as a comparator for controlled trials. By expounding robust evidence, Benedetti added credence to the placebo effect with not just psychological but physiological data acknowledging it as an effective therapeutic action. Furthermore the importance of endogenous opioids and cholecystokinin in the mechanism underlying the relief of pain by placebos was put into sharp relief, giving an intuitive basis and scientific validation to this effect.

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Abhishek, Abhishek, et Michael Doherty. Placebo, nocebo, and contextual effects. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0027.

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Placebo effect is an example of ‘contextual’ effect and is the symptomatic improvement experienced by patients who have unknowingly received a placebo (inactive treatment) instead of an active drug. It occurs due to patient-specific factors such as expectation of improvement and is influenced by the context in which the treatment is delivered. Nocebo effect is the opposite of placebo effect and includes worsening of symptoms or incident adverse effects due to expectancy or negative contextual or practitioner influence. Placebo effect has been demonstrated in a range of musculoskeletal conditions, including osteoarthritis (OA), as well as other conditions such as Parkinson’s disease, irritable bowel syndrome, and asthma. In OA, the placebo effect is strongest for subjective outcomes like pain. In fact, the effect size (ES) of placebo analgesia in OA clinical trials (0.51) is clinically significant and higher than the ES (defined by the additional improvement above placebo) obtained from non-pharmacological (0.25) and pharmacological (0.39) treatments. A number of patient- and intervention-specific and contextual factors influence the magnitude of placebo-induced improvements. Placebo analgesia is real, not a ‘trick of the mind’, and results from central mechanisms that increase descending inhibition of pain. Contextual effects are an integral part of everyday clinical practice. While patient- and intervention-specific determinants cannot be changed easily, healthcare practitioners should optimize the physician-specific factors that enhance positive contextual response and minimize nocebo response. Such a strategy that will increase the overall improvement is particularly relevant for OA where there is no ‘cure’ and a predominance of negative beliefs.

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Ellis, Kathryn. A Brief Overview of the Effect of War Injuries on Sexual Health and Intimacy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190461508.003.0001.

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This chapter establishes definitions of sexual health and intimacy, provides insight into how they interact and affect successful relationships, and communicates the importance of addressing the sexual and intimacy needs of injured service members and their partners. Common deployment-related diagnoses, including post-traumatic stress disorder, traumatic brain injury, orthopedic injuries, spinal cord injuries, genital injuries, burns, and facial injuries, and their possible corresponding limitations are reviewed, along with how such limitations can result in sexual avoidance and intimacy avoidance, thus leading to more relationship issues and poor quality of life. The experience of partners, including perceptions about the dependence of the injured service member, is discussed as well.

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De Silva, Mary J., Alex Cohen et Vikram Patel. Evaluation of interventions in the real world. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199680467.003.0016.

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The goal of global mental health trials is to generate knowledge that can be implemented in the much messier ‘real world’. However, the effect of interventions in the real world may be different from, and most likely much smaller than, the effect sizes reported in trials. It is therefore essential that we evaluate their implementation and effect when they are ‘scaled-up’ as real programmes. The evaluation of scaled-up health programmes typically involves the use of multiple methods which are triangulated to address the key questions of the programme leaders or investigators. This chapter aims to describe what outcomes we might be interested in evaluating and the methods we might use to assess these outcomes, and presents selected case studies which demonstrate these methods in action.

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Dumbauld, Brett R. Thalassinid shrimp ecology and the use of carbaryl to control populations on oyster ground in Washington coastal estuaries. 1994.

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Gordon, David, Ahmad Khattab et Magdalena Anitescu. Bupivacaine and Glucocorticoid-Induced Myonecrosis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0035.

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The most frequently used medications for chronic pain are local anesthetics (LA) and glucocorticoids. Common adverse events from LA, such as seizures and cardiotoxicity, are well known. A lesser known side effect is local tissue reaction to the LA concentration. Myotoxicity is one of the common denominators of direct tissue reaction to LA; it results from the disruption of the mitochondria in the muscle cells. All LA produce some degree of myotoxicity; bupivacaine has the greatest effect and procaine the least. If LA is combined with glucocorticoid, muscle breakdown is even more extensive showing a synergistic effect. Myotoxicity depends primarily on LA concentration, is time dependent, and is enhanced by preexisting altered metabolism. It affects mostly young patients. Potential effects of long-term or repeated administration of the combination LA/glucocorticoids medications should always be considered and discussed with patients.

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Mahon, Anthony D. Aerobic training. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199232482.003.0039.

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Aerobic training is defined as exercise training that involves whole body endurance activity that is sustained for a sufficient length of time and at a sufficient intensity in order to improve cardiorespiratory fitness.1 The effect of aerobic training on physiological function in children has been investigated for nearly four decades. Some of this research has focused on the health-related benefits of this type of training on children and adolescents and for good reason. With increasing rates of obesity, type 2 diabetes, metabolic syndrome, and many other physical inactivity-related disorders, there is ample reason to discern the health-related effects of aerobic training during the paediatric years.2,3 However, there also has been a concerted effort to study the effect of aerobic training on the physiological adaptations, particularly maximal oxygen uptake ( V · O 2 max), that are associated with endurance performance.4 This chapter will focus on the latter consideration and will examine the effect of aerobic training in apparently healthy children and adolescents.

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Davies, Andrew N. Oral care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0085.

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Oral problems are common in patients with advanced cancer as well as in other groups of patients with life-limiting illnesses (and more generally in patients with chronic illness). Oral problems may be related to direct (‘anatomical’) effect of the primary disease, indirect (‘physiological’) effect of the primary disease, treatment of the primary disease, direct/indirect effect of a coexisting disease, treatment of the coexisting disease, or combinations of these factors. The successful management of oral problems involves adequate assessment, appropriate treatment, and adequate re-assessment. In some cases the most appropriate treatment for a patient with advanced cancer is the same treatment that would be given to a patient with early cancer (or no cancer). Thus, intensive treatment of the oral problem often results in the best palliation of the oral problem. It is not justified to withhold treatment on the grounds that the patient has advanced cancer; however, it may be justified to amend treatment (when appropriate).

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Hurd, Barbara. Stirring the Mud : On Swamps, Bogs, and Human Imagination. Mariner Books, 2003.

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Hurd, Barbara. Stirring the Mud : On Swamps, Bogs and Human Imagination. Beacon Press, 2001.

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Hurd, Barbara. Stirring the Mud : On Swamps, Bogs, and the Human Imagination. Beacon Press, 2002.

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47

Loaiciga, Francisco, et Rony Dev. Parenteral Nutrition in Cancer Patients Undergoing Chemotherapy (DRAFT). Sous la direction de Nathan A. Gray et Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0023.

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The meta-analysis by McGeer investigates the benefits of parenteral nutritional support for patients with cancer undergoing chemotherapy. The study concluded that total parenteral nutrition (TPN) has a detrimental effect (decreased survival and poorer tumor response), with an increased infection risk but no significant effect on hematologic or gastrointestinal toxicity. The authors report a net harm with the use of TPN in patients undergoing chemotherapy and recommend that such interventions should be discouraged. This chapter describes the basics of the study, briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

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Malina, Robert M. The influence of physical activity and training on growth and maturation. Sous la direction de Neil Armstrong et Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0032.

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Physical activity in the general youth population and systematic training for sport among young athletes seems to have no effect on size attained and rate of growth in height, or on maturity status and timing. However, activity and training may influence body weight and composition. While both favourably influence bone mineral, variable effects are noted in some sports. Activity has a minimal effect on fatness in normal weight youth, but regular training generally has a positive influence on fatness in youth athletes. Data for fat-free/lean tissue mass are suggestive, but limited. Constitutional factors play a central role in the selection and retention of young athletes in a sport.

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McKinlay Gardner, R. J., et David J. Amor. Uniparental Disomy and Disorders of Imprinting. Sous la direction de R. J. McKinlay Gardner et David J. Amor. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199329007.003.0018.

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Uniparental disomy (UPD) is a fascinating pathogenetic mechanism, albeit that it is applicable to a small but important number of conditions. This chapter discusses the basis of UPD and the different mechanisms by which it may arise. It reviews the concept of epigenetics in this setting. This chapter considers UPD as it may have been observed in all the chromosomes, in some of which it appears to be without any effect, and others in which a UPD effect is well known, including the classic UPD conditions, of which Prader-Willi and Angelman syndromes are the archetypes. The differing reproductive risks in these different syndromes are noted.

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Gluckman, Sir Peter, Mark Hanson, Chong Yap Seng et Anne Bardsley. Vitamins C and E and other antioxidants in pregnancy and breastfeeding. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198722700.003.0017.

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Pregnancy is characterized by oxidative stress, wherein high metabolic demands are accompanied by heightened oxygen requirements in tissues. Additionally, a number of disorders of pregnancy are characterized by a reduction in antioxidant activity. Consequently, it has been hypothesized that maternal supplementation with antioxidants, particularly vitamins C and E, may be beneficial in preventing the occurrence of these disorders. Other important dietary antioxidants include carotenoids, and polyphenols (flavonoids). In general, studies of the effect of providing supplementary vitamin C and E to improve pregnancy outcomes have been inconsistent or have shown no positive effect; some evidence suggests high-dose vitamin E may be harmful. These and other antioxidants are necessary in pregnancy but should ideally be obtained from food sources.

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