Intoxicación por paraquat: descripción de un caso clínico Paraquat poisoning: a Este es el primer caso humano descrito, ocasionado por un T. pallidus. que habían desarrollado los roedores a los raticidas hasta entonces existentes1.

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Directory of Open Access Journals Sweden. Full Text Available Objetivo. Se utilizaron fuentes secundarias. Las variables analizadas fueron: EE, EE y E El riesgo fue raticidaw en ambos sexos, salvo para la causa E Tendencias intoxicaciom mortalidad por traumatismos y envenenamientos en adolescentes: Los traumatismos y envenenamientos ocuparon el primer lugar humaons la mortalidad del grupo adolescente tasa de To determine the standing of mortality by poisoning in children.

Envenenamiento de Chelydra serpentina Reptilia: Testudines por Tityus trivittatus Scorpionida: Buthidae Envenomation of Chelydra serpentina Reptilia: Testudines by Tityus humanps Scorpionida: Este es el primer comunicado sobre el envenenamiento de quelonios por escorpiones.

We report the case of a snapping turtle Chelydra serpentina found tetanized, with the limbs in extension, mydriasis and poor response to external stimuli, in whose terrarium was found a Tityus trivittatus scorpion. Based on the clear clinical picture of envenoming, the turtle was treated with a specific scorpion antivenin, returning to a state of muscle relaxation after six hours of treatment and it was found totally normal at 24 hours, without envenoming sequelae.

This is the first report on turtle envenomation by scorpion.


The scorpion envenomation in reptiles and the treatment with specific antivenom is discussed. Hallazgos de un estudio de caso. To describe the external causes of death and mortality trends due to injuries and poisoning in Mexican adolescents, from to This is a descriptive study of deaths occurring in Mexico from to Full Text Available El plomo Pb es un contaminante ambiental que causa efectos adversos a la salud humana.

Paraquat is the best-selling herbicide throughout the world, It is absorbed by the digestive and inhalatory routes.

If it reaches the lungs, congestion with swelling is developed, increased alveolar macrophages that progresses to fibrosis and pulmonary edema, which occur until 14 days after exposure if not treated timely and correct. Paraquat is directed primarily to the lungs and therefore generates free radicals oxidants, which is why, in cases of acute poisoning is absolutely forbidden to use oxygen except where arterial blood partial pressure of oxygen in is less than 50 mm Hg.

A patient who developed an adult respiratory distress syndrome ARDS secondary to deliberate ingestion of paraquat is presented. Initial patient management was performed ratticidas gastric lavage. Paraquat is a jntoxicacion widely used intoxxicacion agriculture.

Envenomation by neotropical Opisthoglyphous colubrid Thamnodynastes cf. Colubridae in Venezuela Envenenamiento por la colubrida opistoglifa Thamnodynastes cf.

The patient was bitten on the middle finger of the left hand, and shows signs of pronounced local manifestations of envenomation such as taticidas from the tooth imprint, swelling and warmth.

He was treated with local care, analgesics, and steroids. He was dismissed from the hospital and observed at home during five days with marked improvement of envenomation.

The snake was brought to the medical consult and identified as a Thamnodynastes cf. This report represents the first T. El paciente fue mordido en el dedo medio de la mano izquierda, mostrando pronunciados signos ratcidas de sangramiento por la impronta ocasionada por los dientes de la serpiente, edema y calor local. Este es el primer caso humano descrito, ocasionado por un T. O paciente foi submetido a dois ciclos de raticidws imunossupressora com ciclofosfamida, metilprednisolona e dexametasona.

Paraquat is intoxicacioj nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory humznos. We report the case of a year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema.

The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. Paraquat poisoning in the dog. Recovery from paraquat poisoning in the dog is rare.

This is a report of a case of recovery from confirmed paraquat poisoning in a clinical setting. The dog exhibited the usual signs intoxicacoin paraquat poisoning.

envenenamiento por paraquat: Topics by

The diagnosis was confirmed on toxicological analysis of urine using an ion exchange technique. He recovered after seven weeks of intensive therapy. Alternative treatments are discussed. This compound is very notorious to cause rapid development of renal, liver, and respiratory failure with very high mortality due to lack of specific antidote and dearth of high-quality evidence-based treatment.

Respiratory system involvement is the most common cause of death in these people. We hereby report a fatal case of a year-old male with a history of humahos consumption. The patient developed oliguric renal failure, deterioration of liver function, and acute respiratory distress syndrome over next few days.

In this case, none of the strategies worked well, and death ensued due to multi-organ dysfunction syndrome. The effects of paraquat in lungs are considered systemic effects. There are no dermal toxicity studies suitable for evaluation of systemic lung effects in the toxicity database for paraquat Paraquat use among farmers in Korea after the ban. The purpose of this study was to examine the proportion of paraquat use among farmers and to describe their epidemiologic characteristics after the paraquat ban in We interviewed farmers in Korea in Farmers with longer farming experience, longer pesticide application years, and upland farming reported an increased risk of paraquat use although the trend was not statistically significant.

The majority of the farmers used preexisting paraquat Farmers who used paraquat perceived paraquat as a dangerous chemical; however, they disagreed with the necessity of the paraquat ban. Binding of paraquat to cell walls of paraquat resistant and susceptible biotypes of Hordeum glaucum. Paraquat is a widely used, non-selective, light activated contact herbicide acting as a photosystem electron acceptor. Resistance to paraquat in weed species has occurred in Australia and world-wide following extensive use of this herbicide.

The mechanism of resistance to paraquat in ‘Hordeum glaucum’ is correlated with reduced herbicide translocation and may be due to sequestration of herbicide away from its site of action by either binding to cell walls or other means. We measured paraquat binding to a cell wall fraction in resistant and susceptible biotypes of H.

The cell wall fraction was isolated from leaves of resistant and susceptible biotypes and incubated with 14 C-labelled paraquat. From kinetic experiments it seems that there are two types of binding sites in the cell wall with different affinities for paraquat. No significant differences between cell wall, characteristics of resistant and susceptible biotypes of H. Therefore, increased binding of paraquat to the cell wall appears not to be a mechanism for exclusion of paraquat in resistant biotype.

Paraquat -induced radiosensitization of mammalian cells.

The herbicide, paraquat methyl viologen, ‘ dimethy, 4’-bipyridinium dichloridestimulates the production of superoxide anion O 2 sup. In addition, concentrations of cellular glutathione are reduced by reaction with O 2 sup. It is raticidaa here that paraquattoxic in its own right to aerobic cells, acts as a radiosensitizer when cells are exposed to nontoxic concentrations of the drug prior to and during irradiation.

The radiomimetic effect of paraquatalone and in combination with X-rays, was examined. Paraquat affects aerated cells hamster lung V79 cells in a dose-dependent manner. Doses in excess of 1 mM for two hours cause significant cell killing. In combination with radiation, sublethal uhmanos of paraquatgiven for two hours prior to irradiation, enhance the lethal effects of radiation. However, if cells are exposed to the same concentration of paraquat following faticidas, no additional lethal effect is observed.

Paraquat is a useful tool to study the effects of O 2 sup. Acute kidney injury from Paraquat poisoning: Paraquat is a salt widely used as a herbicide. Although paraquat poisoning is rare in the general population, it may be considered as one of the most toxic poisons frequently used for suicide attempts, and is The autoradiographic localization of paraquat in the lung.

Paraquat poisoning in mammals results in a characteristic lung lesion manifested principally as progressive pulmonary fibrosis. Paraquat is actively concentrated into the lung but the site of uptake remains undefined.

A method is described for the autoradiographic localization of paraquat in rats. Preliminary evidence for the site of uptake implicates the bronchiol. To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Fourteen of these patients were received pulmonary irradiation RT. All of the patients ere managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents.

Ingested amounts of paraquat were estimated into three groups A: Pulmonary irradiation was started within 24 hours after admission from day 1 to day 11 after ingestion of paraquat.

X 5 days was delivered without correction of lung density. In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due o multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation.

All 3 patients who were received pulmonary irradiation after 4 days after ingestion were died due to pulmonary fibrosis ratiidas spite of recovery from renal and hepatic toxicity.


Another Vivaldi opera enters the discography, and this one’s a beauty. Based on a story in Boccaccio’s Decameron, with a libretto by Apostolo Zeno revised by. Vivaldi’s genius came to full fruition in his masterpiece Griselda. The story of Patient Griselda, taken from The Decameron, is an uncomfortable one for modern . Griselda was first performed at Venice’s Teatro di San Samuele during spring Apostolo Zeno’s libretto, based on a tale from Boccacio’s Decameron, was .

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Vivaldi’s genius came to full fruition in his masterpiece Griselda. The story of Patient Griselda, taken from The Decameron, is an uncomfortable one for modern day sensibilities, with Griselda required to submit to many horrible tests of her vivalei, and strength of love and service to her husband.

The score contains some of Vivaldi’s finest – and most difficult arias – including Agitata da due venti and Dopo un’orrida procella. Usually sung by a woman in the few modern productions there have been, we cast the amazing David Hansen in the soprano role of the villain Ottone. Enjoy ornaments on ornaments and vocal pyrotechnics to burn! The Griseldw, 2 Dec – Deborah Jones. The villain thinks he’s won the girl!

Caitlin Hulcup sings as Griselda, cast out from the palace, and now forced to sleep in garbage and snow. Miriam Allan as Costanza, sings of the cruelty of fate, and the terror of being forced to do what you know to be wrong. Orchestra of the Antipodes. The Return of Ulysses. Support our Maestro Appeal. Saviour of Opera Companies. Although most of us today relish the composer of The Four Seasons for his instrumental works and flashy violin writing, in his day Antonio Vivaldi also made his mark as an opera composer, impresario, and conductor.

Even though he had begun his career as an instrumentalist and pedagogue, his sensational debut as an opera composer in in Vicenza, with Ottone in villa, inaugurated a prolific vocation in the profitable field of dramma per musica, the theatrical genre most beloved of 18th-century audiences. Vivaldi prided himself on an unconventional and controversial life. By no means a humble man, he flaunted his formidable virtuosity, exaggerated his productivity, and boasted endlessly of his welldeserved international reputation.

In he maintained to have written 94 operas, and to an English visitor he laid claim to 17 printed publications when in reality there were only 12 Vivaldi cheekily inflated the figure by including the sets issued in two volumes.

Even so, recent research has linked Vivaldi as composer or impresario to around 67 different productions, with around 50 original settings; such figures make him the most productive opera composer of the period after Alessandro Scarlatti.

There was no place for a plebeian priest Vigaldi had been ordained inthough he had ceased to celebrate Mass the following year on the sumptuous stages of the S. Giovanni Grisostomo vibaldi S. These houses were equipped with the latest theatrical technology that — amongst other innovations — allowed the stage to accommodate the weight of live elephants and horses.

The gaggle of young singers that Vivaldi preferred was never to be allowed to sully these expensive boards.

But things changed in A librettist called Domenico Lalli, an administrator connected to the Grimani operations, resigned. Vivaldi, in his dual role as composer-impresario, had rather remarkably managed to run up a sizable profit. Vivaldi favoured younger and less expensive singers on the cusp of international careers, and eschewed the exorbitant fees of superstar castrati. He also appears to have encouraged and promoted singers better known for their acting skills. With Lalli out of the way, the Grimanis decided to give the notorious Vivaldi vivwldi try.

For the libretto, they turned to a griselva poet by the name of Carlo Goldoni. Goldoni himself penned an account of his first meeting with Vivaldi: Sensing the fashion for griiselda new modern galant idiom, Vivaldi was careful to contrast the traditional vocal fireworks with a new mellifluous and elegantly structured style.

Griselda, RV 718 (Vivaldi, Antonio)

The fact that her questions about her fate go unanswered by others only outlines even more dramatically the cruel injustice of the situation. As for the Grimanis and the troubled finances of the S. Samuele theatre in Thanks to Vivaldi and his young stars, the Grimanis and their theatre were back in business. Gualtiero tells Griselda that he is replacing her with a more royal consort. She returns her crown to him; he immediately leaves to greet his new bride. The court noble Ottone, who desires Griselda, promises to kill Gualtiero if she will love him instead.

She rejects his suit. Corrado allows Griselda one last moment to bid her son Everardo farewell. Ottone surprises them, and when Griselda again refuses his love, he takes the child away hostage. ACT 2 Ottone delivers an ultimatum to Griselda: In despair, she at first agrees to the bargain to save her son, but her devotion to Gualtiero proves stronger than her maternal love; she calls down the justice of heaven on Ottone as he leaves to carry out his threat.

Meanwhile, Costanza and Roberto continue to struggle with the conflicting demands of love and loyalty. Griselda, now living rough again, cries herself to sleep. Costanza arrives and finds herself strangely drawn to Griselda; she begs Gualtiero to let her employ Griselda as her maid. Corrado arrives with news that Ottone is approaching, intending to abduct Griselda. Gualtiero tells her to accept her fate, but changes his mind at the last minute, and has Ottone escorted away.

Vivaldi Griselda |

ACT 3 Griselda overhears Costanza and Roberto declaring their love for each other; furious at their betrayal of Gualtiero, she launches into a tirade of reproaches, but when Gualtiero arrives, he tells Griselda the matter is none of her business, and orders her to serve Costanza without question, even if she is dallying with Roberto.

The lovers are bemused but delighted at this reprieve. Griselda is further humiliated by being required to direct the wedding preparations.

Gualtiero, still not satisfied, pledges Griselda to Ottone. This is the proof Gualtiero has been waiting for. Faced with such virtue, the people can no longer oppose Griselda as queen.

Gualtiero reveals that Costanza is their long-lost daughter. He gives his blessing to the marriage of Costanza and Roberto. At its core, it concerns the pursuit of professional success, at any personal cost.

Griselda — Opera Settecento Company

This is as it ever was, topical. Reworking a libretto by Apostolo Zeno, playwright Carlo Goldoni and Vivaldi open their version with a crisis: His people are tired of Queen Griselda, a woman of humble birth. A petulant public demands he have a nobler consort. Other characters in the opera are equally driven: He threatens to kill the king unless Griselda has an affair with him.

Costanza, the bride to be, comes to the court with her lover, Roberto, torn between loving him and wanting to be Queen. In the face of such conspiracies, Griselda resists. Her resilience is admirable, yet the extent of her suffering reveals a complex ambiguity: These complexities resonate not only with the struggles that might exist within a domestic union, but with the power that individuals seek and play out in public life.

The opera is fuelled by this tension between professional ambition and personal sacrifice, by behaviour that is both horrific and utterly human. Download the Program including libretto. While each had their individual virtues, all six singers displayed a sure sense of line, shaping arias and recitatives with thoughtfulness and sensitivity. In the title role, mezzosoprano Caitlin Hulcup was outstanding. She displayed excellent clarity of articulation and superb dynamic control.


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La Verita Sugli Addominali Scolpiti comprende anche come mantenere i livelli di insulina costante, frequenza dei pasti e come godere cheat pasti. Scoprirete come mantenere il vostro a bada la fame tra i pasti, mentre bruciare i grassi allo stesso tempo. Il manuale completo allenamento con facile seguire le linee guida dieta ed esercizio fisico.

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AVM S.p.A. – Azienda Veneziana della Mobilità, soggetta alla direzione e coordinamento del Comune di Venezia Sede Legale Isola Nova del Tronchetto. We would board an early ACTV bus, I mean one that goes alongside the I assure you all that ACTV runs a local bus service from Piazzale Roma to Padova, . Bus: take the SITA bus on the Padova-Venezia line, travel length approx. 45 minutes, at the Bus: in the central square of Stra, take the ACTV bus no. 53 of the.

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During our week-long stay in Venice Santa Crocewe’re planning a day trip to Padua.

We would board an early ACTV bus, I mean one that goes alongside the Brenta river, a “slow” bus one hour to Padua which will give us a chance to see some of the countrydise and maybe some villas. Once in Padua, we’ll visit acctv Palazzo Bo of the University of Padua they don’t take reservations for less than ten peoplethen the Scrovegni Chapel.

Then a Canadian-Paduan friend will take us out for dinner, and we’ll board a train back to Venice around Can we count on it? There are no reserved seats on ACTV buses. The agent will tell you which stop to go to they are identified by letters.

Just wait for a bus with “Padova” as the destination. The bus station in Padova is some distance from the train station, but close to Scrovegni Chapel.

Check this site for more info on transportation in and around Venice: I have travelled on that bus. IMO, the confusion or rather the hesitation is due to the fact that the Venice -Brenta- Padua service can both qualifiy as an “Inter-City” and a “Suburban” one.

Otherwise, a few Brenta “Hotels-Villas” sites recommend taking the “53E” bus. Sydneynick, could you tell us more about your experience? Was it worth it? Does a one-way trip Venice to Padua thru Brenta Canal take roughly one hour, as advertised, or, like I read in another forum, can there be long delays due to heavy traffic?

I don’t remember the route number. We found it an interesting experience, as all these local residents got on and off the bus. We felt some connection with the local way of life.

The views along the Brenta Canal are pleasant, and you get glimpses of some of the big villas. As well as the bus trip, I have driven long the Brenta Canal 4 or 5 times, and have never encountered heavy traffic. This topic has been closed to new posts due to inactivity. We hope you’ll join the conversation by posting to an open topic or starting a new one. We remove posts that do not follow our posting guidelines, and we reserve the right to remove any post for any reason.

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[Postdramatisches Theater. English]. Postdramatic theatre / Hans-Thies Lehmann ; translated and with an introduction by Karen Jürs-Munby. p. cm. Includes. Hans-Thies Lehmann – Postdramatisches Read more about lehmann , postdramatisches and Hans-Thies Lehmann – Postdramatisches Views. 4 years ago. Lehmann, · Postdramatisches, · · READ.

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Fanuc CNC Custom Macros: Programming Resources for Fanuc Custom Macro B Users [With CDROM]

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Numerous examples and sample programs are used throughout that serve as practical applications of the techniques presented and as the basis of ready-to-run macro programs. Includes a CD containing all of the sample programs. Hardcoverpages.

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The Art Of Choosing summary shows you how your culture shapes how much Sheena Iyengar thinks learning how to make choices is more. Sheena S. Iyengar is the S.T. Lee Professor of Business in the Management Department at . In the Afterword of the edition of The Art of Choosing, Iyengar distills one aspect of her work explaining and advocating for choice, arguing for. Sheena Iyengar’s research indicates that we can handle more than a few at Columbia Business School, writes in “The Art of Choosing.

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The Art of Choosing

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Sheena Iyengar

Sheena Iyengar is the inaugural S. Chazen Institute of International Business. She is the world’s leading expert on choice and has most recently written the best-selling book, The Art of Choosing. And all this, without the ability to see – Sheena is visually challenged.

It reminds me every day that I must focus on the choices that matter,” she says. In an interview to CD, Iyengar speaks her mind. How would you define choice and what made you so interested in the subject? Choice is more than picking ‘x’ over ‘y’.

It is a responsibility to separate the meaningful and the uplifting from the trivial and the disheartening. It is the only tool we have that enables us to go from who we are today to who we want to be tomorrow.

My interest in choice was developed through three factors. First, I was born to Sikh immigrant parents living sheeha North America and thus grew up living in two different worlds with different languages, different sets of rules, and entirely different narratives about how to live one’s life.

The first emphasised the importance of knowing your duties and fulfilling your responsibilities, while the second emphasized the importance of identifying and acting upon your personal preferences. This made me extremely cognizant of the choices I was making. Second, I am blind. This has made me more aware of the nature of choice-its possibilities choozing limitations-as I have had to constantly think about what I could do and what Choising couldn’t.

Finally, my academic and personal experiences in college and graduate school made me interested in formally studying choice. Is more choice always a good thing? No, too many choices can overwhelm us and cause us to not choose at all. For businesses, this means that if they offer us too many choices, we may not buy anything. They carried different types of choosinv and vinegars, over types of fruits and vegetables, and a dozen or more different types of water.

I used to like going to this store, but one of the things I noticed was that I never bought anything. So what did you do about it? One day, I went to see the manager and asked him whether their store model was working. He said, “What do you mean is it working? Of course, it’s working. Haven’t you seen how many customers we get? He generously agreed to let me do an experiment in his store, and I chose to do an experiment with jam.

They carried different flavors of jam.

We set up a tasting booth near the entrance of the store at which we put out either 6 flavours of jam or We looked at two things. First, in which case were people more likely to stop at the tasting booth?

In which scenario were people more attracted to jam? Selective Reasoning And what more did you find out? The second thing we looked at was in which case people were more likely to buy a jar of jam. We saw the reverse. If you do the math, when there were 6 sheenx on display, people were over six times more likely to buy a jar of jam than when there were 24 jams on display.

Sheena Iyengar: The art of choosing | TED Talk

At first, people found the choices attractive but then they were less likely to buy. So what did you conclude?

This study is indicative of research done over the past decade that has shown that there are three negative consequences of offering people more rather than less choice.

First, the more choices people have, the more likely they are to disengage in the choosing process. Second, the more choices they have, the lower the quality of their decisions. For example, poor financial decisions are often a result of having too many choices, as are inconsistent preferences in all kinds of decision-making.

Third, the more choices people have, the less satisfied they are with what they have chosen even if they did objectively better. Does culture play a role in choice? People in more collectivist cultures may not experience some of the choices that exist for people in more individualist societies. For example, very few people in India would consider changing their religion, whereas more than half of Americans have changed their faith at least once, according to a Pew poll.

More generally, individuals in more collectivist societies are more influenced by a sense of duty to family and society. You write in your book “clearly the way we frame information for ourselves or for others can make a big difference in how we see and respond to choice. Shortly after Robert Goizuetaformer CEO of Coca-Cola, was first appointed, he went to a meeting and discovered that the management was celebrating.

They certainly had cause to celebrate: Goizueta framed this information differently and had a different perspective on their position.

He asked them what percentage of the entire liquid market they owned. Are companies trying to manipulate the choices we make while buying their products?

Companies try to market their products by presenting information in a certain way. The waiter explained the benefits of the bottled water, describing one as “a natural diuretic and antitoxin. The ruse was that all water is a ‘natural diuretic and antitoxin’, and L’eu du Robinet is French for ‘tap water’.

If something is marketed as better, it can trick consumers into believing it is true even if it has no additional benefits. When it comes to choice, why does the world choose Coke more often than Pepsi? Blind taste tests demonstrate that taste is not usually a factor in people’s decisions between Pepsi and Coke. However, studies have also shown that people have more positive associations with Coke. In one study, participants said that shfena preferred samples that were accompanied by images of Coke even though all the samples were the same.

This is explained by our stronger sense of connection to Coke. Throughout its existence, Coke has used advertising to embed itself into the minds of American consumers. The advertisements associate Coke with Christmas, America and even chopsing, making its product more about the brand than the soda, which is almost identical to Pepsi. You write in your book “predictions are edging ever closer to becoming their own causes”.

What do you mean by that?

iynegar When companies try to guess what consumers want, they essentially make the choice for consumers. Since it can take up to two years for an article of clothing to move from design to product, fashion companies try to predict trends. They consult with other companies and buy trends from forecasters, resulting in companies producing products with a lot of similarities and trends being created.

So if that trend is white clothing, you may have a hard time choosing to buy a black wardrobe. We might assume that the demand for white clothing has increased, but it is more likely that the forecasts increased consumption of white clothing. So do we choose fashion or does it choose us? What amazed me the most is the fact that you cannot see and zrt you have managed to be so successful in life. How do you manage? This bodily condition that I did not choose led me to make the most of what I could choose.

It reminds me every day that I must focus on the choices that matter. Balancing hopes, desires and an appreciating of the possibilities with a clear-eyed assessment of the limitations: Read more on Malcolm Gladwell. Work done in the first five months gave Paytm a strong foundation, says founder Vijay Shekhar Sharma.

Professionals struggle with letting people go, but entrepreneurs don’t as much, says Shaadi. My Saved Articles Sign in Sign up. Find this comment iyengae This will alert our moderators to take action Name Reason for reporting: Foul language Slanderous Inciting hatred against a certain community Others. Your Reason has been Reported to the admin.

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VMAT planning for Elekta linear accelerators is supported with the following commercial and clinical routine treatment planning systems. Med Phys. Mar;37(3) Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT: plan quality, delivery efficiency and accuracy. VMAT, formally known as Intensity Modulated Arc Therapy. (IMAT), was first brought up by Dr. . Elekta VMAT can be delivered using single or multiple arcs.

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Gallen, Rorschacherstrasse 95, St. The purpose of this study was to evaluate this new algorithm and to compare it to intensity-modulated radiation therapy IMRT for various disease sites by creating single- and double-arc VMAT plans. A total of plans were evaluated in this study, including 38 endometrial, 57 head and neck, 12 brain, 10 breast and 45 prostate cancer cases.

VMAT plans were generated using a preclinical version of Eclipse with tumor-region-specific optimizing templates without interference of the operator: All plans were evaluated based on target coverage, homogeneity and vmst. The organs elejta risk OARs were analyzed according to plan objectives, such as the mean and maximum doses. If one or more objectives were exceeded, the plan was considered clinically unacceptable, and a second VMAT plan was created by adapting the optimization penalties once.

The mean total body dose was statistically significant lower for the considered arc techniques IMRT: However, the sparing of OARs shows individual behavior that depends strongly on the different tumor regions. A clear difference is found in the number of monitor units MUs per plan: These findings demonstrate that based on optimizing templates with minimal interaction of the operator, the Eclipse TPS is able to achieve a plan quality for the Elekta VMAT delivery technique that is comparable to that of fixed-field IMRT.

Elekta VMAT

Plans with two arcs show better dose distributions than plans with one arc. Different treatment planning systems TPS are available for accelerators from both manufacturers, and the VMAT technique produces plan quality and dose distributions that are comparable and often superior to those of fixed-field step-and-shoot or sliding window IMRT for a wide range of disease sites [ 10 – 20 ].

Moreover, the essential advantage of the VMAT technique is the improved efficiency of the treatment in terms of significant reduction of the number of monitor units MUs and the shorter delivery time [ 102122 ]. VMAT planning for Elekta linear accelerators is supported with the following commercial and clinical routine treatment planning systems: The newest release of the Eclipse TPS v.

The purpose of this study was to evaluate this algorithm for wlekta disease sites by creating single- and double-arc VMAT plans. To exclude this qualitative and difficult-to-measure effect, a template based method that allows plans to be generated with almost no user interaction will be introduced. Therefore, the quality of the optimizer can be analyzed.

The dynamic arc plans are compared to clinical step-and-shoot IMRT plans on a statistical basis. From five different tumor regions — head and neck, brain, cervical and endometrial, breast and prostate — fixed-field step-and-shoot IMRT plans that were used for patient treatment between January and June on an Elekta Synergy Linac were examined. These patient plans included the following:. The study was performed based on ethical ellekta approval Ethics Committee St.

The clinical step-and-shoot IMRT plans were generated using the Eclipse treatment planning system version 8. Depending on the tumor region, 5 to 9 coplanar fields were chosen, consistent e,ekta our clinical standard section II.

Depending on the tumor region at least 3 prostate, cervical to 6 breast, head and neck, brain attempts were taken to get a clinically acceptable IMRT plan.

The dose calculation was performed using the anisotropic analytic algorithm AAA [ 25 ] and a grid size of 2. For cases with one hip implant, two resp. The length of the arcs was adjusted separately for each case one implant: In all cases, the isocenter was placed in the center of the PTV. The dose e,ekta was performed with the AAA algorithm and a grid size of 2.

Based on the available IMRT optimizing templates, new Vmqt optimizing templates for each treatment region and prescribed dose were created in total 10 different templates: All these templates were tested on a few patients to evaluate whether they produced reasonable results concerning the plan quality in comparison to IMRT and concerning the irradiation by measuring the treatment time and dose distribution [ elekga ].

During the optimizing process, the objectives or weights were not adjusted to exclude the influence of the operator, which allows an objective and independent evaluation of the dose distribution of all tumor regions.

Elekta VMAT Radiation Therapy Rapidly Gaining Users Worldwide As Technique Evolves

The adapted plans were then evaluated again and no further adapted plans were created, even if any objectives were not met. To visualize the differences, average cumulative DVHs were calculated per examined tumor region for each organ and treatment technique. CN ranges from 0 to 1, where 1 is the ideal value. rlekta

Between the evaluated tumor regions and prescribed doses, differences were identified. Before 1A, 2A and after modification 1Am, 2Am of the optimization penalties divided by tumor site: The number of monitor units was statistically significant lower for VMAT by factors of 1. Single and double arc plans before 1A, 2A and after modification 1Am, 2Am of the optimization penalties; values are expressed as the mean range.

In a comparison of single- and double-arc techniques, the PTV coverage was significantly different for plans with two arcs. Of the 38 cervical and endometrial cases for the double-arc technique, 19 were in tolerance for both OAR sparing and PTV coverage; after adapting the optimization penalties, 23 plans elketa all objectives.

For the single-arc technique 1Avmah plans were acceptable after adapting 1Am nine. For most non-acceptable plans, the following values were out of eelekta D max of the Elskta 1A: The doses in the OARs were similar to IMRT for both single- and double-arc plans; small but significant differences were detected for total body dose D mean: Double-arc plans showed a significant reduction of high-dose regions in the small intestine V 45 Gy: The maximum target dose and the conformity were better for double-arc plans than for IMRT; for single-arc plans, the corresponding values were below the mean values of IMRT.

Comparing single- and double-arc plans, all parameters except MUs exhibited differences in favor of the double-arc technique, and differences in the parameters for PTV coverage, maximum dose in eleota bladder and rectum were statistically significant.

Mean DVHs of 38 cervical and endometrial cases. IMRT; thin dashed line: For the single-arc technique, 6 plans met the clinical objectives, 8 plans after modifications. Cases with target doses of Significant differences in IMRT for single- and double-arc plans were noted for total body dose D max: However, the maximum spine dose was clearly lower for all VMAT techniques up to The mean dose and V 28 Gy for the parotid glands were slightly better for VMAT after modification of the optimizing process; before modification, they were significantly better for IMRT.

The median dose of the sub-dose elwkta was significantly higher than in IMRT elektw Comparing the single-arc and double-arc techniques revealed significant differences in favor of double-arc plans concerning target coverage of PTV1 D max: Mean DVHs of 39 head and neck cancer cases with prescriptions of The maximum dose in the lips was statistically significant lower for VMAT up to The dose coverage in the target volumes was better for all VMAT techniques.

Comparing the single- and double arc techniques reveals significant differences in favor of double-arc plans concerning target coverage of PTV1 D max: Detailed values and the averaged DVH comparison are shown in the Additional file 2. An acceptable plan was achieved for the double-arc technique in 9 out of 10 breast cancer cases; an acceptable plan was achieved in 5 cases for the single-arc technique. In all non-acceptable cases before and after adapting the optimizing processeither the maximum target dose was too high 1A: The OARs met the clinical objectives in all cases for all techniques.

For both single- and double-arc vamt, the OARs and total body dose showed slight but non-significant improvements compared to IMRT; however, the maximum spine dose 1A: The eleita dose for the heart seems to show a elektq significant improvement for single arc plans IMRT: But the differences depend on the side of the irradiated breast: Due to the low number of cases 6 vmt, 4 rightno statistical significance for the differences can be given.

A comparison of single- and double-arc techniques revealed significant differences in favor of double-arc plans concerning target coverage D max: Detailed values and the averaged DVH comparison are shown in the Additional file 3. A total of 45 prostate cases were analyzed, of which 11 involved pelvic lymph nodes, 16 involved one hip implant mvat 18 involved two hip implants. All 2A plans for the LN cases met the clinical objectives; 1A plans were acceptable in 8 cases, 10 after modification.

Elkta plans with one implant were acceptable in 11 of the 18 total cases and in 14 cases after adapting the optimization penalties. For the single-arc technique, gmat plans met the objectives, 9 after modification.

Cases with two implants had acceptable 2A plans in 6 of 16 cases. After modifying the optimization penalties, the vkat of acceptable plans increased to 11; 5 single-arc plans were dlekta, 7 after modification. Single-arc plans had smaller improvements in comparison to IMRT, with significant differences only for D max A comparison of single- and double-arc plans revealed highly significant differences in favor of 2A in target coverage and the maximum bladder dose.

The Additional file 4 shows detailed results and the averaged DVH comparison. Prostate cases with one hip implant presented varying results depending on the treatment technique. However, conformity was significantly elekfa for single- and double-arc plans CN: The differences between single- and double-arc plans were small: The total body and rectum doses were better in favor of single-arc plans.

Detailed values and the averaged DVH comparison are shown in the Additional file 5. However, the sparing of the implants and the total body dose were significantly reduced in comparison to the IMRT plans implant: The differences between single- and double-arc plans were small; significant differences in favor of 2A were noted for the maximum dose in the PTV Mean DVHs of 18 prostate cancer vmta with two hip implants.

Of the 12 brain cancer eelkta, five 2A plans were acceptable for both OAR sparing and target coverage; after adapting the optimization penalties, 6 plans met all objectives.

For single-arc technique, 4 plans were accepted, 5 after adaptation. However, the maximum doses of the lenses and the optical nerves were lower for VMAT lenses: For the right optical nerve, increases of 2. Significant differences were only observed for conformity in both modified single- and v,at plans CN: Mean DVHs of 12 brain cancer cases.

The question of whether dose distribution and quality vmatt different in VMAT plans compared to IMRT plans has been evaluated in a large number of studies [ 10 – 20 ]. Even if the results of these studies show some differences that may be caused by different optimizing engines, the number of arcs per plan, the linac type or tumor sites, the conclusions are consistent: The main difference between the two techniques, and therefore an advantage for VMAT, lies in the reduction in delivery time.


managementul stresului ocupaţional, debutul carierei didactice. Modern society . Starting from these essentials, Romita B. Iucu highlights several sources of stress for teachers, the most . B. Iucu. Managementul şi gestiunea clasei de elevi. Bibliografie: 1. Sălăvăstru Dorina (), Psihologia educaţiei, Polirom, pp. 2. Iucu Romiţă (), Managementul clasei de elevi, Polirom, pp. Mai jos puteti gasi cartea: Managementul clasei de elevi de Romita B. Iucu. la clasele/grupele/unitatile de invatamant care scolarizează elevi cu deficiente de.

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Studiul ofera, nanagementul prin structura, cit si prin continut, o serie de raspunsuri la problemele controversate pe care le ridica procesele si fenomenele psihopedagogice de instruire si de educare la nivelul clasei de elevi, utilizind ca modalitate explicativ-teoretica paradigma manageriala.

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If you are a seller for this product, would you like to suggest updates through seller support? Scopul analizei – adresata in egala masura educatorilor, invatatorilor, institutorilor, managemenntul si profesorilor interesati de perfectionarea activitatilor, a climatului si a relatiilor educationale – il reprezinta insusirea principalelor repere si constientizarea statutului managementului clasei de elevi in programul de formare initiala si continua a cadrelor didactice.

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