Gotowa bibliografia na temat „Nerve lisse”

Piepende Monitore, tropfende Infusionen, Beatmungsgeräte, Drainagen, Magensonden – die Liste der Herausforderungen für Physiotherapeuten auf Intensivstation ist lang. Technisches Verständnis ist gefordert, gute Nerven und Muskelkraft. Kolleginnen berichten von ihrem intensiven Alltag, der sie fordert und fördert, der manchmal zermürbt und doch Spaß bereitet.

Background:Biologic disease-modifying antirheumatic drug (bDMARD) therapy has been shown to be effective in the treatment of axial spondyloarthritis (axSpA).1,2 Little is understood about patients’ experience of axSpA treatment from their own perspective.Objectives:To characterize patient experiences and perspectives with bDMARD treatments for axSpA, including satisfaction, and use of supplementary treatments when wear-off between doses is perceived among those currently treated with bDMARD therapy.Methods:Adult US participants (pts) within the ArthritisPower registry with physician-diagnosed axSpA were invited to complete electronic PRO measures, such as the BASDAI (0-10 scale, score ≥4 indicates suboptimal disease control), and an online survey about their perspectives of treatment. Analysis compared pt characteristics and treatment satisfaction by whether or not pt reported wear-off between bDMARD doses.Results:128 pts with axSpA and on bDMARD therapy met inclusion criteria of whom 82.8% were female, with mean age of 47 years. Mean BASDAI scores indicated poor disease control (6.4, SD 1.8), worse for those perceiving wear-off between doses compared with those who did not [6.8 (1.6) vs. 5.9 (2.0), p=0.01]. A majority of pts on a bDMARD reported being somewhat (57.8%) or very satisfied (26.6%) with their current axSpA treatment, and about 53.1% were satisfied with how well it controls axSpA-related pain. However, 60.9% (n=78) of pts reported that their current bDMARD typically wears off before the next dose. Treatment satisfaction was lower for pts experiencing wear-off compared to pts without wear-off (highly satisfied: 21.8% vs. 34%; somewhat satisfied: 60.3% vs. 54%; dissatisfied: 17.9% vs. 12%). 82.1% (n=64) of pts reporting wear-off used additional medications or supplements when that happened, chiefly NSAIDs (68.8%, n=44), muscle relaxers (42.2%, n=27) and/or opioids (37.5%, n=24). Among the 20 pts not satisfied with current axSpA treatment, side effects (6/20, 30.0%), or worry about risk of side effects (2/20, 10%) were the main reasons.Conclusion:In a predominantly female sample of bDMARD-treated axSpA patients with high disease activity, most expressed satisfaction with treatment. However, most experienced wear-off between doses and took supplementary medications, including opioids, to manage.References:[1]Dubash S, et al. Ther Adv Chronic Dis. 2018;9(3):77–8.[2]Van Der Heijde D, et al. Ann Rheum Dis. 2017;76(6):978–91.Table 1.Demographic and clinical characteristics by wear-off between bDMARD doses (n=128)Pts currently on bDMARD(N=128)Wear-off between bDMARD oses(N=78)No wear-off / Not sure(N=50)p-valueNumber or mean (% or SD)Age46.9 (10.3)46.1 (9.2)48.2 (11.8)0.25Female106 (82.8)69 (88.5)37(74.0)0.03White115 (89.8)70 (89.7)45 (90.0)0.96Body Mass Index30.9 (7.8)31.2 (8.5)30.4 (6.6)0.57Current Medications, addition to bDMARDConventional Synthetic DMARD (e.g. methotrexate, sulfasalazine)17 (13.3)15 (19.2)2 (4.0)0.01Prescription NSAID59 (46.1)39 (50.0)20 (40.0)0.27Other prescription medication¥70 (54.7)44 (56.4)26 (52.0)0.62Noticed improvement in symptoms related to axSpA since starting current bDMARD80 (62.5)51 (65.4)29 (58.0)0.40Noticed improvement in symptoms NOT related to axSpA since starting current bDMARD40 (31.3)22 (28.2)18 (36.0)0.35BASDAI‡6.4 (1.8)6.8 (1.6)5.9 (2.0)0.01PROMIS Pain Interference ł65.3 (5.7)66.0 (5.1)64.3 (6.4)0.09PROMIS Physical Function ł36.7 (5.6)36.1 (5.3)37.7 (5.8)0.11PROMIS Sleep Disturbance ł59.8 (8.5)61.2 (7.7)57.6 (9.3)0.02* Statistical significance between groups of pts who experienced wear-off between bDMARD or not, p < 0.05¥ Other prescription medications: muscle relaxers, nerve pain medications or anti-depressants, and opioids‡ BASDAI is scored on a 0-10 scale with score ≥4 indicating suboptimal control of diseaseł PROMIS measures use T-score metric in which 50 is mean, 10 is standard deviation (SD), of US population; higher T-score = more of concept measuredAcknowledgements:This study was sponsored by Eli Lilly and Company. We thank the patients who participated in this study.Disclosure of Interests:W. Benjamin Nowell Grant/research support from: Full-time employee of Global Healthy Living Foundation, an independent nonprofit research organization, which received funding pursuant to a contract from Eli Lilly to conduct the study that is the subject of this abstract; Principal Investigator for studies with grant support from AbbVie, Amgen and Eli Lilly, Kelly Gavigan Grant/research support from: Full-time employee of Global Healthy Living Foundation, an independent nonprofit research organization, which received funding pursuant to a contract from Eli Lilly to conduct the study that is the subject of this abstract, Theresa Hunter Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, William Malatestinic Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Rebecca Bolce Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jeffrey Lisse Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Carol Himelein Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jeffrey Curtis Consultant of: AbbVie, Amgen, BMS, Corrona, Eli Lilly, Janssen, Myriad, Pfizer, Roche, Regeneron, Radius, UCB, Grant/research support from: AbbVie, Amgen, BMS, Corrona, Eli Lilly, Janssen, Myriad, Pfizer, Roche, Regeneron, Radius, UCB, Jessica A. Walsh Consultant of: AbbVie, Amgen, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Merck, Pfizer

Ce travail fait le point sur les recherches et idées récentes concernant les Basques dans le golfe du Saint-Laurent et en Acadie atlantique. Des découvertes nouvelles et le retour aux collections existantes ont amplifié la liste des sites basques connus, et ce, dans plusieurs régions. Les recherches en archives ont progressé également, identifiant les lieux de pêche basque dans le sud du golfe, et les lieux d’enterrement de marins décédés. Ce travail révèle la complexité des activités basques selon trois thèmes : la diversité des activités basques, le rapport des Basques d’Espagne avec le pouvoir colonial français, et les rapports entre Basques et Autochtones au xviie siècle, en particulier les Inuits et les Mi’kmaq. Ces thèmes synthétisent les adaptations des Basques au contexte historique qui ne cesse d’évoluer au cours des 250 ans de leur présence. Puisque ces adaptations variaient dans l’espace, ce texte présente les recherches et idées récentes selon quatre régions : la Grande Baie, le sud de Terre-Neuve, l’Acadie atlantique et l’Acadie laurentienne.

Desde a primeira publicação a respeito, em 2001, injeções lipolíticas para gordura localizada tornou-se um procedimento amplamente utilizado na clínica. Consiste de múltiplas injeções subcutâneas de compostos lipolíticos, que podem ter diversos mecanismos de ação. O fármaco mais utilizado atualmente, o desoxicolato de sódio, foi descoberto por acaso, em uma associação com fosfatidilcolina em que sua única função era de veículo da fórmula. Conforme estudos foram sendo realizados, concluiu-se que a ação no tecido era devido ao desoxicolato, um sal biliar que emulsiona os lipídios da membrana celular, resultando em lise do adipócito e consequente necrose do tecido adiposo. Seus principais efeitos adversos, muito frequentemente relatados, incluem dor intensa, edema e formação de nódulos fibrosos nos pontos aplicados. Em decorrência de falhas na aplicação, alguns efeitos adversos mais graves podem ocorrer, como injúria do nervo facial e infecções persistentes. Apesar destes, a utilização de desoxicolato de sódio na camada subcutânea apresenta resultados muito positivos, como publicado em diversos ensaios clínicos, inclusive com relação à satisfação do paciente perante o desfecho final, sendo, portanto, uma boa escolha de técnica para contorno corporal e diminuição de depósitos de gordura localizados. Palavras-chave: injeções lipolíticas, gordura localizada, desoxicolato de sódio, fosfatidilcolina.

Cette thèse concerne l’étude de la géométrie des champs dans le contexte de la géométrie différentiable, utilisant les outils de la théorie de l’homotopie et des catégories supérieures. Ces techniques deviennent nécessaires pour traiter des généralisation aux champs d’objets géométriques fondamentales, tels que les fibrés tangent et cotangent, les formes sur un champs, leurs automorphismes et plus en général les complexes parfaits, qui sont un des objets principaux dans ce travail. Dans la première partie de cette thèse nous faisons une récapitulation des champs différentiables supérieurs, leur homotopie et cohomologie. Dans la deuxième partie nous étudions les représentations à homotopie près des groupoïdes de Lie et nous les relions avec une théorie des complexes parfaits sur les champs différentiables. Parmi nos résultat, nous montrons que une représentation à homotopie près d’un groupoïde de Lie est exactement un module cohésive sur la dg-algèbre des fonctions lisses et que les dg-catégories correspondants sont Morita invariantes. Ça nous permets de donner une définition de dg-catégorie des complexes parfaits sur un champ différentiable. De plus nous construisons un 2-groupoide de Lie des automorphismes des complexes des fibrés vectoriels de longueur 2, qui est un analogue supérieur du champs classifiant BGL_n. Nous concluons avec une définition du 2-champs différentiable des complexes parfaits de amplitude [0,1] par le biais d’une présentation par un 2-groupoide de Lie
This thesis is concerned with the geometry of stacks in the differential geometry context using homotopical and higher categorical techniques. These techniques becomes necessary to deal with simple stack generalizations of crucial objects such as tangent and cotangent bundles, forms on a stack, their automorphisms and more generally perfect complexes, which are one of the main object of study of this work. In the first part of this thesis we give an overview of higher and differentiable stacks, their homotopy theory and cohomology theories. In the second part we study one representation up to homotopy of Lie groupoids and rely them with a theory of perfect complex over differentiable stacks. Among our results, we show that a representation up to homotopy on a Lie groupoid is the same as a cohesive module on its dg-algebra of smooth functions and that the correspondent dg-categories are Morita invariant. This allows us to give a definition of dg-category of perfect complexes on a differentiable stack. We moreover construct a Lie 2-groupoid of automorphisms of 2-terms complexes of vector bundles, which is a higher analogue of the classifying stack BGL_n. We conclude by giving a definition of the differentiable 2-stack of perfect complexes of amplitude [0,1] by means of a Lie 2-groupoid presenting it

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Introdu??o: O tratamento de les?es com perda dos nervos perif?ricos ? ainda um problema n?o resolvido. Na ?rea de pesquisa experimental, modelos animais com perdas nervosas de grande porte t?m sido usados com o objetivo de estudar o efeito de sust?ncias promotoras da regenera??o axonal adicionadas dentro de sistemas de tubuliza??o. Como medida de regenera??o nervosa, o efeito funcional ? considerado como o mais importante o ?ndice funcional da marcha, ou Sciatic Function Index (SFI), ? o m?todo mais utilizado nas les?es de nervo ci?tico em ratos; seu uso, por?m, tem sido questionado em modelos de transec??o nervosa (neurotmese). O objetivo do presente trabalho experimental ? estudar o desempenho do SFI, em um modelo de transec??o e perda de grande porte (12 mm) em nervo ci?tico de ratos, com o fim de verificar se a utiliza??o do SFI ? uma ferramenta confi?vel para diferenciar padr?es de recupera??o funcional e regenera??o nervosa ap?s perdas segmentares de grande porte em ratos. M?todos: Foram utilizadas 30 f?meas de ratos Wistar, adultos, isog?nicos, divididos em 5 grupos, nos quais se realizou uma perda de 12 mm do nervo ci?tico direito. Posteriormente, tal perda foi reparada com auto-enxerto ou com tubo de silicone preenchido com uma matriz de fibrina, onde se adicionaram c?lulas mononucleares de medula ?ssea (CMMO), fator de crescimento neural (NGF) ou uma combina??o destes. O ?ndice funcional da marcha (SFI) foi medido entre as 5? e 16? semanas ap?s a cirurgia. Resultados: Do total de ratos tratados com tubo, 21 dos 24 animais falharam em reconstituir nervo no tubo (87,5%). Os tr?s animais em que se evidenciou crescimento de nervo dentro do tubo n?o mostraram diferen?as no SFI em rela??o aos outros em que n?o cresceu nervo. Todos os animais com tubuliza??o mostraram aus?ncia de recupera??o funcional no SFI durante o seguimento. Depois de 16 semanas, a m?dia do SFI? DP dos 4 grupos com tubo foi -77,88 ? 8,3, obtendo valores significativamente piores aos obtidos com auto-enxertos, com m?dia SFI ?DP, -56,97?12,71, com valor p=0,003. Ainda que a diferen?a tenha sido significativa, o grupo com auto-enxerto apresentou uma melhoria limitada: 43% do valor considerado normal, ap?s 16 semanas de observa??o. Discuss?o: As diferen?as do SFI encontradas entre os grupos com aus?ncia de efeito (tubo) e o melhor efeito poss?vel (auto-enxerto) foi significativa (p=0,003); por?m, a baixa precis?o da estimativa e a baixa amplitude de valores encontrada entre eles determinam um m?todo com baixo poder. Conclus?es: O ?ndice funcional da marcha (SFI) n?o ? um m?todo adequado para avaliar regenera??o nervosa ap?s les?es com perda segmentar de 12 mm em nervo ci?tico de rato, por ter um baixo poder para detectar verdadeiras diferen?as.