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أكتب لكم من طهران : سيرة روائية
منذ الثورة التي أطاحت بالشاه في العام ميلادي1979 تعيش إيران حالة من الغليان الدائم والتقلبات الاجتماعية والسياسية الكبيرة. من هناك تكتب دلفين منوي الصحافية الفرنسية من أصول إيرانية تجربتها في الحياة في إيران لمدة عشر سنوات ومن ضمنها أحد أكثر الفترات غموضا في تاريخ إيران، الحركة الخضراء، وقامت بتأليف سيرتها في حوالي (339) صفحة.
BOOK
Warburg-associated acidification represses lactic fermentation independently of lactate, contribution from real-time NMR on cell-free systems
Lactate accumulation and acidification in tumours are a cancer hallmark associated with the Warburg effect. Lactic acidosis correlates with cancer malignancy, and the benefit it offers to tumours has been the subject of numerous hypotheses. Strikingly, lactic acidosis enhances cancer cell survival to environmental glucose depletion by repressing high-rate glycolysis and lactic fermentation, and promoting an oxidative metabolism involving reactivated respiration. We used real-time NMR to evaluate how cytosolic lactate accumulation up to 40 mM and acidification up to pH 6.5 individually impact glucose consumption, lactate production and pyruvate evolution in isolated cytosols. We used a reductive cell-free system (CFS) to specifically study cytosolic metabolism independently of other Warburg-regulatory mechanisms found in the cell. We assessed the impact of lactate and acidification on the Warburg metabolism of cancer cytosols, and whether this effect extended to different cytosolic phenotypes of lactic fermentation and cancer. We observed that moderate acidification, independently of lactate concentration, drastically reduces the glucose consumption rate and halts lactate production in different lactic fermentation phenotypes. In parallel, for Warburg-type CFS lactate supplementation induces pyruvate accumulation at control pH, and can maintain a higher cytosolic pyruvate pool at low pH. Altogether, we demonstrate that intracellular acidification accounts for the direct repression of lactic fermentation by the Warburg-associated lactic acidosis.
Journal Article
A three-component cognitive behavioural lifestyle program for preconceptional weight-loss in women with polycystic ovary syndrome (PCOS): a protocol for a randomized controlled trial
Background
Obesity in women with polycystic ovary syndrome (PCOS) negatively affects all clinical features, and a 5 to 10% weight loss has shown promising results on reproductive, metabolic and psychological level. Incorporating a healthy diet, increasing physical activity and changing dysfunctional thought patterns in women with PCOS are key points in losing weight. The biggest challenge in weight management programs is to achieve a reasonable and sustainable weight loss. The aim of this study is to explore whether Cognitive Behavioural Therapy (CBT) by a mental health professional, working in a multidisciplinary team with a dietician and a physical therapist (a three-component intervention), is more effective for weight loss in the long term, within 12 months. We will also explore whether mobile phone applications are effective in supporting behavioural change and sustainable weight loss.
Methods
The present study is a longitudinal randomized controlled trial (RCT) to study the effectiveness of a three-component 1-year cognitive-behavioural lifestyle intervention in overweight/obese women with PCOS. A total of 210 participants are randomly assigned to three groups: 1) CBT provided by the multidisciplinary team or; 2) CBT provided by the multidisciplinary team and Short Message Service (SMS) or; 3) usual care: encourage weight loss through publicly available services (control group). The primary aim of the 12-month intervention is to explore whether a three-component 1-year cognitive-behavioural lifestyle intervention is effective to decrease weight, when compared to usual care. Secondary outcomes include: the effect of the intervention on the PCOS phenotype, waist circumference, waist to hip ratio, ovulation rates, total testosterone, SHBG, free androgen index (FAI), AMH, hirsutism, acne, fasting glucose, blood pressure and all psychological parameters. Additionally, we assessed time to pregnancy, ongoing pregnancies, clinical pregnancies, miscarriages and birth weight.
All outcome variables are measured at the start of the study, and again at 3 months, 6 months, nine months and 12 months.
Discussion
We expect that CBT provided by a multidisciplinary team, especially combined with SMS, is effective in developing a healthy lifestyle and achieving a long-term weight loss in women with PCOS. Losing 5– 10% body weight improves various PCOS characteristics. Consequently, we expect to show that CBT provided by a multidisciplinary team improves reproductive and metabolic outcomes, as well as quality of life, while at the same time being cost-effective.
Trial registration
Registered at the Netherlands National Trial Register with number
NTR2450
on August 2nd, 2010.
Journal Article
لم أخرج من ليلى
لا يمكن فى أيه حال، أن تقرأ تلك الصفحات بوصفها شهاده موضوعيه عن (الرحله الطويله) فى منزل المسنين، ولا بوصفها تشهيرا ( فقد كانت الممرضات - بصفه عامه - ذوات إخلاص كبير)، وإنما فقط بقيه من ألم. \"لم أخرج من ليلى\" هى العباره الأخيره التى كتبتها أمى. كثيرا ما أحلم بها، وعندما أستيقظ ولمده دقيقه أكون على يقين أنها تعيش بالفعل تحت الشكل المزدوج: ميته وحيه فى آن، مثل أولئك الشخوص فى الأساطير الإغريقيه الذين عبروا مرتين نهر الموتى.
BOOK
Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users
Background
A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff.
Methods
The study population is a nationally representative research sample of nursing staff (further referred to as the Nursing Staff Panel), of whom 685 (67%) completed a survey questionnaire about their experiences with recently introduced technologies. Participants were working in Dutch hospitals, psychiatric organizations, care organizations for mentally disabled people, home care organizations, nursing homes or homes for the elderly.
Results
Half of the respondents were confronted with the introduction of a new technology in the last three years. Only half of these rated the introduction of the technology as positive.
The factors most frequently mentioned as impeding actual use were related to the (kind of) technology itself, such as malfunctioning, ease of use, relevance for patients, and risks to patients. Furthermore nursing staff stress the importance of an adequate innovation strategy.
Conclusions
A prerequisite for the successful introduction of new technologies is to analyse determinants that may impede or enhance the introduction among potential users. For technological innovations special attention has to be paid to the (perceived) characteristics of the technology itself.
Journal Article
مكتبة ساحة الأعشاب : قل لي ماذا تقرأ، أقل لك من أنت : رواية
الكتاب الحقيقي، يهزك من الداخل، يوقظ فيك مملكة الرغبات، وشعب الممكنات، وجيش \"لم لا؟\" المتمرد\". تجاوز عتبة مكتبة ساحة الأعشاب، واستسلم لسحر مكان يتغنى بالكتب، والقراء، والمكتبات، ادخل هذا المكان الذي يغمره الدفء، والنور، والتشارك، واذهب برحلة إلى عالم الكتب حيث \"كل قراءة هي سفر وعشق\" وكل مكتبة هي \"مكان يخلق روابط\". تحكي لنا ناتالي، أستاذة سابقة حققت حلمها وأصبحت كتبية في قرية صغيرة، قصتها وقصص زبائنها : حبهم وصداقاتهم، مصالحاتهم الأسرية، شكوكهم، تأملاتهم الحياتية وتطلعاتهم الروحية... تروي ناتالي، تارة كاتمة سر وتارة مرشدة، مسارات هذه الشخصيات المختلفة، وتكشف لنا عن ثقافتها الأدبية، ما يجعلنا نتعرف إلى العناوين التي تحبها ونتذكر أهمية الكتب وما تحمله لنا من متعة عظيمة.
Book
Comparison of creatinine-based equations for estimating glomerular filtration rate in deceased donor renal transplant recipients
Background: Estimating glomerular filtration rate (GFR) is important for clinical management in kidney transplantation recipients (KTR). However, very few studies have evaluated the performance of the new GFR estimating equations (Lund-Malmö Revised-LMR, and Full Age Spectrum-FAS) in KTR.Methods: GFR was estimated (eGFR) using CKD-EPI, MDRD, LMR, and FAS equations and compared to GFR measurement (mGFR) by reference methods (inuline urinary and iohexol plasma clearance) in 395 deceased-donor KTR without corticosteroids. The equations performance was assessed using bias (mean difference of eGFR and mGFR), precision (standard deviation of the difference), accuracy (concordance correlation coefficient-CCC), and agreements (total deviation index-TDI). The area under receiver operating characteristic curves (ROC) and the likelihood ratio for a positive result were calculated.Results: In the total population, the performance of the CKD-EPI, MDRD and FAS equations was significantly lower than the LMR equation regarding the mean [95%CI] difference in bias (-2.0 [-4.0; -1.5] versus 9.0 [7.5; 10.0], 5.0 [3.5; 6.0] and 10.0 [8.5; 11.0] mL/min/1.73m2, P<0.005) and TDI (17.10 [16.41; 17.88], 25.91 [24.66; 27.16], 21.23 [19.48; 23.13] and 25.84 [24.16; 27.57], respectively). Concerning the CCC, all equation had poor agreement (<0.800) without statically difference between them. However, all equations had excellent area under the ROC curve (>0.900), and LMR equation had the best ability to correctly predict KTR with mGFR<45 mL/min/1.73 m2 (positive likelihood ratio: 8.87 [5.79; 13.52]).Conclusion: Among a referral group of subjects KTR, LMR equation had the best mean bias and TDI, but with no significant superiority in other agreement tools. Caveat is required in the use and interpretation of PCr-based equations in this specific population.
Journal Article
4CPS-221 Cutaneous infection caused by corynebacterium diphtheriae: a case report
BackgroundCutaneous diphtheria is a skin infection caused by toxigenic and non-toxigenic strains of Corynebacterium diphtheriae. It is characterised by chronic nonhealing ulcers. Diagnosis may be delayed because it is a rare infection in developed countries. Usual treatment is erythromycin or penicillin, although erythromycin is more effective than penicillin.PurposeTo describe a case of cutaneous diphtheria caused by non-toxigenic C. diphtheriae in a Visiting Friends and Relatives (VFR) patient.Material and methodsData were obtained by a review of the electronic medical records, Pubmed and Uptodate.ResultsA 25-years-old female. No known drug allergy. No usual treatment. She is from Guinea Bissau but she has lived in Spain since she was 7-years-old. She has been on holiday in Guinea Bissau from April to May 2017. Two weeks before her return she had a papular lesion in her left leg and subsequently it was ulcerated. Two days after she returned, she went to the hospital. Progressively similar lesions appeared in both legs, right shoulder and back. Exudate samples from ulcers were taken for microbiological culture and biopsy. In addition, we performed a protocol to care for immigrants: serology for strongyloides, treponema pallidum, plasmodium falciparum/vivas/malariae/ovale and HIV-1/2 were negative as well as PCR for Loa-loa and filarias. Skin histology showed eosinophil infiltrates with a central ulceration. PAS/Ziehl–Neelsen stains remained negative. Microbiological culture of ulcer swabs revealed C. diphtheria with Streptococcus pyogenes group A and methicillin-sensitive Staphylococcus aureus superinfection. PCR analysis for C. diphtheria toxin was negative. Pharyngeal swab cultures remained negative for C. diphtheriae. The patient was treated with erythromycin 500 mg/6 hours for 14 days. Topical treatment included daily fusidic acid. Lesions improved progressively with the treatment. Within 2 weeks all skin lesions had completely resolved.ConclusionCutaneous diphtheria was caused by non-toxigenic C. diphtheria. It is a highly contagious infection. Due to high vaccination rates it is a quite a rare infection in developed countries, but due to the increase in migration and refugees into Europe, more cases are being seen. Cutaneous diphtheria should be included in the differential diagnosis of patients with skin ulcerations, especially in immigrants.No conflict of interest
Journal Article