The strategic management: the methodology applied by the "Centre Hospitalier Regional Universitaire"

This work is a general presentation of the "Démarche Stratégique", a strategic process applied by the "Centre Hospitalier Régional Universitaire" (CHRU) at Lille, France. The hospital management methodology relies on the strategic analysis of the best alternatives for rationalizing the hospital mission. It takes into account a competitive environment, in which it is necessary to structure health care networks based on the negotiation of inpatient care goals. The author presents the phases and main methodological tools of the approach, as well as a preliminary evaluation of its potentials.     

三维超声心动图测定机械瓣瓣口面积初步经验

观察三维超声心动图测定机械瓣瓣口面积的可行性。方法１１例机械瓣置换病例,用任意 切面（ａｎｙｐｌａｎｅ）３ＤＥ测定机械瓣瓣口有效面积,将测定值与多普勒超声心动图（ＤＥ）测定的有效瓣口面积（包括实测值和文献报道测值）及生产厂商提供的离体瓣口面积比较。     

An Importin-β-like Protein from Nicotiana benthamiana Interacts with the RNA Silencing Suppressor P1b of the Cucumber Vein Yellowing Virus,Modulating Its Activity

During a plant viral infection, host–pathogen interactions are critical for successful replication and propagation of the virus through the plant. RNA silencing suppressors (RSSs) are key players of this interplay, and they often interact with different host proteins, developing multiple functions. In the Potyviridae family, viruses produce two main RSSs, HCPro and type B P1 proteins. We focused our efforts on the less known P1b of cucumber vein yellowing virus (CVYV), a type B P1 protein, to try to identify possible factors that could play a relevant role during viral infection. We used a chimeric expression system based on plum pox virus (PPV) encoding a tagged CVYV P1b in place of the canonical HCPro. We used that tag to purify P1b in Nicotiana-benthamiana-infected plants and identified by mass spectrometry an importin-β-like protein similar to importin 7 of Arabidopsis thaliana. We further confirmed the interaction by bimolecular fluorescence complementation assays and defined its nuclear localization in the cell. Further analyses showed a possible role of this N. benthamiana homolog of Importin 7 as a modulator of the RNA silencing suppression activity of P1b.     

Complicaciones relacionadas con el cateterismo cardíaco pediátrico y cardiopatías congénitas

Introduction:

Congenital heart diseases are the most common congenital abnormalities in newborns with a prevalence of 1%. Therapeutic and diagnostic cardiac catheterization has revolutionized the treatment of these diseases; however, it can be associated with complications.

Objective:

To describe the incidence and type of complications associated with pediatric cardiac catheterization in a reference center for congenital heart defects.

Methodology:

Retrospective observational study, with analytical intention based on records of cardiac catheterization performed on patients with congenital and acquired heart disease.

Results:

2,688 records were included for nine consecutive years. 53.9% were men, 21.3% with ages between 2 and 5 years and 20.3% between 6 months and 2 years. 63.5% of the procedures were elective. The prevalence of complications in the first 24 hours after catheterization was 6.7% (4.2% minor and 2.4% major). Early death occurred in 0.8% of the procedures. Factors associated with complications were age at catheterization <28 days (OR 2.18, 95% CI ^[1.28-3.70]), precatheter oxygen saturation <79% (OR 2.15, 95% CI ^[1.02-4.53]), use of pre-catheter inotropics (OR 3.00, 95% CI ^[1.68-5.33]). The variables included in the model explain 38% of the variance of post-cardiac catheterization complications in patients younger than 18 years.

Discussion:

Cardiac catheterization is associated with major and minor complications including death. The associated factors were less than 28 days, lower oxygen saturation and use of pre-catheter inotropics.Key words: Complications, Cardiac catheterization, Child, Mortality, Incidence