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La mortalité précoce auprès des utilisateurs de clozapineMichaud, Isabelle 08 1900 (has links)
Objectif : La mortalité précoce chez la population psychiatrique, notamment atteinte de schizophrénie, est un phénomène fort étayé dans la littérature médicale et l’exposition aux antipsychotiques a été postulée pour expliquer, en partie, celle-ci. À notre connaissance, aucune étude ne s’est intéressée à la mortalité précoce auprès des utilisateurs de clozapine. L’objectif de cette étude est l’exploration des causes spécifiques de la mortalité précoce chez ceux-ci, dont la mortalité subite, inattendue et d’origine indéterminée, et de leurs caractéristiques au moment du décès.
Méthodologie : Le devis est de type non expérimental, rétrospectif et descriptif par séries de cas. La population à l’étude est constituée de sujets âgés entre 18 et 64 ans utilisateurs de clozapine au moment du décès. Des variables sociodémographiques, psychiatriques, médicales, pharmacologiques et en lien avec la cause, l’origine et les circonstances du décès, incluant l’autopsie, ont été analysées.
Résultats : L’échantillon est composé de 100 sujets pour lesquels 67 ont fait l’objet d’une autopsie. L’âge moyen au moment du décès est de 47,4 ans (écart-type de 9,1 ans). La principale cause de mortalité est la mort subite, inattendue et d’origine indéterminée (n = 63; 63,0%). Si une origine naturelle est déterminée, elle est d’abord pulmonaire (n = 11; 37,9%), principalement en lien avec la pneumonie (n = 8; 72,7%). Une association significative entre la mort subite, inattendue et d’origine indéterminée, et le diagnostic de schizophrénie (valeur-p = 0,022), la dyslipidémie (valeur-p = 0,003) et la plage horaire de la survenue du décès (valeur-p = 0,020) est observée. La majorité, s’élevant à 53,5%, des individus décédés d’une mort subite, inattendue et d’origine indéterminée, dont la nature indéterminée est confirmée par l’autopsie, survient la nuit.
Conclusion : La mort subite, inattendue et d’origine indéterminée est la principale cause de mortalité auprès des utilisateurs de clozapine. Elle est associée au diagnostic de schizophrénie et à la plage horaire de la survenue du décès, dont la prépondérance s’avère nocturne, à l’instar de la mort subite chez les épileptiques, appelée Sudden unexpected death in epilepsy (SUDEP).
Déclaration d’intérêt : Aucun. / Objective: Early mortality is associated to psychiatric disorders, especially schizophrenia. Antipsychotics may explain, at least partly, this phenomenon. To our knowledge, there is no literature regarding early mortality among clozapine users. The purpose of this study is to explore the causes of early mortality among these individuals, including sudden, unexpected, and undetermined death, and their related characteristics.
Methodology: This study is a non-experimental, retrospective and descriptive case series. The population is aged from 18 to 64 years old and used clozapine at the time of their death. Sociodemographic, psychiatric, medical, pharmacological variables and others related to the cause, origin and circumstances of the death, including autopsy, were analyzed.
Results: The sample size is 100 participants. Of these, 67 were autopsied. The mean age at the time of death is 47,4 years (+/- 9,1 years). The leading cause of death is sudden, unexpected death of undetermined origin (n = 63, 63,0%). If a natural origin is determined, it is primarily related to a pulmonary disorder (n = 11; 37,9%), mainly pneumonia (n = 8, 72,7%). A significant association between sudden, unexpected, and undetermined death, and the diagnosis of schizophrenia (p-value = 0,022), dyslipidemia (p-value = 0,003), and time slot of occurrence of death (p-value = 0,020) is observed. Fifty-three percent of patients with sudden unexpected death of undetermined origin, meaning a medical cause could not be identified following an autopsy, died during their sleep or at night.
Conclusion: Sudden, unexpected and undetermined death is the leading cause of death among clozapine users. It is associated with schizophrenia and the time slot of the occurrence of death, whose preponderance is nocturnal, as Sudden unexpected death in epilepsy (SUDEP) is.
Declaration of interest: None.
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Efficacy of selective laser trabeculoplasty on lowering intraocular pressure fluctuations and nocturnal peak intraocular pressure in treated primary open-angle glaucoma patientsPillunat, Karin R., Kocket, Greta A., Herber, Robert, Jasper, Carolin S., Lenk, Janine, Pillunat, Lutz E. 19 March 2024 (has links)
Purpose
To investigate the efficacy of adjunctive selective laser trabeculoplasty (SLT) in reducing 24-h intraocular pressure (IOP) fluctuations and nocturnal IOP peaks.
Methods
In this prospective interventional case series, 157 medically treated eyes of 157 patients with primary open-angle glaucoma (POAG) who were assigned SLT to further reduce IOP were consecutively included. Each patient had a complete glaucoma work-up and 24-h IOP monitoring (6 measurements, including one in the supine position) taken before and on average 6 months after SLT. The main outcome measures were the reduction of 24-h IOP fluctuations and nocturnal peak IOP. Secondary outcome measures were success rates, factors influencing the reduction of high 24-h IOP fluctuations and nocturnal peak IOP, complications, and severe adverse events.
Results
Medicated mean 24-h IOP (mmHg) was statistically significantly reduced from 15.1 ± 2.6 to 13.8 ± 2.4 (P < 0.001) and IOP fluctuations from 6.5 ± 2.7 to 5.4 ± 2.6 (P < 0.001) 6 months after SLT. Ninety-four eyes (59.9%) initially had high IOP fluctuations (more than 5 mmHg). These were reduced from 8.1 ± 2.3 to 5.6 ± 2.7 at 6 months (P < 0.001). Fifty-two eyes (55.3%) had fluctuations below 5 mmHg post-SLT which was defined as success. Fifty-one patients (32.5%) had nocturnal IOP peaks. In these cases, nocturnal IOP was reduced by 19.2% from 20.1 ± 3.4 to 16.2 ± 3.3 mmHg at 6 months (P = 0.001).
Conclusions
The current study demonstrates that adjunctive SLT not only reduces mean 24-h IOP in treated POAG patients, but also has an additional benefit in reducing IOP fluctuations and nocturnal peak IOP.
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Reducing Phreatophyte TranspirationDavenport, David C. 16 April 1977 (has links)
From the Proceedings of the 1977 Meetings of the Arizona Section - American Water Resources Assn. and the Hydrology Section - Arizona Academy of Science - April 15-16, 1977, Las Vegas, Nevada / Transpiration rates (T) of riparian phreatophytes can be high. Antitranspirant (AT) sprays can curtail T without the ecological imbalance made by eradication. Saltcedar (Tamarix sp.) and cottonwood (Populus sp.) in 15-gal. drums enabled replicated trials on isolated plants or on canopies. T of isolate saltcedar plants could be 2x that of plants in a fairly dense canopy. T for a unit ground area of saltcedar varied from 2.2 (sparse -) to 15.8 (dense-stand) mm/day in July at Davis. Extrapolation of experimental T data to field sites must, therefore, be made carefully. Wax -based ATs increased foliar diffusive resistance (R), and reduced T of saltcedar and cottonwood 32-38% initially and 10% after 3 weeks. R increased naturally in the afternoon when evaporative demand was high and if soil water was low. Nocturnal T of salt cedar was 10% of day T. AT effectiveness increased with a higher ratio of day: night hours, and with lower soil water stress. Therefore, AT will be most effective on long summer days in riparian areas where ground water is available.
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Énergie et mélancolie : les entrelacs de l'écriture dans les Notebooks de S.T. Coleridge Volume 1, 2 et 3Page-Jones, Kimberley 13 September 2013 (has links)
Durant toute sa vie, Samuel Taylor Coleridge, poète et philosophe romantique anglais, a consigné ses pensées et ses réflexions sous forme de fragments dans des Notebooks, aujourd’hui regroupés dans cinq volumes. Derrière cette écriture mosaïque se dessine l’histoire d’un esprit nourri d’une insatiable curiosité pour le monde naturel et la psyché humaine. Libre de toute contrainte de structure et de genre, l’espace des Notebooks est peut-être celui qui s’ajuste le mieux au rythme si particulier de la pensée du poète. Ces textes se donnent ainsi à lire comme le reflet d’une pensée en constante évolution, qui sans cesse digresse, explore des possibles, ouvre des voies inexplorées. Cette thèse se propose donc de tenter d’en saisir les variations par une approche rythmanalytique du corpus d’étude. L’écriture des premiers carnets est essentiellement nomade, elle témoigne d’un plaisir de pérégriner, de s’ouvrir à la texture du monde. Elle se nourrit de l’énergie d’un corps en mouvement et d’une volonté d’habiter poétiquement l’espace. Toutefois, au fil du temps, le regard du poète semble peu à peu substituer le diffus et le nocturne à l’espace géopoétique ; l’écriture des Carnets se replie sur l’intime de l’être et se teinte de mélancolie. L’écriture de la mélancolie ne serait-elle pas dès lors l’envers sombre de l’écriture nomade, une écriture qui se nourrit de l’énergie du désir et de l’angoisse, et qui ne cesse de s’enrouler sur elle-même pour tendre vers ce point obscur ? Néanmoins, la mélancolie des Carnets n’est jamais synonyme d’effondrement ou de néant, elle n’appelle pas le vide mais, bien au contraire, trouve sa source d’inspiration dans une formidable vitalité pour faire advenir au jour de la parole ce qui ne se donne à voir que dans l’obscurité de la nuit. / During all his life, the English poet and romantic philosopher Samuel Taylor Coleridge secretly kept his thoughts and reflections in his Notebooks, which have been published in five volumes. This mosaic writing tells the story of a mind fed on an insatiable appetite and curiosity for the natural world and the human mind. Freed from any structural or generic constraint, the Notebooks certainly offered the poet a scriptural space well-suited for the rhythm of his thought. These texts can thus be read as the reflection of a mind constantly evolving, digressing, exploring new areas and opening new vistas. This work is an attempt to seize the variations of the Coleridgian thought by approaching rhythmically the first three volumes of the Notebooks. The writing of his first notebooks is essentially nomadic and asserts the pleasure of wandering through the natural world and delving into its texture. It feeds upon the energy of a body exploring space and of a mind struggling to inhabit the world poetically. Yet, as time passes, the poet’s gaze seems to linger more on the nocturnal sky than on the natural space. The writing of the Notebooks is then no longer the poetic substrate of the early days; it turns inward, loaded with melancholy. The writing of melancholy could therefore be seen as the darker side of the nomadic writing, one that feeds upon the energy of desire and anxiety, that takes a circumvoluted path towards this “dark spot”. Nevertheless, melancholy does not mean the annihilation of the self nor does it call for hollowness. Its source of inspiration resides in the vital force of creation which strives to bring to the light of speech that which can only be glimpsed at in the darkness of the night.
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El mito de la Quintrala : Estructuras simbólicas en dos novelas de Gustavo Frías / The myth of La Quintrala : The symbolic structures in two novels by Gustavo FríasBelmar Shagulian, Jasmin January 2017 (has links)
The purpose of this comparative study is to analyse La Quintrala’s myth as a symbolic discourse, thereby filling a gap in the previous studies about La Quintrala. The theoretical and methodological framework of this analysis consists of a hermeneutical approach based on the method of figurative structuralism: mythocriticism. This is a dual classification method of symbols: Diurnal and Nocturnal Orders that expose the symbolic structures formed by symbols and archetypes found in mythemes in a compilation of corpora. The first one is Gustavo Frías’ novels Tres Nombres para Catalina: Catrala (2008) and Tres nombres para Catalina: la doña de Campofrío (2008); the second is a historic essay (hypotext), Benjamín Vicuña Mackenna’s Los Lisperguer y la Quintrala (1944), and four novels: Magdalena Petit’s (2009) La Quintrala, Mercedes Valdivieso’s (1991) Maldita yo entre las Mujeres, Virginia Vidal’s (2002) Oro, veneno y puñal, and Gustavo Frías’ El Inquisidor (2008). Mythocriticism is employed in the analysis to show what the mythical structure of the hero’s journey (Separation, Initiation, Return) reveal. Such journey is combined structurally with the Mother archetype (White, Red and Black Goddess), the intrinsic archetype of La Quintrala’s myth. The heroic structure unveils its own mythemes, La Quintrala’s and the first corpus’s mytheme through the diachronic and synchronic flow of the hero’s journey. This method permits to identify and compare the progression of the symbolic structures. The analysis demonstrates a transformation of the symbolic structures between both corpora. This survey reveals that Vicuña Mackenna and Petit, and partially Vidal and El Inquisidor, exhibit an inclination to the diurnal symbols that strengthen, through a heterodiegetic narrator, the representations of the witch-femme fatale, counteractive attributes of the Red and Black Goddesses in the myth. Valdivieso, on the other hand, shows a propensity to the nocturnal symbols of inversion and intimacy that emphasize the Red Goddess’ features, though the novel also exposes La Quintrala as a witch-femme fatale. This exposure occurs through the use of both an autodiegetic narrator –La Quintrala– and a heterodiegetic one –the hypotext embodied in the popular voice– that appear to contrast each other. Finally, in Tres Nombres para Catalina, La Quintrala as the autodiegetic narrator dominates the whole story. She personifies the Great Goddess archetype who bestows her new positive attributes during the adventure. This novel assumes primordially the nocturnal symbolism incarnated by both the mystical and the synthetical structures and relegates the diurnal discourse of the hypotext to a secondary position in the narrative. Nonetheless, Tres Nombres para Catalina’s narrative still relies on the hypotext to reproduce and reconstruct all the mythemes in the myth of La Quintrala. Conclusively, the results of this analysis indicate that the identification of all the mythemes supports the hypothesis of a transformation in the symbolic structures which characterize La Quintrala in both corpora. This reveals the embodiment of Tres Nombres para Catalina’s own mytheme, consisting of a vindication and a recognition to her indigenous heritage, and the acceptance of her mestizaje. As a consequence, Tres nombres para Catalina, in comparison to the second corpus, diverges and expands the symbolic structures, but still shows a continuity of the myth.
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Birds, bats and arthropods in tropical agroforestry landscapes: Functional diversity, multitrophic interactions and crop yieldMaas, Bea 20 November 2013 (has links)
No description available.
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