AIM： TO assess： （1） frequency and clinical relevance of gluten sensitive enteropathy （GSE） detected by serology in a mass screening program; （2） sensitivity of antitransglutaminase （tTGA） and ...antiendomysium antibodies （EmA）; and （3） adherence to gluten-free diet （GFD） and follow-up.
METHODS： One thousand, eight hundred and sixty-eight subjects recruited from an occupational health department underwent analysis for tTGA and EmA and, if positive, duodenal biopsy, DQ2/DQ8 genotyping, clinical feature recording, blood tests, and densitometry were performed. Since 〉 98% of individuals had tTGA 〈 2 U/mL, this value was established as the cut-off limit of normality and was considered positive when confirmed twice in the same sample. Adherence to a GFD and follow up were registered.
RESULTS： Twenty-six （1.39%） subjects had positive tTGA and/or EmA, and 21 underwent biopsy： six Marsh Ⅲ （one Ⅲa, four Ⅲb, one Ⅲc）, nine Marsh Ⅰ and six Marsh 0 （frequency of GSE 1：125）. The sensitivity of EmA for GSE was 46.6% （11.1% for Marsh Ⅰ, 100% for Marsh Ⅲ）, while for tTGA, it was 93.3% （88.8% for Marsh Ⅰ, 100% for Marsh Ⅲ）. All 15 patients with abnormal histology had clinical features related to GSE. Marsh Ⅰ and Ⅲ subjects had more abdominal pain than Marsh 0 （P = 0.029）, and a similar trend was observed for distension and diarrhea. No differences in the percentage of osteopenia were found between Marsh Ⅰ and Ⅲ （P = 0.608）. Adherence to follow-up was 69.2%. Of 15 GSE patients, 66.7% followed a GFD with 80% responding to it.
CONCLUSION： GSE in the general population is frequent and clinically relevant, irrespective of histological severity, tTGA is the marker of choice. Mass screening programs are useful in identifying patients who can benefit from GFD and follow-up.
An abnormal plasma polyunsaturated fatty acid pattern (PUFA) (increased n3 and decreased n6 PUFA) has been reported in active inflammatory bowel disease (IBD). The possibility of a primary defect in ...the PUFA metabolism in IBD was hypothesised. The aim of this study was to assess plasma PUFA pattern in inactive inflammatory bowel disease and to ascertain whether patients who had had a colectomy and who were suffering from ulcerative colitis have a similar PUFA pattern than those patients with non-active ulcerative colitis and who had not had a colectomy. Plasma fatty acids were analysed by semi-capillary column gas-liquid chromatography in three groups of patients with inactive IBD (24 patients with inactive ulcerative colitis who had not had a colectomy, 15 patients with ulcerative colitis who had had a colectomy, and 27 patients with Crohn's disease). Plasma concentration and percentage of C22:6n3 and unsaturation index were significantly higher in patients with inactive ulcerative colitis without a colectomy and the Crohn's disease group (p < 0.0001) than in controls. Plasma concentration and percentage of C22:6n3 and the unsaturation index remained significantly higher, in both the operated and non-operated ulcerative colitis patients when compared with controls (p < 0.0001). These results suggest that in inactive IBD, an increased PUFA biosynthesis might be the cause of the high values of n3 compounds. These findings although seen in active disease, are more noticeable in remission because of the lack of artefactual factors (malnutrition, steroids, inflammation). In addition, persistence of high values in both groups of ulcerative colitis patients--that is, those who had had a colectomy and those who had not suggests the existence of a primary abnormality in the PUFA metabolism in IBD.
The amino acid composition of the diet ingested by reference and cafeteria diet-fed lean and obese Zucker rats has been analyzed from day 30 to 60 after birth. Their body protein amino acid ...composition was measured, as well as the urinary and faecal losses incurred during the period studied. The protein actually selected by the rats fed the cafeteria diet had essentially the same amino acid composition as the reference diet. The mean protein amino acid composition of the rat showed only small changes with breed, age or diet. Cafeteria-fed rats had a higher dietary protein digestion/absorption efficiency than reference diet-fed rats. Obese rats wasted a high proportion of dietary amino acids when given the reference diet, but not on the cafeteria diet. In all cases, the amino acids lost as such in the urine were a minimal portion of available amino acids. In addition to breed, the rates of protein accretion are deeply influenced by diet, but even more by the age--or size--of the animals: cafeteria-fed rats grew faster, to higher body protein settings, but later protein accrual decreased considerably; this is probably due to a limitation in the 'blueprint for growth' which restricts net protein deposition when a certain body size is attained. Obese rats, however, kept accruing protein with high rates throughout. Diet composition--and not protein availability or quality--induced deep changes in amino acid metabolism. Since the differences in the absolute levels of dietary protein or carbohydrate energy ingested by rats fed the reference or cafeteria diets were small, it can be assumed that high (lipid) energy elicits the changes observed in amino acid metabolism by the cafeteria diet. The effects induced in the fate of the nitrogen ingested were more related to the fractional protein energy proportion than to its absolute values. Cafeteria-fed rats tended to absorb more amino acids and preserve them more efficiently; these effects were shown even under conditions of genetic obesity. There were deep differences in handling of dietary amino acids by dietary or genetically obese rats. The former manage to extract and accrue larger proportions of their dietary amino acids than the latter. The effects of both 'models' of amino acid management were largely additive, suggesting that the mechanisms underlying the development of obesity did not run in parallel to those affecting the control of amino acid utilization. Obesity may be developed in both cases despite a completely different strategy of amino acid assimilation, accrual and utilization.
Collecting tortoises for the pet trade is one of the factors threatening species of
Testudo in the Mediterranean area. The collection of
Testudo graeca graeca for pets is described in southeast ...Spain, where the main European population of this subspecies coincides with an area where keeping tortoises in captivity is a long-established custom. This present paper, based on inquiries made to children, reveals that this practice continues to be a common activity, and estimates a captive population in the order of tens of thousand of tortoises. Tortoises are collected as a result of chance encounters with wild animals by local inhabitants, and without any commercial objectives. The captive breeding and the release of tortoises without any institutional control is also common. These activities could be an important threat for the species. Implications for conservation are discussed and a critical review of the conservation strategies developed in relation to this threat (trade control and re-introduction programmes) are presented. We suggest that environmental education programmes are necessary to reduce casual collection and to change the social perception of tortoises as pets.
Abstract Two cases of vocal cord closure, which was responsible for acute intraoperative impairment of mechanical ventilation in two patients with entropy-controlled depth of anesthesia, are ...reported. Administration of low-dose neuromuscular blocking drug was associated with immediate vocal cord relaxation and restoration of efficient mechanical ventilation.
Le malaise des enseignants Esteve, José M.; Fracchia, Alice F.B.
Revue française de pédagogie,
1988, Letnik:
84, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Teachers unrest - The authors analyse two types of factors which help the coming out of this unrest and its effects on the personality of teachers and the practice of their profession. Then they ...propose strategies that could thwart some of these consequences, and plans concerning teachers training and appointment.
Le malaise des enseignants, défini comme l'ensemble de réactions que manifeste ce groupe professionnel en quête de son identité, est devenu un sujet de recherche au début des années 80. Ce travail analyse les facteurs impliqués dans l'apparition de -ce malaise. Il en ressort deux types : des facteurs relevant du contexte social (changement du rôle des enseignants et des familles, incertitude sur les objectifs de l'éducation, contestation accrue du travail des enseignants, etc.) et des facteurs qui agissent directement sur le déroulement des cours (moyens et matériel mis à disposition, conditions de travail, etc.).
Après avoir étudié les effets que ce malaise peut avoir sur la personnalité des enseignants et l'exercice de leur profession, nous nous sommes attachés à présenter des stratégies susceptibles de prévenir ou de pallier certaines de ces conséquences. On peut ainsi envisager des actions concernant le recrutement des enseignants, leur formation initiale et continue.
Ever since cerebral salt wasting syndrome (CSW) was first described in 1950, there have been debates over its existence and whether it has an important place in the differential diagnosis of ...hyponatraemia. We report the case of a neurosurgical patient with sustained hyponatraemia and abnormally high sodium loss in the urine, with signs of fluid volume depletion. Hyponatraemia was not corrected after an intravenous infusion of saline solution. Stable concentrations of blood sodium above 130 mmol/l were achieved with the administration of 100 mg of hydrocortisone daily, with an ensuing reduction in sodium elimination through the urine.
PDF
