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Author: Tristan Jacquin de Margerie Publisher: ISBN: Category : Languages : fr Pages : 47
Book Description
Introduction. L'index de résistance intra-rénale (RRI) est un marqueur vasculaire bien étudié dans le diabète. Il est connu pour être lié à un terrain d'athérosclérose et ses facteurs de risque cardiovasculaire. Par contre, son influence pronostique dans une population de patients diabétiques de type 2 n'a jamais été évaluée. Méthode. Les données de 380 patients diabétiques ayant bénéficié d'un bilan cardiovasculaire global dans notre service de 2008 à 2011 ont été analysés de manière rétrospective. Les patients ont bénéficié d'une évaluation cardiovasculaire globale : une évaluation des facteurs de risque cardiovasculaires, une échographie cardiaque, un écho doppler des troncs supra-aortiques, des membres inférieurs et des artères rénales. La pression artérielle a été évaluée par monitoring des 24 heures. Le critère primaire était la mortalité toute cause et les critères secondaires : la survenue d'événements cardiovasculaires majeurs (MACE), d'événements rénaux (ER) et d'hospitalisations pour insuffisance cardiaque (IC). Résultats. Les données étaient disponibles pour 329 patients diabétiques de type 2 (49,6 % d'hommes, âge moyen 64.76 ans ; ancienneté médiane du diabète 132 mois ; HbA1c moyenne 8.20% ; pression artérielle systolique clinique moyenne 145.4mmHg ; clairance MDRD moyenne de 82.80 ml/min/1.73m2). Au cours du suivi (médiane 7,6 ans), les patients avec un RRI élevé (RRI≥0.7) présentaient un moins bon pronostic. L'RRI est montré comme marqueur prédictif indépendant de mortalité toute cause (hazard ratio (HR) 3.93 ; IC95 %[1.82 ; 8.49] p=0.0005), de MACE (HR 2.25 ; IC95%[1.28 ; 3.92] p=0.0047) et d'ER (HR 4.93 ; IC95%[2.20 ; 11.04] p=0.0001). Aucun lien significatif n'a pu être montré concernant les IC (HR 1.997 ; IC95% [0.287 ; 13.904] p=0.4848). Conclusion. le RRI peut servir de marqueur pronostique complémentaire pour affiner la compréhension du surrisque des populations diabétiques de type 2 en termes de mortalité toute cause, de survenue d'événements cardiovasculaires ou rénaux majeurs chez la population diabétique. Aucun lien statistique n'a été retrouvé avec l'insuffisance cardiaque.
Author: Tristan Jacquin de Margerie Publisher: ISBN: Category : Languages : fr Pages : 47
Book Description
Introduction. L'index de résistance intra-rénale (RRI) est un marqueur vasculaire bien étudié dans le diabète. Il est connu pour être lié à un terrain d'athérosclérose et ses facteurs de risque cardiovasculaire. Par contre, son influence pronostique dans une population de patients diabétiques de type 2 n'a jamais été évaluée. Méthode. Les données de 380 patients diabétiques ayant bénéficié d'un bilan cardiovasculaire global dans notre service de 2008 à 2011 ont été analysés de manière rétrospective. Les patients ont bénéficié d'une évaluation cardiovasculaire globale : une évaluation des facteurs de risque cardiovasculaires, une échographie cardiaque, un écho doppler des troncs supra-aortiques, des membres inférieurs et des artères rénales. La pression artérielle a été évaluée par monitoring des 24 heures. Le critère primaire était la mortalité toute cause et les critères secondaires : la survenue d'événements cardiovasculaires majeurs (MACE), d'événements rénaux (ER) et d'hospitalisations pour insuffisance cardiaque (IC). Résultats. Les données étaient disponibles pour 329 patients diabétiques de type 2 (49,6 % d'hommes, âge moyen 64.76 ans ; ancienneté médiane du diabète 132 mois ; HbA1c moyenne 8.20% ; pression artérielle systolique clinique moyenne 145.4mmHg ; clairance MDRD moyenne de 82.80 ml/min/1.73m2). Au cours du suivi (médiane 7,6 ans), les patients avec un RRI élevé (RRI≥0.7) présentaient un moins bon pronostic. L'RRI est montré comme marqueur prédictif indépendant de mortalité toute cause (hazard ratio (HR) 3.93 ; IC95 %[1.82 ; 8.49] p=0.0005), de MACE (HR 2.25 ; IC95%[1.28 ; 3.92] p=0.0047) et d'ER (HR 4.93 ; IC95%[2.20 ; 11.04] p=0.0001). Aucun lien significatif n'a pu être montré concernant les IC (HR 1.997 ; IC95% [0.287 ; 13.904] p=0.4848). Conclusion. le RRI peut servir de marqueur pronostique complémentaire pour affiner la compréhension du surrisque des populations diabétiques de type 2 en termes de mortalité toute cause, de survenue d'événements cardiovasculaires ou rénaux majeurs chez la population diabétique. Aucun lien statistique n'a été retrouvé avec l'insuffisance cardiaque.
Author: Konstantin Nikolaou Publisher: Springer ISBN: 3319425862 Category : Medical Languages : en Pages : 1116
Book Description
The fourth edition of this well-received book offers a comprehensive update on recent developments and trends in the clinical and scientific applications of multislice computed tomography. Following an initial section on the most significant current technical aspects and issues, detailed information is provided on a comprehensive range of diagnostic applications. Imaging of the head and neck, the cardiovascular system, the abdomen, and the lungs is covered in depth, describing the application of multislice CT in a variety of tumors and other pathologies. Emerging fields such as pediatric imaging and CT-guided interventions are fully addressed, and emergency CT is also covered. Radiation exposure, dual-energy imaging, contrast enhancement, image postprocessing, CT perfusion imaging, and CT angiography all receive close attention. The new edition has been comprehensively revised and complemented by contributions from highly experienced and well-known authors who offer diverse perspectives, highlighting the possibilities offered by the most modern multidetector CT systems. This book will be particularly useful for general users of CT systems who wish to upgrade and enhance not only their machines but also their knowledge.
Author: World Health Organization. Scientific Group on Nutritional Anaemias Publisher: ISBN: Category : America Languages : en Pages : 48
Book Description
Investigations of nutritional anemias of pregnancy made by WHO in India, Israel, Mexico, Poland and Venezuela have shown that the prevalence of anemia in pregnant women ranges from 21% to 80%. Iron deficiency was present in 40-99% of these women and has been responsible for the major occurrences of anemia. Studies on the absorption of iron from various foods indicated that it is necessary to express dietary iron intake in terms of both total iron intake and its absorbability. Loss of body iron occurs in the gastrointestinal tract, urine, sweat, by exfoliation of skin, and through blood loss attributed to parasitic infection. The optimum dietary requirements of iron when absorbed cover physiological losses and conditions such as growth and pregnancy. The total iron demanded during pregnancy is about 900 mg of which 200 mg is lost during and immediately following delivery. The iron requirement increases greatly during pregnancy and since the high requirment during the last trimester cannot be met from consumed food, the diet must be supplemented by administration of medicinal iron. The strengthening of education programs for mothers, sanitary measures particularly in rural areas, the supplementing of foods with iron by enriching wheat flour and baby foods, the supplementing of medicinal iron during pregnancy, the daily administration of small amounts of iron to schoolchildren and further studies on nutritional anemias are all means of changing the present nutritional status.
Author: Irene Papanicolas Publisher: McGraw-Hill Education (UK) ISBN: 033524727X Category : Medical Languages : en Pages : 418
Book Description
International comparison of health system performance has become increasingly popular, made possible by the rapidly expanding availability of health data. It has become one of the most important levers for prompting health system reform. Yet, as the demand for transparency and accountability in healthcare increases, so too does the need to compare data from different health systems both accurately and meaningfully. This timely and authoritative book offers an important summary of the current developments in health system performance comparison. It summarises the current state of efforts to compare systems, and identifies and explores the practical and conceptual challenges that occur. It discusses data and methodological challenges, as well as broader issues such as the interface between evidence and practice. The book draws out the priorities for future work on performance comparison, in the development of data sources and measurement instruments, analytic methodology, and assessment of evidence on performance. It concludes by presenting the key lessons and future priorities, and in doing so offers a rich source of material for policy-makers, their analytic advisors, international agencies, academics and students of health systems.
Author: Nathan I. Cherny Publisher: Oxford University Press, USA ISBN: 0199656096 Category : Medical Languages : en Pages : 1281
Book Description
Emphasising the multi-disciplinary nature of palliative care the fourth edition of this text also looks at the individual professional roles that contribute to the best-quality palliative care.
Author: Richard Hain Publisher: Oxford University Press ISBN: 019882131X Category : Medical Languages : en Pages : 535
Book Description
The importance of palliative care for children facing life threatening illness and their families is now widely acknowledged as an essential part of care, which should be available to all children and families, throughout the child's illness and at the end of life. The new edition of the Oxford Textbook of Palliative Care for Children brings together the most up to date information, current knowledge, evidence, and developments of clinical practice in the field. The book is structured into four sections. 'Foundations of Care' describes core issues, the foundations on which paediatric palliative care is based. 'Child and Family Care' looks at different aspects of psychological, social, and cultural care for the sick child or young person, and their family. These chapters cover the time course of the illness, around the time of death and support for the bereaved family. 'Symptom Care' focuses on the uses of medication, specific symptoms, and their management. Finally, 'Delivery of Care' examines practical approaches to care in different environments and the needs of clinicians. Two new editors join the team from Canada and South Africa, reflecting our aims to contribute towards the development of care for children across the world, and to be a resource for both experienced clinicians and those new to the field. Comprehensive in scope, exhaustive in detail, and definitive in authority, this third edition has been thoroughly updated to cover new practices, current epidemiological data, and the evolving models that support the delivery of palliative medicine to children. This includes two new chapters, looking in detail at 'Decision Making' and 'Perinatal Care', and a new section highlighting the emerging importance of 'Palliative Care for Children in Humanitarian Crises'. This book is an essential resource for anyone who works with children worldwide.
Author: World Bank Publisher: World Bank Publications ISBN: 0821385631 Category : Social Science Languages : en Pages : 114
Book Description
This report provides the most comprehensive and rigorous analysis of Iraqi income and expenditure in several decades. The report makes extensive use of the Iraq Household Socio-Economic Survey, the first nationwide income and expenditure survey since 1988. IHSES data is complemented income and expenditure data from a wide range of other measures of living standards, allowing us to analyze living standards in a holistic way. The analysis presented here was performed with two main goals first, to inform the Government s Poverty Reduction Strategy; and second, to serve as a baseline for future assessments of changes in living standards and the identification of critical issues for deeper examination. Iraqi living standards have two unusual characteristics. First, they have fallen over the past generation. Second, they feature surprisingly little inequality. These characteristics are both rooted in Iraq s recent history of authoritarian government, war, military occupation, insurgency, and civil strife leading to infrastructure destruction and population displacement. There have been few opportunities for individuals to prosper from professional or entrepreneurial activities. Decades of neglected investment have resulted in deterioration of social services and economic infrastructure. Consequently, individuals have lacked capabilities to prosper and an investment climate conducive to prosperity. School enrollment and life expectancy have declined. Extremely low returns to education reflect the combination of poor educational quality and lack of employment opportunities. In terms of economic infrastructure, access to reliable electricity and water, and even access to paved roads are low, are further reflections of decades of neglect. While the upper end of the distribution has been pulled down by a lack of opportunities, the lower end has been supported by direct government provision of food. The Public Distribution System (PDS) provides 85 percent of food needs. While PDS has been useful as a safety net for the poor and the vulnerable, the system is expensive, inefficient, and fiscally risky. Indeed, PDS food rations account for a far greater share of public spending than does education or health. Going forward, Iraq faces two main challenges. First, although Iraq does not have to develop from scratch, it faces a formidable challenge in re-development. Second, a shift by the Government is required from direct provision of basic subsistence toward investment in human capacities. The Government can provide an enabling environment through investments in economic infrastructure and services to business and citizens, thus allowing the population to make productive use of education and their own labor. Both challenges are now being taken up by the Poverty Reduction Strategy, which articulates a detailed set of required actions and outlines priorities for government spending.
Author: Christine Parent Publisher: Springer Science & Business Media ISBN: 354030326X Category : Computers Languages : en Pages : 475
Book Description
From environmental management to land planning and geo-marketing, the number of application domains that may greatly benefit from using data enriched with spatio-temporal features is expanding very rapidly. This book shows that a conceptual design approach for spatio-temporal databases is both feasible and easy to apprehend. While providing a firm basis through extensive discussion of traditional data modeling concepts, the major focus of the book is on modeling spatial and temporal information.
Author: Tristan Jacquin de Margerie
Author: Tristan Jacquin de Margerie
Author: Konstantin Nikolaou
Author: World Health Organization. Scientific Group on Nutritional Anaemias
Author: Irene Papanicolas
Author: Nathan I. Cherny
Author: Dominique Jean baron Larrey
Author: Richard Hain
Author: World Bank
Author: Yves Requena
Author: Christine Parent